BACKGROUND: Academic surgery requires commitment beyond financial incentives. Nevertheless, the monetization of clinical effort measured by WRVU is not well characterized. Previous work indicates academic (Ac) surgery charges a premium of 16% compared with nonacademic (NonAc) counterparts. In this study, we analyze patterns in the valuation of Ac and NonAc work across general surgery subspecialties. STUDY DESIGN: MGMA datasets (CY 2014, 2018 and 2022) were queried for total cash compensation (TCC) and WRVU among colorectal (CR), general (GS), surgical oncology (SONC), plastic (PRS), transplant (TX), trauma (TR) and vascular (VASC) surgery. TCC, WRVU and TCC/WRVU were compared between Ac and NonAc. ANOVA and t-test were used as appropriate
p <
0.05 was deemed statistically significant. Linear regression was used to perform trend analysis to evaluate TCC/wRVU over time by subspecialty. RESULTS: TCC in all Ac subspecialties was less than NonAc at all years. WRVUs in Ac subspecialties were greater than NonAc at all years. TCC/WRVU in all Ac subspecialties was less than NonAc at all years. Differences between Ac and NonAc TCC/WRVU varied from -6/ -52% (TR
p=0.03) to +/ +6% (CR
p=NS). Trend analysis shows the gap between Ac and NonAc TCC/wRVU in multiple general surgery subspecialties is widening. CONCLUSION: Ac exacts a passion tax over NonAc for virtually all general surgery subspecialties. As measured by TCC/WRVU, Ac TR charges the highest tax (-52%
p=0.03), followed by PRS (-40%
p=0.01), SONC (-27%
p=0.02), VASC (-12%
p=0.02), TX (-10%
p=NS), and GS (-9%
p=0.04). Only Ac CR yields a positive "return" (+6%
p=NS). Embarking on a career in Ac demands a passion for values that transcend financial gain.