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The Burden Of Covid-19 On Plastic Surgeons Financial Relationships With The Industry: Insights From The Physician Payments Sunshine Act
Charalampos Siotos, MD1, Jennifer Ferraro, BS1, Kalliopi Siotou, DDS2, Amir Dorafshar, MD1.
1Rush University Medical Center, Chicago, IL, USA, 2National and Kapodistrian University of Athens, Athens, Greece.

PURPOSE: The healthcare system has been greatly affected by the coronavirus disease 2019 (COVID-19) pandemic. Quantification of industry-physician payments under the Physician Payments Sunshine Act has not been performed since the start of the COVID-19 pandemic. The aim of this study is to compare pre- and post-COVID-19 payments between industry and medical providers for all physicians, surgeons, and subspecialized surgeons.
METHODS: Payment information was obtained from the Open Payments Program (OPP) database for the 2019 and 2020 reported periods for three physician groups: all physicians, all surgeons, and each surgical subspecialty. Comparison and analysis of payment amount and type between these years was performed for each cohort.
RESULTS: Physicians experienced a 36% decrease in industry payments with surgeons experiencing a 30.4% decrease. All surgical subspecialties experienced a significant decrease in industry payments excluding transplant surgery (-34.25, p=0.7366) and trauma surgery (-46.46, p=0.1712) which decreased insignificantly, and neurological surgery which increased insignificantly (+2.29, p=0.2002). Charitable contributions (+22.49, p=0.1198) and compensation for services other than consulting (+170.93, p<0.0001) were the only payment types that increase from 2019 to 2020. Among plastic surgeons, total amount of payments had significantly decreased from $47,929,752.87 and 72,044 unique payments in 2019 to $33,319,238.14 (-31%) and 29,946 (-58%) payments in 2020. Variations among the different states were identified (Figure 1). The number of plastic surgeons who received payment also decreased (-21%). Payments to general plastic surgeons had the greatest decrease (-56%, p<0.0001), while payments to plastic surgeons within the head and neck had the least (-9.4%, p=0.3513). Types of payments to plastic surgeons by industry for gifts (-89%), travel and lodging (-83%), speaker fees (-68%), and entertainment (-65%) had the highest decline. In contrast, industry payments to plastic surgeons for charitable contributions (61%) and grants (273%) were considerably higher in 2020 compared to the year prior despite the overall decrease in total payments.
CONCLUSION: The COVID-19 pandemic has significantly impacted industry physician payments across all medical and surgical fields with payment decreases across almost all specialties. Quantification of industry-physician payment trends can help hospitals, patients, and providers better understand the detrimental impact of COVID-19 on physician education, support of surgical practices, and inter-institutional collaboration.


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