Letting Academic Physicians Retain More Clinical Revenue: A Perspective

Post-college, I invested years in academic labs, absorbing the belief that publishing symbolizes academic significance. Being affiliated with top-tier universities was perceived as an indicator of merit.

This perception shifted during my residency. I encountered an exceptional radiologist from private practice and suggested he join Mallinckrodt, a renowned radiology institute in the Midwest. His pithy response? "Mallinckrodt should work for me." He highlighted the income disparity: private practitioners often earn much more than their academic counterparts.

Medicine's curriculum, largely influenced by Abraham Flexner's century-old philosophy, emphasizes research's intrinsic value. In my Midwest upbringing, universities with "state" or "A&M" (like Iowa State, Texas A&M) were linked with agriculture and engineering, whereas "University of" usually denoted institutions offering broader education, perhaps medical or law degrees. I later recognized this naming pattern isn’t universal. Still, it’s evident that vocational-oriented universities aren't as dominant in esteemed associations or top U.S. News rankings.

Research reputation is tethered to scientific funding. Institutions often channel up to 50% of faculty grant money for "indirect" expenses. A sizeable government grant can sometimes barely cover essential lab equipment and an assistant’s salary. Once, I observed a professor misdirect cancer charity funds, questioning the belief that "all research is valuable".

In academic medicine, patient interaction often dictates compensation more than grant submissions. For me, publishing isn't about impressing superiors but about catalyzing positive change. Today's digital era questions traditional academic metrics: impact factor relevance dwindles and the importance of book chapters seems inflated. Prometheus Lionhart, a self-published radiologist, is evidence, as his review series is highly sought-after by trainees.

Attending academic conferences feels like a ritual. Many resemble leisure trips under the guise of professional development. Although occasionally insightful, online platforms could disseminate the same knowledge efficiently.

Medical education's emphasis on research seems dogmatic, potentially detracting from genuine clinical training. If we want superior educators for our future physicians, academic physicians should be allowed to keep more of their clinical revenue.

Cory Michael is a radiologist.