Primary care teaching physicians' losses of productivity and revenue at three ambulatory-care centers

This study reports two years of basic data concerning University of Illinois clerkship students, their teaching faculty, and their patients at three community health centers. Students from four classes (1985, 1986, 1987, and 1988) were studied in 1985 and 1986. The faculty were family physicians, internists, and pediatricians who provided 20% of the undergraduate medical education for the last 30 months of a four-year curriculum. The study's goal was to develop estimates of the primary care teaching physicians' productivity, to compare them with the productivity of physicians not involved in teaching, and to provide estimates of revenue shortfalls that occurred for the physicians who were teaching. The estimated productivity of the teaching physicians, working 29 hours a week in ambulatory-care settings, was lower by 30-40% when they were teaching medical students than the productivity of nonteaching physicians regionally and nationally. The average patient-care revenue loss for a full-time-equivalent faculty member per full-time-equivalent student for 1985 was estimated to be $27,531 (regional comparison) or $21,143 (national comparison). The corresponding figures for 1986 were $24,294 and $21,525, respectively. The study's results should be useful to those who are planning to establish ambulatory-care delivery systems and also to directors of existing ambulatory-care delivery systems who may be contemplating accepting medical students.