The Midwest Surgical Association
Income, productivity, and satisfaction of breast surgeons

Presented August 4 at the 52nd Annual Meeting of the Midwest Surgical Association, August 2–5, 2009, Lake Geneva, WI.
https://doi.org/10.1016/j.amjsurg.2009.09.006Get rights and content

Abstract

Background

The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction.

Methods

A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons.

Results

There were 772 responses. An increasing percentage of breast care was associated with lower incomes (P = .0001) and similar income satisfaction (P = .4517) but higher job satisfaction (P = .0001). The increasing proportion of breast care was also associated with fewer hours worked per week (P = .0001). Although incomes were lower in surgeons with a higher proportion of their practice in breast care, income satisfaction was not affected.

Conclusions

Although cause and effect relationships between income and breast surgery are difficult to establish, several trends do emerge. Most significantly, we found that dedicated breast surgeons have higher job satisfaction ratings and similar income satisfaction despite lower incomes.

Section snippets

Methods

A 19-question survey was mailed to all 2,160 active members of the American Society of Breast Surgeons with mailing addresses in the United States; active members are general surgeons with a demonstrated interest in breast surgery. The survey asked questions regarding age, sex, proportion of practice dedicated to breast care, fellowship training, work hours, practice patterns, income derived from clinical services, and income and job satisfaction.

Data from surveys were summarized and tabulated.

Results

Out of 2,160 surveys mailed, 772 were returned (35.7% response rate). Responses were received from 48 states and the District of Columbia. The mean age of respondents was 50.1 ± 9.1 years (range 31–83), the mean years in practice was 17.3 ± 9.3 (range 1–50), and 41% were women; 12.4% of respondents were breast fellowship trained, 14.7% had surgical oncology fellowship training, and 14.4% reported fellowship training in another field.

Seven percent reported working with breast fellows, 37.2% with

Income

Our data clearly shows that surgeons dedicating a greater portion of their practice to breast care have lower incomes. The important question then becomes whether this is because of other factors specific to breast care practitioners (ie, hours worked, sex, and so on) or is it related to factors specific to the practice of breast care (ie, Medicare RVU valuations, features unique to the patient population, and so on).

Dedicated breast surgeons reported working fewer hours. To evaluate this,

Limitations

There are some limitations to this study that warrant discussion. Some of the questions generated such disparate responses as to question the clarity of the questions themselves. The number of new breast cancer patients seen per month was wildly unrealistic in many responses, and the data were not incorporated into any of the analysis. Reporting on the number of RVUs produced per month was also unreliable. This was, in part, because of the small minority of respondents that were able to answer

Conclusions

It is clear that incomes for dedicated breast surgeons are lower than those of general surgeons. There are a number of factors that likely influence income. These include trends in sex, number of hours worked, and RVU valuations assigned to breast procedures, to name a few. Although the data gathered in this survey cannot reliably establish cause and effect relationships, certain important trends do seem to emerge. One of the most interesting and compelling findings from this survey is the

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    The primary care background of the MBS is also important in long-term medication management as is needed with preventive therapies, which are vastly underutilized.11 Dedicated breast surgeons report high job satisfaction scores, and the field continues to grow as one of the most fulfilling and rewarding areas of surgery,12 but surgeons must be adequately supported. It is likely that we will continue to see reconfiguration in the healthcare workforce, with more formalized and subspecialized roles for PCPs.

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