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

Abstract

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