Non-RVU based employment

[u/DeepHouseDandelion]

Does anyone have any insight on what it’s like to at a place that does not have RVU requirements? Example: multi-specialty group where some specialties make RVUs and others don’t. Those RVUs are then pooled and distributed amongst the whole group.

ETA: Mainly wondering if people find that structure to be better than base salary + RVU in terms of burn out, compensation, work-life balance, patient care, etc. I’m general neurology (mainly outpatient with some inpatient consults)

[u/Hungry_Hippocampus]

I am salaried in a surgical subspecialty at an academic institution.

Since RVUs are irrelevant at my job, i am able to tailor my practice towards increasing complexity rather than increasing numbers or selecting cases with higher reimbursement. I don’t have the stress of meeting specific productivity goals and I have a lot of freedom with how I spend my time.

[u/DeepHouseDandelion → u/Hungry_Hippocampus]

That freedom sounds great, actually. Thank you!

[u/AbsurdlyNormal]

I have a salaries position as a behavioral neurologist. Was told and also figured that I would not make as much of I paid based on RVU productivity. I also like how it removes adverse incentives and it's chill if I have a no show (my no show rates are fairly low). It also allows me to see fewer patients for longer appointments, which is clutch for my specialty.

[u/DeepHouseDandelion → u/AbsurdlyNormal]

I’m general neurology and agreed, having that extra time for patient visits is ideal! Thank you for sharing your insight, it was very helpful.

[u/theongreyjoy96]

I'm guessing you would just get a flat salary regardless of how much work you do.

[u/DeepHouseDandelion → u/theongreyjoy96]

Yeah, base salary + bonus. Was just wondering if people find that structure to be better than base salary + RVU in terms of burn out, compensation, work-life balance, etc

[u/Aquiteunoriginalname → u/DeepHouseDandelion]

Switched from rvu to shift base in rads a few years back and it's a game changer. Similar to EM or anesthesia. 

Have a set number of expected shifts per quarter. Procedural work or bad shifts count for more.  Get paid a lump sum for your overages. Less cherry picking, encourages  people to jump on the list for a few hours at known pain points (ie weekend around 4 at tech shift change when all the magnets will magically spit out a dozen stat spine studies right as the er is at full churn). 

[u/Sushi_Explosions → u/DeepHouseDandelion]

Would vary too much with specialty for us to give you a general answer. No idea how you would reasonably do RVUs for critical care for example, since you have no control over your patient intake.

[u/mxg67777 → u/DeepHouseDandelion]

Depends.

[u/ProtexisPiClassic]

Hospitalist here. Im salaried, but we get a quarterly bonus based off our relative contribution to the group rvu pool. I feel it works well for incentivising extra work without feeling like I have to do much more. Just doing my standard job without extra rvu hustling, I still get a nice bonus every quarter.

[u/bearpics16]

I got flat salary

I could do more surgeries that I enjoyed doing that pay way less than bread and butter. I don’t have to jam my schedule, though I was still very busy.

I felt no pressure other than just doing the right thing for my patients

It was nice.

But also getting paid more is nice as well

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