Family physician satisfaction with two different academic compensation schemes.

Academic family physicians are typically required to be involved in many activities other than clinical work, including research, administration, and teaching. These activities are not always reimbursed to the same level as clinical work.1,2 Reduced income in academic settings may act as a disincentive for physicians, particularly family physicians, to pursue academic medical careers3 and may also cause a deterioration in the quality of clinical education.4 Many academic compensation schemes (ACSs) have been developed in an attempt to compensate academic physicians for the full spectrum of their activities. Reimbursement of non-clinical activities according to a relative value scale model using relative value units is one type of ACS.5-9 These reimbursement plans are also referred to as comprehensive relative-value-based incentive plans (CRVPs).9 CRVPs generally have three essential characteristics; they (1) include a “comprehensive” list of activities, including clinical, teaching, research, administrative, and other activities relevant to the department mission, (2) assign “relative” merit, and (3) monetary “value” to these activities. A recent systematic review of the effects of ACSs included studies of eight different compensation schemes; six of these compensation schemes were CRVPs.10 The review concluded that CRVPs improved research productivity and possibly clinical productivity but had no effect on physician engagement in teaching. This review noted that only one included study11 considered physician satisfaction and that in this study “...physician satisfaction varied among faculty and was associated with faculty understanding of the plan and inversely associated with years of service.”10 Other studies not included in this systematic review have shown varying levels of physician satisfaction with the use of CRVPs to reimburse