title: Improving clinical productivity in an academic surgical practice through transparency.
abstract: BACKGROUND
  Patient care revenue is becoming an increasingly important source of funding to support the academic surgery department missions of research and education. Transparency regarding productivity metrics will improve clinical productivity among members of an academic surgical practice.
  
  
  METHODS
  Clinical productivity-related data were collected and compared between 2 time periods. Data were stratified by pretransparency and post-transparency time periods. Comparisons were made using the Wilcoxon-Mann-Whitney test, and p values ≤0.05 were considered significant.
  
  
  RESULTS
  The faculty compensation plan remained the same across both time periods; faculty members were paid a base salary plus practice plan income based on individual collections minus practice overhead and academic program support taxes. Before 2006, clinical productivity data were not made public among faculty members. In 2006, the departmental leadership developed a physician scorecard that led to transparency with regard to productivity. After publication of the scorecard, clinical productivity increased, as did the number of partners producing a threshold number of work relative value units (RVU) (6,415 wRVU = 1.0 full time equivalent [FTE]). This occurred during a time of reduced collections per RVU. There was no change in the work assignments (percent effort for clinical service, research, and teaching) for the physicians between the 2 time periods, or the overall effort assigned to the Veterans Affairs hospital.
  
  
  CONCLUSIONS
  Clinical productivity can be improved by making productivity metrics transparent among faculty members. Additional measures must be taken to ensure that research and teaching activities are appropriately incentivized.
authors.affiliation: Hiram C Polk Jr, MD Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA. charles.scoggins@louisville.edu
authors.forename: Charles R
authors.initials: CR
authors.lastname: Scoggins
authors.forename: Timothy
authors.initials: T
authors.lastname: Crockett
authors.forename: Lex
authors.initials: L
authors.lastname: Wafford
authors.forename: Robert M
authors.initials: RM
authors.lastname: Cannon
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D019985:Benchmarking / Q000379:methods*; D030881:Disclosure; D004526:Efficiency; D005180:Faculty, Medical / Q000458:organization & administration*; D006801:Humans; D010816:Physician Incentive Plans / Q000458:organization & administration; D015397:Program Evaluation; D015895:Relative Value Scales; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000458:organization & administration*