Scarborough John E, Bennett Kyla M, Schroeder Rebecca A, Swedish Tristan B, Jacobs Danny O, Kuo Paul C
Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Ann Surg. 2009 Sep;250(3):432-9. doi: 10.1097/SLA.0b013e3181b38de2.
To determine whether academic surgeons are satisfied with their salaries, and if they are willing to forego some compensation to support departmental academic endeavors.
Increasing financial constraints have led many academic surgery departments to rely on increasingly on clinical revenue generation for the cross-subsidization of research and teach missions.
Members of 3 academic surgical societies (n = 3059) were surveyed on practice characteristics and attitudes about financial compensation. Univariate and multivariate logistic regression analyses were performed to identify determinants of salary satisfaction and willingness to forego compensation to support academic missions.
One thousand thirty-eight (33.9%) surgeons responded to our survey, 947 of whom maintain an academic practice. Of these academic surgeons, 49.7% expressed satisfaction with their compensation. Length of career, administrative responsibility for compensation and membership in the American Surgical Association or the Society of University Surgeons were predictive of salary satisfaction on univariate analysis. Frequent emergency call duty, increased clinical activity, and greater perceived difference between academic and private practice compensation were predictive of salary dissatisfaction. On multivariate analysis, increased clinical activity was inversely associated with both salary satisfaction (adjusted odds ratio [AOR], 0.77; [95% CI: 0.64, 0.94]; P = 0.009) and amount of compensation willingly killed for an academic practice (AOR, 0.71; [0.61, 0.83]; P < 0.0005).
Increasing reliance on clinical revenue to subsidize nonclinical academic missions is disaffecting many academic surgeons. Redefined mission priorities, enhanced nonfinancial rewards, utilization of nonclinical revenue sources (eg, philanthropy, grants), increased efficiency of business practices and/or redesign of fund flows may be necessary to sustain recruitment and retention of young academic surgeons.
确定学术外科医生对其薪资是否满意，以及他们是否愿意放弃部分薪酬以支持科室的学术活动。
日益增加的财务限制导致许多学术外科科室越来越依赖临床创收来交叉补贴研究和教学任务。
对3个学术外科学会的成员（n = 3059）进行了关于执业特征和对财务补偿态度的调查。进行单变量和多变量逻辑回归分析，以确定薪资满意度和愿意放弃薪酬以支持学术任务的决定因素。
1038名（33.9%）外科医生回复了我们的调查，其中947名从事学术执业。在这些学术外科医生中，49.7%对其薪酬表示满意。单变量分析显示，职业生涯时长、薪酬管理职责以及美国外科协会或大学外科医生协会会员身份可预测薪资满意度。频繁的急诊值班、临床活动增加以及学术与私人执业薪酬之间的感知差异较大可预测薪资不满意。多变量分析显示，临床活动增加与薪资满意度（调整后的优势比[AOR]，0.77；[95%置信区间：(0.64, 0.94)]；P = 0.009）以及愿意为学术执业放弃的薪酬金额（AOR，0.71；[0.61, 0.83]；P < 0.0005）均呈负相关。
越来越依赖临床收入来补贴非临床学术任务正使许多学术外科医生感到不满。重新定义任务优先级、增加非财务奖励、利用非临床收入来源（如慈善、资助）、提高业务效率和/或重新设计资金流可能是维持年轻学术外科医生招聘和留用所必需的。
