Benchmarking Academic Anatomic Pathologists: The Association of Pathology Chairs Survey

Abstract

The most common benchmarks for faculty productivity are derived from Medical Group Management Association (MGMA) or Vizient-AAMC Faculty Practice Solutions Center^® (FPSC) databases. The Association of Pathology Chairs has also collected similar survey data for several years. We examined the Association of Pathology Chairs annual faculty productivity data and compared it with MGMA and FPSC data to understand the value, inherent flaws, and limitations of benchmarking data. We hypothesized that the variability in calculated faculty productivity is due to the type of practice model and clinical effort allocation. Data from the Association of Pathology Chairs survey on 629 surgical pathologists and/or anatomic pathologists from 51 programs were analyzed. From review of service assignments, we were able to assign each pathologist to a specific practice model: general anatomic pathologists/surgical pathologists, 1 or more subspecialties, or a hybrid of the 2 models. There were statistically significant differences among academic ranks and practice types. When we analyzed our data using each organization's methods, the median results for the anatomic pathologists/surgical pathologists general practice model compared to MGMA and FPSC results for anatomic and/or surgical pathology were quite close. Both MGMA and FPSC data exclude a significant proportion of academic pathologists with clinical duties. We used the more inclusive FPSC definition of clinical "full-time faculty" (0.60 clinical full-time equivalent and above). The correlation between clinical full-time equivalent effort allocation, annual days on service, and annual work relative value unit productivity was poor. This study demonstrates that effort allocations are variable across academic departments of pathology and do not correlate well with either work relative value unit effort or reported days on service. Although the Association of Pathology Chairs-reported median work relative value unit productivity approximated MGMA and FPSC benchmark data, we conclude that more rigorous standardization of academic faculty effort assignment will be needed to improve the value of work relative value unit measurements of faculty productivity.

Keywords: Medical Group Management Association; Vizient-AAMC Faculty Practice Solutions Center; anatomic pathology; benchmarking; clinical effort; productivity; surgical pathology; work relative value units.

Figure 1.

A, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists across all clinical effort allocations in the general practice model. In the rectangular box are included those pathologists who would be in the FPSC (≥0.6 cFTE) analysis, which would also include the MGMA analysis (≥0.67 cFTE). B, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists in the general practice model, who would be included in the FPSC analysis (≥0.6 cFTE). The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; MGMA, Medical Group Management Association; wRVUs, work relative value units.

Figure 2.

A, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists across all clinical effort allocations in the hybrid practice model. In the rectangular box are included those pathologists who would be in the FPSC (≥0.6 cFTE) analysis which would also include the MGMA analysis (≥0.67 cFTE). B, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists in the hybrid practice model who would be included in the FPSC analysis (≥0.6 cFTE). The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; MGMA, Medical Group Management Association; wRVUs, work relative value units.

Figure 3.

A, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists across all clinical effort allocations in the single subspecialty practice model. In the rectangular box are included those pathologists who would be in the FPSC (≥0.6 cFTE) analysis, which would also include the MGMA analysis (≥0.67 cFTE). B, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists in the single subspecialty practice model, who would be included in the FPSC analysis (≥0.6 cFTE). The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; MGMA, Medical Group Management Association; wRVUs, work relative value units.

Figure 4.

A, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists across all clinical effort allocations in the multiple subspecialties practice model. In the rectangular box are included those pathologists who would be in the FPSC (≥0.6 cFTE) analysis, which would also include the MGMA analysis (≥0.67 cFTE). B, Scattergram of part B effort versus wRVUs with a nonparametric density analysis for faculty pathologists in the multiple subspecialties practice model, who would be included in the FPSC analysis (≥0.6 cFTE). The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; MGMA, Medical Group Management Association; wRVUs, work relative value units.

Figure 5.

A, Scatterplot of days on service versus part B effort allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the general practice model. B, Scatterplot of wRVUs versus days on service allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the general practice model. The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; wRVUs, work relative value units.

Figure 6.

A, Scatterplot of days on service versus part B effort allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the hybrid practice model. B, Scatterplot of wRVUs versus days on service allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the hybrid practice model. The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; wRVUs, work relative value units.

Figure 7.

A, Scatterplot of days on service versus part B effort allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the single subspecialty practice model. B, Scatterplot of wRVUs versus days on service allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the single subspecialty practice model. The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; wRVUs, work relative value units.

Figure 8.

A, Box plot with outliers for wRVUs for 5 single subspecialties for full-time pathologists (FPSC definition of ≥ 0.6 cFTE). B, Box plot with outliers for days on service for 5 single subspecialties for full-time pathologists (FPSC definition of ≥ 0.6 cFTE). Only those subspecialties with at least 10 pathologists were included. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; wRVUs, work relative value units.

Figure 9.

A, Scatterplot of days on service versus part B effort allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the multiple subspecialties practice model. B, Scatterplot of wRVUs versus days on service allocation for full-time (as defined by FPSC, cFTE ≥ 0.6) pathologists in the multiple subspecialties practice model. The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner. FPSC indicates Vizient-AAMC Faculty Practice Solutions Center; cFTE indicates clinical full-time equivalent; wRVUs, work relative value units.

Figure 10.

Scattergram of number of residents versus educational effort allocation for residency program directors within the anatomic pathologist data set. The darkest color (top quartile) shows the densest cluster (top quartile) of points, each of which represents a faculty pathologist, while the lightest shows the least concentrated (bottom quartile). The intermediate colors show the second and third quartiles. The line of regression with its associated equation and coefficient of determination (R ²) are noted in the upper left corner.