Residents as a valuable asset: the financial benefits of residency program expansion

Background Hospital systems across America are rapidly expanding to meet increasing population needs and address evolving care complexity. There is also a developing need to train more surgeons to address a predicted deficit of up to 23,000 surgeons by the year 2032. To assess how we could address i...
Ausführliche Beschreibung

Background Hospital systems across America are rapidly expanding to meet increasing population needs and address evolving care complexity. There is also a developing need to train more surgeons to address a predicted deficit of up to 23,000 surgeons by the year 2032. To assess how we could address increasing patient loads and help to reduce physician shortages, we completed a financial model to calculate the cost of expanding our general surgery cohort by one position, compared to completing the same workload using advanced practice providers (APPs). Methods We assessed costs of employment for surgical residents as well as advanced practice providers accounting for itemized benefits (including salary, health insurance, dental insurance, vision insurance, licensing, malpractice insurance, life insurance, disability insurance, continuing medical education, conference travel, meals, uniforms, medical equipment, match fees, certification, incentive fees, parking, society fees, ACGME fees, GME costs, and pagers), job functions, established patient care ratios, work hours, and attrition rates. We assumed sufficient surgical case volume to accomplish American Board of Surgery training goals for all residents following cohort expansion and institutional maximum had been reached for CMS reimbursement for resident employment. Results When reviewing actual FTEs accomplished by general surgery residents, PGY-1 residents complete 4.33 FTEs, PGY-2 residents 3.52 FTEs, Lab-1 and Lab-2 residents 0 FTEs, PGY-3 Residents 3.39 FTEs, PGY-4 Residents 4.04 FTEs, and Chief (PGY-5) residents 3.27 FTEs. All told, addressing this same work volume with APPs would require 18.56 FTEs to account for the workload of five clinical residents. The total cost of expanding our residency cohort by one position would total $602,878.22 in a seven-year program (including lab residents) and $450,612.92 in a five-year program, compared to $2,093,191.96 to address this workload with a workforce of advanced practice providers. Conclusion APPs perform an essential service to our care teams and help to balance the patient load and improve the educational environment for our surgical trainees. However, scaling up residency programs in the setting of sufficient case volume can provide significant financial benefit to hospital systems and help to address our nations projected surgical workforce shortage. Ausführliche Beschreibung

Autor*in:	Leraas, Harold [verfasserIn] Johnson, Meredith Tracy, Elisabeth Migaly, John Alseidi, Adnan

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	General surgery Residency Graduate medical education

Anmerkung:

© The Author(s), under exclusive licence to Association for Surgical Education 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Übergeordnetes Werk:	Enthalten in: Global surgical education - [Cham] : Springer Nature Switzerland, 2022, 2(2023), 1 vom: 23. Jan.
Übergeordnetes Werk:	volume:2 ; year:2023 ; number:1 ; day:23 ; month:01

Links:	Volltext

DOI / URN:	10.1007/s44186-023-00102-y

Katalog-ID:	SPR04912658X