Gender Differences in Clinical Practice and Medicare Reimbursement Among Mohs Surgeons

Motosko, Catherine C.; Waldman, Abigail; Stevenson, Mary L.; Council, M. Laurin

doi:10.1097/dss.0000000000003743

Cited by 4 publications

(7 citation statements)

References 15 publications

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“…13 Mohs micrographic surgery in particular has been historically noted as a more male-dominant field. 14 There were roughly equal females and males in the top 10th percentile of payments; however, male pediatric dermatologists were still receiving higher monetary compensation. Twenty percent of males made it to the top 10th percentile compared to only 7% of females.…”

Section: Discussionmentioning

confidence: 99%

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The distribution of industry payments among pediatric dermatologists from 2015 to 2021

Ravipati,

Pradeep,

Elman

2023

Pediatric Dermatology

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Background/ObjectivesTo understand the landscape of industry payments to pediatric dermatologists to foster transparency and identify potential disparities in funding.MethodsUsing the Centers for Medicare and Medicaid Services (CMS) Open Payments database, a national cross‐sectional study was performed examining payments to pediatric dermatologists from 2015 to 2021.ResultsOf the 147 pediatric dermatologists who received industry funding, 35 were male and 112 were female. $9 million in payments was amassed, with 10% of pediatric dermatologists accounting for 94% of total industry payments. Consulting was the most common service, with Pfizer Inc., Amgen Inc., and Regeneron Healthcare Solutions Inc. representing the top three companies. Mean payment was $143,836 for males and $35,943 for females (p < .001). Eight female and seven male pediatric dermatologists received payments in the top 10th percentile, with different average payment in this subgroup (females $447,588 vs. males $698,746, p = .03). 11 states did not have a pediatric dermatologist receiving industry payments, while California (19) and Texas (12) had the most.ConclusionsThere are approximately 400 board‐certified pediatric dermatologists in the United States and fewer than 40% are receiving monetary compensation from private industry. A fraction of physicians accounted for a majority of total industry payments and industry payments to male pediatric dermatologists were higher despite nearly triple the number of female pediatric dermatologists. With the rise of valuable partnerships between healthcare and industry in modern medicine, the implications of geographic, gender, and financial disparity of industry payments in pediatric dermatology are worthy of further study.

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Section: Discussionmentioning

confidence: 99%

“…This contrasts with dermatology as a whole, which has exhibited more male than female physicians in various settings 13 . Mohs micrographic surgery in particular has been historically noted as a more male‐dominant field 14 …”

Section: Discussionmentioning

confidence: 99%

The distribution of industry payments among pediatric dermatologists from 2015 to 2021

Ravipati,

Pradeep,

Elman

2023

Pediatric Dermatology

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“…Not only do women make up only 28.1% of the Mohs micrographic surgery workforce, but they also are not well represented in industry relationships. 2,3 When women decide to collaborate with industry, their cumulative mean payments received are significantly lower than those of male Mohs surgeons (Table 1). On further data analysis, this gender disparity is dependent on the type of industry relationship and practice region, which is reassuring because only a few were statistically significant (Table 1, Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…1 In Mohs micrographic surgery, there is significant gender discrepancy with women representing only 28.1% of the Mohs workforce. 2 Furthermore, women have been found to receive less mean total annual Medicare reimbursement payments for Mohs micrographic surgery compared with their male colleagues. 2 Industry relationships in Mohs surgery, including in female Mohs surgeons, has not been explored in the literature.…”

mentioning

confidence: 99%

“…2 Furthermore, women have been found to receive less mean total annual Medicare reimbursement payments for Mohs micrographic surgery compared with their male colleagues. 2 Industry relationships in Mohs surgery, including in female Mohs surgeons, has not been explored in the literature. Because of gender disparities in Mohs micrographic surgery, we sought to compare industry payments between female and male Mohs surgeons.…”

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confidence: 99%

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Industry Payments Comparison Between Female and Male Mohs Surgeons From 2015 to 2021

Rosales Santillan,

Guzman,

Waldman

2023

Dermatol Surg

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BACKGROUND There are limited data on female Mohs surgeon industry relationships. OBJECTIVE To evaluate industry payment activity between female and male Mohs surgeons. MATERIALS AND METHODS A retrospective review of the U.S. Centers for Medicare and Medicaid Services open payments data was performed between 2015 and 2021 for Mohs surgeons in the United States. Gender, academic affiliation, practice region, annual total payment, cumulative payment, and industry payment type was collected. RESULTS Male Mohs surgeons received higher mean total payments than female Mohs surgeons (p = .04), which persisted when data were stratified based on industry payment type and practice region. Both genders had similar median total payments (p = .4). Females in academic practice received higher mean total payments than those in private practice. Females experienced a significant lower mean total payment compared with males in the South (p = .03). CONCLUSION High total payments received by male Mohs surgeons skewed the data, which is supported by a significant mean total payment difference despite a similar median total payment distribution. Female Mohs surgeons receiving the top payments may address this mean payment difference. Females seem to have higher payments if they practice in the Northeast and are in academics. Further studies are needed to evaluate this payment gap.

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Trends in Gender Representation and Impact of Practice Setting on Productivity and Reimbursement Gap for Female Mohs Micrographic Surgery Physicians: A Cross-sectional Study

Sakunchotpanit,

Trepanowski,

Awerman

et al. 2024

Dermatol Surg

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BACKGROUND Mohs micrographic surgery (MMS) is a male-predominant dermatologic subspecialty. The impact of practice setting and gender composition on the productivity and reimbursement of female MMS surgeons has not been thoroughly examined. OBJECTIVE To determine changes in female representation, productivity, and Medicare reimbursement across practice types. MATERIALS AND METHODS Retrospective cross-sectional analysis of Centers for Medicare and Medicaid Services database for Medicare Part B claims during pre–COVID-19 (2013–2019) and post–COVID-19 (2019–2022) pandemic. RESULTS From 2013 to 2019, the number of MMS surgeons billing Medicare increased by 22% from 2,135 to 2,605, with proportion of female physicians increased by only 4% (28% to 32%, p = .012). In 2019, female MMS surgeons performed fewer total cases and earned less payments than male counterparts across all practice settings. Productivity and reimbursement gaps, as compared to national median values for male MMS surgeons, were highest for female MMS surgeons working in mixed-gender practices (39% and 39%) and lowest in single-surgeon practices (17% and 27%). All-female multisurgeon practices saw the greatest improvement in both productivity and reimbursement gaps (55% to 25% and 47% to 29%, respectively). From 2019 to 2022, case volume decreased across all practice types, reflecting a significant COVID-19 impact on MMS services. CONCLUSION Proportion of female MMS surgeons nationwide increased very slightly between 2013 and 2022. However, productivity and reimbursement gaps remained significant and varied across practice settings.

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Gender Differences in Clinical Practice and Medicare Reimbursement Among Mohs Surgeons

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 4 publications

References 15 publications

The distribution of industry payments among pediatric dermatologists from 2015 to 2021

The distribution of industry payments among pediatric dermatologists from 2015 to 2021

Industry Payments Comparison Between Female and Male Mohs Surgeons From 2015 to 2021

Trends in Gender Representation and Impact of Practice Setting on Productivity and Reimbursement Gap for Female Mohs Micrographic Surgery Physicians: A Cross-sectional Study

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