title: Measuring physicians' productivity: a three-year study to evaluate a new remuneration system.
abstract: OBJECTIVE
  To evaluate a new assessment tool measuring physicians' academic productivity and its use in a performance-based remuneration system.
  
  
  METHODS
  The authors developed an assessment tool based on existing tools to measure productivity. Yearly, from 2008 to 2011, physicians at the University of Western Ontario received a score of up to three points for each of four components (impact, application, scholarly activity, mentorship) in each of four domains (clinical practice, education, research, administration). Scores were weighted by the percentage of time physicians spent on tasks in each domain. Year 1 scores were a baseline. In Years 2 and 3, scores were tied to remuneration. The authors compared scores and associations, accounting for age and academic rank, across the three years.
  
  
  RESULTS
  The 37 participating physicians included 11 assistant, 23 associate, and 4 full professors. The mean weighted total baseline score across all four domains was 7.44. Years 2 and 3 scores were highly correlated with Year 1 scores (r = 0.85, Years 1 and 2; r = 0.89, Years 1 and 3). Year 2 mean weighted scores did not differ significantly from Year 1 scores. Assistant professors' scores improved significantly between Years 1 and 2 (+1.08, P < .001). Lower Year 1 scores were correlated with a greater improvement in scores between Years 1 and 2, and age was negatively correlated with score changes between Years 2 and 3.
  
  
  CONCLUSIONS
  Although the tool may be a robust measurement of physicians' productivity, performance-based remuneration had no effect on physicians' overall performance.
authors.affiliation: Dr. Filler is professor and chair, Department of Pediatrics, University of Western Ontario, and chief, Children's Hospital, London Health Science Centre, London, Ontario, Canada. Dr. Burkoski is vice president/chief nursing executive, Quality, Patient Safety, and Professional Practice, London Health Science Centre, London, Ontario, Canada. Dr. Tithecott is assistant professor, Department of Pediatrics, and associate dean of undergraduate medical education, University of Western Ontario, London, Ontario, Canada.
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.forename: Vanessa
authors.initials: V
authors.lastname: Burkoski
authors.forename: Gary
authors.initials: G
authors.lastname: Tithecott
mesh_terms: D000328:Adult; D004526:Efficiency; D004650:Employee Performance Appraisal / Q000379:methods*; D005180:Faculty, Medical; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D009864:Ontario; D010816:Physician Incentive Plans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012456:Salaries and Fringe Benefits / Q000191:economics*