Exploring the Link Between Factors in Musculoskeletal Oncology Surgery Fellowships and Industry Supplemental Income

Alexandra H Aitchison; Philip H Khoury; William Stoeber; Albert T Anastasio; Anthony N Baumann; Mark M Cullen; Peter Monahan; Kempland C Walley; William Eward

doi:10.7759/cureus.70714

Exploring the Link Between Factors in Musculoskeletal Oncology Surgery Fellowships and Industry Supplemental Income

Cureus. 2024 Oct 2;16(10):e70714. doi: 10.7759/cureus.70714. eCollection 2024 Oct.

Authors

Alexandra H Aitchison¹, Philip H Khoury², William Stoeber³, Albert T Anastasio⁴, Anthony N Baumann⁵, Mark M Cullen⁴, Peter Monahan⁶, Kempland C Walley⁷, William Eward⁴

Affiliations

¹ Department of Orthopedics, Duke University School of Medicine, Durham, USA.
² Department of Orthopedics, University of Maryland School of Medicine, Baltimore, USA.
³ Department of Orthopedic Surgery, The Perse School Cambridge, Cambridge, GBR.
⁴ Department of Orthopedic Surgery, Duke University Medical Center, Durham, USA.
⁵ Department of Rehabilitation Services, University Hospitals, Cleveland, USA.
⁶ Department of Orthopedics, Penn State College of Medicine, Hershey, USA.
⁷ Department of Orthopedic Surgery, University of Michigan, Ann Arbor, USA.

Abstract

Introduction In the complex landscape of healthcare economics, the financial relationship between physicians and industry remains a topic of significant interest and reflection. While the dynamics of industry relationships in certain orthopedic subspecialties have been well documented, the intricacies of industry payments within musculoskeletal (MSK) oncology programs have yet to be thoroughly explored. In this study, we aim to examine the relationship between academic and industry productivity at the fellowship level. Additionally, we seek to identify the associations between the flow of industry supplemental income to orthopedic oncologists and the specific residency and fellowship training programs they are affiliated with. Methodology A comprehensive retrospective analysis was conducted using data from the Centers for Medicare and Medicaid Services, Scopus, and other relevant databases in 2023. This study included 19 fellowship programs across the United States, encompassing a total of 68 faculty physicians. Various variables were examined, including H-index, lifetime supplemental income, geographical location, residency affiliation, and association with top-ranked hospitals. Results A statistically significant correlation was found between academic and industry productivity at the individual faculty level (p = 0.003), but not at the fellowship level (p = 0.198). The top 10% of earners accounted for approximately 70% of the total lifetime supplemental income among all fellowship faculty. Additionally, there was no statistically significant association between lifetime supplemental income or academic productivity per fellowship and geographical region, nor with the ranking of affiliated residency programs or hospitals. Conclusions Industry productivity among individual faculty in MSK oncology fellowship programs in the United States is significantly associated with academic productivity; however, this association was not observed at the fellowship level. Furthermore, no statistically significant relationship was found regarding the region or the ranking of the affiliated residency programs or hospitals.

Keywords: academics and industry; industry supplemental income; musculoskeletal oncology; musculoskeletal oncology fellowship; orthopaedic surgery.