Department of Urology, University of Kansas Medical Center, Kansas City, Kansas, USA.
University of Kansas School of Medicine, Kansas City, Kansas, USA.
J Surg Educ. 2024 Oct;81(10):1462-1468. doi: 10.1016/j.jsurg.2024.07.001. Epub 2024 Aug 3.
To explore the financial interactions between urology residents and the healthcare industry over a 5-year training period, assessing the implications of these interactions on medical education and practice considering the Physician Payments Sunshine Act.
Longitudinal analysis of Open Payments data for a single class of urology residents from 2018 to 2023.
Data were extracted from the CMS Open Payments Database and cross-referenced with residency program information from the American Urological Association (AUA) and the Accreditation Council for Graduate Medical Education (ACGME).
A cohort of 314 urology residents were identified to have matched in 2018, with 173 residents having reported financial interactions through the Open Payments Program (OPP), representing 55% of the cohort.
Analysis revealed that $129,632 was disbursed to the 173 residents throughout their surgical training, with a significant majority (approximately three-quarters or around $100,000) allocated for food and beverage. A statistically significant difference in payment amounts was observed between genders, with male residents receiving an average of $869 compared to $454 for female residents. Payments increased progressively with each postgraduate year (PGY) level, peaking in the fifth year. Despite notable disparities in compensation across AUA sections, no statistically significant variation was found (p = 0.21). The study also highlighted the underestimation of industry influence due to discretionary and heterogeneous reporting practices.
The study underscores a significant, yet potentially underreported, financial interaction between urology residents and the healthcare industry, suggesting a deepening relationship as residents progress through their training. The findings call for a more uniform reporting system to enhance transparency and provide a clearer understanding of the industry's role in medical education and practice. Additionally, many residents may not be aware that their financial interactions are being documented and made public, a factor that could influence their professional behavior and expectations.
探讨泌尿科住院医师在五年培训期间与医疗保健行业的财务互动，考虑到医师薪酬阳光法案，评估这些互动对医学教育和实践的影响。
对 2018 年至 2023 年期间的一个泌尿科住院医师班级的 Open Payments 数据进行纵向分析。
数据从 CMS Open Payments 数据库中提取，并与美国泌尿科协会 (AUA) 和研究生医学教育认证委员会 (ACGME) 的居住项目信息进行交叉核对。
确定了一个由 314 名泌尿科住院医师组成的队列，这些住院医师在 2018 年进行了匹配，其中有 173 名住院医师通过 Open Payments 计划 (OPP) 报告了财务互动，占队列的 55%。
分析显示，在整个外科培训过程中，129632 美元分配给了 173 名住院医师，其中大部分（约四分之三或约 100000 美元）用于餐饮。男女住院医师的支付金额存在显著差异，男性住院医师的平均支付金额为 869 美元，而女性住院医师的支付金额为 454 美元。随着毕业后年数 (PGY) 的增加，支付金额逐渐增加，在第五年达到峰值。尽管 AUA 各部门的薪酬差距明显，但差异无统计学意义 (p=0.21)。该研究还强调了由于自由裁量和异质报告做法，行业影响力被低估的问题。
该研究强调了泌尿科住院医师与医疗保健行业之间存在重大但可能未报告的财务互动，这表明随着住院医师培训的进展，两者之间的关系日益加深。研究结果呼吁建立更统一的报告制度，以提高透明度，并更清楚地了解行业在医学教育和实践中的作用。此外，许多住院医师可能不知道他们的财务互动正在被记录和公开，这一因素可能会影响他们的职业行为和期望。
