# Examining the Relationship Between Academic Excellence and Clinical Productivity in Orthopedic Surgery

## TL;DR

This study finds that top academic orthopedic surgeons maintain high clinical activity while being productive researchers.

## Contribution

The study identifies patterns linking academic excellence and clinical productivity in orthopedic surgery.

## Key findings

- High-achieving academic orthopedic surgeons have higher clinical volumes and publication scores.
- There are significant gender and geographic disparities in academic and clinical metrics.
- Top researchers in hip/knee and shoulder/elbow subspecialties have notably higher clinical volumes.

## Abstract

Background/Objectives: The relationship between clinical volume and academic performance in orthopedic surgery remains understudied. The purpose of this study is to explore the characteristics of high-achieving academic orthopedic surgeons in an attempt to extrapolate patterns and trends that govern the relationship between clinical performance and academia in orthopedic surgery. Methods: The 2023 National Plan and Provider Enumeration System and Medicare claims data (2021–2022) databases were used to include all active orthopedic surgeons of different subspecialties. A publication score, based on publication volume, journal impact, and authorship position, was calculated for each included surgeon, and surgeons who scored in the top 5% were deemed high-achieving academic orthopedic surgeons. Additional data pertaining to demographic characteristics, clinical volume, relative value units (RVUs), and Healthgrades ratings were recorded and analyzed. Results: A total of 23,403 orthopedic surgeons were included in our study, with 1169 considered top researchers. There were significant disparities in multiple parameters according to gender. Moreover, there were geographic variations among orthopedic surgeons with regard to mean publication scores, clinical volume, and RVUs. The top researcher cohort had a higher mean publication score (p < 0.001) and a higher mean clinical volume (p < 0.001) when compared to the total surgeon cohort. Mean RVUs were higher in the total surgeon cohort, although not reaching significance. Hip and knee, as well as shoulder and elbow surgeons, had significantly greater clinical volumes in the top researcher cohort than in the total surgeon cohort (p < 0.001). Despite differences in clinical and research metrics, there were no significant differences in mean Healthgrades ratings and the mean number of Healthgrades ratings between the top researcher sample and the non-top researcher sample. Conclusions: Higher research productivity was not associated with lower clinical productivity, as high-achieving academic orthopedic surgeons demonstrated high academic performance while remaining clinically active.