The same experts warn that the new survey population and methodologies will make it difficult to draw direct comparisons to data from previous surveys. For example, the 2007-2008 SHM survey included roughly a quarter of respondents from academic settings; the 2010 report has barely 1% of its respondents from academic settings (see Figure 1, p. 14). Traditionally, compensation and productivity levels for academic hospitalists are lower than nonacademic hospitalists. Most experts agree the “filtering” effect of the survey population factors heavily into the across- the-board increases in compensation and productivity in the 2010 report.
“The survey instrument that we use has been used historically for nonacademic physicians,” Litzau explains. “We also have an academic survey that is performed in the fall [Sept. 13 through Nov. 5], where we collect data specifically for academic faculty. We see very different trends within those two types of practice. It is difficult to draw clear comparisons between the two.”
Dr. Landis refers to the new report as a “baseline” and advises hospitalist leaders to review the caveats and cautions section (see “Survey Stipulation: Only Fools Rush In,” p. 16) before jumping right to the numbers. “This is a new set of numbers. Probably the more important comparison will be this set of numbers compared with the next set of data, next year,” he adds.
Even so, the “filtering” effect should provide nonacademic hospitalist groups a more accurate picture of compensation and productivity trends. One hospitalist leader says it’s a “win-win” for both academic and nonacademic practice leaders.
“As a community-based hospitalist, I always had to drill into those organizations that were similar to me. Being able to have more filtered information, it allows us to drill into the areas that are more important and then present that information to our CEO, CFO, VPMA,” says William D. Atchley Jr., MD, FACP, SFHM, chief of hospital medicine at Sentara Medical Group in Norfolk, Va., and a member of Team Hospitalist.
New Info, Deeper Analysis
In addition to a larger response rate and more filtered approach, the new report will offer greater frequency (annually), new data points, and in-depth breakdowns of key productivity metrics. Some of the new metrics reported include:
- Staff per FTE hospitalist physician;
- Staff turnover;
- Retirement benefits;
- Compensation to collections ratio;
- Compensation per encounter;
- Compensation per wRVU;
- Collections per encounter;
- Collections per wRVU; and
- Work RVUs per encounter.
The report will be available every fall, as compared to biannually for past SHM surveys. It also will offer more “cuts” of the data, including median, mean, 25th percentile, 75th percentile, and 90th percentile reports, along with regional breakdowns for many compensation and productivity metrics.
This data reflects the best numbers we have in our business. We have better participation and better quality data analysis than we have ever had before.
—William “Tex” Landis, MD, FHM, medical director, Wellspan Hospitalists, York, Pa., SHM Practice Analysis Committee chair
Benchmarking data are used to set productivity goals and compensation levels in hospitalist practices throughout the country, and most administrators use multiple sources of data to make those decisions.
“If we are showing our hospitalists are generating 5,000 wRVUs per year, and the national median is 4,100, you can do the math. I can say, ‘We need to bring on another hospitalist. The timing is right, and we need to be recruiting,’ ” says Dr. Atchley, who has worked with benchmarking data for 15 years and currently supervises 45 full-time hospitalists who service five hospitals in southeast Virginia. “It’s always good to have national benchmarks to compare to, because that is always the question that is going to be asked. [Hospital administrators] want regional and national comparisons.”