Industry Payments and Implicit Bias in Cardiothoracic Surgery: Difference in Industry Payments to Cardiothoracic Surgeons by Gender

Abstract

Industry payments, as sources of revenue and prestige, may contribute to gender implicit bias. We examined industry payments to cardiothoracic (CT) surgeons to determine differences with respect to gender while accounting for practice focus and experience. Payments to CT surgeons from 2014, 2016, 2018, 2020, and 2022 were abstracted from the CMS Open Payment database. Data was restricted to individual payments over $1000 and the following payment criteria: consulting fees; compensation for services other than consulting; honoraria; education; compensation for serving as faculty or as a speaker for a non-accredited and noncertified continuing education program; and grant. Physician profiles were queried for gender, practice type, and year of last fellowship completion. Descriptive statistics were reported based on these factors. In 2014, 509 CT surgeons (497 male and 12 female) received meaningful industry payments. Male surgeons received $10,471,192 (99.3%) with median payment of $6,500 and mean of $21,069 while females received $70,310 (0.7%) with median of $3,500 and mean of $5,859. In 2022, 674 CT surgeons (613 male and 61 female) received industry payments, with men receiving $10,967,855 (92.4%) with a median payment of $6,611 and mean of $17,892 and women receiving $905,431(7.6%) with a median payment of $6,000 and mean of $14,843. Industry payments to women increased from 2014 to 2022 as the proportion of women in practice rose. Industry support of women, with increases in compensation and roles as speakers, consultants, and educators, offers a potential strategy to combat implicit bias within CT surgery.