We investigated whether/how cardiac surgeons can be productive both academically and clinically. Using online resources (New York State Adult Cardiac Surgery database, SCOPUS), we collected individual clinical volumes (operations performed/year), academic metrics (ongoing publications, role as author), practice setting, and seniority for all cardiac surgeons in the State of New York from 1994 to 2011. Over time, individual clinical volumes decreased (median operations/ year: 193 in 1995 vs 126 in 2010; P < 0.001), whereas academic productivity remained unchanged (median publications/year: 0.7 vs 0.3; P 5 0.55). There was no correlation (Spearman’s correlation coefficient: 20.061; P 5 0.08) between the number of new publications and operations/year for the whole population. More operations/year (median: 155 vs 144; P 5 0.03) were performed by surgeons without versus with publications during that same year. Who published more worked at hospitals with higher clinical volumes (Spearman’s correlation coefficient: 0.16; P < 0.001) and was more likely affiliated with thoracic surgery fellowship programs (median publications/year: 1.7 for affiliated vs 0 for nonaffiliated surgeons; P < 0.001). Cardiac surgeons could be classified into four categories: w40 per cent clinically busy, but not publishing at all; w45 per cent operating less, but publishing a little; w15 per cent clinically very productive (operating as much as the nonpublishers) and publishing a lot; and w1 per cent operating the least, but publishing the most.