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Love's Labor Lost: Exploring The Premium Associated With Academic Practice In Cardiovascular Interventional Subspecialties
Rajavi Parikh, D.O.1, Tyler Zander, MD
1, Melissa Kendall, MD
1, Rachel Wolansky, MD
1, Emily Grimsley, MD
1, Joseph Sujka, MD
1, Dave Anderson
2, Murray Shames, MD
1, Evan Lipsitz, MD
3, Jean Bismuth, MD
1, Paul Kuo, MD
1.
1University of South Florida, Tampa, FL, USA,
2Sullivan Cotter, Southfield, MI, USA,
3Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
OBJECTIVES: Pursuing academic medicine demands passion that transcends monetary rewards. Previous work indicates academic providers incur a 16% premium compared to nonacademic providers. The differences between cardiovascular interventional subspecialties have not been explored. This study analyzes patterns in valuation of academic (Ac) and nonacademic (NonAc) work across cardiovascular interventional subspecialties.
METHODS: MGMA datasets (2014, 2018 and 2022) were queried for total cash compensation (TCC) and work relative value units (WRVU) among interventional cardiology (IC), interventional radiology (IR) and vascular surgery (Vasc). TCC, WRVU and TCC/WRVU were compared between Ac and NonAc providers in each subspecialty. ANOVA and t-test were used as appropriate; p <0.05 was deemed statistically significant.
RESULTS: Across all years, WRVUs in Ac IR and Vasc were greater than NonAc counterparts. Ac IC WRVUs were less than NonAc IC. In 2022, Ac IR generated +448/+6% (p=NS) and Ac Vasc +798/+9% (p=NS) more than NonAc counterparts. Ac IC generated -1213/-12% (p=0.001) less WRVUs than NonAc IC. WRVUs are decreasing in Ac/NonAc IR and Vasc and increasing in Ac/NonAc IC over time. TCC was less in all Ac subspecialties compared to NonAc in all years. In 2022, Ac was paid -$263,735/-36% (IC; p<0.001), -$95,636/-16% (IR; p<0.001), -$105,907/-17% (Vasc; p<0.001) less than NonAc counterparts. Ac and NonAc TCC is increasing in all subspecialties over time. TCC/WRVU was less for Ac subspecialties compared to NonAc at all years except IC in 2018 and IR in 2014 where Ac/NonAc had equivalent TCC/WRVU. In 2022, Ac TCC/WRVU in 2022 was -$10.12/-13% (IC; p=0.002), -$11.08/-11% (IR; p=0.01), -$8.69/-11% (Vasc; p=0.028) less than NonAc counterparts.
CONCLUSIONS: Ac levies a passion tax over NonAc for all cardiovascular interventional subspecialties. As measured by TCC/WRVU, Ac IC exacts the highest premium (-13%; p=0.002), followed by IR (-11%; p=0.01) and Vasc (-11%; p=0.028). These results inform career decisions weighing passion for unfunded research and education activities with ever present expectations of clinical productivity.
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