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
Autor*in: |
Leraas, Harold [verfasserIn] |
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Englisch |
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2023 |
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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. |
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Übergeordnetes Werk: |
Enthalten in: Global surgical education - [Cham] : Springer Nature Switzerland, 2022, 2(2023), 1 vom: 23. Jan. |
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volume:2 ; year:2023 ; number:1 ; day:23 ; month:01 |
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DOI / URN: |
10.1007/s44186-023-00102-y |
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SPR04912658X |
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520 | |a 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. | ||
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700 | 1 | |a Alseidi, Adnan |4 aut | |
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10.1007/s44186-023-00102-y doi (DE-627)SPR04912658X (SPR)s44186-023-00102-y-e DE-627 ger DE-627 rakwb eng Leraas, Harold verfasserin (orcid)0000-0003-4556-1218 aut Residents as a valuable asset: the financial benefits of residency program expansion 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © 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. 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. General surgery (dpeaa)DE-He213 Residency (dpeaa)DE-He213 Graduate medical education (dpeaa)DE-He213 Johnson, Meredith aut Tracy, Elisabeth aut Migaly, John aut Alseidi, Adnan aut Enthalten in Global surgical education [Cham] : Springer Nature Switzerland, 2022 2(2023), 1 vom: 23. Jan. (DE-627)1796985570 (DE-600)3114727-6 2731-4588 nnns volume:2 year:2023 number:1 day:23 month:01 https://dx.doi.org/10.1007/s44186-023-00102-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 2 2023 1 23 01 |
spelling |
10.1007/s44186-023-00102-y doi (DE-627)SPR04912658X (SPR)s44186-023-00102-y-e DE-627 ger DE-627 rakwb eng Leraas, Harold verfasserin (orcid)0000-0003-4556-1218 aut Residents as a valuable asset: the financial benefits of residency program expansion 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © 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. 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. General surgery (dpeaa)DE-He213 Residency (dpeaa)DE-He213 Graduate medical education (dpeaa)DE-He213 Johnson, Meredith aut Tracy, Elisabeth aut Migaly, John aut Alseidi, Adnan aut Enthalten in Global surgical education [Cham] : Springer Nature Switzerland, 2022 2(2023), 1 vom: 23. Jan. (DE-627)1796985570 (DE-600)3114727-6 2731-4588 nnns volume:2 year:2023 number:1 day:23 month:01 https://dx.doi.org/10.1007/s44186-023-00102-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 2 2023 1 23 01 |
allfields_unstemmed |
10.1007/s44186-023-00102-y doi (DE-627)SPR04912658X (SPR)s44186-023-00102-y-e DE-627 ger DE-627 rakwb eng Leraas, Harold verfasserin (orcid)0000-0003-4556-1218 aut Residents as a valuable asset: the financial benefits of residency program expansion 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © 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. 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. General surgery (dpeaa)DE-He213 Residency (dpeaa)DE-He213 Graduate medical education (dpeaa)DE-He213 Johnson, Meredith aut Tracy, Elisabeth aut Migaly, John aut Alseidi, Adnan aut Enthalten in Global surgical education [Cham] : Springer Nature Switzerland, 2022 2(2023), 1 vom: 23. Jan. (DE-627)1796985570 (DE-600)3114727-6 2731-4588 nnns volume:2 year:2023 number:1 day:23 month:01 https://dx.doi.org/10.1007/s44186-023-00102-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 2 2023 1 23 01 |
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10.1007/s44186-023-00102-y doi (DE-627)SPR04912658X (SPR)s44186-023-00102-y-e DE-627 ger DE-627 rakwb eng Leraas, Harold verfasserin (orcid)0000-0003-4556-1218 aut Residents as a valuable asset: the financial benefits of residency program expansion 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © 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. 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. General surgery (dpeaa)DE-He213 Residency (dpeaa)DE-He213 Graduate medical education (dpeaa)DE-He213 Johnson, Meredith aut Tracy, Elisabeth aut Migaly, John aut Alseidi, Adnan aut Enthalten in Global surgical education [Cham] : Springer Nature Switzerland, 2022 2(2023), 1 vom: 23. Jan. (DE-627)1796985570 (DE-600)3114727-6 2731-4588 nnns volume:2 year:2023 number:1 day:23 month:01 https://dx.doi.org/10.1007/s44186-023-00102-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 2 2023 1 23 01 |
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10.1007/s44186-023-00102-y doi (DE-627)SPR04912658X (SPR)s44186-023-00102-y-e DE-627 ger DE-627 rakwb eng Leraas, Harold verfasserin (orcid)0000-0003-4556-1218 aut Residents as a valuable asset: the financial benefits of residency program expansion 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © 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. 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. General surgery (dpeaa)DE-He213 Residency (dpeaa)DE-He213 Graduate medical education (dpeaa)DE-He213 Johnson, Meredith aut Tracy, Elisabeth aut Migaly, John aut Alseidi, Adnan aut Enthalten in Global surgical education [Cham] : Springer Nature Switzerland, 2022 2(2023), 1 vom: 23. Jan. (DE-627)1796985570 (DE-600)3114727-6 2731-4588 nnns volume:2 year:2023 number:1 day:23 month:01 https://dx.doi.org/10.1007/s44186-023-00102-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 2 2023 1 23 01 |
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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. 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residents as a valuable asset: the financial benefits of residency program expansion |
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Residents as a valuable asset: the financial benefits of residency program expansion |
abstract |
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. © 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. |
abstractGer |
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. © 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. |
abstract_unstemmed |
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. © 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. |
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Residents as a valuable asset: the financial benefits of residency program expansion |
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Johnson, Meredith Tracy, Elisabeth Migaly, John Alseidi, Adnan |
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10.1007/s44186-023-00102-y |
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2024-07-03T23:26:14.757Z |
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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.</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">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. 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|
score |
7.397979 |