RESUMEN
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.
Asunto(s)
Análisis Costo-Beneficio , Internet , Cirugía Plástica , Humanos , Cirujanos/economía , Cirugía Plástica/economíaRESUMEN
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.
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Investigación Biomédica , Fundaciones , Cirugía Plástica , Humanos , Femenino , Masculino , Estudios Retrospectivos , Cirugía Plástica/educación , Cirugía Plástica/economía , Fundaciones/economía , Investigación Biomédica/economía , Apoyo a la Investigación como Asunto , Estados Unidos , Procedimientos de Cirugía Plástica/educación , Procedimientos de Cirugía Plástica/economíaAsunto(s)
Publicaciones Periódicas como Asunto/economía , Publicaciones Periódicas como Asunto/normas , Edición/economía , Edición/normas , Cirujanos/psicología , Cirugía Plástica , Investigación Biomédica/economía , Investigación Biomédica/normas , Conflicto de Intereses/economía , Humanos , Cirujanos/economía , Cirujanos/normas , Cirugía Plástica/economía , Cirugía Plástica/normasAsunto(s)
Financiación del Capital/tendencias , Sector de Atención de Salud/economía , Cirugía Plástica/economía , Financiación del Capital/historia , Financiación del Capital/estadística & datos numéricos , Sector de Atención de Salud/historia , Sector de Atención de Salud/estadística & datos numéricos , Sector de Atención de Salud/tendencias , Historia del Siglo XXI , Estudios Retrospectivos , Cirugía Plástica/historia , Cirugía Plástica/estadística & datos numéricos , Cirugía Plástica/tendencias , Estados UnidosRESUMEN
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.
Asunto(s)
Conflicto de Intereses/economía , Bases de Datos Factuales/normas , Sector de Atención de Salud/economía , Cirujanos/economía , Cirugía Plástica/economía , Algoritmos , Centers for Medicare and Medicaid Services, U.S./estadística & datos numéricos , Bases de Datos Factuales/estadística & datos numéricos , Sector de Atención de Salud/estadística & datos numéricos , Humanos , Renta/estadística & datos numéricos , Cirujanos/estadística & datos numéricos , Cirugía Plástica/estadística & datos numéricos , Estados UnidosRESUMEN
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.
Asunto(s)
Conflicto de Intereses/economía , Sector de Atención de Salud/economía , Renta/estadística & datos numéricos , Cirujanos/estadística & datos numéricos , Cirugía Plástica/estadística & datos numéricos , Centers for Medicare and Medicaid Services, U.S. , Bases de Datos Factuales/estadística & datos numéricos , Revelación/normas , Revelación/estadística & datos numéricos , Femenino , Sector de Atención de Salud/estadística & datos numéricos , Humanos , Masculino , Sociedades Médicas/estadística & datos numéricos , Cirujanos/economía , Cirujanos/normas , Cirugía Plástica/economía , Estados UnidosRESUMEN
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.
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Planes de Aranceles por Servicios/tendencias , Planes de Incentivos para los Médicos/tendencias , Reembolso de Incentivo/tendencias , Cirujanos/economía , Cirugía Plástica/economía , Eficiencia , Planes de Aranceles por Servicios/historia , Planes de Aranceles por Servicios/estadística & datos numéricos , Predicción , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Planes de Incentivos para los Médicos/historia , Planes de Incentivos para los Médicos/estadística & datos numéricos , Reembolso de Incentivo/historia , Reembolso de Incentivo/estadística & datos numéricos , Cirujanos/estadística & datos numéricos , Cirugía Plástica/historia , Cirugía Plástica/organización & administración , Cirugía Plástica/estadística & datos numéricos , Estados UnidosAsunto(s)
Investigación Biomédica/organización & administración , Becas/organización & administración , Equidad de Género/estadística & datos numéricos , Internado y Residencia/organización & administración , Cirugía Plástica/educación , Investigación Biomédica/economía , Investigación Biomédica/estadística & datos numéricos , Bases de Datos Factuales , Becas/economía , Becas/estadística & datos numéricos , Femenino , Humanos , Internado y Residencia/economía , Internado y Residencia/estadística & datos numéricos , Masculino , Cirugía Plástica/economía , Encuestas y Cuestionarios/estadística & datos numéricosAsunto(s)
Conflicto de Intereses/economía , Bases de Datos Factuales/estadística & datos numéricos , Sector de Atención de Salud/economía , Cirujanos/economía , Cirugía Plástica/economía , Sector de Atención de Salud/estadística & datos numéricos , Humanos , Cirujanos/ética , Cirujanos/estadística & datos numéricos , Cirugía Plástica/ética , Cirugía Plástica/estadística & datos numéricos , Estados UnidosAsunto(s)
Difusión de la Información/métodos , Medios de Comunicación Sociales/estadística & datos numéricos , Cirujanos/estadística & datos numéricos , Cirugía Plástica/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Comercialización de los Servicios de Salud/métodos , Comercialización de los Servicios de Salud/estadística & datos numéricos , Educación del Paciente como Asunto/métodos , Educación del Paciente como Asunto/estadística & datos numéricos , Procedimientos de Cirugía Plástica/economía , Procedimientos de Cirugía Plástica/métodos , Procedimientos de Cirugía Plástica/estadística & datos numéricos , Cirugía Plástica/economía , Cirugía Plástica/métodos , Grabación en VideoAsunto(s)
Conducta en la Búsqueda de Información , Motor de Búsqueda , Competencia Clínica , Humanos , Difusión de la Información/métodos , Comercialización de los Servicios de Salud/métodos , Derivación y Consulta , Cirujanos/economía , Cirujanos/organización & administración , Cirugía Plástica/economía , Cirugía Plástica/métodos , Cirugía Plástica/organización & administraciónAsunto(s)
Comercialización de los Servicios de Salud/tendencias , Medios de Comunicación Sociales/tendencias , Cirugía Plástica/tendencias , Estética , Humanos , Difusión de la Información/métodos , Comercialización de los Servicios de Salud/métodos , Procedimientos de Cirugía Plástica/educación , Procedimientos de Cirugía Plástica/métodos , Medios de Comunicación Sociales/economía , Medios de Comunicación Sociales/estadística & datos numéricos , Cirugía Plástica/economía , Cirugía Plástica/estadística & datos numéricos , Grabación en Video/tendenciasRESUMEN
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.
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COVID-19/prevención & control , Liderazgo , Rol Profesional , Cirugía Plástica/organización & administración , COVID-19/economía , COVID-19/epidemiología , COVID-19/transmisión , Control de Enfermedades Transmisibles/normas , Salud Global , Humanos , Pandemias/economía , Pandemias/prevención & control , Grupo de Atención al Paciente/economía , Grupo de Atención al Paciente/organización & administración , SARS-CoV-2/patogenicidad , Cirujanos/organización & administración , Cirugía Plástica/economía , IncertidumbreRESUMEN
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.
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Obtención de Fondos/organización & administración , Cirugía Plástica/economía , Humanos , Organizaciones sin Fines de Lucro/economía , Organizaciones sin Fines de Lucro/organización & administración , Cirujanos/economía , Cirujanos/organización & administración , Cirugía Plástica/organización & administración , Estados UnidosRESUMEN
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.
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Internado y Residencia/métodos , Guías de Práctica Clínica como Asunto , Medios de Comunicación Sociales/normas , Cirujanos/normas , Cirugía Plástica/normas , Humanos , Internado y Residencia/normas , Comercialización de los Servicios de Salud/ética , Comercialización de los Servicios de Salud/métodos , Comercialización de los Servicios de Salud/normas , Educación del Paciente como Asunto/ética , Educación del Paciente como Asunto/métodos , Educación del Paciente como Asunto/normas , Relaciones Médico-Paciente/ética , Profesionalismo , Procedimientos de Cirugía Plástica/economía , Procedimientos de Cirugía Plástica/educación , Medios de Comunicación Sociales/ética , Cirujanos/economía , Cirugía Plástica/economíaRESUMEN
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.