Abstract
Background:
Political action committees (PACs) play a crucial role in the US political landscape, supporting legislative agendas for various professional groups. The Orthopaedic PAC, established by the American Association of Orthopaedic Surgeons, exemplifies this model by directing funds to influence healthcare policy in alignment with orthopaedic interests. However, more research is needed on the correlation between PAC contributions and legislative outcomes, specifically within health care.
Objective:
This study analyzed the Orthopaedic PAC's financial contributions over time, focusing on spending trends, geographic distribution, and partisan alignment to understand potential associations with healthcare legislative activity.
Methods:
We conducted a retrospective quantitative analysis of Orthopaedic PAC contributions using publicly available data from the Federal Election Commission from 1999 to 2022. Contributions exceeding $200 were analyzed to assess spending patterns by party affiliation, geographic distribution, and temporal trends. Descriptive statistics contextualized Orthopaedic PAC activity within the broader healthcare PAC landscape. Geographic information systems (GIS) mapping visualized regional variations, and JMP Pro statistical software was used for all analyses.
Results:
The Orthopaedic PAC's financial contributions have generally increased over time, with notable peaks during critical legislative cycles, such as the 2010 Affordable Care Act. Contributions generally favored Republican candidates, particularly in Texas, Alabama, and California. Geographic trends indicated concentrated support in the Southeast and Midwest regions. Comparative analyses showed that the Orthopaedic PAC outspent many other healthcare PACs, highlighting its strong financial engagement. However, no direct causative link between contributions and specific legislative outcomes could be established.
Conclusion:
This study highlights the Orthopaedic PAC's financial strategies and political alignment, underscoring its sustained engagement in healthcare policy advocacy. Although spending trends suggest a strategic response to legislative events, further research is needed to evaluate the direct impact of PAC contributions on policy outcomes.
Political action committees (PACs) have become integral to the American political landscape, serving as conduits for organizations to support legislative agendas that reflect their interests. Within health care, PACs linked to professional groups, including the American Association of Orthopaedic Surgeons (AAOS), play a particularly active role in advocating for policies that affect practice and patient care.1 The Orthopaedic PAC, established by the AAOS, exemplifies this model by representing orthopaedic surgeons' interests in health policy discussions and allocating resources to support candidates and legislation that align with their goals.2 However, although PACs contribute millions to political campaigns, there is limited data on whether these financial investments correlate with specific legislative outcomes, especially in health care.3 This gap in knowledge underscores the need for a data-driven analysis of the role PACs, such as the Orthopaedic PAC may play in shaping healthcare policy.
The substantial financial contributions made by healthcare PACs, including those from the Orthopaedic PAC, suggest an intent to impact healthcare policy. Yet, empirical evidence that links PAC contributions to actual policy changes remains sparse. In addition, although PACs are known for substantial contributions across election cycles, there is little research comparing the distribution, scale, and political alignment of contributions among different healthcare PACs.4 Examining how the Orthopaedic PAC allocates its resources over time and whether these contributions coincide with notable shifts in healthcare policy can provide insights into the strategic priorities that shape orthopaedic practice and patient care. This study aims to contribute to a broader understanding of PACs' roles within the healthcare legislative framework by focusing on these elements.
To address these gaps, this study investigates the Orthopaedic PAC's financial contributions, analyzing their potential association with legislative activity in health care. Specifically, we aimed to answer the following questions: (1) How do the Orthopaedic PAC's financial contributions compare in scale and political distribution to those of other healthcare PACs? (2) Is there a measurable association between the Orthopaedic PAC's contributions and legislative actions relevant to healthcare policy? (3) What patterns emerge in the Orthopaedic PAC's resource allocation across election cycles, and how might they reflect shifts in its strategic focus? Addressing these questions will offer a clearer view of the Orthopaedic PAC's involvement within the healthcare policy arena.5
Methods
This study employed a quantitative analysis approach to examine the financial activities of the Orthopaedic Political Action Committee (PAC) using data from the Federal Election Commission (FEC). Our primary data source was the FEC's publicly available database, from which we extracted contributions made by the Orthopaedic PAC to political candidates and organizations within specified election cycles. The analysis period spans from 1999 to 2024, allowing for broad coverage across multiple election cycles. However, the data from 2024 is incomplete and is not included in trend analyses.
Data Extraction and Preparation
Contribution data were systematically aggregated, focusing on financial transactions directed toward both House of Representatives and Senate candidates, delineated by state and year. Per FEC reporting requirements, contributions exceeding $200 within each 2-year election cycle were included, allowing for an analysis of spending patterns with particular attention to party alignment and evolving contribution amounts over time.
The study employed a retrospective observational design to assess the Orthopaedic PAC's financial influence. Descriptive statistics were used to quantify spending trends, including allocations to Democratic versus Republican candidates and total raised and spent funds over time. To contextualize the Orthopaedic PAC's activities within the broader landscape of healthcare PACs, we conducted comparative analyses with other health professional PACs—including those representing physician specialty societies (e.g., dermatology, neurosurgery), nursing organizations, and allied health groups such as physician assistants and physical therapists—evaluating their relative financial scale. Geographic Information Systems (GIS) software was employed to create color-coded maps, with log-transformed contributions visualized to show regional differences, providing a comprehensive view of the PAC's strategic focus across the U.S. JMP Pro statistical software (JMP, Version 17, SAS Institute Inc., Cary, NC) was used for all analyses.
Compliance and Ethical Considerations
This study adhered to the Enhancing the Quality and Transparency of Health Research (EQUATOR) guidelines, following ethical data handling and reporting standards. Given the public availability of the data, institutional review board approval was not required. The study design ensured the anonymity and confidentiality of the individuals and entities involved. No funding was received for this study.
Results
Financial Contributions and Spending Trends
From 2000 to 2022, the Orthopaedic PAC's financial contributions increased steadily, with notable peaks in the 2010 and 2012 election cycles. Contributions favored Republican candidates in most cycles, with the highest spending toward Republicans observed in 2012 at $1,260,500. By contrast, Democratic candidates received their most considerable contributions in 2010, totaling $613,300. The lowest spending for both parties occurred in 2000, with $137,843 directed to Democrats and $108,279 to Republicans (Figure 1).
Figure 1.
Grouped bar chart showing Orthopaedic PAC contributions to Democrats (blue) and Republicans (red) from 2000 to 2022, with peaks in 2010 and 2012, and a decline in contributions after 2012.
The overall upward trend in contributions continued from 2000 through 2012, with substantial increases in the 2004 and 2010 cycles. By 2010, the PAC's total spending reached $1,260,500 for Republicans and $490,000 for Democrats. Contributions remained elevated in 2012, with $1,260,500 to Republicans and $613,300 to Democrats.
After 2012, the data show a general decline in contributions, with the 2014 and 2016 cycles seeing reduced but stable spending levels. Contributions to both parties were lower in 2020 than prior peaks, with Republicans receiving $736,349 and Democrats receiving $448,500. By 2022, contributions slightly increased for both parties, with $580,000 directed toward Republicans and $593,500 toward Democrats.
The total funds raised by the PAC closely aligned with the total funds spent throughout the period, reflecting a high spending ratio across multiple cycles (Table 1). In 2010, the PAC raised $2,419,766 and spent $2,086,837, whereas in 2012, the total raised was $3,161,324, with $2,922,329 spent. From 2014 to 2022, there was a gradual reduction in total funds raised and spent, with $2,212,568 raised in 2022 and $2,382,501 paid in 2020 (Figure 2).
Table 1.
Ortho PAC Expenditures, for Each Sector by Year
| Years | Administrative | Campaign Expenses | Contributions | Fundraising | Media | Salaries | Transfers | Unclassifiable | All |
| 2001-2002 | $5,761.00 | . | $564,070.00 | $1,467.00 | . | . | . | . | $571,298.00 |
| 2003-2004 | $18,338.00 | . | $640,779.00 | . | . | . | $195,000.00 | . | $854,117.00 |
| 2005-2006 | $30,183.00 | . | $1,087,940.00 | . | . | . | $60,802.00 | . | $1,178,925.00 |
| 2007-2008 | $36,686.00 | . | $1,434,925.00 | $930.00 | . | $4,382.00 | . | $236,000.00 | $1,712,923.00 |
| 2009-2010 | $48,976.00 | . | $1,974,500.00 | $1,918.00 | . | . | . | . | $2,025,394.00 |
| 2011-2012 | $42,043.00 | . | $2,387,000.00 | $8,653.00 | $514,245.00 | . | $107,000.00 | $5,000.00 | $3,063,941.00 |
| 2013-2014 | $38,077.00 | $2,500.00 | $2,036,100.00 | $6,484.00 | . | $3,500.00 | . | $350.00 | $2,087,011.00 |
| 2015-2016 | $45,476.00 | $101,216.00 | $2,229,975.00 | $350.00 | $198,188.00 | . | . | $5,030.00 | $2,580,235.00 |
| 2017-2018 | $67,278.00 | . | $2,480,294.00 | . | $24,730.00 | . | . | $221,618.00 | $2,793,920.00 |
| 2019-2020 | $57,110.00 | . | $2,237,053.00 | . | $90,000.00 | $689.00 | . | . | $2,384,852.00 |
| 2021-2022 | $57,851.00 | . | $1,940,000.00 | . | $20,000.00 | . | . | $166,738.00 | $2,184,589.00 |
| 2023-2024 | $16,302.00 | . | $628,000.00 | . | . | . | . | $147.00 | $644,449.00 |
| All | $464,081.00 | $103,716.00 | $19,640,636.00 | $19,802.00 | $847,163.00 | $8,571.00 | $362,802.00 | $634,883.00 | $22,081,654.00 |
Figure 2.
This bar and line chart displays the total amount of funds raised (blue line) and total funds spent (orange bars) by the Orthopaedic PAC from 2000 to 2022. Percentage increases and decreases between election cycles are labeled above the bars. The data show consistent growth in both funds raised and spent up until 2012, followed by a general decline with minor fluctuations.
The 2024 data are incomplete and have not been included in the analysis.
Allocation of Funds by Geographic Region and Candidate Support
Senate
Figure 3 illustrates the Orthopaedic PAC's financial contributions to US Senate candidates from 1999 to 2024. This updated heat map uses a scaled representation of contributions, with red indicating donations to Republican candidates and blue representing support for Democratic candidates. The intensity of the color corresponds to the magnitude of financial contributions, providing a clearer depiction of regional and temporal trends over time.
Figure 3.
Heatmap showing total PAC contributions to Senate candidates (1999-2024). Red indicates Republican support, blue indicates Democratic support, with color intensity reflecting contribution magnitude. 2023-2024 data are incomplete.
Our analysis shows that Orthopaedic PAC contributions have become increasingly concentrated in Southern and Midwestern states, such as Texas, Alabama, and Kentucky, which exhibit consistently deep red shading, reflecting strong and sustained support for Republican candidates. This pattern intensifies in later election cycles, particularly between 2011 and 2020, indicating a strategic focus aligned with conservative healthcare policies.
Conversely, Democratic contributions remain concentrated in the Northeast and West Coast states, including New York, Massachusetts, and California, where blue shading is more consistent across cycles. However, Democratic contributions appear less geographically widespread compared with Republican allocations, suggesting a more targeted funding approach in these regions.
Notably, swing states, such as Arizona, Georgia, and Florida, demonstrate fluctuating shading between election cycles, reflecting a dynamic allocation strategy that shifts in response to political competitiveness. This pattern is particularly evident after 2016, where funding distributions appear more polarized, with Republican contributions intensifying in the Southeast and Democratic contributions remaining strong in select coastal states.
The latest election cycle (2023-2024) presents incomplete data, making it difficult to assess final trends. However, preliminary observations suggest a continued but evolving allocation strategy, with Republican contributions still dominant in the Southeast and parts of the Midwest, whereas Democratic funding remains visible in key strongholds like California and the Northeast. Further updates are needed to fully evaluate trends from this cycle.
House of Representatives
Figure 4 depicts Orthopaedic PAC contributions to candidates for the US House of Representatives from 1999 to 2024. The heat map follows a red-to-blue gradient, with red indicating Republican support and blue representing Democratic contributions. The intensity of the shading corresponds to the magnitude of contributions, illustrating regional and temporal shifts over time.
Figure 4.
Heatmap displaying total PAC contributions to House candidates (1999-2024). Red represents Republican contributions, blue represents Democratic contributions, with color intensity corresponding to funding levels. 2023-2024 data are incomplete.
The Orthopaedic PAC consistently allocated substantial financial resources to Republican candidates in Southern and Midwestern states, particularly South Carolina, Tennessee, Texas, and Ohio. A detailed breakdown of these expenditures, including contributions to candidates, administrative expenses, and fundraising, is provided in Table 2. Between 2004 and 2016, these regions exhibited deep red shading, reflecting strong and sustained financial support for conservative legislative agendas. This trend persists beyond 2016, with intensified Republican contributions observed in the Southeast and Midwest, particularly in Alabama, Kentucky, and Missouri.
Table 2.
Ortho PAC Detailed Expenditures, 2001-2024
| Detailed Expenditures | Total Expenditures | |
| Sum | % of Total | |
| Contributions to committees | $3,629,837.00 | 11.32 |
| Contributions to federal candidates | $13,267,896.00 | 11.32 |
| Miscellaneous administrative | $441,231.00 | 11.32 |
| Contributions to national parties | $2,111,000.00 | 10.38 |
| Contributions to joint fundraising committees | $412,000.00 | 6.60 |
| Contributions to state and local parties | $95,000.00 | 5.66 |
| Miscellaneous contributions | $124,903.00 | 5.66 |
| Fundraising fees | $12,450.00 | 4.72 |
| Unclassifiable | $629,533.00 | 4.72 |
| Administrative event expenses and food | $7850.00 | 2.83 |
| Contributions to state and local candidates | $0.00 | 2.83 |
| Fundraising events | $5602.00 | 2.83 |
| Salaries wages and benefits | $8571.00 | 2.83 |
| Transfers to national parties | $360,000.00 | 2.83 |
| Campaign mailings and materials | $98,716.00 | 1.89 |
| Fundraising consulting | $1750.00 | 1.89 |
| Miscellaneous media | $222,918.00 | 1.89 |
| Unclassifiable event expenses | $5350.00 | 1.89 |
| Web ads | $110,000.00 | 1.89 |
| Accountants compliance and legal services | $15,000.00 | 0.94 |
| Broadcast ads | $514,245.00 | 0.94 |
| Campaign events and activities | $5000.00 | 0.94 |
| Transfers to candidates | $802.00 | 0.94 |
| Transfers to committees | $2000.00 | 0.94 |
| All | $22,081,654.00 | 100.00 |
By contrast, Democratic contributions remain concentrated in the Northeast and West Coast states, including Massachusetts, Connecticut, and California, where blue shading is consistently present across multiple election cycles. However, compared with Republican allocations, Democratic contributions appear more limited in geographic scope, suggesting a more targeted funding strategy.
Swing states such as North Carolina, Florida, and Pennsylvania demonstrate notable fluctuations in shading intensity over time, indicating strategic shifts in funding allocation based on evolving political dynamics. These variations are especially evident post-2016, where contributions become more concentrated in competitive districts, reflecting an adaptive approach to changing electoral landscapes.
The most recent election cycle (2023-2024) presents incomplete data, limiting a full assessment of emerging trends. However, preliminary observations indicate continued Republican dominance in key Southeastern and Midwestern states, whereas Democratic support remains concentrated in historically blue strongholds. Future data updates will be necessary to confirm the final contribution patterns for this cycle.
Comparison of Political Contributions Among Health Professional PACs
The data in Figure 5 compare the Orthopaedic PAC's financial contributions with the average spending of other healthcare PACs from 1999 to 2022. Throughout this period, the Orthopaedic PAC consistently outspent the average contribution levels of other healthcare PACs, underscoring a strategic emphasis on significant political influence.
Figure 5.
Bar chart compares contributions from the Orthopaedic PAC (blue bars) to the average contributions of other healthcare PACs (gray bars) from 1999 to 2022. “Other healthcare PACs” include PACs affiliated with physician specialty societies (e.g., dermatology, neurosurgery), nursing organizations, and allied health professions such as physical therapy and physician assistants. Significant political events, such as the passage of the Affordable Care Act (ACA) and telehealth regulation during COVID-19, are highlighted. The chart shows steady increases in Orthopaedic PAC contributions with notable spikes during key healthcare legislative changes.
Notably, Orthopaedic PAC contributions experienced substantial growth during key legislative events, such as the Affordable Care Act (ACA) in 2009-2010 and telehealth regulation during the COVID-19 pandemic in 2019-2020. During the ACA's enactment, the Orthopaedic PAC allocated $1.49 million, an increase of 484% compared with earlier cycles, reflecting heightened engagement in shaping healthcare policy. The surge continued into the 2011-2012 cycle, peaking at $1.76 million, representing a 780% increase from initial spending.
By contrast, the average contributions from other healthcare PACs remained significantly lower and fluctuated less over time. This trend highlights the Orthopaedic PAC's proactive and robust financial commitment, particularly during periods of major healthcare reform. The overall spending trajectory showcases the PAC's focused and sustained efforts to influence policy decisions that impact orthopaedic surgery and healthcare delivery.
The Orthopaedic PAC and other healthcare PACs exhibit distinct preferences for political candidates based on their ideological leanings. Contributions are notably concentrated among candidates with apparent party affiliations, as detailed in Table 2. The Orthopaedic PAC prefers Republican or conservative-leaning candidates, with substantial support also directed at candidates perceived as neutral or “on the fence.” This distribution pattern suggests a strategic approach, allocating resources where potential policy impacts may be most significant. Other healthcare PACs, meanwhile, display a more balanced distribution, with allocations spread across various ideological positions, reflecting a broader influence strategy. This divergence highlights differing priorities and approaches to engaging with policymakers across the healthcare landscape.
Discussion
Financial Impact
Our analysis demonstrates strategic variations in the Orthopaedic PAC's financial contributions across election cycles, possibly reflecting shifts in political priorities or adaptations to the broader political landscape. Over the years, the PAC's financial support has generally increased, with marked peaks during specific election periods and a tendency to favor Republican candidates. This pattern suggests a deliberate approach to support legislative agendas relevant to the orthopaedic community.2,6,7
The PAC's contributions remained substantial even during the COVID-19 pandemic, with more than $3 million raised in 2021, supported by strategic fundraising and donor engagement. This robust financial base continued into 2022, indicating sustained support within the orthopaedic field.8-16
Various studies have explored how political funding influences election outcomes, with some types of PAC expenditures correlated with legislative success.17,18 For instance, contributions during specific years align with policy discussions on healthcare pricing and integration, pertinent to orthopaedic practice's operational and clinical aspects. Similarly, recent healthcare trends, such as value-based care, coincide with areas in which the PAC has demonstrated interest, potentially influencing reimbursement strategies and practice management in orthopaedics.8-16
Legislative Considerations
The Orthopaedic PAC's expenditure patterns appear responsive to critical legislative and regulatory changes within the healthcare sector. Its financial strategies, evident in shifts in contributions and campaign expenditures, reflect an ongoing engagement with liability, reimbursement, and broader healthcare reforms. For example, administrative costs rose in the early 2000s, potentially in response to medical liability reform discussions. Similarly, the passage of the Affordable Care Act (ACA) in 2010, a major healthcare policy shift, coincided with increased PAC contributions and campaign spending, possibly reflecting an alignment with key healthcare reforms.
The Orthopaedic PAC's spending also appears responsive to emerging health issues. During the opioid crisis, for instance, investments were made in media campaigns focusing on public awareness around pain management, which aligns with evolving regulatory priorities. Similarly, during the COVID-19 pandemic, the PAC directed resources toward advocating for permanent telehealth regulations to address shifting healthcare delivery needs. These sustained expenditures in both political contributions and operational costs highlight the PAC's strategic approach to supporting policies that intersect with orthopaedic practice while adapting to changes in the healthcare landscape.
Geographic Influence
Our data collectively illustrate the Orthopaedic PAC's strategic financial involvement in US electoral politics, showing a general preference for Republican candidates in Congressional elections but with variations over time that reflect shifts in political landscapes and strategic priorities. The data suggest a complex approach to political contributions, with geographic and partisan considerations influencing the PAC's distribution of funds across different election cycles. When looking at contributions to House of Representatives candidates, contributions were more balanced across states. Still, later cycles show a trend toward more significant, concentrated contributions in specific states, indicating a strategic shift in the PAC's focus. Particularly from 2011 to 2014 onward, there is a noticeable broadening in the strategic focus, with significant contributions in the Southeast and Midwest regions, suggesting a sustained interest in these areas. When looking at the Orthopaedic PAC's contributions to Senate candidates, these data reveal widespread contributions across the country, showcasing clear geographic patterns of political support. Over time, there is a noticeable trend toward more notable contributions in certain states, indicating strategic adjustments by the PAC. States such as Texas, California, and New York consistently receive more substantial contributions, highlighting their political importance. The 2021-2022 cycle, in particular, shows a solid Republican leaning in contributions.
The geographic distribution of contributions from the Orthopaedic PAC markedly impacts political influence at the federal level. The PAC has a strong presence in Washington, DC, advocating for orthopaedic patients and the profession.1 Our data demonstrate the Orthopaedic PAC's apparent rise in political involvement, with a shift toward Republican committees, a finding echoed by Jarvis et al2 However, the influence of PACs is not solely based on financial contributions, as it also involves ongoing, implicit, reciprocal exchanges that impact the legislative process.3
Our study provides insights into the political behavior of health professional PACs, showing how their contribution patterns change over time and highlighting periods of heightened activity. The upward contribution trend over the years for some PACs reflects a growing political engagement among health professionals. This influence is underscored by the Orthopaedic PAC's substantial fiscal impact and participation compared with other physician-based lobbyist organizations.
The geographic distribution of contributions from the Orthopaedic PAC can impact political influence at the federal level through its association with disparities in PAC services, the sustainability of political engagement, competition among pressure groups, and the composition of orthopaedic professionals. Understanding these dynamics is crucial for comprehensively assessing the influence of geographic factors on political engagement and influence at the federal level.
Limitations
This study provides an overview of the Orthopaedic PAC's financial activities, yet several limitations should be noted. First, our reliance on Federal Election Commission (FEC) data, which is self-reported by PACs, may introduce potential inaccuracies in recorded contribution amounts and recipient details. This reliance on self-reported data limits the study's ability to verify all contributions and expenditures independently. In addition, FEC data exclude contributions under $200, which may underestimate the Orthopaedic PAC's total financial engagement, particularly in cases where smaller contributions could accumulate to influence legislative outcomes.
The analysis also focuses on quantitative financial contributions, thus excluding qualitative forms of political influence, such as lobbying, direct advocacy, or informal relationships and communications between PAC members and policymakers. These forms of influence may play a significant role in policy advocacy but are not easily captured by quantitative data. Furthermore, the 2024 data were incomplete at the time of analysis and, as a result, were not included in this study. This gap may affect the completeness of recent trend observations and limits our ability to assess fully the Orthopaedic PAC's most current contributions.
Moreover, this study's retrospective design limits our capacity to draw direct causal links between PAC contributions and specific legislative outcomes. Although the analysis highlights trends in spending patterns and geographic and partisan preferences, it cannot conclusively demonstrate that financial contributions from the Orthopaedic PAC directly influenced any particular policy or legislative decision. This limitation underscores the challenge of attributing legislative impacts solely to monetary donations, as policy outcomes are often shaped by a complex array of factors, including lobbying efforts, public opinion, and broader political forces. Future studies with longitudinal designs may help clarify temporal relationships between PAC activities and legislative developments, offering more robust insights into the possible connections between contributions and policy changes over time.
To provide a more comprehensive understanding of PAC influence, future studies could also benefit from mixed-method approaches, integrating qualitative data collection to capture lobbying activities and other forms of advocacy not reflected in FEC data. In addition, broader data sources and more granular analyses could offer insights into smaller-scale contributions, personal interactions, and the impact of nonfinancial engagements, adding depth to our understanding of how PACs interact with the political process.
Conclusion
This study analyses the Orthopaedic PAC's financial contributions within the US political landscape, highlighting observed geographic and partisan distribution patterns across election cycles. In particular, regional variations in spending appear to reflect the dominant political affiliations of recipients in each state, suggesting a geographically adaptive funding strategy. Our findings reveal that the PAC's contributions generally favor Republican candidates, with spending peaks aligning with specific legislative periods. However, this study cannot establish a direct influence of these contributions on particular policy outcomes. By examining FEC data from multiple election cycles, the PAC's strategic allocations reflect a sustained engagement with issues relevant to orthopaedic surgeons and healthcare policy more broadly.
These findings contribute to understanding financial contributions' role in political advocacy for the orthopaedic community, showing how targeted political funding can align with healthcare legislative cycles. This analysis offers a perspective on how professional organizations like the Orthopaedic PAC participate in the legislative process, underscoring the importance of further research into how such contributions may impact policy over time. Future studies could expand on this work by investigating the potential relationships between PAC contributions and specific policy changes, contributing valuable insights to the broader field of healthcare advocacy and policy development.
Acknowledgments
The authors thank John Axelrod for his political consultation and assistance in developing the conceptual framework for this study.
Footnotes
None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Nadarajah, Dr. Barnes, Dr. Belding, Dr. Nwankwo, Dr. Stephens, Dr. Chhabra, and Dr. Deasey.
All authors have significantly contributed to the conception, design, data analysis, interpretation, drafting, and/or critical revision of this manuscript.
Contributor Information
Vidushan Nadarajah, Email: VNadarajah.MD@gmail.com.
Miranda Barnes, Email: miranda.barnes2022@gmail.com.
Jonathan Belding, Email: jonbelding@gmail.com.
Basilia O. Nwankwo, Email: basilianwankwomd@gmail.com.
Susan E. Stephens, Email: drsstephens@theinstituteforspine.com.
A. Bobby Chhabra, Email: ac2h@uvahealth.org.
Matthew J. Deasey, Email: mjd7c@uvahealth.org.
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