A Closer Look at the Relationship Between Industry and Orthopaedic Sports Medicine Surgeons

Abstract

Background: A recent study demonstrated that discrepancies exist between disclosures reported by authors publishing in The American Journal of Sports Medicine and disclosures listed in the Physician Payments Sunshine Act–initiated Open Payments database, managed by the Centers for Medicare & Medicaid Services (CMS). However, no study to date has explored the relationship between the biopharmaceutical and device industry (industry) and the membership base of the American Orthopaedic Society for Sports Medicine (AOSSM). Purpose: To critically examine the relationship between orthopaedic sports medicine surgeons and industry. Study Design: Cross-sectional study. Methods: The publicly available CMS Open Payments database website was accessed to search for sports medicine orthopaedic surgeons in the United States who were members of the AOSSM. Financial data, specifically general, research, and ownership payments for 2015, were recorded for each surgeon. The American Academy of Orthopaedic Surgeons (AAOS) disclosures of each surgeon were then obtained. Descriptive statistics and simple proportions were calculated to summarize the collected data, including years in practice and amount of payment. Median values for general payments were compared to provide a more accurate reflection of payments transferred to a “typical” sports medicine surgeon. Results: A total of $58,113,561 in general payments, $3,996,051 in research payments, $72,481,814 in money invested, and $144,552,383 in interest earned from money invested were identified as being paid to 2274 surgeons (all amounts in US$). The distribution of total general payments received was skewed: 10% of surgeons received 95.4% ($55,463,183) of the total general payments. A total of 1433 surgeons had completed, up-to-date AAOS disclosures. Although 44% (635 surgeons) self-reported no financial conflict to the AAOS, the Open Payments database indicated some level of industry support to these surgeons. Unreported general payments totaled $1,393,212, or a median of $561 per surgeon (interquartile range, $10-$200,048). Conclusion: Although orthopaedic sports medicine surgeons received substantial payments from industry, most of the total general payments were given to a small proportion of people. The regional distribution of these payments did not differ significantly. Summary reports of data are largely skewed by outliers and should be interpreted with caution. However, a large percentage of these surgeons failed to reveal industry support of any kind in their AAOS disclosures, including meals and educational funding, demonstrating the importance of transparency and accuracy when completing financial disclosures.