An update survey of academic radiologists' clinical productivity

Ying Lu, Shoujun Zhao, Philip W Chu, Ronald L Arenson
Journal of the American College of Radiology: JACR 2008, 5 (7): 817-26

RATIONALE AND OBJECTIVES: The total number of procedures and their relative value units (RVUs) were used to measure the productivity of radiologists. Besides variations in productivity due to differences in the percentage of clinical effort, baseline productivity also varies among clinical subspecialty sections. The authors' previous research used the full-time equivalent (FTE) as the unit to adjust for differences in the percentage of clinical effort and a set of adjustment factors (or calibration constants) to modify the default work RVUs according to types of procedures. These adjustments led to comparable average productivity measurements across subspecialty sections. Since 2003, radiology practice has continued to change, including the introduction of positron emission tomography/computed tomography into clinical practice, suggesting a need to update the understanding of clinical productivity and refine the authors' adjustment procedure. In this study, the authors analyzed the most recent survey of academic departments and derived updated adjustment factors for differences in workload among subspecialty sections. The results can be used to determine faculty staffing requirements and evaluate radiologists' performance.

MATERIALS AND METHODS: A survey performed by the Society of Chairmen of Academic Radiology Departments collected data in 2006 for 1,134 radiologists in 24 departments, including 10 departments that also reported productivity in an earlier 2003 survey. These data included the numbers of procedures (represented by Current Procedural Terminology [CPT] codes) performed by radiologists, percentage clinical effort, subspecialty sections, and the number of clinical days. The numbers of CPT codes were converted into total work RVUs per FTE faculty member. By grouping the CPT codes into 6 prespecified examination categories, adjustment factors were created to adjust the RVUs for CPT categories to ensure that the median total adjusted work RVUs from different subspecialty sections were comparable.

RESULTS: Overall, the mean clinical workload in 2006 was 9,671 examinations, a statistically significant 15% increase from 2003. The mean number of work RVUs per FTE was 7,136, a 22% increase from 2003. The adjustment factors have been modified from those presented in the authors' earlier paper, including reductions for interventional radiology, computed tomography, magnetic resonance imaging, nuclear medicine, and a new adjustment factor for "special procedures." These adjustments reduced differences in adjusted RVUs per FTE between subspecialty sections.

CONCLUSIONS: Clinical workload, as measured by RVUs per FTE and adjusted RVUs per FTE, is very useful for determining optimal staffing in subspecialty sections and in radiology departments in general. Workload continues to increase, both in examination complexity and in numbers of overall procedures. Adjustment factors make workload comparisons between subspecialty sections more valid and meaningful.

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