Assistant professor Yale School of Medicine New Haven, Connecticut, United States
Background: Education on physician productivity (how physician clinical work output is measured and subsequently translated into compensation) is largely absent from graduate medical education. As potential work force challenges in pediatrics loom and compensation is sited by medical graduates as a factor in career decision-making, this knowledge is important as pediatric residents transition from learner to attending. Objective: Our aim was to assess pediatric residents’ knowledge of how physician productivity is measured, how it relates to physician compensation, the potential influence on this knowledge on career choice, and resident education on physician productivity to better understand the learning gap on these topics. Design/Methods: We conducted a cross-sectional study at a single, tertiary care academic program in New England. We designed a anonymous, 13-question survey to assess our pediatric residents’ baseline perceived knowledge of how physician productivity is measured (Table 1). This survey was distributed using a QR code at an educational session, then with two email reminders. Results: 47 out of 84 residents (56%) responded to the survey (8 PGY1, 16 PGY2, 21 PGY3, 2 PGY4). The majority of respondents identified as female (33, 70%) and white (21, 62%); 13 (28%) are planning on pursuing primary care. 13 residents (28%) reported that their career choice was influenced by income. Most residents disagreed or strongly disagreed that they know how clinical productivity is measured (28, 60%) and how measured clinical productivity relates to their future salaries (26, 55%). 13 residents (28%) agreed or strongly agreed that they know what an RVU is and measures, and 12 (26%) agreed or strongly agreed that they know how an rVU related to physician clinical productivity. Most residents have not had any formal learning on clinical productivity (41, 87%), but 40% report having some informal teaching on this topic. 46 residents would be interested in formal education in clinical productivity. For EPA 13, 29% of residents rated themselves as trusted to observe only, 38% to execute with direct supervision, and 33% to execute with consultation; there was no statistical difference by PGY year.
Conclusion(s): Pediatric residents report limited knowledge on clinical productivity. Education on physician productivity is an important and desired part of training that needs to be filled in pediatric graduate education. As this topic is valuable for trainees as they accept attendings positions, pediatric residents may be unprepared for this aspect of their new roles.
Table 1: Survey questions administered to pediatrics residents to assess baseline knowledge on physician productivity Survey_RVU_residentsOct25.pdfThis table contains the survey administered to pediatric residents to obtain a baseline assessment of their knowledge of physician productivity.
