Background: Changes in the health-care industry have led to
increasing demand for physician-driven clinical volume. This environment has
altered the traditional balance among teaching, research, and service
responsibilities for faculty in residency training programs. As economic
pressures mount and budgets shrink, academic departments are exploring ways of
paying faculty that would help to maintain the global mission of the
organization. The purpose of this study was to examine the compensation
strategy for faculty in academic orthopaedic surgery departments in the United
States with a focus on compensation methods for academic productivity.
Methods: Thirty-one academic orthopaedic surgery residency training
programs were recruited for the study. Two methods of data collection were
used: (1) a survey was mailed electronically to the program chairpersons or
the finance directors, and (2) eight program leaders were interviewed to
obtain more in-depth information regarding compensation for academic
productivity in their organizations.
Results: All thirty-one programs responded to the survey. To
compensate faculty for clinical productivity, twenty-two programs used a
salary and bonus system, two used salary alone, and the remainder used
combined methods. Nineteen departments had a compensation system that included
academic productivity, and twelve did not. Of those that compensated for
academic work, seven used the chair's decision, six used a point system, one
used academic rank alone, and the remainder used a combination of methods. The
point systems varied in breadth, focus, and amount of detail.
Conclusions: Most, but not all, departments accounted for academic
productivity in their compensation system. Most programs used the chair's
discretion to determine academic bonuses, but several departments had
developed point systems. There are common themes with regard to this issue,
including the importance of the academic mission, the need for clinical
revenues, the value of flexibility and transparency, and the importance of
culture and leadership.