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Measuring Productivity by RVU


The most common complaint amongst physicians in our practice is that someone is working harder than someone else. It’s a contest no one wins.

The most common complaint amongst physicians in our practice is that someone is working harder than someone else. It’s a contest no one wins.

We’ve looked at several ways to measure productivity and decided that relative value units (RVUs) are the best option for us. The practice has not used an incentive model for bonus distribution based on RVUs to date, although that was one of the first solutions mentioned. Anticipating complaints over inequity of RVUs for interventional radiology is our main concern, as are asymmetries in the type of work done by different radiologists and appropriate rewards for time spent on administration. So what is short of an incentive system, but still a positive incentive?

We’ve chosen RVU analysis and feedback as the intermediate solution. Everyone gets a tally of their cumulative RVUs with their paycheck each quarter, along with an anonymous list of what each other MD produced individually that quarter. Our experience is that this incentivizes those below the average and also may quell the complainers, some of whom find themselves in the middle of the group.

And what would be a more extensive next step to address the issue?  We are looking into using a "traffic" manager for assignment of exams.

The manager assigns work appropriate to the individual’s skills at morning and noontime, so as to even out the work distribution. By doing so, everyone can work at their own pace and be fairly measured for how much work is done.  We start by working out how many studies our radiologists read on average at specific locations.

Then, with that information in hand, and by group vote, we pick a standard deviation for each work rotation. Next, the traffic manger pushes those studies out to the workstations or populates a work-list for each radiologist, (choose whichever your PACS can do). This ensures that the low producers at least do the average. When there is overflow after that, we’ll distribute it equally, not just send it to those who have finished their work as we used to do.

By using this type of incentive, work is still shared and physicians are able to work to their skill set and within their own style of time management.

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