title: Estimating the effects of informal radiology resident teaching on radiologist productivity: what is the cost of teaching?
abstract: OBJECTIVE
  One mission of an academic radiology department is to teach. The greatest teaching effort is directed at radiology residents. As clinical work demands increase, informal, non-revenue-generating, teaching may suffer. We sought to determine the economic consequences of teaching.
  
  
  METHODS
  With the use of a picture archiving and communications system, 6 radiology faculty members independently interpreted and dictated digitally acquired bone and chest radiographs for 1 hour alone and again 10-12 weeks later with a first-year resident. During the second session, the quality of teaching was graded by independent observers. The number of cases, relative value units (RVUs), and reimbursement for each session were calculated.
  
  
  RESULTS
  The difference in number of cases dictated working alone (mean, 44.7) and with a first-year resident (mean, 23.5) was significant (P = 0.007). The difference between RVUs generated by faculty alone (mean, 9.0) and with a resident (mean, 4.5) also was significant (P = 0.006), and the difference in dollars billed when working alone (mean, $1558.45) and with a resident (mean, $777.65) was significant (P = 0.007). As teaching quality increased, the number of cases interpreted, dollars billed, and RVUs trended lower.
  
  
  CONCLUSIONS
  Informal resident teaching significantly reduces clinical throughput, reducing examination volume, RVUs, and dollars billed by approximately half.
authors.affiliation: Department of Radiology, University Hospitals, University of Michigan Medical Center, 1500 East Medical Center Drive, TC 2910, Ann Arbor, MI 48109, USA. djamadar@umich.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Jamadar
authors.forename: Ruth
authors.initials: R
authors.lastname: Carlos
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Caoili
authors.forename: Perry G
authors.initials: PG
authors.lastname: Pernicano
authors.forename: Jon A
authors.initials: JA
authors.lastname: Jacobson
authors.forename: Smita
authors.initials: S
authors.lastname: Patel
authors.forename: Mitra
authors.initials: M
authors.lastname: Noroozian
authors.forename: Qian
authors.initials: Q
authors.lastname: Dong
authors.forename: Janet E
authors.initials: JE
authors.lastname: Bailey
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Patterson
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Klein
authors.forename: James D
authors.initials: JD
authors.lastname: Good
authors.forename: Ella A
authors.initials: EA
authors.lastname: Kazerooni
authors.forename: N Reed
authors.initials: NR
authors.lastname: Dunnick
mesh_terms: D001842:Bone and Bones / Q000000981:diagnostic imaging; D003365:Costs and Cost Analysis; D017598:Efficiency, Organizational / Q000191:economics; D005180:Faculty, Medical; D006801:Humans; D007396:Internship and Residency / Q000191:economics*; D013902:Radiography, Thoracic; D011871:Radiology / Q000191:economics / Q000193:education*; D011873:Radiology Information Systems; D012051:Reimbursement Mechanisms; D015895:Relative Value Scales; D013663:Teaching / Q000191:economics*