The Dawn of Transparency: Insights from the Physician Payment Sunshine Act in Plastic Surgery.
BACKGROUND
The Physician Payments Sunshine Act (PSSA) is a government initiative that requires all biomedical companies to publicly disclose payments to physicians through the Open Payments Program (OPP). The goal of this study was to use the OPP database and evaluate all nonresearch-related financial transactions between plastic surgeons and biomedical companies.


METHODS
Using the first wave of OPP data published on September 30, 2014, we studied the national distribution of industry payments made to plastic surgeons during a 5-month period. We explored whether a plastic surgeon's scientific productivity (as determined by their h-index), practice setting (private versus academic), geographic location, and subspecialty were associated with payment amount.


RESULTS
Plastic surgeons (N = 4195) received a total of US $5,278,613. The median (IQR) payment to a plastic surgeon was US $115 (US $35-298); mean, US $158. The largest payment to an individual was US $341,384. The largest payment category was non-CEP speaker fees (US $1,709,930) followed by consulting fees (US $1,403,770). Plastic surgeons in private practice received higher payments per surgeon compared with surgeons in academic practice (median [IQR], US $165 [US $81-$441] vs median [IQR], US $112 [US $33-$291], rank-sum P < 0.001). Among academic plastic surgeons, a higher h-index was associated with 77% greater chance of receiving at least US $1000 in total payments (RR/10 unit h-index increase = 1.47 1.772.11, P < 0.001). This association was not seen among plastic surgeons in private practice (RR = 0.89 1.091.32, P < 0.4).


CONCLUSIONS
Plastic surgeons in private practice receive higher payments from industry. Among academic plastic surgeons, higher payments were associated with higher h-indices.
From the Departments of *Surgery, and †Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine; ‡Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD; and §Division of Plastic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA.
Rizwan
R
Ahmed
Joseph
J
Lopez
Sunjae
S
Bae
Allan B
AB
Massie
Eric K
EK
Chow
Karan
K
Chopra
Babak J
BJ
Orandi
Bonnie E
BE
Lonze
James W
JW
May
Justin M
JM
Sacks
Dorry L
DL
Segev
D016265:Conflict of Interest / Q000191:economics / Q000331:legislation & jurisprudence*; D016208:Databases, Factual; D030881:Disclosure / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D004345:Drug Industry / Q000191:economics / Q000331:legislation & jurisprudence*; D005378:Financial Support; D037921:Gift Giving; D019981:Health Care Sector / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D007883:Legislation, Medical; D066231:Surgeons / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D013518:Surgery, Plastic / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States