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The RVU Compensation Model and Head and Neck Surgical Education
Michael S Chow1, Alex J Gordon2, Abhinav Talwar3
1Department of Otolaryngology, Head and Neck Surgery, New York University, New York, New York, USA.
The Laryngoscope
|June 8, 2023
Summary
Training head and neck surgeons incurs significant financial opportunity costs. Physician reimbursement models fail to account for the extra time and effort involved in surgical education.
Area of Science:
- Surgical education
- Health economics
Background:
- Head and neck surgery training involves residents and fellows.
- Current physician reimbursement models may not adequately reflect training costs.
Purpose of the Study:
- To quantify the financial opportunity cost of training surgical residents and fellows in head and neck procedures.
- To analyze the impact of trainee involvement on physician productivity.
Main Methods:
- A retrospective review of 34,078 ablative head and neck surgical procedures from 2005-2015.
- Comparison of work relative value units (wRVU) generated per hour for attendings alone versus attendings with residents or fellows using NSQIP data.
Main Results:
- The rate of wRVU generation per hour was highest for attendings alone (10.3), followed by attendings with residents (8.9), and attendings with fellows (7.0).
- Opportunity costs were estimated at $60.44/hour for resident involvement and $78.98/hour for fellow involvement.
Conclusions:
- Physician reimbursement based on wRVU does not account for the additional effort required for surgical training.
- The financial implications of training future surgeons need consideration in reimbursement policies.
