Leverence Robert, Nuttall Richard, Palmer Rachel, Segal Mark, Wood Alicia, Yancey Fay, Shuster Jonathon, Brantly Mark, Hromas Robert
R. Leverence is professor and vice chair, Department of Medicine, and chief, Division of Hospital Medicine, College of Medicine, University of Florida Health, and director of utilization review, Shands Teaching Hospital, Gainesville, Florida.R. Nuttall is chief financial officer, School of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.R. Palmer is vice chair for administration, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.M. Segal is professor and chief, Division of Nephrology, Hypertension, and Renal Transplantation, and co-vice chair for research, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.A. Wood is chief financial officer, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.F. Yancey is chief operating officer, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.J. Shuster is professor, Departments of Health Outcomes and Policy, and Biostatistics, Epidemiology and Research Design Program, Clinical and Translational Science Institute, and biostatistician, College of Medicine, University of Florida Health, Gainesville, Florida.M. Brantly is professor and chief, Division of Pulmonary, Sleep and Critical Care Medicine, and co-vice chair for research, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.R. Hromas is professor and chair, Department of Medicine, College of Medicine, University of Florida Health, Gainesville, Florida.
Acad Med. 2017 Aug;92(8):1133-1137. doi: 10.1097/ACM.0000000000001484.
Academic physician reimbursement has moved to productivity-based compensation plans. To be sustainable, such plans must be self-funding. Additionally, unless research and education are appropriately valued, faculty involved in these efforts will become disillusioned, yet revenue generation in these activities is less robust than for clinical care activities.
Faculty at the Department of Medicine, University of Florida Health, elected a committee of junior and senior faculty and division chiefs to restructure the compensation plan in fiscal year (FY) 2011. This committee was charged with designing a new compensation plan based on seven principles of organizational philosophy: equity, compensation coupled to productivity, authority aligned with responsibility, respect for all academic missions, transparency, professionalism, and self-funding in each academic mission.
The new compensation plan was implemented in FY2013. A survey administered at the end of FY2015 showed that 61% (76/125) of faculty were more satisfied with this plan than the previous plan. Since the year before implementation, clinical relative value units per faculty increased 7% (from 3,458 in FY2012 to 3,704 in FY2015, P < .002), incentives paid per faculty increased 250% (from $3,191 in FY2012 to $11,153 in FY2015, P ≤ .001), and publications per faculty increased 15% (from 2.6 in FY2012 to 3.0 in FY2015, P < .001). Grant submissions, external funding, and teaching hours also increased per faculty but did not reach statistical significance.
An important next step will be to incorporate quality metrics into the compensation plan, without affecting costs or throughput.
学术型医生的薪酬已转向基于生产力的薪酬计划。要实现可持续发展，此类计划必须自筹资金。此外，除非研究和教育得到适当重视，参与这些工作的教职员工将会感到失望，然而这些活动中的创收能力不如临床护理活动强劲。
佛罗里达大学健康医学系的教职员工选出了一个由初级和高级教职员工以及科室主任组成的委员会，对2011财年的薪酬计划进行重组。该委员会负责根据组织理念的七条原则设计一项新的薪酬计划：公平、薪酬与生产力挂钩、权力与责任匹配、尊重所有学术使命、透明度、专业性以及每个学术使命的自筹资金。
新的薪酬计划于2013财年实施。在2015财年末进行的一项调查显示，61%（76/125）的教职员工对该计划比上一个计划更满意。自实施前一年以来，每位教职员工的临床相对价值单位增加了7%（从FY2012年的3458增加到FY2015年的3704，P <.002），每位教职员工获得的激励增加了250%（从FY2012年的3191美元增加到FY2015年的11153美元，P≤.001），每位教职员工的出版物数量增加了15%（从FY2012年的2.6增加到FY2015年的3.0，P <.001）。每位教职员工的资助申请、外部资金和教学时长也有所增加，但未达到统计学显著性。
重要的下一步将是在不影响成本或工作量的情况下，将质量指标纳入薪酬计划。
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