Developing a model for attending physician workload and outcomes


Henry J. Michtalik, Peter J. Pronovost, Jill A. Marsteller, Joanne Spetz, Daniel J. Brotman

Jun. 11, 2013

With increased economic pressures on hospitals, limitations on resident physician hours, and payment reductions for preventable harms, hospitals seek to increase productivity while improving the quality of patient care. Frequently, relative value units and patient encounters are used to track physician productivity and establish national benchmarks.1,2 However, productivity varies based on a range of characteristics that are not generally reported, limiting the accuracy of comparisons across institutions. Also, comprehensive process and outcome measures from different stakeholders' perspectives need to be established to align diverse health care interests, ensure widespread acceptability, and provide comprehensive goals.3 In the present study, we (1) identify an actionable measure of attending physician workload; (2) characterize factors accounting for differences in workload; and (3) identify a congruent set of measures that would be valued by disparate stakeholders.