Neonatology’s race to the bottom: RVUs, cFTEs, and physician time

The clinical productivity of neonatology divisions is often defined as relative value units (RVUs) produced per clinical full-time equivalent physicians (cFTEs). Based on the realities of neonatology clinical billing, commonly daily bundled charges, and one cFTE defined as a fixed number of clinical...

Full description

Saved in:
Bibliographic Details
Published in:Journal of perinatology 2021-10, Vol.41 (10), p.2561-2563
Main Author: Mercurio, Mark R.
Format: Article
Language:English
Subjects:
692/1537
692/700/3935
Analysis
Benchmarks
Influence
Labor productivity
Medical care
Medicine
Medicine & Public Health
Neonatology
Patients
Pediatric Surgery
Pediatrics
Perspective
Physicians
Productivity
Quality management
Race
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The clinical productivity of neonatology divisions is often defined as relative value units (RVUs) produced per clinical full-time equivalent physicians (cFTEs). Based on the realities of neonatology clinical billing, commonly daily bundled charges, and one cFTE defined as a fixed number of clinical hours per year, the RVU:cFTE ratio will inevitably be proportional to the number of NICU patients per physician clinical hour. As a result, increasing productivity defined as the RVU:cFTE ratio, a commonly incentivized goal in neonatology, requires decreasing physician time per patient. As neonatology groups seek to surpass RVU:cFTE benchmarks based upon productivity of peer institutions, they end up in a “race to the bottom,” each striving to spend less time per patient than their peers. This definition of physician productivity fails to consider the importance of time itself as an essential “product” provided by physicians, and can undermine the clinical mission and quality of care.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-021-01192-6