Division of Vascular Diseases and Surgery, Department of Surgery and the Ohio State Heart and Vascular Center, the Ohio State University College of Medicine, Columbus, Ohio 43210, USA.
J Vasc Surg. 2012 Jul;56(1):267-72. doi: 10.1016/j.jvs.2012.03.013. Epub 2012 May 10.
Health care reform is forcing "alignment" between hospitals and physicians. The acceleration of employment of physicians by hospitals is bringing into focus contractual terms where compensation is tied to clinical productivity. Physician productivity is being almost entirely defined by work relative value units (WRVUs). However, vascular surgeons may bring value to a health system in ways that are unique and separate from clinical revenue as measured by WRVUs. Incentives for physicians should also be tied to behaviors that are desired, such as quality of care, efficiency, patient outcomes, patient satisfaction scores, teaching, and research, depending on the specific environment. Vascular surgeons must be aware of proper use and misuse of WRVUs and have access to the most appropriate benchmarks in negotiations for employment. With increasing employment of physicians by hospitals and focus on "alignment," a more comprehensive measure of physician productivity is necessary.
医疗改革正在迫使医院和医生“协同一致”。医院加速雇佣医生的同时，也将重点放在了薪酬与临床生产力挂钩的合同条款上。医生的生产力几乎完全由工作相对价值单位（WRVU）来定义。然而，血管外科医生可能会以独特的方式为医疗系统带来价值，而这些价值与 WRVU 衡量的临床收入是分开的。激励医生的因素也应该与期望的行为挂钩，如护理质量、效率、患者预后、患者满意度评分、教学和研究，具体取决于特定的环境。血管外科医生必须了解 WRVU 的正确和错误使用方法，并在就业谈判中获得最合适的基准。随着医院对医生的雇佣不断增加以及对“协同一致”的关注，需要用更全面的方法来衡量医生的生产力。
