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The Differential Impact of Plastic Surgery Subspecialties on the Financial Performance of an Academic Clinical Practice

Chao, Albert H. M.D.; Khansa, Ibrahim M.D.; Kaiser, Christopher C.P.A.; Bell, Julian M.H.A., C.P.A.; Miller, Michael J. M.D.

Plastic and Reconstructive Surgery: June 2014 - Volume 133 - Issue 6 - p 748e–755e
doi: 10.1097/PRS.0000000000000174
Breast: Original Articles

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.

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.

Received for publication October 1, 2013; accepted December 18, 2013.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Albert H. Chao, M.D., 915 Olentangy River Road, Suite 2100, Columbus, Ohio 43212,

©2014American Society of Plastic Surgeons