Contribution of Plastic Surgery to a Health Care System

Abstract

With the fluctuating economic conditions and the health care reform taking place in the United States, it is critical for plastic surgeons to be aware of their financial value to health care systems. The authors evaluated surgeon productivity and economic contributions made to their hospital by the Division of Plastic Surgery. Operative case logs for the departments of surgery, neurosurgery, and orthopedics were reviewed for fiscal year 2009. Margins, revenue, and surgeon total relative value units (a measure of productivity) were analyzed. Average relative value unit for all surgical specialties was 94,595, whereas that for the Division of Plastic Surgery was 54,288. Average value per surgeon for the health system was 12,149. For plastic surgery, average value per surgeon was 14,272, and the division was ranked fourth highest among all surgical services. The mean number of relative value units per case was 24.5 among all services; for plastic surgery, it was 31.2. Approximately one-third of all procedures performed by plastic surgery were in collaboration with another surgical specialty. The average net revenue for primary inpatient admissions per relative value unit was $381 for all surgical services and $222 for plastic surgery. A total of $2.2 to $3.7 million was the estimated savings for the hospital from complication salvage cases performed by the division. Plastic surgery contributes significantly to hospital bottom line in performing joint cases and salvaging complications. In the current economic environment, it is crucial for plastic surgeons to be fully cognizant of their positive influence and economic impact on the hospital margin.