Fox Chase Cancer Center, Philadelphia, PA; Fred Hutchinson Cancer Research Center, Seattle, WA; H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, Tampa, FL; Stanford Hospital and Clinics, Stanford, CA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD; University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; University of Washington, Seattle, WA; Roswell Park Cancer Institute, Buffalo, NY; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; Dana-Farber Cancer Institute, Boston, MA; Comprehensive Cancer Center-Arthur G. James Cancer Hospital; Richard J. Solove Research Institute, The Ohio State University, Columbus, OH; and the University of Nebraska Medical Center, Omaha, NE.
J Oncol Pract. 2007 Jan;3(1):2-8. doi: 10.1200/JOP.0712001.
Oncologists in academic cancer centers usually generate professional fees that are insufficient to cover salaries and other expenses, despite significant clinical activity; therefore, supplemental funding is frequently required in order to support competitive levels of physician compensation. Relative value units (RVUs) allow comparisons of productivity across institutions and practice locations and provide a reasonable point of reference on which funding decisions can be based.
We reviewed the clinical productivity and other characteristics of oncology physicians practicing in 13 major academic cancer institutions with membership or shared membership in the National Comprehensive Cancer Network (NCCN). The objectives of this study were to develop tools that would lead to better-informed decision making regarding practice management and physician deployment in comprehensive cancer centers and to determine benchmarks of productivity using RVUs accrued by physicians at each institution. Three hundred fifty-three individual physician practices across the 13 NCCN institutions in the survey provided data describing adult hematology/medical oncology and bone marrow/stem-cell transplantation programs. Data from the member institutions participating in the survey included all American Medical Association Current Procedural Terminology (CPT®) codes generated (billed) by each physician during each organization's fiscal year 2003 as a measure of actual clinical productivity. Physician characteristic data included specialty, clinical full-time equivalent (CFTE) status, faculty rank, faculty track, number of years of experience, and total salary by funding source. The average adult hematologist/medical oncologist in our sample would produce 3,745 RVUs if he/she worked full-time as a clinician (100% CFTE), compared with 4,506 RVUs for a 100% CFTE transplant oncologist.
Our results suggest specific clinical productivity targets for academic oncologists and provide a methodology for analyzing potential factors associated with clinical productivity and developing clinical productivity targets specific for physicians with a mix of research, administrative, teaching, and clinical salary support.
尽管临床活动量很大，但学术癌症中心的肿瘤学家通常产生的专业费用不足以支付工资和其他费用；因此，为了支持有竞争力的医生薪酬水平，经常需要额外的资金。相对价值单位（RVU）允许对机构和实践地点的生产力进行比较，并为资金决策提供合理的参考依据。
我们回顾了在国家综合癌症网络（NCCN）成员或共享成员的 13 个主要学术癌症机构中执业的肿瘤学家的临床生产力和其他特征。本研究的目的是开发工具，以便在综合癌症中心的实践管理和医生部署方面做出更明智的决策，并使用每个机构的医生累计的 RVU 来确定生产力基准。在调查中，来自 13 个 NCCN 机构的 353 名个体医生实践提供了描述成人血液学/肿瘤医学和骨髓/干细胞移植项目的数据。参与调查的成员机构的数据包括每位医生在每个机构的 2003 财年期间根据美国医学协会当前程序术语（CPT®）代码生成（计费）的所有数据，作为实际临床生产力的衡量标准。医生特征数据包括专业、临床全职等效（CFTE）状态、教职等级、教职轨道、经验年限以及按资金来源划分的总薪酬。如果我们的样本中的普通成年血液学家/肿瘤学家全职作为临床医生（100% CFTE）工作，他/她将产生 3745 RVU，而 100% CFTE 移植肿瘤学家则产生 4506 RVU。
我们的结果为学术肿瘤学家提供了具体的临床生产力目标，并提供了一种分析与临床生产力相关的潜在因素并为具有研究、管理、教学和临床薪酬支持混合的医生制定具体临床生产力目标的方法。
