Impact of clinical volume on scholarly activity in an academic children's hospital: trends, implications, and possible solutions

Purpose. To evaluate the effect of changes in clinical volume on scholarly activities in an academic pediatric radiology department. Methods. For each academic year from 1995 to 2000 we queried the departmental radiology information system for clinical examination volume and work complexity expressed in work relative value units (RVU) per full-time equivalent (FTE) radiologist. Publication activity by faculty and fellows was assessed by an electronic (Medline) search for all peer-reviewed articles. Departmental presentations at annual meetings of four major radiological societies were determined from published proceedings. The relationship between scholarly activity and clinical volumes was assessed by linear regression. Results. Over the 6-year study period, the number of clinical exams per FTE radiologist increased by 17% (P < 0.05) and the number of RVUs per FTE radiologist increased by 46% (P < 0.02). During the same period, the number of peer-reviewed publications per FTE radiologist decreased by 69% (P < 0.01 by linear regression), while number of presentations at national meetings dropped by 16% (P = NS). Number of clinical examinations and RVU per FTE were both strong predictors of decreasing publication rate (r = -1, P < 0.04), but not of academic presentations at national meetings. There was no correlation between clinical and academic productivity for individual faculty in the final year of the study (r < 0.01, P = NS). Conclusions. Increases in clinical workload have negatively affected the academic productivity of pediatric radiologists at a large children's hospital.