Plastic Surgeons’ Perceptions of Financial Conflicts of Interest and the Sunshine Act

Background: It is unknown whether recent legislation known as the Physician Payments Sunshine Act has affected plastic surgeons' views of conflicts of interest (COI). The purpose of this study was to evaluate plastic surgeons' beliefs about COI and their comprehension of the government-mandated Sunshine Act. Methods: Plastic surgeon members of the American Society of Plastic Surgeons were invited to complete an electronic survey. The survey contained 27 questions that assessed respondents' past and future receipt of financial gifts from industry, awareness of the Sunshine Act, and beliefs surrounding the influence of COI on surgical practice. Results: A total of 322 individuals completed the survey. A majority had previously accepted gifts from industry (n = 236; 75%) and would accept future gifts (n = 181; 58%). Most respondents believed that COI would affect their colleagues' medical practice (n = 190; 61%) but not their own (n = 165; 51%). A majority was aware of the Sunshine Act (n = 272; 89%) and supported data collection on surgeon COI (n = 224; 73%). A larger proportion of young surgeons believed patients would benefit from knowing their surgeon's COI (P = 0.0366). Surgeons who did not expect COI in the future believed financial COI could affect their own clinical practice (P = 0.0221). Conclusions: Most plastic surgeons have a history of accepting industry gifts but refute their influence on personal clinical practice. Surgeon age and anticipation of future COI affected beliefs about the benefits of COI disclosure to patients and the influence of COI on surgical practice. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Published online 4 April 2018. Received for publication January 4, 2018; accepted February 6, 2018. Ms. Purvis and Dr. Lopez contributed equally to this work. Institution to which work should be attributed: Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, 1780 E. Fayette St Bloomberg 7th Floor Rm 7314, Baltimore, MD 21231. IRB Approval: This study was approved by our hospital Institutional Review Board (IRB00091046). Disclosure: Dr. May, Jr, is a scientific consultant for ­Integra and Helios and an educational consultant for Johnson-Johnson–Mentor. Dr. Dorafshar receives research support and royalties from KLS Martin and research support from De Puy ­Synthes. For the remaining authors, none were declared. Funding from the Department of Plastic and Reconstructive Surgery at the Johns Hopkins Hospital was received for this article. The American Society of Plastic Surgeons assisted with administration of the survey. The Article Processing Charge was paid for by the authors. Supplemental digital content is available for this ­article. Clickable URL citations appear in the text. Joseph Lopez, MD, MBA, Department of Plastic Surgery, Johns Hopkins Hospital, 1780 E. Fayette St Bloomberg 7th Floor Rm 7314, Baltimore, MD 21231, E-mail: Jlopez37@jhmi.edu Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.

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