Physician workload and practice management in pediatric gastroenterology

Area of Science:

• Pediatric Gastroenterology
• Healthcare Management
• Workforce Analysis

Background:

• The pediatric gastroenterology workforce has expanded significantly in recent decades.
• The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) established a task force to examine practice structures within pediatric gastroenterology organizations.

Purpose of the Study:

• To investigate the current practice structures of pediatric gastroenterology organizations.
• To understand variations in clinical operations, staffing, compensation, and wellness initiatives.

Main Methods:

• A 19-item electronic survey was administered to clinical or academic division directors who are members of NASPGHAN.
• The survey collected data on practice structure, clinical workload, healthcare team composition, compensation models, and wellness program participation.

Main Results:

• The survey achieved a 30% response rate, exclusively from academic practice directors.
• Median weekly clinical sessions were seven, with a median annual work relative value unit (wRVU) target of 4000-4500.
• Healthcare team ratios (per provider FTE) included: Nursing 0.80, Medical Assistant (MA) 0.29, Dietitian 0.29, Social Worker 0.14, and Psychologist 0.13.
• Compensation models varied, with 68% on salary plus bonus, 28% on salary only, and 4% with at-risk components.
• Most practices (80%) engaged in wellness activities, commonly didactic lectures on physician burnout, annual burnout check-ins (68%), and social events (60%).

Conclusions:

• Pediatric gastroenterology practices exhibit variability in weekly clinical sessions and annual wRVU targets, aligning with national 50th percentile benchmarks.
• Consistent healthcare team staffing ratios were observed across different practice sizes and types.
• The majority of practices are actively implementing wellness initiatives to address physician burnout.