Table 3:

Effects of strategies on faculty productivity and compensation

Study	Clinical productivity	Research productivity	Teaching productivity	Compensation
Garson et al.3	Total revenue increased 1% Revenue per patient-care FTE decreased 2% (patient-care FTE increased, according to author)	Unfunded research decreased 12% Grant dollars per square foot increased 12% Percentage of basic researchers who held or applied for an NIH grant as principal investigator increased 35% Percentage of researchers who supported at least half of the portion of their salaries allocated to research increased 6% Faculty who had previously claimed research time with no research productivity shifted to patient-care time	Not assessed	Not assessed
Cramer et al.6	Mean clinical points dropped from 3008 in 1997 to 2547 in 1999 Clinical points per session rose from 9.8 in 1997 to 10.4 in 1999	Mean research points rose from 524 in 1997 to 775 in 1999	Mean teaching points dropped from 1195 in 1997 to 1146 in 1999 Course coordinators had easier time getting faculty participation at the predoctoral and resident levels	Not assessed
Sussman et al.7	20% increase in wRVU volume Growth in wRVUs was “slightly out of proportion” to volume of visits; possibly related to an active coding–education and coding–auditing program Improvement or no change in patient satisfaction after introduction of the system	Not assessed	Not assessed	Physicians’ salaries and the overall clinical revenue “increased slightly” under the new system Salary decreases for under- performance were limited to annual adjustments
Andreae et al.8	89% of faculty increased clinical productivity Twice as many faculty as in previous year reached median for wRVU production As a group, clinical productivity increased 20% in the first year after implementation; this increase “exceeded the market’s growth trends for primary care physicians”	Not assessed	No change in the number of student and resident sessions No difference in students’ evaluation of their educational experience	Compensation for the group increased by 8% Percentage of increase in clinical productivity was 2.5 times greater than increase in compensation for the group; authors explained that this was due in part to the relative underproduction for the level of compensation at baseline
Tarquinio et al.9	Mean number of RVUs per clinician-educator grew by a compound annual growth rate of 8.1% before and 11.3% after implementation; corresponding numbers for clinicians in the medical centre were –3.4% and 3.1%	Amount of research funding per physician-scientist grew by a compound annual growth rate of 9.3% before and 22.5% after implementation Ranking of department according to NIH awards improved from 26 to 12 (there were concurrent increases in NIH annual budgets)	No change in evaluations by students or house staff, which remained very high (author communication) Clinician-educators and physician-scientists reported spending less time teaching (50% and 43% respectively) and less time on academic services (67% and 49% respectively); no association with receiving research bonus	8.6% of improvement in collections was attributable to improved billing or better payer contracts
Miller et al.10	Not assessed	Federal and other extramural funding sources dramatically increased	Evaluations by medical students were “the best at UCSF” Authors reported that the residency program “flourished”	Mean difference in total compensation narrowed between ranks Variability in compensation increased in all ranks, especially at the assistant professor level Distribution of total compensation “dramatically” changed in favour of junior faculty
Reich et al.11	Measure of clinical productivity per full-time equivalent increased by 31% (p < 0.0001) Measure of clinical productivity per location decreased by 10% (p = 0.046)	Rate of publication by faculty did not change after implementation of the strategy	Educational output was stable before and after implementation	Mean compensation increased by 40% (95% CI 29.0%–50.4%) Compensation for instructors and assistant professors increased more than compensation for associate professors and professors (p < 0.001) both before and after implementation Increased mean supplemental pay with relatively fewer faculty, and increasing workload undertaken by stable number of full-time equivalent faculty Implementation of compensation model coincided with introduction of electronic point-of-care charge capture and submission system
Schweitzer et al.12,13	Not assessed	In the school of medicine: NIH grants increased from 39 to 127 during the 10-year period Annual NIH funding increased by a factor of 7 Ranking according to NIH awards improved from 95 to 73 (of 124) Total annual extramural funding increased from $20 million to $90 million (comparable increases observed in nursing and dentistry schools) Number of full journal articles increased by 60%, with an increase in impact (as measured by standard impact metrics)	Not assessed	Not assessed

Note: CI = confidence interval, FTE = full-time equivalent, NIH = National Institutes of Health, RVU = relative-value unit, wRVU = work component of the RVU¹⁴ (see Table 1 footnote for description of RVU and wRVU), UCSF = University of California at San Francisco.