RESUMO
BACKGROUND: Patients often evaluate the reputations of plastic surgeons based on their performances on physician review websites. This article aims to compare rating methodologies and conduct a cost-benefit analysis of physician review websites to further understand how plastic surgeons and their patients can utilize review websites to inform their practice and care. METHODS: A review of online literature, blogs, and 17 of the most common physician review websites was conducted to identify information on review website methodology, cost, and benefits most pertinent to plastic surgeons and their patients. RESULTS: Physician review websites utilize various combinations of physician-related and unrelated criteria to evaluate plastic surgeons. Across 17 reviewed platforms, most (71%) utilize star ratings to rate physicians, 18% require an appointment to conduct a review, and 35% feature search engine optimization. Many websites (53%) allow physicians to pay for benefits or extension packages, with benefits offered including advertising, search engine optimization, competitor blocking, social media marketing, consultant services, and data analytics. Competitor blocking was provided by the most number of websites who offered additional services for pay (78%). CONCLUSIONS: Appointments are not required to post physician reviews on many review websites, and many websites allow physicians to purchase packages to enhance their search engine optimization or consumer reach. Accordingly, plastic surgeons' reputations on review websites may be influenced by factors extraneous to actual patient care. Patients and physicians should be cognizant that physician review websites may not be reflective of factors related to quality of patient care.
Assuntos
Análise Custo-Benefício , Internet , Cirurgia Plástica , Humanos , Cirurgiões/economia , Cirurgia Plástica/economiaRESUMO
Federal government research grants provide limited funding to plastic surgeon-scientists, with reconstructive research taking precedence over aesthetic research. The Aesthetic Surgery Education and Research Foundation (ASERF) is a nonprofit, 501(c)(3) organization that seeks to support innovative, diverse research endeavors within aesthetic surgery. A total of 130 ASERF-funded studies and 32 non-funded applications from 1992 to 2022 were reviewed. Kruskal Wallis, Fisher's exact, and chi-squared tests were utilized to assess the potential relationship between self-identified gender, practice setting, geographical location, and study type with individual grant amounts and grant funding decision. Although significant differences were observed between male and female grant recipient h-indices (P < .05), there were no differences in the amount of funding they received (P > .05). Grant amounts were also consistent between study types as well as principal investigator practice settings and geographical locations (P > .05). The subanalysis revealed that the practice setting of the primary investigator (PI) was the only variable to exhibit a significant association with the decision to award funding (P < .05). Further, of the 61 applicants between 2017 and 2022, only 2 PIs self-identified as female. ASERF serves as an excellent funding source for global aesthetic surgery. To promote further research diversification, increased emphasis should be placed on recruiting applicants from outside academia and those who identify as female or gender nonbinary.
Assuntos
Pesquisa Biomédica , Fundações , Cirurgia Plástica , Humanos , Feminino , Masculino , Estudos Retrospectivos , Cirurgia Plástica/educação , Cirurgia Plástica/economia , Fundações/economia , Pesquisa Biomédica/economia , Apoio à Pesquisa como Assunto , Estados Unidos , Procedimentos de Cirurgia Plástica/educação , Procedimentos de Cirurgia Plástica/economiaAssuntos
Publicações Periódicas como Assunto/economia , Publicações Periódicas como Assunto/normas , Editoração/economia , Editoração/normas , Cirurgiões/psicologia , Cirurgia Plástica , Pesquisa Biomédica/economia , Pesquisa Biomédica/normas , Conflito de Interesses/economia , Humanos , Cirurgiões/economia , Cirurgiões/normas , Cirurgia Plástica/economia , Cirurgia Plástica/normasAssuntos
Financiamento de Capital/tendências , Setor de Assistência à Saúde/economia , Cirurgia Plástica/economia , Financiamento de Capital/história , Financiamento de Capital/estatística & dados numéricos , Setor de Assistência à Saúde/história , Setor de Assistência à Saúde/estatística & dados numéricos , Setor de Assistência à Saúde/tendências , História do Século XXI , Estudos Retrospectivos , Cirurgia Plástica/história , Cirurgia Plástica/estatística & dados numéricos , Cirurgia Plástica/tendências , Estados UnidosRESUMO
BACKGROUND: The Open Payments database was created to increase transparency of industry payment relationships within medicine. The current literature often examines only 1 year of the database. In this study, the authors use 5 years of data to show trends among industry payments to plastic surgeons from 2014 to 2018. In addition, the authors lay out the basics of conflict-of-interest reporting for the new plastic surgeon. Finally, the authors suggest an algorithm for the responsible management of industry relationships. METHODS: This study analyzed nonresearch payments made to plastic surgeons from January 1, 2014, to December 31, 2018. Descriptive statistics were calculated using R Statistical Software and visualized using Tableau. RESULTS: A total of 304,663 payments totaling $140,889,747 were made to 8148 plastic surgeons; 41 percent ($58.28 million) was paid to 50 plastic surgeons in the form of royalty or license payments. With royalties excluded, average and median payments were $276 and $25. The average yearly total per physician was $2028. Of the 14 payment categories, 95 percent of the total amount paid was attributable payments in one of six categories. Seven hundred thirty companies reported payments to plastic surgeons from 2014 to 2018; 15 companies (2 percent) were responsible for 80 percent ($66.34 million) of the total sum paid. Allergan was responsible for $24.45 million (29.6 percent) of this amount. CONCLUSIONS: Although discussions on the proper management of industry relationships continue to evolve, the data in this study illustrate the importance of managing industry relationships. The simple guidelines suggested create a basis for managing industry relationships in the career of the everyday plastic surgeon.
Assuntos
Conflito de Interesses/economia , Bases de Dados Factuais/normas , Setor de Assistência à Saúde/economia , Cirurgiões/economia , Cirurgia Plástica/economia , Algoritmos , Centers for Medicare and Medicaid Services, U.S./estatística & dados numéricos , Bases de Dados Factuais/estatística & dados numéricos , Setor de Assistência à Saúde/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Estados UnidosRESUMO
BACKGROUND: The Physician Payments Sunshine Act of 2010 mandated that all industry payments to physicians be publicly disclosed. To date, industry support of plastic surgeons has not been longitudinally characterized. The authors seek to evaluate payment trends from 2013 to 2018 and characteristics across plastic surgeon recipients of industry payments. METHODS: The authors cross-referenced those in the 2019 American Society of Plastic Surgeons member database with Centers for Medicare & Medicaid Services Open Payments database physician profile identification number indicating industry funds received within the study period. We categorized surgeons by years since American Board of Plastic Surgery certification, practice region, and academic affiliation. RESULTS: A sum of $89,436,100 (247,614 payments) was received by 3855 plastic surgeons. The top 1 percent of earners (n = 39) by dollar amount received 52 percent of industry dollars to plastic surgeons; of these, nine (23 percent) were academic. Overall, 428 surgeons (11 percent) were academic and received comparable dollar amounts from industry as their nonacademic counterparts. Neither geographic location nor years of experience were independent predictors of payments received. The majority of individual transactions were for food and beverage, whereas the majority of industry dollars were typically for royalties or license. CONCLUSIONS: Over half of all industry dollars transferred went to just 1 percent of American Society of Plastic Surgeons members receiving payments between 2013 and 2018. Considerable heterogeneity exists when accounting for payment subcategories.
Assuntos
Conflito de Interesses/economia , Setor de Assistência à Saúde/economia , Renda/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Centers for Medicare and Medicaid Services, U.S. , Bases de Dados Factuais/estatística & dados numéricos , Revelação/normas , Revelação/estatística & dados numéricos , Feminino , Setor de Assistência à Saúde/estatística & dados numéricos , Humanos , Masculino , Sociedades Médicas/estatística & dados numéricos , Cirurgiões/economia , Cirurgiões/normas , Cirurgia Plástica/economia , Estados UnidosAssuntos
Pesquisa Biomédica/organização & administração , Bolsas de Estudo/organização & administração , Equidade de Gênero/estatística & dados numéricos , Internato e Residência/organização & administração , Cirurgia Plástica/educação , Pesquisa Biomédica/economia , Pesquisa Biomédica/estatística & dados numéricos , Bases de Dados Factuais , Bolsas de Estudo/economia , Bolsas de Estudo/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/economia , Internato e Residência/estatística & dados numéricos , Masculino , Cirurgia Plástica/economia , Inquéritos e Questionários/estatística & dados numéricosRESUMO
BACKGROUND: Surgeons are critical for the success of any health care enterprise. However, few studies have examined the potential impact of value-based care on surgeon compensation. METHODS: This review presents value-based financial incentive models that will shape the future of surgeon compensation. The following incentivization models will be discussed: pay-for-reporting, pay-for-performance, pay-for-patient-safety, bundled payments, and pay-for-academic-productivity. Moreover, the authors suggest the application of the congruence model-a model developed to help business leaders understand the interplay of forces that shape the performance of their organizations-to determine surgeon compensation methods applicable in value-based care-centric environments. RESULTS: The application of research in organizational behavior can assist health care leaders in developing surgeon compensation models optimized for value-based care. Health care leaders can utilize the congruence model to determine total surgeon compensation, proportion of compensation that is short term versus long term, proportion of compensation that is fixed versus variable, and proportion of compensation based on seniority versus performance. CONCLUSION: This review provides a framework extensively studied by researchers in organizational behavior that can be utilized when designing surgeon financial compensation plans for any health care entity shifting toward value-based care.
Assuntos
Planos de Pagamento por Serviço Prestado/tendências , Planos de Incentivos Médicos/tendências , Reembolso de Incentivo/tendências , Cirurgiões/economia , Cirurgia Plástica/economia , Eficiência , Planos de Pagamento por Serviço Prestado/história , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Previsões , História do Século XX , História do Século XXI , Humanos , Planos de Incentivos Médicos/história , Planos de Incentivos Médicos/estatística & dados numéricos , Reembolso de Incentivo/história , Reembolso de Incentivo/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/história , Cirurgia Plástica/organização & administração , Cirurgia Plástica/estatística & dados numéricos , Estados UnidosAssuntos
Comportamento de Busca de Informação , Ferramenta de Busca , Competência Clínica , Humanos , Disseminação de Informação/métodos , Marketing de Serviços de Saúde/métodos , Encaminhamento e Consulta , Cirurgiões/economia , Cirurgiões/organização & administração , Cirurgia Plástica/economia , Cirurgia Plástica/métodos , Cirurgia Plástica/organização & administraçãoAssuntos
Marketing de Serviços de Saúde/tendências , Mídias Sociais/tendências , Cirurgia Plástica/tendências , Estética , Humanos , Disseminação de Informação/métodos , Marketing de Serviços de Saúde/métodos , Procedimentos de Cirurgia Plástica/educação , Procedimentos de Cirurgia Plástica/métodos , Mídias Sociais/economia , Mídias Sociais/estatística & dados numéricos , Cirurgia Plástica/economia , Cirurgia Plástica/estatística & dados numéricos , Gravação em Vídeo/tendênciasAssuntos
Conflito de Interesses/economia , Bases de Dados Factuais/estatística & dados numéricos , Setor de Assistência à Saúde/economia , Cirurgiões/economia , Cirurgia Plástica/economia , Setor de Assistência à Saúde/estatística & dados numéricos , Humanos , Cirurgiões/ética , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/ética , Cirurgia Plástica/estatística & dados numéricos , Estados UnidosAssuntos
Disseminação de Informação/métodos , Mídias Sociais/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Marketing de Serviços de Saúde/métodos , Marketing de Serviços de Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/estatística & dados numéricos , Procedimentos de Cirurgia Plástica/economia , Procedimentos de Cirurgia Plástica/métodos , Procedimentos de Cirurgia Plástica/estatística & dados numéricos , Cirurgia Plástica/economia , Cirurgia Plástica/métodos , Gravação em VídeoRESUMO
SUMMARY: In the wake of the death toll resulting from coronavirus disease of 2019 (COVID-19), in addition to the economic turmoil and strain on our health care systems, plastic surgeons are taking a hard look at their role in crisis preparedness and how they can contribute to crisis response policies in their own health care teams. Leaders in the specialty are charged with developing new clinical policies, identifying weaknesses in crisis preparation, and ensuring survival of private practices that face untenable financial challenges. It is critical that plastic surgery builds on the lessons learned over the past tumultuous year to emerge stronger and more prepared for subsequent waves of COVID-19. In addition, this global health crisis presents a timely opportunity to reexamine how plastic surgeons can display effective leadership during times of uncertainty and stress. Some may choose to emulate the traits and policies of leaders who are navigating the COVID-19 crisis effectively. Specifically, the national leaders who offer empathy, transparent communication, and decisive action have maintained high public approval throughout the COVID-19 crisis, while aggressively controlling viral spread. Crises are an inevitable aspect of modern society and medicine. Plastic surgeons can learn from this pandemic to better prepare for future turmoil.
Assuntos
COVID-19/prevenção & controle , Liderança , Papel Profissional , Cirurgia Plástica/organização & administração , COVID-19/economia , COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis/normas , Saúde Global , Humanos , Pandemias/economia , Pandemias/prevenção & controle , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/organização & administração , SARS-CoV-2/patogenicidade , Cirurgiões/organização & administração , Cirurgia Plástica/economia , IncertezaRESUMO
SUMMARY: Social media are a powerful tool that creates a unique opportunity for the young plastic surgeon and trainee to share content, brand oneself, educate the public, and develop one's own professional voice early. The majority of all plastic surgery programs and particularly those that are highly ranked have social media opportunities for their residents, yet clear rules to guide implementation of social media programming in residency have remained unspecified. These guidelines and pitfalls can be used to inform a productive and professional entry into plastic surgery social media use for the resident and young plastic surgeon. Details regarding specific platform use to maximize exposure are provided. The core principles of patient safety and privacy, authentic photography, plastic surgery education and advocacy, and professionalism inform these guidelines. Pitfalls include establishment of an online physician-patient relationship, engaging in debate by means of online reviews, providing medical entertainment, and engaging in non-plastic surgery politics. Use of these guidelines will allow the young plastic surgeon and trainee to succeed by means of social media platforms in an ethical and professional manner.
Assuntos
Internato e Residência/métodos , Guias de Prática Clínica como Assunto , Mídias Sociais/normas , Cirurgiões/normas , Cirurgia Plástica/normas , Humanos , Internato e Residência/normas , Marketing de Serviços de Saúde/ética , Marketing de Serviços de Saúde/métodos , Marketing de Serviços de Saúde/normas , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/normas , Relações Médico-Paciente/ética , Profissionalismo , Procedimentos de Cirurgia Plástica/economia , Procedimentos de Cirurgia Plástica/educação , Mídias Sociais/ética , Cirurgiões/economia , Cirurgia Plástica/economiaRESUMO
BACKGROUND: Philanthropy in plastic surgery supports research, clinical care, academic infrastructure, and education in the United States and internationally. Plastic surgeons have opportunities to innovatively address unmet needs in their local and global communities by forming philanthropic nonprofit organizations. METHODS: The authors queried three national philanthropic databases (Charity Navigator, Guidestar, and ProPublica) for Internal Revenue Service 990 form tax return information related to philanthropic plastic surgery organizations. The authors analyzed the financial information publicly available about current plastic surgery philanthropic organizations and their funding sources. RESULTS: Seventy-three federally tax-exempt groups identified plastic surgery as their primary area of work to the Internal Revenue Service in 2019, and 52 of those organizations said they engaged in clinical and/or educational philanthropy.3 In 2017, a total of $158.5 million was donated to these groups in cash and noncash donations including equipment and time. Analyses of 6 years (2013 to 2018) of tax records from groups that provide plastic surgery clinical, research, or educational philanthropy reveal that government grants provide very little funding for this work. Eighty-six percent of money raised for these groups in 2017 was collected by means of direct donations. Money obtained from fundraising events contributed 2 percent to their total monies raised in 2017 on average and 8 percent came from noncash gifts. CONCLUSIONS: A broad body of academic research is reviewed here that guides best practices and measuring a group's impact and outcomes. The details of a philanthropic group's organization and finances directly influence the impact of their work and, as such, are worthy of our sustained attention.
Assuntos
Obtenção de Fundos/organização & administração , Cirurgia Plástica/economia , Humanos , Organizações sem Fins Lucrativos/economia , Organizações sem Fins Lucrativos/organização & administração , Cirurgiões/economia , Cirurgiões/organização & administração , Cirurgia Plástica/organização & administração , Estados UnidosRESUMO
BACKGROUND: Economic evaluations in healthcare are designed to inform decisions by the estimation of cost and effect trade-off of two or more interventions. This review identified and appraised the quality of reporting of economic evaluations in plastic surgery based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. METHODS: Electronic databases were searched: MEDLINE, EMBASE, The Cochrane Library, Ovid Health Star, and Business Source Complete from January 1, 2012 to November 30, 2019. Data extracted included: the type of economic evaluation (i.e., cost-utility analysis (CUA), cost-effectiveness analysis (CEA), cost-benefit analysis (CBA), cost-minimization analysis (CMA)), domain of plastic surgery, journal, year, and country of publication. The CHEERS checklist (with 24 items) was used to appraise the quality of reporting. RESULTS: Ninety-two economic evaluations were identified; CUA (10%), CEA (31%), CBA (4%), and CMA (50%). Breast surgery was the top domain (48%). Most were conducted in the USA (61%) and published in Plastic and Reconstructive Surgery journal (28%). One-third were published in the last two years. The average CHEERS checklist compliance score was 15 (63%). The average CHEERS checklist compliance score per type of evaluation was 19 (77%) for CUA, 17 (70%) for CEA, 13 (52%) for CBA, and 14 (57%) for CMA. The least reported CHEERS checklist items included: time horizon (15%), discount rate (18%), and assessment of heterogeneity (15%). Thirty-two percent of studies were inappropriately titled (i.e., methodologically incorrect). CONCLUSION: Quality of reporting of economic evaluations is suboptimal. The CHEERS checklist should be consulted when performing and reporting economic evaluations in plastic surgery.