Abstract WMP96: Industry Payments to Vascular Neurologists, a Six-Year Analysis of the Open Payments Program From 2013 to 2018

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sen Sheng ◽  
Krishna Nalleballe ◽  
Aliza Brown ◽  
Syed Ali ◽  
Rohan Sharma ◽  
...  
Keyword(s):  
United States ◽  
Growth Rate ◽  
Clinical Practice ◽  
Retrospective Analysis ◽  
The United States ◽  
The Other ◽  
Steady Growth ◽  
Regional Trends ◽  
Open Payments ◽  
Total Payment

Objective: To analyze and characterize industry payment to vascular neurologists from 2013 to 2018 using open Payments Database. Methods: This is a retrospective analysis of open payments database, which is available publicly. We calculated the percentage of vascular neurologists in the United States receiving payments and payment characteristics. We have analyzed the top 1% payment to vascular neurologist with detailed payment category analysis, payment regional trends, and sponsors each year. The number of board-certified vascular neurologists is available from the database of the American Board of Psychiatry and Neurology. Results: From Jan 2013 to Dec 2018, industry payments to vascular neurologists have increased significantly each year, while a relatively stable fraction (17%) of US vascular neurologists received industry payments totaling $ 3,782,222 (6 years combined). The median payment per physician ranges from $ 115 to $ 241, while 90th percentile payments vary from $1,766 to $ 4,988 with a maximum payment up to $190,551. Nine payment categories are available and the highest amounts were paid for "Consulting Fee". The payment proportion from top 10 sponsors consists of 75% of the total amount since 2013. The payment to the south region has a steady growth rate among the other regions and has the highest payment amount of $ 470,551 in 2018. Top 1% vascular neurologists received more than 60% of the total payment. Among the top 1% vascular neurologists, 73% are likely to be key leaders in the field. Among the top 1%, 42% are specialized in neuro-intervention and less than 15% have Authored AHA/ASA guideline papers. Conclusion: Payments to vascular neurologists is highly skewed with the top 1% receiving around one-third of all payments, less than 15% of these vascular neurologists have authored AHA/ASA guidelines. The industry is known to target key leaders in the field whether this is translating to changes in clinical practice should be looked into more thoroughly.

scholarly journals Industry Payment to Vascular Neurologists

Stroke ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 1339-1343 ◽  
Author(s):  
Krishna Nalleballe ◽  
Sen Sheng ◽  
Chenghui Li ◽  
Ruchira Mahashabde ◽  
Amarnath R. Annapureddy ◽  
...  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
American Heart Association ◽  
American Heart ◽  
Conflicts Of Interest ◽  
Heart Association ◽  
The United States ◽  
Regional Trends ◽  
Impact Patient Care ◽  
And Behavior

Background and Purpose— Industry payments to physicians raise concerns regarding conflicts of interest that could impact patient care. We explored nonresearch and nonownership payments from industry to vascular neurologists to identify trends in compensation. Methods— Using Centers for Medicare and Medicaid Services and American Board of Psychiatry and Neurology data, we explored financial relationships between industry and US vascular neurologists from 2013 to 2018. We analyzed payment characteristics, including payment categories, payment distribution among physicians, regional trends, and biomedical manufacturers. Furthermore, we analyzed the top 1% (by compensation) of vascular neurologists with detailed payment categories, their position, and their contribution to stroke guidelines. Results— The number of board certified vascular neurologist increased from 1169 in 2013 to 1746 in 2018. The total payments to vascular neurologist increased from $99 749 in 2013 to $1 032 302 in 2018. During the study period, 16% to 17% of vascular neurologists received industry payments. Total payments from industry and mean physician payments increased yearly over this period, with consulting fee (31.1%) and compensation for services other than consulting (30.7%) being the highest paid categories. The top 10 manufacturers made the majority of the payments, and the top 10 products changed from drug or biological products to devices. Physicians from south region of the United States received the highest total payment (38.72%), which steadily increased. Payments to top 1% vascular neurologists increased from 64% to 79% over the period as payments became less evenly distributed. Among the top 1%, 42% specialized in neuro intervention, 11% contributed to American Heart Association/American Stroke Association guidelines, and around 75% were key leaders in the field. Conclusions— A small proportion of US vascular neurologists consistently received the majority of industry payments, the value of which grew over the study period. Only 11% of the top 1% receiving industry payments have authored American Heart Association/American Stroke Association guidelines, but ≈75% seem to be key leaders in the field. Whether this influences clinical practice and behavior requires further investigation.

Working With Interpreters to Support Students Who Are English Language Learners

2016 ◽  
Vol 1 (16) ◽  
pp. 15-27 ◽  
Author(s):  
Henriette W. Langdon ◽  
Terry Irvine Saenz
Keyword(s):  
United States ◽  
English Language Learners ◽  
Language Learners ◽  
English Language ◽  
First Language ◽  
The United States ◽  
The Other ◽  
Primary Language ◽  
Second Best ◽  
Support Students

The number of English Language Learners (ELL) is increasing in all regions of the United States. Although the majority (71%) speak Spanish as their first language, the other 29% may speak one of as many as 100 or more different languages. In spite of an increasing number of speech-language pathologists (SLPs) who can provide bilingual services, the likelihood of a match between a given student's primary language and an SLP's is rather minimal. The second best option is to work with a trained language interpreter in the student's language. However, very frequently, this interpreter may be bilingual but not trained to do the job.

Armed Violence in the Ideology of Contemporary Islamic Fundamentalism - Study models

2019 ◽  
Vol 2 (4) ◽  
pp. 237
Author(s):  
Laith Mzahim Khudair Kazem
Keyword(s):  
United States ◽  
United States Of America ◽  
The United States ◽  
The Other ◽  
Islamic Fundamentalism ◽  
Islamic Movements ◽  
Important Means ◽  
Armed Violence ◽  
Goals And Objectives ◽  
At Home

The armed violence of many radical Islamic movements is one of the most important means to achieve the goals and objectives of these movements. These movements have legitimized and legitimized these violent practices and constructed justification ideologies in order to justify their use for them both at home against governments or against the other Religiously, intellectually and even culturally, or abroad against countries that call them the term "unbelievers", especially the United States of America.

Can India Balance China in Asia?

2017 ◽  
Author(s):  
Jonathan Holslag
Keyword(s):  
United States ◽  
Central Asia ◽  
Economic Reforms ◽  
The United States ◽  
The Other ◽  
Military Power ◽  
Regional Power ◽  
Political Fragmentation ◽  
Strong Interest ◽  
The One

The chapter argues that India has a strong interest to balance China and that the two Asian giants will not be able grow together without conflict. However, India will not be able to balance China’s rise. The chapter argues that India remains stuck between nonalignment and nonperformance. On the one hand, it resists the prospect of a new coalition that balances China from the maritime fringes of Eurasia, especially if that coalition is led by the United States. On the other hand, it has failed to strengthen its own capabilities. Its military power lags behind China’s, its efforts to reach out to both East and Central Asia have ended in disappointment, and its economic reforms have gone nowhere. As a result of that economic underachievement, India finds itself also torn between emotional nationalism and paralyzing political fragmentation, which, in turn, will further complicate its role as a regional power.

The Proximity of Other Skins

2019 ◽  
Author(s):  
Celine Parreñas Shimizu
Keyword(s):  
United States ◽  
South Korea ◽  
The United States ◽  
The Philippines ◽  
The Other ◽  
The West ◽  
Pain And Suffering ◽  
The Spectator ◽  
Existing Frames ◽  
The Voice

Transnational films representing intimacy and inequality disrupt and disgust Western spectators. When wounded bodies within poverty entangle with healthy wealthy bodies in sex, romance and care, fear and hatred combine with desire and fetishism. Works from the Philippines, South Korea, and independents from the United States and France may not be made for the West and may not make use of Hollywood traditions. Rather, they demand recognition for the knowledge they produce beyond our existing frames. They challenge us to go beyond passive consumption, or introspection of ourselves as spectators, for they represent new ways of world-making we cannot unsee, unhear, or unfeel. The spectator is redirected to go beyond the rapture of consuming the other to the rupture that arises from witnessing pain and suffering. Self-displacement is what proximity to intimate inequality in cinema ultimately compels and demands so as to establish an ethical way of relating to others. In undoing the spectator, the voice of the transnational filmmaker emerges. Not only do we need to listen to filmmakers from outside Hollywood who unflinchingly engage the inexpressibility of difference, we need to make room for critics and theorists who prioritize the subjectivities of others. When the demographics of filmmakers and film scholars are not as diverse as its spectators, films narrow our worldviews. To recognize our culpability in the denigration of others unleashes the power of cinema. The unbearability of stories we don’t want to watch and don’t want to feel must be borne.

Stress Testing to Assess Recovery from Extreme Events

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
M. John Plodinec
Keyword(s):  
Climate Change ◽  
United States ◽  
Financial Institutions ◽  
Extreme Events ◽  
Stress Testing ◽  
The United States ◽  
The Other ◽  
New Approach ◽  
Rapid Spread ◽  
Potential Benefits

Abstract Over the last decade, communities have become increasingly aware of the risks they face. They are threatened by natural disasters, which may be exacerbated by climate change and the movement of land masses. Growing globalization has made a pandemic due to the rapid spread of highly infectious diseases ever more likely. Societal discord breeds its own threats, not the least of which is the spread of radical ideologies giving rise to terrorism. The accelerating rate of technological change has bred its own social and economic risks. This widening spectrum of risk poses a difficult question to every community – how resilient will the community be to the extreme events it faces. In this paper, we present a new approach to answering that question. It is based on the stress testing of financial institutions required by regulators in the United States and elsewhere. It generalizes stress testing by expanding the concept of “capital” beyond finance to include the other “capitals” (e.g., human, social) possessed by a community. Through use of this approach, communities can determine which investments of its capitals are most likely to improve its resilience. We provide an example of using the approach, and discuss its potential benefits.

Industry Payments to Plastic Surgeons: What Has Changed Over the Last Six-Years Following Implementation of the Physician Payment Sunshine Act?

2021 ◽  
Author(s):  
Rowland W Pettit ◽  
Jordan Kaplan ◽  
Matthew M Delancy ◽  
Edward Reece ◽  
Sebastian Winocour ◽  
...  
Keyword(s):  
United States ◽  
User Interface ◽  
Stock Options ◽  
Data Interpretation ◽  
The United States ◽  
Inclusion Criteria ◽  
Physician Payment ◽  
The Past ◽  
To Receive ◽  
Open Payments

Abstract Background The Open Payments Program, as designated by the Physician Payments Sunshine Act is the single largest repository of industry payments made to licensed physicians within the United States. Though sizeable in its dataset, the database and user interface are limited in their ability to permit expansive data interpretation and summarization. Objectives We sought to comprehensively compare industry payments made to plastic surgeons with payments made to all surgeons and all physicians to elucidate industry relationships since implementation. Methods The Open Payments Database was queried between 2014 and 2019, and inclusion criteria were applied. These data were evaluated in aggregate and for yearly totals, payment type, and geographic distribution. Results 61,000,728 unique payments totaling $11,815,248,549 were identified over the six-year study period. 9,089 plastic surgeons, 121,151 surgeons, and 796,260 total physicians received these payments. Plastic surgeons annually received significantly less payment than all surgeons (p=0.0005). However, plastic surgeons did not receive significantly more payment than all physicians (p = 0.0840). Cash and cash equivalents proved to be the most common form of payment; Stock and stock options were least commonly transferred. Plastic surgeons in Tennessee received the most in payments between 2014-2019 (mean $ 76,420.75). California had the greatest number of plastic surgeons to receive payments (1,452 surgeons). Conclusions Plastic surgeons received more in industry payments than the average of all physicians but received less than all surgeons. The most common payment was cash transactions. Over the past six years, geographic trends in industry payments have remained stable.

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