SPECIAL TOPIC
Benchmarking Academic Plastic Surgery
Services in the United States
Elaine Horibe Song, M.D.,
Ph.D., M.B.A.
Afshin Shirazian, M.B.A.
Brian Binns, M.B.A.
Yuedi Fleming, M.B.A.
Lydia Masako Ferreira,
M.D., Ph.D., M.B.A.
Rod J. Rohrich, M.D.
Kodi Azari, M.D.
Los Angeles, Calif.; Sa ˜o Paulo, Brazil;
and Dallas, Texas
Summary: Rising health care costs and increasingly demanding patients are
only some of the challenges faced by academic plastic surgery services in their
pursuit of excellence in education, research, and patient care. Benchmarking,
when correctly applied, is a powerful tool that can help services learn from each
other’s experiences. This study aimed at creating the first benchmarking report
summarizing performance indicators and management practices of some of the
most complete academic plastic surgery units in the United States. Results
provide an opportunity for plastic surgery leaders to benchmark against their
own units, identify eventual gaps, and improve their performance as
needed. (Plast. Reconstr. Surg. 129: 1407, 2012.)
I
n March of 2010, President Obama signed the
Affordable Care Act, a bill that aims at overhaul-
ing the American health care system. One of the
bill’s main focuses is to deter costs from rising un-
controllably. However, experts forecast that even af-
ter successful implementation of the new cost-con-
taining measures, it will take several years until the
long-term health care cost curve converges toward
the inflation curve.
1–3
Meanwhile, health care pro-
viders struggle to adapt to a new environment where
patients demand more for less.
4
Leaders of academic plastic surgery services
need to use extra diligence to make their units thrive
in the current economic context. In addition to de-
livering highly specialized care, academic services
are responsible for forming new leaders in plastic
surgery and for expanding medical knowledge
through research. The three academic pillars (i.e.,
patient care, research, and education) are inter-
twined and interdependent in most academic ser-
vices. Nevertheless, reduced reimbursement for pro-
fessional services and tighter private and public
funding have imposed a shift in priorities for the
majority of academic programs.
5,6
As a result, more
time is spent on revenue-generating clinical activities
than on teaching or research activities.
To manage their units, chairs/chiefs often use
methods acquired over years of experience, and
often these methods are the ingredients that make
their services successful. By systematically studying
practices of successful units, academic institutions
can accelerate their own progress. This is the es-
sence of benchmarking, a powerful tool that,
when used properly, is the best tool with which to
efficiently overcome challenges posed by the cur-
rent state of health care.
7
Widely used in other
fields, benchmarking is defined by the American
Productivity and Quality Center as “the process of
identifying, learning, and adapting outstanding
practices and processes from another organiza-
tion to help improve performance.” The field of
management is rich in examples of market leaders
such as Toyota, Xerox, and IBM, which routinely
apply benchmarking practices to hone their com-
petitive advantages.
The aim of this study was to create the first
benchmarking report summarizing performance
indicators and management practices of some of
the U.S. academic plastic surgery units with well-
developed patient care, research, and education
pillars. Results provide an opportunity for plastic
surgery leaders to benchmark against their own
units, identify eventual gaps, and improve their
performance as needed.
From the Anderson School of Management, University of
California, Los Angeles; the Division of Plastic Surgery,
Federal University of Sa ˜o Paulo; the Department of Plastic
Surgery, University of Texas Southwestern Medical Center;
and the Department of Orthopedic Surgery, David Geffen
School of Medicine at the University of California, Los
Angeles.
Received for publication September 12, 2011; accepted
January 3, 2012.
Copyright ©2012 by the American Society of Plastic Surgeons
DOI: 10.1097/PRS.0b013e31824f8f16
Disclosure: This study was funded by authors
only. The authors have no financial interest to
declare in relation to the content of this article.
www.PRSJournal.com 1407