18 - COMPARING PAYMENTS TO SURGEONS FROM DRUG AND MEDICAL DEVICE CORPORATIONS REVEALS INEQUALITIES BETWEEN GENDER AND SPECIALTIES

Objectives: Maintaining trust in the patient-doctor relationship requires transparency in the details of the financial relationships between physicians and drug and medical device corporations. These details are publicly available and patients are encouraged to ask surgeons to interpret their implications. The purpose of this study was to better equip surgeons in responding to these inquiries and to compare the distribution of these payments by gender and specialty.

Methods: The 2021 Open Payments dataset was searched for all payments to surgeons from the fourteen different specialties recognized by the American College of Surgeons. The total payments per surgeon were compared by calculating the mean with standard deviation (SD) and a Student’s t-test. The median payments with interquartile range (IQR) were compared with a Wilcoxon rank-sum test. The Gini index, a measure of income inequality, was calculated for each specialty.

Results: There were 96,724 surgeons who received over $755 million from drug and medical device companies. There were 72,245 (74.7%) men and 24,479 (25.3%) women. The total amount of payments to men was $712 million (94.2%) and to women was $44 million (5.8%). The mean total payments for men was $9,855 (SD $175,189) and $1,792 (SD $16,733, p< 0.001) for women. The median total payments for men was $261 (IQR $79-$1,156) and for women was $164 (IQR $51-$486, p< 0.001). The highest and lowest Gini index was pediatric and cardiothoracic surgery, respectively.

Conclusion: Male surgeons received a disproportionately higher amount of payments from drug and device corporations compared to female surgeons. Pediatric surgeons had the most inequality while payments to cardiothoracic surgeons were the most equally distributed. Surgeons should be aware of their own standing within the Open Payments database in order to respond appropriately to patient inquiries.