title: Patient Attitudes Toward Orthopedic Surgeon Ownership of Related Ancillary Businesses.
abstract: Physician ownership of businesses related to orthopedic surgery, such as surgery centers, has been criticized as potentially leading to misuse of health care resources. The purpose of this study was to determine patients' attitudes toward surgeon ownership of orthopedic-related businesses.
  
  
  
  We surveyed 280 consecutive patients at 2 centers regarding their attitudes toward surgeon ownership of orthopedic-related businesses using an anonymous questionnaire. Three surgeon ownership scenarios were presented: (1) owning a surgery center, (2) physical therapy (PT), and (3) imaging facilities (eg, Magnetic Resonance Imaging scanner).
  
  
  
  Two hundred fourteen patients (76%) completed the questionnaire. The majority agreed that it is ethical for a surgeon to own a surgery center (73%), PT practice (77%), or imaging facility (77%). Most (>67%) indicated that their surgeon owning such a business would have no effect on the trust they have in their surgeon. Although >70% agreed that a surgeon in all 3 scenarios would make the same treatment decisions, many agreed that such surgeons might perform more surgery (47%), refer more patients to PT (61%), or order more imaging (58%). Patients favored surgeon autonomy, however, believing that surgeons should be allowed to own such businesses (78%). Eighty-five percent agreed that patients should be informed if their surgeon owns an orthopedic-related business.
  
  
  
  Although patients express concern over and desire disclosure of surgeon ownership of orthopedic-related businesses, the majority believes that it is an ethical practice and feel comfortable receiving care at such a facility.
authors.affiliation: University of California, San Francisco, San Francisco, California.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Yi
authors.affiliation: Hospital for Special Surgery, New York, New York.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Cross
authors.affiliation: Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Staci R
authors.initials: SR
authors.lastname: Johnson
authors.affiliation: University of Chicago, Chicago, Illinois.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Rasinski
authors.affiliation: Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Nunley
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Della Valle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003132:Commerce / Q000941:ethics*; D030881:Disclosure; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072161:Orthopedic Surgeons / Q000191:economics / Q000941:ethics*; D009985:Orthopedics / Q000191:economics / Q000941:ethics*; D010067:Ownership; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: conflict of interest; economics; orthopedics; patient attitudes; surgeons