Letters to the Editor: Letters & Announcements
To the Editor:
We believe that in an academic anesthesiology department, an incentive plan should attempt to reward both clinical and academic productivity (1). Miller and Cohen at the University of California San Francisco (2) described a productivity incentive program that had, as its chief goal, rewarding clinical productivity to retain junior faculty. They demonstrate (using a system based on billable units) that their program narrows the gap in total salary compensation across academic ranks and argue that this does not adversely impact academic productivity in a department such as theirs, arguably one of the strongest academic departments in the country.
However, we agree with Abouleish et al. (3) that the focus on rewarding clinical productivity may undermine the academic mission. To support both of these missions, we developed an incentive plan over the last three years (2002–2005) based on both clinical and academic productivity. We defined clinical productivity as the number of ASA time units billed per faculty member adjusted for non-revenue generating clinical activity (Converted ASA Time units) and allocated 55% of the incentive pool dollars to clinical productivity. The balance of the incentive pool (45%) was allocated to Academic Productivity (Research, Scholarship, and Resident and Medical Student Education) as well as Service and Teamwork. In our department, incentive dollars, which constitute 15% of the total faculty compensation pool, are paid in addition to base salaries determined according to academic rank and based on the SAAC Salary Survey National Report (4).
We demonstrated a trend that indicates that although Assistant Professors had more or equivalent Converted ASA Time units, to Full Professors in the Department (P = 0.1) (Fig. 1), academic productivity was not disincentivized, as Full Professors received similar or larger incentives (P = 0.14). Thus importantly, an administrator, researcher, or educator could make up a shortfall in clinical productivity incentive dollars through academic productivity. This ensures that we provide an incentive for academic productivity in our department. Conversely, individual clinicians, have the opportunity to ensure comparable incentives through enhancing clinical productivity.
Berend Mets, MB, PhD
Kent Eckerd, MBA
Department of Anesthesiology
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine
1.Kratz R, Mets B. Finding an incentive plan that actually works. The Physician Executive 2005;31:54–6.
2.Miller R, Cohen N. The impact of productivity based incentives on faculty salary based compensation. Anesth Analg 2005;101:195–9.
3.Abouleish A, Apfelbaum J, Prough D, et al. The prevalence and characteristics of incentive plans for clinical productivity among academic anesthesia departments. Anesth Analg 2005;100:493–501.