Radiologists (and all physicians for that matter) are compensated based on RVU, or relative value unit. RVUs are measured using a variety of factors: work, expenses, and liability insurance. Those variables are divided into different components that evaluate time, skill, judgement, equipment, and supplies. The Medicare rate is determined by multiplying the RVU by a dollar conversion factor. RVUs were conceived in the late 1980s by Harvard University researchers who estimated the work put into a series of patient vignettes. According to the National Health Policy forum, “Estimating and updating the RVUs is a labor-intensive process because there are no readily available, up-to-date data on the resource requirements of each service.”
Yet, as technology continues to change and shape radiology practices, radiologists are pressured to collect more patient data and produce faster diagnoses in order to meet RVU benchmarks. Over time, CT, MRI, PET-CT, and nuclear imaging techniques have redefined the way RVUs are measured. One healthcare worker who goes under the handle Cancer Geek, considers these changes to be negatively impacting the field. In a Medium blog post, he wrote, “Think about walking into work one day and your manager or boss telling you that you need to do 2X the work in the same amount of time or find your salary cut by 50%.”
Technology has forced radiologists to work faster, as if they were laborers trying to make their quotas in a factory. The demand to meet RVU standards has jeopardized the quality of their work and reduced communication practices.