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What is a trauma surgeon's worth? A 2025 reexamination of the question posed in 2000
Melissa A Kendall1, Tyler Zander, Emily A Grimsley
1From the Department of Surgery (M.A.K., T.Z., E.A.G., R.L.W., J.S., P.C.K.), University of South Florida, Tampa, Florida; Sullivan Cotter (D.O.A.), Southfield, Michigan; and Department of Surgery (F.L.), Loyola University of Chicago, Chicago, Illinois.
Introduction:
Compensation disparities significantly impact junior faculty, especially trauma surgeons (TSs) facing complex compensation structures. Only 20.3% of TSs think that their compensation is determined objectively, highlighting the importance of understanding compensation metrics. We aim to measure the worth of different trauma-related specialties through total cash compensation (TCC), work relative value units (wRVUs), and TCC/wRVU.
Methods:
Total cash compensation, wRVU, and TCC/wRVU data were obtained from Medical Group Management Association from 2010 to 2023 for critical care specialists, orthopedic surgeons, general surgeons, and TSs in academic (Ac) and nonacademic (non-Ac) settings. Z test compared mean values between Ac VERSUS non-Ac annually. Ac/non-Ac ratios were calculated to assess compensation trends.
Results:
Academic physicians consistently earned less TCC than non-Ac counterparts, with TSs showing the highest mean difference in 2023 (-$132,941). Academic TSs generated significantly more wRVUs than non-Ac counterparts (2,169-2,886 more annually) through 2018, but this advantage disappeared by 2023. Academic TSs consistently earned less per wRVU, with the most dramatic disadvantage in 2010 (Ac/non-Ac ratio of 0.50). While this improved to 0.82 by 2023, it remained the lowest among all trauma-related specialties (compared with 0.89 for orthopedic surgeons, 1.39 for critical care specialists, and 0.96 for general surgeons).
Conclusion:
Our longitudinal study demonstrates that Ac physicians receive lower TCC and TCC/wRVU, even while historically maintaining higher clinical productivity. The traditional justification that lower Ac compensation reflects reduced clinical activity is challenged by our finding that Ac trauma clinicians historically generated more wRVUs. Trauma surgeons face a "double disadvantage," which is being undercompensated relative to both non-Ac TSs and other Ac specialists. Rectifying these compensation inequities is critical to preserving the Ac mission and ensuring excellence in trauma care, education, and research.
Level Of Evidence:
Economic and Value Based Evaluations; Level III.
