Practice patterns of academic general thoracic and adult cardiac surgeons

Michael T. Ingram, David H Wisner, David T Cooke

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform.

Methods: We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions.

Results: The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P < .001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P < .001), only 2.5%of the total wRVUs generated by CSs were from E &M codes versus 18.8%for GTSs. Critical care codes were 1.5%of total evaluation and management billing for both CSs and GTSs.

Conclusions: Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization.

Original languageEnglish (US)
Pages (from-to)1162-1166
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number4
DOIs
StatePublished - Oct 1 2014

Fingerprint

Thorax
Surgeons
Current Procedural Terminology
Video-Assisted Thoracic Surgery
Critical Care
Inpatients
Databases
Medical Faculties
Diagnosis-Related Groups
Ambulatory Care
Aortic Valve
Mitral Valve
Coronary Artery Bypass

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Practice patterns of academic general thoracic and adult cardiac surgeons. / Ingram, Michael T.; Wisner, David H; Cooke, David T.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 148, No. 4, 01.10.2014, p. 1162-1166.

Research output: Contribution to journalArticle

@article{3b3595e00a014f668df11a78ee55508b,
title = "Practice patterns of academic general thoracic and adult cardiac surgeons",
abstract = "Objective: We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform.Methods: We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions.Results: The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P < .001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P < .001), only 2.5{\%}of the total wRVUs generated by CSs were from E &M codes versus 18.8{\%}for GTSs. Critical care codes were 1.5{\%}of total evaluation and management billing for both CSs and GTSs.Conclusions: Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization.",
author = "Ingram, {Michael T.} and Wisner, {David H} and Cooke, {David T}",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.jtcvs.2014.04.035",
language = "English (US)",
volume = "148",
pages = "1162--1166",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Practice patterns of academic general thoracic and adult cardiac surgeons

AU - Ingram, Michael T.

AU - Wisner, David H

AU - Cooke, David T

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Objective: We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform.Methods: We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions.Results: The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P < .001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P < .001), only 2.5%of the total wRVUs generated by CSs were from E &M codes versus 18.8%for GTSs. Critical care codes were 1.5%of total evaluation and management billing for both CSs and GTSs.Conclusions: Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization.

AB - Objective: We hypothesized that academic adult cardiac surgeons (CSs) and general thoracic surgeons (GTSs) would have distinct practice patterns of, not just case-mix, but also time devoted to outpatient care, involvement in critical care, and work relative value unit (wRVU) generation for the procedures they perform.Methods: We queried the University Health System Consortium-Association of American Medical Colleges Faculty Practice Solution Center database for fiscal years 2007-2008, 2008-2009, and 2009-2010 for the frequency of inpatient and outpatient current procedural terminology coding and wRVU data of academic GTSs and CSs. The Faculty Practice Solution Center database is a compilation of productivity and payer data from 86 academic institutions.Results: The greatest wRVU generating current procedural terminology codes for CSs were, in order, coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In contrast, open lobectomy, video-assisted thoracic surgery wedge, and video-assisted thoracic surgery lobectomy were greatest for GTSs. The 10 greatest wRVU-generating procedures for CSs generated more wRVUs than those for GTSs (P < .001). Although CSs generated significantly more hospital inpatient evaluation and management (E & M) wRVUs than did GTSs (P < .001), only 2.5%of the total wRVUs generated by CSs were from E &M codes versus 18.8%for GTSs. Critical care codes were 1.5%of total evaluation and management billing for both CSs and GTSs.Conclusions: Academic CSs and GTSs have distinct practice patterns. CSs receive greater reimbursement for services because of the greater wRVUs of the procedures performed compared with GTSs, and evaluation and management coding is a more important wRVU generator for GTSs. The results of our study could guide academic CS and GTS practice structure and time prioritization.

UR - http://www.scopus.com/inward/record.url?scp=84908246538&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908246538&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2014.04.035

DO - 10.1016/j.jtcvs.2014.04.035

M3 - Article

C2 - 24836992

AN - SCOPUS:84908246538

VL - 148

SP - 1162

EP - 1166

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 4

ER -