Behind the wall of industry payments: An individual factor analysis of gender disparities in consulting fees and royalties to U.S. cardiothoracic surgeons.

BACKGROUND: Less is known about gender-based differences in industry-sponsored payments within cardiothoracic surgery. We evaluated the magnitude and drivers of these disparities in the United States. METHODS: A retrospective cross-sectional analysis was conducted from the 2023 Centers for Medicare & Medicaid Services Open Payments Database, including consulting fees and royalty payments. RESULTS: Among 468 payments totaling $9,384,973, men received 91.2% ($8,618,735) and women 8.8% ($766,238) of total payments. Men received higher median consulting payments than women ($6536 vs. $6000; p = 0.004). Women were more likely to be early/mid-career, more represented in thoracic surgery (56.1% vs 35.8%), and less likely to hold chief positions (7% vs 27%) or have >10 years of practice (51% vs 82%), all p < 0.0.5. In univariate analysis, >10 years in practice was associated with higher payments. CONCLUSION: Significant gender disparities persist and appears to be a multifactorial issue drive by inequities in leadership and seniority.