Academic Productivity in Orthopaedic Traumatology Correlates Positively With Industry Compensation.

OBJECTIVE: To determine the association between academic productivity and industry compensation among Orthopaedic Traumatologists. DESIGN: Retrospective cohort study. SETTING: Review of the Centers for Medicaid and Medicare Services Open Payments program from 2016 to 2020. PARTICIPANTS: 1120 Orthopaedic Traumatologists. MAIN OUTCOME MEASUREMENTS: To determine if an Orthopaedic Traumatologist's h-index and m-index, as generated from Web of Science, Scopus, and Google Scholar User Profile databases, correlate with total payments from medical industry in 7 categories, including Royalties and Licensing Fees, Consulting Fees, Gifts, Honoraria, and 3 unique Speaking Fee delineations. RESULTS: Of 30,343 Orthopaedic Surgeons in the Open Payments program, 1120 self-identified with the Orthopaedic Trauma taxonomy. From 2016 to 2020, 499 surgeons (44.6%) received compensation in one of the eligible categories, most commonly from Consulting Fees (67.3%), though payments from Royalties provided the greatest gross income (70.4%). Overall, for all 1120 surgeons, h-index (r = 0.253, P < 0.001) and m-index (r = 0.136, P < 0.01) correlated positively with mean annual total industry compensation. The highest annual compensation group had higher h-index ($0 vs. $1-$1k vs. $1k-$10k vs. >$10k: 5.0 vs. 6.6 vs. 9.6 vs. 16.8, P < 0.001) and m-index ($0 vs. $1-$1k vs. $1k-$10k vs. >$10k: 0.48 vs. 0.60 vs. 0.65 vs. 0.89, P < 0.001) scores than either the intermediate or the no compensation groups. Multivariable analysis of factors associated with increased industry compensation, including H-index and years active, identified both as having significant associations with physician payments [H-index (B = 0.073, P < 0.001); years active (B = 0.059, P < 0.001)]. Subgroup analysis of the highest annual earner group (>$250k/year) also demonstrated the highest overall h-index (27.6, P < 0.001) and m-index (1.23, P = 0.047) scores, even when compared with other high-earners ($10k-$50k, $50k-$250k). Overall, each increase in h-index above an h-index of 3 was associated with an additional $1722 (95% CI: $1298-2146) of annual industry compensation. CONCLUSIONS: Academic productivity metrics have a positive association with industry compensation for Orthopaedic Traumatologists. This may highlight a potential ancillary benefit to scholarly efforts.

The Association Between Orthopaedic Surgeon Academic Productivity Metrics and Compensation from Medical Industry.

INTRODUCTION: Academic research has value well beyond personal financial gain. However, these endeavors do require a notable amount of time and opportunity cost. Academic productivity may raise a researcher's profile within the field, increasing the likelihood for interactions with the medical industry and possibly cultivating relationships with future monetary significance. METHODS: Queries of the Centers for Medicaid and Medicare Services publicly available Open Payments System allowed for extraction of industry compensation data for orthopaedic surgeons. Aggregate data produce three compensation groups (mean annual income) for individual physicians: none; 1 to $100,000; and >$100,000. Physicians in the highest income category were matched 1:1 with physicians in each of the other two compensation groups. Selected physicians then underwent an academic productivity assessment. Queries of Web of Science, Scopus, and Google Scholar User Profile databases provided the h-index and m-index for each surgeon. Bivariate and multivariate analyses produced statistical results. In addition to the analysis of the tiered income groups, analysis of compensation as a continuous variable also occurred. RESULTS: From 2016 to 2020, 636, 7,617, and 22,091 US orthopaedic surgeons earned mean annual industry compensation >$100,000; between $1 and $100,000; and $0, respectively. Royalties (80.8%) predominated in the top earning group, compared with Consulting Fees (46.5%) in the second-tier group. The highest income group had higher h-index ($0 versus $1 to 100,000 versus >$100,000 = 3.6 versus 7.5 versus 20.0, P < 0.001) and m-index ($0 versus $1 to 100,000 versus >$100,000 = 0.26 versus 0.44 versus 0.80, P < 0.001) scores than either the intermediate or no compensation groups. In addition, h-index and m-index correlated positively with total compensation (h-index: r = 0.32, P < 0.001; m-index: r = 0.20, P < 0.001). Multivariable analysis of factors associated with increased industry compensation identified h-index (B = 0.034, P < 0.001) and years active (B = 0.042, P < 0.001) as having significant associations with physician compensation. Physician subspecialty also correlated with industry compensation. DISCUSSION: Academic research can provide invaluable contributions to the improvement of patient care. These efforts often require notable personal sacrifice with minimal direct remuneration. However, academic productivity metrics correlate positively with industry compensation, highlighting a possible supplementary benefit to scholarly efforts. LEVEL OF EVIDENCE: Level III.

Impact of Fellow Versus Resident Assistance on Outcomes Following Pancreatoduodenectomy.

BACKGROUND: Participation by surgical trainees in complex procedures is key to their development as future practicing surgeons. The impact of surgical fellows versus general surgery resident assistance on outcomes in pancreatoduodenectomy (PD) has not been well studied. The purpose of this study was to determine differences in patient outcomes based on level of surgical trainee. METHODS: Consecutive cases of PD (n = 254) were reviewed at a single high-volume institution over a 2-year period (July 2013-June 2015). Thirty-day outcomes were monitored through the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) and Quality In-Training Initiative. Patient outcomes were compared between PD assisted by general surgery residents versus hepatopancreatobiliary fellows. RESULTS: The hepatopancreatobiliary surgery fellows and general surgery residents participated in 109 and 145 PDs, respectively. The incidence of each individual postoperative complication (renal, infectious, pancreatectomy-specific, and cardiopulmonary), total morbidity, mortality, and failure to rescue were the same between groups. CONCLUSIONS: Patient operative outcomes were the same between fellow- and resident-assisted PD. These results suggest that hepatopancreatobiliary surgery fellows and general surgery residents should be offered the same opportunities to participate in complex general surgery procedures.