OBJECTIVES : In 2013, the Centers for Medicare and Medicaid Services (CMS) introduced the Open Payment Database that captures financial relationships between industry and physicians. We sought to analyze the nature and temporal trends of industry payments to physicians since its introduction.

METHODS : We conducted a retrospective study using publicly available data from the CMS Open Payment Database. The analysis included allopathic & osteopathic physicians who received payments from 2014 – 2017. Physicians were categorized by specialty: Medicine (i.e., primary care, internal medicine), Surgery, or Subspecialty (i.e., anesthesiology, dermatology, radiology). Reported payments were totaled per-physician and then analyzed by payment type, categorized as compensation, education, and gifts. The median total payments per physicians per year were reported and then further differentiated by payment type. Descriptive statistics were used to describe the nature and temporal trends of industry payments to physicians.

RESULTS : In the study period, more than 37 million payments totaling $4,835,908,597 were made to 295,189 physicians (146,609 medicine, 80,140 surgery, 68,440 subspecialty). Of the $4 billion, 68% were compensation payments, followed by 29% education and 3% gift. The median of the total per-physician payments decreased from 2014 to 2017 across all specialties (Medicine $511 to $469, Surgery $374 to $329, Subspecialty $243 to $235). Median compensation payments increased in medicine only (2014 – $2,298 to 2017 – $7,450) while median education payments decreased in medicine, surgery, and subspecialty from 2014 to 2017 ($60 to $15; $97 to $48; $77 to $23, respectively).

CONCLUSIONS : The nature and temporal trends of industry payments to physicians vary widely between specialties. Further research is required to understand the basis for variations in payments between specialties since the initiation of The Sunshine Act.