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ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH

The Impact of Productivity-Based Incentives on Faculty Salary-Based Compensation

Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California

Address correspondence and reprint requests to Ronald D. Miller, MD, Professor and Chairman, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA. Address e-mail to aaeditor{at}pacbell.net.

In industry and academic anesthesia departments, incentives and bonus payments based on productivity are accounting for an increasing proportion of a total compensation. When incentives are primarily based on clinical productivity, the impact on the distribution of total compensation to the faculty is not known. We compared a pure salary-based compensation methodology based entirely on academic rank to salary plus incentives and/or clinical productivity compensation (i.e., billable hours). The change in compensation methodology resulted in two major findings. First, the productivity-based compensation resulted in a large increase in the variability of total compensation among faculty, especially at the Assistant Professor rank. Second, the mean difference in total compensation between Assistant and Full Professors decreased. The authors conclude that this particular incentive plan, primarily directed toward clinical productivity, dramatically changed the distribution of total compensation in favor of junior faculty. Although not analytically investigated, the potential impact of these changes on faculty morale and distribution of faculty activities is discussed.

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