Background: Given the changes in health care economics and the changes in increasing rates of uninsured and undercovered patients in the United States, the revenue stream for all physicians, and particularly those in academic medical centers, is subject to fluctuations that make it difficult to fund the missions of education and research. Often, academic plastic surgeons are required to use clinical revenue to supplement efforts in research and education. A large margin on clinical revenue that was present perhaps 10 or 20 years ago has been eroded by many socioeconomic factors, making it difficult to provide optimal training in academic environments for our residents.
Methods: In an attempt to ascertain “best in show,” a survey was sent to 89 plastic surgery programs that requested information regarding faculty salaries, relative value units, National Institutes of Health support, ancillary revenue support for taking call, and the number of faculty within individual programs.
Results: Fifty-three programs responded with completed data.
Conclusion: The following practices directly contribute to stable financial environments: external support for call coverage, recruitment support, and gain sharing associated with health system profitability. Coverage agreements with outside facilities can be lucrative if properly negotiated. Paid medical directorships for administrative/clinical oversight are helpful. Payor mixes with high percentages of commercial, managed care, and self-pay (aesthetic) and low percentages of Medicaid are beneficial. Practices with a healthy mix of aesthetic surgery add strength.
From the University of Pennsylvania.
Received for publication July 14, 2009; accepted October 28, 2009.
Disclosure: The author has no financial interest to declare in relation to the content of this article.
L. Scott Levin, M.D., Department of Orthopaedic Surgery and Department of Surgery Division of Plastic Surgery, University of Pennsylvania, 2 Silverstein, 3400 Spruce Street, Philadelphia, Pa. 19104, firstname.lastname@example.org