Objective:

To assess compensation, workload, and productivity among advanced heart failure and transplant cardiology (AHFTC) physicians in the United States.

Approach:

• Survey Development: Eight board-certified AHFTC physicians and a survey methodology expert developed a 49-item survey assessing demographics, practice characteristics, and career perceptions.
• Survey Distribution: The survey was administered through REDCap and distributed through the Heart Failure Society of America physician listserv from February 1 to March 26, 2025. Non-US respondents were excluded. Compensation and productivity data reflect 2024.
• Statistical Analysis: Analyses used Fisher exact tests, Student t tests, and Spearman correlations. Compensation and work relative value units (wRVUs) were collected in categories, with assigned category values used for numerical estimates. Analyses also adjusted for clinical full-time equivalent effort.

Key Findings:

• Among 183 respondents, 127 (69%) practiced in university settings and 56 (31%) in community settings.
• Approximately 49% received salary-only compensation, 6.6% received productivity-only compensation, and 44% received a combination.
• Estimated median compensation was lower among university-based than community-based respondents ($450,000 vs $550,000; P < .01).
• Median wRVU production adjusted for clinical effort was lower among university-based respondents: 8,600 (interquartile range, 6,700–10,700) vs 11,100 (interquartile range, 8,500–13,300; P < .01).
• Both groups reported a median of 60 work hours per week. University-based respondents allocated less time to clinical work and more to education and research.
• Compensation correlated with clinical effort–adjusted wRVU productivity in both settings, with a stronger association in community practice. Compensation per wRVU for clinical work did not differ significantly between settings after adjustment for clinical effort.

Interpretation:

University-based respondents reported lower compensation and clinical productivity despite similar total work hours and call responsibilities. Differences in clinical effort and nonclinical responsibilities provide context for these findings.

Limitations:

• Self-reported metrics and missing productivity data introduce potential nonresponse or recall bias.
• Broad compensation and productivity categories limit precision; assigning $650,000 to compensation above $600,000 may underestimate higher earnings.
• Data reflect 2024 compensation and productivity without adjustment for inflation.

Conclusion:

This national survey documents differences in AHFTC compensation, effort allocation, and productivity by practice setting. The authors recommend regular surveys to improve transparency and support advocacy.