62. The Burden of Covid-19 on Plastic Surgeons Financial Relationships With the Industry: Insights From The Physician Payments Sunshine Act

Abstract

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. 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.