Surgical Work Output: Is There Room for Increase? An Analysis of Surgical Work Effort from 1999 to 2003

Objective: To analyze physician work production over a 5-year period to discover trends in productivity. Summary background data: Surgical workforce calculations over the past 25 years have projected major oversupply as well as looming shortages. Recent studies indicate that demand for surgical services will increase over the next two decades as the population ages and develops age related chronic diseases. This study examines actual physician productivity to determine whether there is capacity for increased work output in response to projected increases in demand. Methods: Physician productivity data as measured by relative value units were obtained from the Medical Group Management Association Physician Compensation Reports for a 5-year period. Surgeons were compared with nonsurgeons and across subspecialties. Results: Surgeon and nonsurgeon productivity in terms of relative value units remained relatively stable over the study period; surgical:nonsurgical productivity per provider was 1.30-1.46:1. Conclusions: Surgeons produce a significant amount of the total work in multi-specialty medical groups. These results may indicate that the surgical and general surgical workforce has reached a plateau with respect to clinical productivity. Predicted increases in demand for procedure-based work to care for the aging population are likely to be difficult to meet with the available workforce.