A systematic review of 39 studies across 13 surgical specialties found that surgeon compensation models in the US remain heterogeneous, with salary, work relative value unit–based, hybrid, fee-for-service, and value-based structures associated with differing effects on clinical productivity, quality, and nonclinical contributions. Productivity-driven models increased surgical volume but often did not capture case complexity or nonclinical work, while salary and hybrid approaches supported teamwork and academic activities but were linked to lower volume or greater administrative complexity, with limited adoption and mixed effects observed for value-based models.

Source: JAMA Surgery