Impact of FTE Adjustments in Clinical Productivity in Academic Otolaryngology

Introduction: Adjusting physician full-time equivalent (FTE) can help improve provider satisfaction and prevent burnout, yet the relationship between FTE and operational efficiency remains poorly characterized in surgical specialties. Understanding these associations could inform evidence-based workforce planning strategies.

Methods: We conducted a retrospective cross-sectional analysis of 49 ENT providers at an academic surgical institute during 2025. Provider FTE ranged from 0.06 to 1.0. Primary outcomes included work volume, work per FTE (efficiency), and national benchmark percentile rankings. Providers were stratified into four FTE categories: Low ( < 0.5, n=7), Medium (0.5-0.75, n=8), High (0.75-0.9, n=21), and Full (0.9-1.0, n=13). We performed Pearson correlations and linear regression for statistical analysis.

Results: FTE demonstrated a strong positive correlation with absolute work volume (r=0.746, p< 0.001; R²=0.556), with each 0.1 FTE increase associated with 796 additional work units. Productivity efficiency remained stable across all FTE categories (p=0.667; mean 8,374 units/FTE). The 0.75-0.9 FTE range achieved the highest average benchmark percentile (64.1%), with 76.2% of providers performing at or above the 50th national percentile compared to 53-62% in other categories. This group demonstrated the most consistent performance, with the lowest variability in both efficiency metrics (SD 1,796) and benchmark rankings (SD 17.4). Overall, 67.3% of all providers met or exceeded median national benchmarks, though only 24.5% exceeded the 80th percentile.

Conclusions: While FTE strongly predicts absolute work volume, productivity efficiency remains constant across FTE levels, indicating that providers maintain similar work intensity regardless of time commitment. The 0.75-0.9 FTE range represents an optimal balance. These findings support targeted FTE models for maximizing productivity and national benchmark rankings. Additional work is needed to investigate the overall financial incentive for providers receiving less salary for decreased FTE.