title: The differential impact of plastic surgery subspecialties on the financial performance of an academic clinical practice.
abstract: BACKGROUND
  In an academic center, plastic surgery provides multiple important and distinct services. Limited data exist on how each service affects a department clinically and financially.
  
  
  METHODS
  All new patient consultations and surgical cases between 2004 and 2012 were reviewed. Conversion rates from consultation to surgery and relative value units were calculated. Professional and facility revenues, costs, and net income were ascertained. These measures were compared between different subspecialties.
  
  
  RESULTS
  A total of 12,020 new patient consultations and 5741 surgical cases were reviewed. Total growth in consultations was greatest for breast reconstruction (396.8 percent), followed by aesthetic (83.8 percent), oncology (12.9 percent), general (-16.9 percent), and burn/trauma (-75.0 percent). The conversion rate from consultation to surgery was highest in breast reconstruction (57.0 ± 3.1 percent) and oncology (56.9 ± 6.6 percent), followed by burn/trauma (47.0 ± 6.8 percent), general (46.1 ± 3.5 percent), and aesthetic (37.0 ± 4.8 percent). Total growth in professional net income was greatest for breast reconstruction (1241.4 percent), followed by oncology (378.4 percent), general (159.7 percent), aesthetic (130.5 percent), and burn/trauma (-20.9 percent). Total growth in facility net income was greatest for breast reconstruction (7619.5 percent), followed by oncology (2648.0 percent), aesthetic (432.3 percent), general (283.3 percent), and burn/trauma (108.7 percent).
  
  
  CONCLUSIONS
  Breast reconstruction exhibited the greatest growth in consultations, and oncologic consultations demonstrated the highest consultation-to-surgery conversion rate. The higher consultation volume and conversion rate associated with breast reconstruction resulted in greater financial gains for both the department and the hospital. These findings may be of utility in the development of academic plastic surgery programs.
authors.affiliation: Columbus, Ohio From the Department of Plastic Surgery, The Ohio State University Plastic Surgery, LLC, and the Arthur G. James Cancer Hospital, The Ohio State University.
authors.forename: Albert H
authors.initials: AH
authors.lastname: Chao
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Khansa
authors.forename: Christopher
authors.initials: C
authors.lastname: Kaiser
authors.forename: Julian
authors.initials: J
authors.lastname: Bell
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Miller
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D001943:Breast Neoplasms / Q000191:economics / Q000601:surgery; D002056:Burns / Q000191:economics / Q000601:surgery; D005260:Female; D006785:Hospitals, University / Q000191:economics; D006801:Humans; D007182:Income; D016462:Mammaplasty / Q000191:economics; D009820:Ohio; D019651:Plastic Surgery Procedures / Q000191:economics*; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000191:economics; D013518:Surgery, Plastic / Q000145:classification / Q000191:economics*