More on How Doctors Are Paid

One way the [Relative Value Update Committee (the RUC, pronounced “ruck” by health wonks)] figures out how much doctors should earn is by estimating how long it takes to do a particular procedure, like the average time of a colonoscopy. Those estimates, Whoriskey and Keating’s analysis suggests, are inflated. If those numbers are right, 78 doctors in Florida must work more than 24 hours a day to perform all the medical procedures they bill. One especially impressive doctor finds time for 50 hours worth of procedures in a given day. (More from Sarah Kliff)

Comments (14)

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  1. Baker says:

    Well the name of the committee make this quote make a bit more sense:

    “But she defended the accuracy of the values assigned to procedures, saying that the committee is careful to make sure that the relative values of the procedures are accurate — that is, procedures involving more work are assigned larger values than those that involve less”

    • August says:

      “In the past 22 years of turning prices over to Medicare, the agency “has accepted about 90 percent of the RUC’s recommended values—essentially transferring the committee’s decisions directly into law.”

      Government failed to re-index the prices, so they just kept bumping the prices up.

  2. Cabaret says:

    They use possibly distorted survey data too.

    “These specialist societies get their data from surveys of their own membership—a group of people who stand to gain directly and materially from making a procedure seem as difficult, time-consuming, and stressful as possible”

  3. Nigel says:

    I find attempting to argue that doctors are paid to much or to little is extremely hard to do, because you can obviously take into account medicine/tool costs, but labor is a completely different issue.

  4. Pamela says:

    Please now we want to tell doctors how long they should take to do delicate procedures? If I am having eye surgery I don’t want my doc racing thru the procedure because some suit says it should be done within so many minutes! Politically correct or not, my doc can take as long as he needs. The suit isn’t doing the procedure and I am sure he wouldn’t want his physician cutting corners to get it done.

    • Susan says:

      It’s not about asking the doctors to rush or do something in less time. It’s about an accurate assessment of how long something actuall takes.

      • Dr. Mike says:

        Why is an accurate assessment necessary? Is this because you think doctors are paid by the hour, and a more accurate assessment will adjust their pay? Such thinking would represent a fundamental misunderstanding of how the RVU is used.

  5. Hoads says:

    I’m confused by this. Does the RVS set actual Medicare payment to physician? If so, does Kiff acknowledge the 90 day global payments to physicians where a surgery fee to physician includes 90 days post surgery? It’s essentially a capitated rate where surgeons are paid at single procedure rate for the actual surgery that also includes any inpatient or outpatient physician visits within 90 days of surgery.

    And understand– physician fees finance the entire physician practice where capital, labor and office rent prices continue to rise such that the inverse relationship between price/volume in technology are not independent variables in physician provided medical care.