Nudotor Richard, Ha Jinny S, Ruck Jessica M, Aziz Hamza, Kilic Ahmet, Bush Errol L
Department of Surgery, Anne Arundel Medical Center, Annapolis, Md.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
J Thorac Cardiovasc Surg. 2024 Nov 10. doi: 10.1016/j.jtcvs.2024.11.005.
Thoracic surgery program directors (PDs) are key mentors for the next generation of cardiothoracic surgeons and surgeon-scientists. This study evaluates the industry payments to PDs compared to other practicing thoracic surgeons, with the aim of assessing potential conflicts of interest and their influence.
PDs were identified using the Electronic Residency Application System (ERAS) and their National Provider Identifiers (NPIs). Industry payments from 2015 to 2021 were extracted from the OpenPayments (cms.gov) database. We analyzed the number and types of payments, including consulting fees, speaking engagements, and research-related contributions. Payments were compared by PD characteristics, such as gender, specialty, and academic metrics, using the χ test and Kruskal-Wallis test.
All 77 identified PDs (66 males and 11 females) received industry payments, totaling $14,094,422 across 8028 transactions. The median payment was $16,716, with the maximum reaching $2,661,001. Male PDs and PDs in cardiac specialties received significantly higher payments. Research funding for PDs was awarded predominantly to males (100%). Significant disparities were observed in industry payments to PDs compared to non-PDs, especially in food and beverage and educational activities. PDs initially received more than double the research payments compared to non-PDs in the early years. This disparity was reduced significantly by 2021, reflecting a move toward more equitable research funding.
The substantial payment to PDs reflects their significant role in thoracic surgery but raises concerns regarding potential influence on trainees. These findings underscore the need for increased transparency and measures to address disparities in industry support, particularly concerning gender and specialty.
胸外科项目主任（PDs）是下一代心胸外科医生和外科科学家的关键导师。本研究评估了与其他执业胸外科医生相比，行业对PDs的支付情况，旨在评估潜在的利益冲突及其影响。
使用电子住院医师申请系统（ERAS）及其国家提供者识别码（NPIs）来识别PDs。从OpenPayments（cms.gov）数据库中提取2015年至2021年的行业支付信息。我们分析了支付的数量和类型，包括咨询费、演讲活动和与研究相关的贡献。使用χ检验和Kruskal-Wallis检验，按PDs的特征（如性别、专业和学术指标）对支付情况进行比较。
所有77名已识别的PDs（66名男性和11名女性）都获得了行业支付，在8028笔交易中总计14,094,422美元。支付中位数为16,716美元，最高达到2,661,001美元。男性PDs和心脏专科的PDs获得的支付显著更高。PDs的研究资金主要授予男性（100%）。与非PDs相比，PDs在行业支付方面存在显著差异，尤其是在食品饮料和教育活动方面。在早期，PDs最初获得的研究支付是非PDs的两倍多。到2021年，这种差距显著缩小，这反映了在研究资金方面朝着更公平的方向发展。
对PDs的大量支付反映了他们在胸外科中的重要作用，但引发了对其对受训人员潜在影响的担忧。这些发现强调了提高透明度以及采取措施解决行业支持方面差异的必要性，特别是在性别和专业方面。
