Flanagan T, Mitchner B, Weyl-Feyling D, Laros R K
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, USA.
Obstet Gynecol. 1995 Dec;86(6):1014-7. doi: 10.1016/0029-7844(95)00321-h.
To quantify the cost of teaching residents ambulatory obstetrics and gynecology, expressed as the difference in revenue generated between a faculty physician practicing as a private practitioner and a faculty physician serving as a resident supervisor.
Outpatient revenue generated by faculty generalists and residents was analyzed. The net gain in revenue was calculated per half-day session for faculty and residents by subtracting contractual allowances and expenses from gross patient charges. Net revenue gain per half-day clinical session per year for a faculty member practicing as a private practitioner was compared with that of a faculty member functioning as a supervisor. The net gain for the faculty supervisor was based on the revenue generated by the residents supervised.
The faculty member serving as a private practitioner generated a net gain per session per year of $23,947. The faculty member acting as supervisor for two residents per session generated a net gain or loss per session per year of -$9678, -$972, and $15,542 for first-, second-, and third-year residents, respectively. The cost of teaching, expressed as the difference in the net gain of a faculty member as private practitioner and the net gain of a faculty member as supervisor, for first-, second-, and third-year residents was $33,625, $24,919, and $8405, respectively, per session per year.
This analysis shows that first-year residents are an expense to the practice site, second-year residents are close to breaking even, and third-year residents begin to generate a net gain.
量化培训住院医师门诊妇产科的成本，以私人执业的教员医师与担任住院医师督导的教员医师所产生的收入差异来表示。
分析了全科教员和住院医师产生的门诊收入。通过从患者总收费中减去合同补贴和费用，计算出教员和住院医师每半天课程的净收入增益。将私人执业的教员每年每半天临床课程的净收入增益与担任督导的教员的净收入增益进行比较。教员督导的净增益基于所督导住院医师产生的收入。
私人执业的教员每年每节课的净增益为23,947美元。担任督导的教员每节课分别督导一名一年级、二年级和三年级住院医师时，每年每节课的净增益或损失分别为 -9678美元、-972美元和15,542美元。以私人执业教员的净增益与督导教员的净增益之差表示的教学成本，对于一年级、二年级和三年级住院医师，每年每节课分别为33,625美元、24,919美元和8405美元。
该分析表明，一年级住院医师对执业地点来说是一项开支，二年级住院医师接近收支平衡，三年级住院医师开始产生净增益。
