Assuntos
Medicina/estatística & dados numéricos , Oftalmologistas/economia , Médicas/economia , Médicos/economia , Salários e Benefícios/estatística & dados numéricos , Estudos Transversais , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Feminino , Mão de Obra em Saúde , Humanos , Renda/estatística & dados numéricos , Masculino , Programas Nacionais de Saúde/estatística & dados numéricos , Ontário , Médicos/estatística & dados numéricos , Médicas/estatística & dados numéricos , Distribuição por Sexo , Sexismo/economiaRESUMO
IMPORTANCE: Given scrutiny over financial conflicts of interest in health care, it is important to understand the types and distribution of industry-related payments to physicians. OBJECTIVE: To determine the types and distribution of industry-related payments to physicians in 2015 and the association of physician specialty and sex with receipt of payments from industry. DESIGN, SETTING, AND PARTICIPANTS: Observational, retrospective, population-based study of licensed US physicians (per National Plan & Provider Enumeration System) linked to 2015 Open Payments reports of industry payments. A total of 933â¯295 allopathic and osteopathic physicians. Outcomes were compared across specialties (surgery, primary care, specialists, interventionalists) and between 620â¯166 male (66.4%) and 313â¯129 female (33.6%) physicians using regression models adjusting for geographic Medicare-spending region and sole proprietorship. EXPOSURES: Physician specialty and sex. MAIN OUTCOMES AND MEASURES: Reported physician payment from industry (including nature, number, and value), categorized as general payments (including consulting fees and food and beverage), ownership interests (including stock options, partnership shares), royalty or license payments, and research payments. Associations between physician characteristics and reported receipt of payment. RESULTS: In 2015, 449â¯864 of 933â¯295 physicians (133â¯842 [29.8%] women), representing approximately 48% of all US physicians were reported to have received $2.4 billion in industry payments, including approximately $1.8 billion for general payments, $544 million for ownership interests, and $75 million for research payments. Compared with 47.7% of primary care physicians (205â¯830 of 431â¯819), 61.0% of surgeons (110â¯604 of 181â¯372) were reported as receiving general payments (absolute difference, 13.3%; 95% CI, 13.1-13.6; odds ratio [OR], 1.72; P < .001). Surgeons had a mean per-physician reported payment value of $6879 (95% CI, $5895-$7862) vs $2227 (95% CI, $2141-$2314) among primary care physicians (absolute difference, $4651; 95% CI, $4014-$5288). After adjusting for geographic spending region and sole proprietorship, men within each specialty had a higher odds of receiving general payments than did women: surgery, 62.5% vs 56.5% (OR, 1.28; 95% CI, 1.26-1.31); primary care, 50.9% vs 43.0% (OR, 1.38; 95% CI, 1.36-1.39); specialists, 36.3% vs 33.4% (OR, 1.15; 95% CI, 1.13-1.17); and interventionalists, 58.1% vs 40.7% (OR, 2.03; 95% CI, 1.97-2.10; P < .001 for all tests). Similarly, men reportedly received more royalty or license payments than did women: surgery, 1.2% vs 0.03% (OR, 43.20; 95% CI, 25.02-74.57); primary care, 0.02% vs 0.002% (OR, 9.34; 95% CI, 4.11-21.23); specialists, 0.08% vs 0.01% (OR, 3.67; 95% CI, 1.71-7.89); and for interventionalists, 0.13% vs 0.04% (OR, 7.98; 95% CI, 2.87-22.19; P < .001 for all tests). CONCLUSIONS AND RELEVANCE: According to data from 2015 Open Payments reports, 48% of physicians were reported to have received a total of $2.4 billion in industry-related payments, primarily general payments, with a higher likelihood and higher value of payments to physicians in surgical vs primary care specialties and to male vs female physicians.
Assuntos
Pesquisa Biomédica/economia , Economia Médica , Indústrias/economia , Investimentos em Saúde/economia , Medicina , Propriedade/economia , Médicos/economia , Conflito de Interesses , Feminino , Humanos , Investimentos em Saúde/estatística & dados numéricos , Modelos Logísticos , Masculino , Medicina/estatística & dados numéricos , Razão de Chances , Medicina Osteopática/economia , Medicina Osteopática/estatística & dados numéricos , Médicos/estatística & dados numéricos , Médicas/economia , Médicas/estatística & dados numéricos , Atenção Primária à Saúde/economia , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Retrospectivos , Distribuição por Sexo , Cirurgiões/economia , Cirurgiões/estatística & dados numéricos , Estados UnidosRESUMO
OBJECTIVE: To investigate and to characterise the practice patterns, academic rank, and income variables that exist in order to better understand the career of a sports medicine physician in the USA. DESIGN: A cross-sectional survey of family physicians holding a Certificate of Added Qualifications in Sports Medicine through the American Board of Family Medicine as of January 2006. RESULTS: The survey was completed by 325 of 862 physicians (a return rate of 38%). Of all respondents, 212 (65%) reported completing a Primary Care Sports Medicine Fellowship, 276 (85%) were male and 49 (15%) were female, and 300 (92%) reported having a MD, while 25 (8%) had a DO. Clinical duties represented the largest proportion of the physicians' schedules (7.94 half days/week), and the majority of physicians performed routine athletic event coverage. The average salary for all physicians was $166,000 US. Higher-income groups included: men ($172,000 vs $132 000 for women); regions including Central, South East, and South West; full professors; and non-student health or urgent care clinical work. With control for all other variables, four groups demonstrated significantly higher odds of being high income earners (annual gross salary > $200,000 US). These groups included age over 40, male sex, practice owner, and seeing over 10 patients per half day. CONCLUSIONS: Salary can be related to age, gender, number of patients seen, and practice ownership. No statistical difference among salaries was found between MDs and DOs, osteopathic manipulative therapy (OMT) practice, region of the country, or how practices are marketed.