title: Industry Financial Relationships in Orthopaedic Surgery: Analysis of the Sunshine Act Open Payments Database and Comparison with Other Surgical Subspecialties.
abstract: BACKGROUND
  Industry financial relationships for orthopaedic surgeons in the United States are now publicly reported in the Sunshine Act Open Payments database. We sought to present these data in a more easily understandable format and to describe how industry relationships in orthopaedic surgery compare with other surgical subspecialties.
  
  
  METHODS
  The Open Payments database was searched for all records of industry financial relationships for orthopaedic surgeons. Data analyzed included the value of reported financial relationships per surgeon, the type of financial relationship, and geographic region. Similar analytics were collected for neurological surgery, urology, plastic surgery, and otolaryngology. Data were normalized to the overall number of providers in each subspecialty in the United States from the American Medical Association 2012 data.
  
  
  RESULTS
  For 12,320 orthopaedic surgeons, 58,127 industry financial relationships were reported, with a total value of $80.2 million. Royalties or licensing fees, which were received by 1.7% of U.S. orthopaedic surgeons, accounted for 69.5% of the total monetary value of payments to orthopaedic surgeons. Between August and December 2013, 50.1% of U.S. orthopaedic surgeons had a reported financial relationship. Orthopaedics had the second lowest percentage of physicians with industry financial relationships among the five surgical subspecialties studied. The overall value of payments per orthopaedic surgeon was higher than in the other subspecialties, driven by the large value of royalties and licensing.
  
  
  CONCLUSIONS
  One-half of U.S. orthopaedic surgeons have industry financial relationships reported in the Open Payments database. Orthopaedic surgeons are less likely than most surgical subspecialists to receive industry payments, and the majority of the overall value of orthopaedic financial relationships is driven by a small number of orthopaedic surgeons receiving royalties and licensing for reimbursable innovation within the field.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Suite 200, Chicago, IL 60622. E-mail address for G.L. Cvetanovich: Gregory.cvetanovich@gmail.com.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Cvetanovich
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Suite 200, Chicago, IL 60622. E-mail address for G.L. Cvetanovich: Gregory.cvetanovich@gmail.com.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Chalmers
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Suite 200, Chicago, IL 60622. E-mail address for G.L. Cvetanovich: Gregory.cvetanovich@gmail.com.
authors.forename: Bernard R
authors.initials: BR
authors.lastname: Bach
mesh_terms: D000574:American Medical Association; D016208:Databases, Factual / Q000191:economics; D005260:Female; D006801:Humans; D007221:Industry / Q000191:economics*; D007373:Interinstitutional Relations; D008297:Male; D019637:Orthopedic Procedures / Q000191:economics* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000191:economics; D011445:Prospective Payment System / Q000191:economics*; D013043:Specialties, Surgical / Q000191:economics*; D014481:United States