Doctor Pay: RVUs Determine Income

Summary

Dr. Eric Bricker discusses the intricacies of physician payment through work Relative Value Units (wRVUs) in healthcare. He explains how wRVUs are tied to specific CPT codes for services like office visits and procedures, and how they translate into annual salaries. The video highlights the disparity in wRVUs between specialties, particularly the undervaluation of primary care physicians' work, which often doesn't convert into billable codes. This system, he argues, hinders effective primary care and needs reform for better healthcare outcomes.

Takeaways

• 🚑 The video is a continuation of a series on physician payment, focusing on 'Work RVUs' (Relative Value Units) and their significance in healthcare operations.
• 💼 Dr. Eric Bricker provides a link to a previous video for more details on RVUs and assumes the audience has a basic understanding of the concept.
• 🔢 Work RVUs are tied to specific CPT codes, which are used when a doctor bills for their services, such as office visits or procedures.
• 📈 The value of an RVU is determined by the RUC (Relative Value Scale) and is associated with the complexity and time required for a service.
• ⏰ An example given is the CPT code 99202 for a new patient visit with medium complexity, which equates to 0.93 RVUs and requires about 20 minutes of face-to-face time.
• 💉 Another example is the CPT code 45380 for a colonoscopy with biopsy, which takes 30-60 minutes and equates to 3.56 RVUs.
• 💰 The annual salary of a physician can be calculated based on the total RVUs they generate in a year, with an example of a gastroenterologist earning $712,000 for 10,500 RVUs.
• 🏥 The video discusses the median RVUs by specialty, with cardiothoracic surgeons having the highest at 9822 RVUs per year, and primary care physicians significantly lower at 4900 RVUs per year.
• 🕊️ The video points out the discrepancy in RVUs between specialists and primary care physicians, despite similar weekly working hours.
• 💼 The benefits of the RVU system are skewed towards the employers of physicians, as it encourages competition and volume of patients seen.
• 🔑 However, the cons for physicians include not being paid for all the work they do, particularly affecting primary care physicians who perform a lot of unbillable care coordination.
• 🔄 The video concludes that the current RVU-based fee-for-service system hinders effective primary care and suggests that changes are needed for improvement.

Q & A

What is the topic of Dr. Eric Bricker's video?

The topic of Dr. Eric Bricker's video is 'Dr. Pay Part 2: Work RVUs', which discusses the concept of Relative Value Units (RVUs) and their impact on physician payment.

What does RVU stand for?

RVU stands for Relative Value Unit, a measure used to determine the payment for medical services provided by physicians.

How are RVUs connected to the services a doctor provides?

RVUs are tied to specific CPT (Current Procedural Terminology) codes, which represent the services provided by doctors such as office visits or procedures.

What is an example of an Evaluation and Management (E/M) CPT code?

An example of an E/M CPT code is 99202, which represents a new patient visit of medium to lower complexity with an expected 20 minutes of face-to-face time with the patient.

How many RVUs are assigned to the 99202 CPT code?

The 99202 CPT code is assigned 0.93 RVUs.

What is the significance of the number of RVUs a physician accumulates?

The number of RVUs a physician accumulates is directly related to their annual income, as it translates into the volume of services they have provided.

How does the video illustrate the difference in RVUs between a primary care physician and a specialist?

The video uses the example of a gastroenterologist who performs a colonoscopy with biopsy (CPT code 45380), which has 3.56 RVUs, compared to the E/M code 99202 with 0.93 RVUs, showing the higher value assigned to certain procedures.

What is the average number of RVUs for a gastroenterologist in the 75th percentile?

A gastroenterologist in the 75th percentile builds 10,500 RVUs per year.

How does the video address the issue of primary care physicians and their workload?

The video points out that primary care physicians often work a similar number of hours per week as specialists but have significantly fewer RVUs due to the nature of their work, which may not be billable under CPT codes.

What is the median number of RVUs for primary care physicians in internal medicine and family practice?

The median number of RVUs for primary care physicians in internal medicine and family practice is 4,900 per year.

What is the main argument against the current RVU-based fee-for-service system as presented in the video?

The main argument against the current RVU-based fee-for-service system is that it does not adequately compensate primary care physicians for the non-billable work they do, such as care coordination, which is essential for effective primary care.

How does the video suggest the current system affects the quality of primary care?

The video suggests that the current system, by not compensating for all the work done by primary care physicians, may lead to insufficient care coordination and a lack of adequate and effective primary care.