title: Activities and Compensation of Advanced Heart Failure Specialists: Results of the Heart Failure Society of America (HFSA) Survey.
abstract: BACKGROUND
  In the current era, where advanced heart failure (AHF) has become an American Board of Internal Medicine-certified subspecialty, new data are needed to benchmark and value levels of clinical effort performed by AHF specialists (AHFMDs).
  
  
  RESULTS
  A 36-question survey was sent to 728 AHFMDs, members of the Heart Failure Society of America, and 224 (31%) responded. Overall, 56% worked in academic medical centers (AMCs) and were younger (48 ± 9 y vs 52 ± 10 y; P < .01) and were represented by a higher proportion of women (34% vs 21%, P < .01) compared with non-AMCs. The percentage of time in clinical care was lower in AMCs (64 ± 19% vs 78 ± 18%; P = .002), with similar concentration on evaluation and management services (79 ± 18% in AMCs vs 72 ± 18 % in non-AMCs; P = NS). The majority of nonclinical time was spent in program administration (10% in both AMCs and non-AMCs) and education/research (15% in AMC vs 5% in non-AMCs). Although 69% of respondents were compensated by work-relative value units (wRVUs), only a small percentage knew their target or the amount of RVUs generated. The mean annual wRVUs generated were lower in AMCs compared to non-AMCs (5,452 ± 1,961 vs 9,071 ± 3,484; P < .001). The annual compensation in AMCs was lower than in non-AMCs (45% vs 10% <$250,000 and 17% vs 61% >$350,000; P < .001) and the satisfaction with compensation was higher in non-AMCs.
  
  
  CONCLUSIONS
  AHFMDs' compensation is largely dependent by practice type (AMC vs non-AMC) and clinical productivity as measured by wRVUs. These data provide an opportunity for benchmarking work effort and compensation for AHFMDs, allowing distinction from segments of cardiologists with greater opportunity to accrue procedural wRVUs. They also show several differences between AMCs and non-AMCs that should be considered when formulating work assignment and compensation for AHFMDs.
authors.affiliation: University of California, San Francisco, California. Electronic address: liviu.klein@ucsf.edu.
authors.forename: Liviu
authors.initials: L
authors.lastname: Klein
authors.affiliation: University of California, San Diego, California.
authors.forename: Barry H
authors.initials: BH
authors.lastname: Greenberg
authors.affiliation: Tufts University Medical Center, Boston, Massachusetts.
authors.forename: Marvin A
authors.initials: MA
authors.lastname: Konstam
authors.affiliation: Cardiovascular Clinical Studies, Boston, Massachusetts.
authors.forename: Douglas
authors.initials: D
authors.lastname: Gregory
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Robb D
authors.initials: RD
authors.lastname: Kociol
authors.affiliation: University of Wisconsin Medical Center, Madison, Wisconsin.
authors.forename: Maryl R
authors.initials: MR
authors.lastname: Johnson
authors.affiliation: University of California, San Francisco, California.
authors.forename: Teresa
authors.initials: T
authors.lastname: de Marco
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D019985:Benchmarking; D002309:Cardiology / Q000592:standards / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D016304:Hospitals, Private; D006801:Humans; D007182:Income / Q000639:trends*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards*; D012720:Severity of Illness Index; D012955:Societies, Medical; D013038:Specialization / Q000191:economics / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States
keywords: Compensation; academic medical center; heart failure specialists; relative value units