Practice patterns of academic general thoracic and adult cardiac surgeons.
OBJECTIVE
We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform.


METHODS
We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions.


RESULTS
The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P<.001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P<.001), only 2.5% of the total wRVUs generated by CSs were from E & M codes versus 18.8% for GTSs. Critical care codes were 1.5% of total evaluation and management billing for both CSs and GTSs.


CONCLUSIONS
Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization.
Section of General Thoracic Surgery, University of California Davis Medical Center, Sacramento, Calif.
Michael T
MT
Ingram
Department of Surgery, University of California Davis Medical Center, Sacramento, Calif.
David H
DH
Wisner
Section of General Thoracic Surgery, University of California Davis Medical Center, Sacramento, Calif; Department of Surgery, University of California Davis Medical Center, Sacramento, Calif. Electronic address: david.cooke@ucdavis.ucdmc.edu.
David T
DT
Cooke
D000046:Academic Medical Centers; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000193:education / Q000706:statistics & numerical data; D016208:Databases, Factual; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000193:education / Q000706:statistics & numerical data*; D014481:United States