Industry Payments and Sentiments Toward Robotic Surgery Among US Physicians.

Abstract

Importance: Given the rapid adoption of robotic surgery and its association with substantial industry payments, objective documentation of physicians' perceptions toward robotic surgery is important.

Objective: To assess US-based physicians' sentiments toward robotic surgery and whether industry payments are associated with their perceptions.

Design, setting, and participants: This cohort study analyzed publicly available posts made from March 19, 2009, to April 1, 2024, by 268 US-based physicians who followed the Society of American Gastrointestinal and Endoscopic Surgeons on X (formerly Twitter). Trainees and individuals without validated clinical practices were excluded. Physicians' specialties were confirmed using the National Provider Identifier Registry.

Exposure: Payments from Intuitive Surgical Inc, a biotechnology company that manufactures robotic products for use in surgery, were identified via the Open Payments website. Among the physicians, 177 (66.0%) received payments and 91 (34.0%) did not.

Main outcomes and measures: Polarity and subjectivity scores of social media posts shared by physicians. Polarity was scored from -1 to 1, with higher scores reflecting more positive sentiment, lower scores reflecting more negative sentiment, and 0 indicating neutrality. Subjectivity was scored from 0 to 1, with higher scores reflecting more subjective opinions and lower scores reflecting objective facts.

Results: This study comprised 268 physicians (154 men [57.5%], 68 women [25.4%], and 46 physicians [17.2%] with sex not reported; 113 general surgeons [42.2%] and 155 physicians in surgical subspecialties [57.8%]). The overall sentiment scores ranged from -0.25 to 0.5 (mean [SD] score, 0.1 [0.2]; 95% CI, 0.09-0.13) and subjectivity scores ranged from 0 to 0.9 (mean [SD] score, 0.4 [0.2]; 95% CI, 0.38-0.41), suggesting that posts were relatively objective with occasional personal insights. No significant difference was seen in mean polarity scores between the 177 physicians who received payments and the 91 physicians who did not (mean [SD] score, 0.12 [0.2]; 95% CI, 0.09-0.14 vs 0.1 [0.2]; 95% CI, 0.07-0.14). Physicians posting before and after receiving industry payments showed consistent positive sentiments (median polarity, 0.1 [IQR, 0.03-0.21]) and decreased subjectivity after receiving payment. Physicians in the top 25% of payment distribution had more positive sentiments and increased subjectivity after receiving payments, whereas those in the bottom 75% showed little change.

Conclusions and relevance: In this cohort study of US-based physicians, publicly available social media data were used to quantify perceptions of robotic surgery. These findings demonstrate the potential of such data to inform health care practices, guide balanced information dissemination, and uphold the integrity of health information shared by physicians.