59% of physicians say productivity-based pay is 'unfair'

Most physicians expressed disapproval of relative value unit-based pay in Medscape's 2024 "Physicians and RVUs Report." 

The report surveyed 1,005 physicians between March 1 and May 26.

Medical billing is based on standardized relative value units, which are assigned their value by CMS. Most physicians' pay is at least partly based on their RVU generation, and many physicians told Medscape that arrangement puts financial strain on their practice and relationships with patients. 

In a survey question asking about the methodology for determining reimbursements for services based on RVUs, about 39% of respondents said the current equation was "unfair" and 20% said it was "very unfair." 

"It becomes a business transaction and cold relationship that undermines trust, and therefore compliance," one physician said in the survey in elaborating on their response. "Ultimately, it makes patients more apt to look to other sources for their medical information."

In another survey question, 60% of physicians told Medscape that they had some level of unhappiness with the impact that RVUs have on their personal finances. 

"I am already mad that the medical field and practice is controlled by health insurers and what they pay and authorize," a New York anesthesiologist said in the survey. "Then, [that approach] is transferred to medical offices and hospitals, where physicians are paid by RVUs." 




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