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Cardiothoracic surgeons provide tremendous value to the patients and institutions they serve. But understanding their value and translating it into fair compensation has always been challenging. While there are external resources that provide general guidance on surgeon compensation, there are no compensation surveys that capture the nuances of the specialty. Until now.

STS has commissioned Gallagher, a consulting firm with more than four decades of experience in physician compensation and valuation services, to conduct a first-of-its-kind compensation survey in early October to help CT surgeons practicing in the U.S. understand their value in the market specific to their specialty, practice, career stage, and geographic region. Data collected will be kept confidential and will not be shared with STS.

A compensation report, featuring only aggregated data consistent with federal guidelines to ensure data integrity and anonymity, will make it easier for CT surgeons to evaluate employment opportunities and negotiate salaries and benefits.

The compensation report—slated for release January 2024—will be available to STS surgeon members who participate in the survey at no cost, and to STS members and nonmembers who do not participate in the survey for a fee.

How To Participate in the STS Compensation Survey

Non-resident/trainee CT surgeons should have received an email with instructions on how to complete the survey from Gallagher or you can access the survey here. The survey should take about 15 minutes to complete.

Participants should have their 2022 W-2 (or equivalent income documentation), compensation plan, and associated annual compensation calculations and productivity (e.g., wRVUs, etc.) reports at hand before they begin. Participants should contact their practice administrator if they do not have access to the required documentation.

Deadline for completing the survey is October 27, 2023.

If you have questions or do not receive an email invitation but wish to participate, email jenna_lambrecht@ajg.com.

Dr. Zach Brennan’s preference for high-stakes careers led him to choose cardiothoracic surgery. He went into the specialty with eyes wide open, knowing that it was not for the faint of heart. Like most CT surgeons, Dr. Brennan is a self-proclaimed workaholic and is excited by the specialty’s rapid innovations and minimally invasive surgery new developments.

Dr. Brennan received the STS Looking to the Future Scholarship, which he said boosted his skills, knowledge, and resolve. Today, he is training in Cedars-Sinai Medical Center’s Integrated Cardiothoracic Surgery Residency program. He unequivocally adds that the mentorship of Tyler Wallen, DO, a general surgeon specializing in cardiac surgery at Geisinger; Jeffrey Jacobs, MD,  pediatric cardiac surgeon and professor of surgery and pediatrics at the University of Florida; and Anthony Perez-Tamayo, MD, cardiothoracic surgeon at Loyola University Medical Center,  sold him on cardiothoracic surgery. “I was hooked from Day 1!” he says. “Now, being able to walk a medical student through a procedure early on in residency, teaching some of the same basic things mentors have taught me, was a really surreal moment—a full circle experience that was really special.” 

He is no stranger to extreme challenges. Dr. Brennan spent 14 years working in military and government service as a federal agent in intelligence and law enforcement. He worked on local and global issues: improvised explosive devices in Afghanistan, curbed proliferation of missile chips throughout the world, and mastered Arabic. 

Surgery represented the change he was looking for that still fulfilled his drive to respond tactically and strategically to difficult situations. He was awestruck when he first observed aortic surgery with circulatory arrest, a congenital heart transplant, and went on heart procurements. “I think that learning and growing as a surgeon while also facing the complexities of treating CT patients have been challenging, but very welcomed ones.” Outside the OR, the connection to patients hit home and stuck during Dr. Brennan's first residency rotation: a post-operative patient in the cardiac ICU whom he had treated asked him to sign a special heart-shaped pillow. 

Dr. Brennan hopes to build on his interaction thus far with STS, participating in committees in his capacity as a resident and moving on to leadership roles.

With a multitude of interests, sailing, scuba diving, reading, playing guitar, and board games with friends are on top of his favorites list. He prizes traveling and does it with his dog, Korah, whom he has taken to every coast and border of the U.S. 

Catch up with Dr. Brennan on X (formerly Twitter) at @zachjbrennan and watch his recent TEDx Talk.

This summer, I hope everyone found find time to escape the record-breaking heat while spending quality time with family and friends. Recently, while driving to the beach with my family and thinking about what to write for this column, I was surfing the satellite radio channels and was inspired by the title of the 1986 Janet Jackson song, “What Have You Done for Me Lately?” My mission for my day at the beach was clear: Update STS members on the Society’s exciting accomplishments, ongoing projects, and future plans that will directly benefit each one.

Strengthening the STS National Database

In the last President’s Column, I talked about the power of the STS Database and its impact on the specialty. Combined, the four registries of the STS National Database ─ adult cardiac surgery, general thoracic surgery, congenital heart surgery, and STS-Intermacs ─ have accurate, patient-level data on nearly 10 million cardiothoracic surgery operations. STS data along with research trials have been used to develop numerous clinical practice guidelines. Risk calculators are available to help assess the suitability for surgery in patients. Over the last three decades, risk-adjusted data has improved the safety of care, and 30-day outcomes of countless patients.

We now have the ability and opportunity to link our vast data with the National Death Index and with Medicare claims data to demonstrate long-term efficacy, comparative effectiveness, and value-based care compared with other interventional treatments. Over the next six months, we will publish sentinel papers with long-term outcomes on hundreds of thousands of patients demonstrating the efficacy of surgery on specific topics of adult cardiac surgery, general thoracic surgery, congenital heart surgery, and mechanical circulatory support devices. The first sentinel manuscript, which includes more than one million coronary artery bypass grafting patients from our database, demonstrates the long-term survival benefit of multi-arterial grafting and has been submitted to a high-impact journal.

That said, the STS Database is not perfect. Our users have helped to identify gaps and shortcomings as the Database has evolved from its original purpose to provide individual surgeons with tools to benchmark their program’s quality assessment and performance improvement.

Members have asked if the purpose of the database has changed to one of research for the benefit of some academic surgeons rather than serving as a patient care and quality assurance tool for all surgeons. Some members have noted that data collection has become too labor intensive because of the many data elements. Others have complained about the added expense due to abstractors, data coordinators, and third-party vendors needed to manage the data. There continue to be questions about the risk modeling and the relevance of the reported index cases given the rapidly evolving surgical practices related to the increase in transcatheter, endovascular, and endoscopic procedures, and novel drug therapies. 

STS has been listening to this valuable member input, and we have made several changes to decrease the burden, lower the costs, and improve the efficiency of data reporting and return. We recently changed the data warehousing from Duke Clinical Research Institute (DCRI) to IQVIA. We moved most of the data analytics from DCRI to the STS Research Center, which will improve the efficiency and near real-time reporting, analysis, and return of program data. More than 10% of programs are using direct data entry to IQVIA, which allows these programs to bypass the need (and the cost) for third-party data vendors.

Moreover, we are modifying our data dashboard to improve its intuitive appearance and make it more user-friendly. Our goal is to encourage further engagement among surgeons and data coordinators and our STS staff are available to help train more people in direct data entry.

The STS Next Generation Risk Calculator

The STS recently launched a next-generation Operative Risk Calculator to assess the risk of adult cardiac surgery operations. This improved bedside patient care tool includes current risk model adjustment calibrated every three months to ensure up-to-date risk assessment for patients. In addition to the risk of mortality, the risk calculator also provides procedure-specific risk of individual complications associated with index operations (CABG, AVR, MVR, MV repair including one specifically for repair of primary MR, AVR-CABG, MVR-CABG, and MV repair-CABG), as well as the soon to be reported multi-valve and aortic procedures. 

The new risk calculator includes recently added risk factors, such as liver disease, concomitant tricuspid valve procedure, NYHA class, and others not previously included. In addition to providing the calculated risks of individual complications and mortality, the risk calculator also updates and records the impact of each specific risk factor responsible for the composite risk scores to facilitate patient discussions, pre-operative optimization, and medical record charting. A summary page can be easily copied into the electronic medical record. The user-friendly risk calculator is viewable on an intuitively easy-to-use single computer screen and is available on most mobile devices.

With all the new changes, one constant remains: STS’s commitment to ensure that the database exists for all CT surgeons, not just selected large academic centers. The STS database captures 98% of all cardiac surgery operations performed in the United States, allowing every program of every size to benchmark data with the outcomes of “like institutions,” as well as the entire STS cohort.

We have been collecting and analyzing data on the evolving practice of cardiac surgery and will soon be reporting outcomes of multiple-valve operations with and without coronary artery surgery, as well as proximal aortic surgery, including aortic root procedures.

2024 Strategy and Planning

The STS Board of Directors, Council Chairs, and senior staff recently completed a strategic planning process. In this post-COVID world, much has changed in our profession, our specialty, and our membership. A new strategic plan is essential to reaffirm our mission and to set the STS’s top priorities and objectives for the next five years.

As you know, the STS is committed to championing the value and impact of the specialty through quality and research initiatives, advocacy, and strategic partnership. We also are steadfast in our commitment to advance the health, well-being, and inclusion of all CT surgeons from medical school through retirement. But we can’t do it alone. We must do it together.

As part of the 2024 planning process, STS commissioned a survey to collect member feedback, ideas, and insights that will help us explore new ways to enhance membership value, advocate for the specialty and deliver quality educational experiences.

Based on your feedback, we have initiated efforts to address concerns regarding inclusion, selection of STS leaders, and surgeon compensation disparities.

We hired an external consultant to evaluate STS’s DEI policies. I created two new Presidential Task Forces: The Nominating Committee Advisory Task Force to review and improve the current process for identifying, mentoring, and nominating senior STS leaders; and The Surgeon Compensation Task Force to create an annual cardiothoracic surgeon survey to help us better understand workplace-related compensation issues and negotiation matters. The regional, subspecialty, and practice-type specific salary/benefits data will be available to better equip cardiothoracic surgeons to advocate for themselves during contracting and salary negotiations.

STS's Reach Is Extraordinary

STS is everywhere we need it to be to help advance this specialty. The Annals of Thoracic Surgery is the most widely read CT surgery journal in the world. The Thoracic Surgery Foundation, STS’s philanthropic arm, has awarded $1 million in educational, research, and outreach grants in the past year. STS Advocacy is making unprecedented progress to represent your voice in Washington, DC.

As president of the STS, I recently was invited to testify on the value of medical registries at the U.S. House of Representatives Subcommittee on Health regarding Medicare coverage pathways for innovative drugs, medical devices, and technology. Of all the witnesses testifying at this hearing, the STS was one of only two medical specialty societies invited. The impact of our database and the effectiveness of our advocacy efforts literally give the STS a seat at the table in Washington, DC.

After spending the afternoon at the beach, my family and I packed up the car and started to drive back to our hotel. It was a great day at the beach. As luck would have it, the 1974 Bachman-Turner Overdrive song “You Ain’t Seen Nothin’ Yet” came on the radio as we pulled out of the beach parking lot. In one day, two classic rock song titles have proven to be an inspiration to help me write this article. What an exciting time to be a CT surgeon and a member of the STS!

Note: Check out the print magazine mailed directly to you for more informative and inspirational news and stories. Not a member? Join today.