Gender Disparities in Financial Relationships Between Industry and Orthopaedic Surgeons

Area of Science:

• Orthopaedic Surgery
• Medical Economics
• Gender Studies

Background:

• Financial relationships between physicians and industry vary by gender in surgical fields.
• Previous research indicates gender-based differences in industry ties across various medical specialties.
• This study specifically investigates gender disparities in financial relationships within orthopaedic surgery.

Purpose of the Study:

• To determine if significant gender disparities exist in financial relationships between industry and orthopaedic surgeons.
• To analyze the nature and extent of industry payments to male versus female orthopaedic surgeons.
• To identify factors associated with industry payments in orthopaedic surgery.

Main Methods:

• Retrospective analysis of publicly available data from the Centers for Medicare & Medicaid Services (CMS) Open Payments database (2016-2017).
• Extracted data on royalties, licensing, and consulting fees paid to orthopaedic surgeons.
• Compared total payment amounts and number of payments between male and female surgeons, considering subspecialty and practice location. Employed multivariable linear regression to identify predictors of payment volume and value.

Main Results:

• Industry payments (royalties, consulting fees) were made to 3,418 orthopaedic surgeons, representing 11% of the AAOS census.
• The overwhelming majority of total payment amounts (99.6%) were received by male surgeons, with women receiving only 0.4%.
• Male gender, increased years of experience, practicing in the Mountain region, and adult reconstructive subspecialty were significant predictors of both the number and amount of industry payments received.

Conclusions:

• Male gender, years of experience, geographic region (Mountain), and adult reconstructive subspecialty independently predict higher industry payments in orthopaedic surgery.
• These identified disparities in financial relationships may perpetuate inequities in academic advancement, scholarship, and leadership opportunities for women in the field.