Abstracts of Posters Presented at the International Anesthesia Research Society; 72nd Clinical and Scientific Congress; Orlando, FL; March 7-11, 1998: Anesthesia/OR Economics
Evaluation of a faculty member's contribution to the Departmental mission often is subjective, leading to inequitable distribution of Departmental income and assets. In addition, academic leaders have had difficulty in devising incentive plans to maximize faculty performance. We have devised and implemented an objective evaluation/incentive device as a Departmental management tool.
METHODS: Faculty performance was divided according to the traditional academic triad of scholarly activity, teaching, and service. Every desirable activity, no matter how trivial, was assigned to an appropriate category. In order to establish a gold-standard, an activity performed by each faculty member was identified and agreed upon by all faculty members. Then, each of the other activities was given a relative value based on the gold-standard and agreed to by a majority of the faculty. A mechanism for verification of each activity was implemented. A committee of faculty and staff was chosen to reevaluate the existing value system and to consider addition or deletion. Finally, the Departmental Chair identified a reward/incentive system.
RESULTS: It was decided that a day of attending activity in the operating room, intensive care unit, or pain clinic would serve as the gold-standard. Initially, Departmental income and staffing were such that salaries were maximized around the 70th percentile, according to SAAC and AAMC criteria. Non-clinical time was awarded only for activity deemed essential by the Chair. The system was utilized to reward above average activity by assigning more non-clinical time to encourage substantial research and teaching productivity, exemplified by presentation at national meetings, publications, and resident/student evaluations. Over several years, staffing increased, clinical revenues declined, and faculty established productive research programs and teaching plans. As a result, a financial bonus system replaced non-clinical time as the activity incentive. Base salaries were decreased approximately 20% and a bonus system was initiated, such that mean income remained unchanged.
CONCLUSIONS: Initially, by making non-clinical time, rather than income the reward, scholarly activity was encouraged. All faculty had equivalent opportunity to achieve success, but with time, certain faculty excelled and, with the reward of more non-clinical time, their success was self-propagating. Those faculty who were unable to achieve much success in teaching or research have remained as clinical instructors, or have resigned. When bonus pay was substituted as an incentive, an individual with average activity according to the relative value scale, achieved a base salary plus bonus equivalent to the previous years average income. Those individuals with sub-average activity achieved less of a bonus and those with above average achievement received a larger bonus. Those faculty who use non-clinical time for scholarly activity still receive credit. If scholarly activity can be maintained, while maintaining clinical activity, the bonus is greater. In summary, a relative value system was implemented and utilized successfully to encourage scholarly activity, teaching, and active clinical practice. Alteration of the reward system resulted in appropriate faculty behavior.