Assessing the potential versus the actual earnings of academic radiologists: effects of unequal duty service assignments.

RATIONALE AND OBJECTIVES: The purpose of this study was to determine if annual total work relative value units (RVUs) can be used to accurately compare physician productivity and effort among a small group of similarly trained radiologists. MATERIALS AND METHODS: The annual procedures for nine abdominal imaging radiologists were obtained. The work RVU was assigned to each procedure and summed for each radiologist. The daily work RVU mean earnings by duty service (eg, ultrasound [US], gastrointestinal radiology) were calculated for each radiologist and for the entire group. RESULTS: Annual total work RVUs earned by the six full-time radiologists ranged widely (5,000 to >9,000). Mean work RVUs earned per day by all the radiologists for each duty service also ranged widely (74 for US vs 23 for gastrointestinal radiology). The range of mean work RVUs earned per day by the radiologists within each duty service was narrower, however, and had almost no statistical significance. The wider range of annual total work RVUs earned by the radiologists resulted primarily from unequal distribution of duty service assignments. For example, radiologists with more days spent performing gastrointestinal radiology had lower annual total RVUs compared to radiologists with more days spent performing computed tomography or US. CONCLUSION: The RVU is an accurate measure of income production but may be an inaccurate measure of effort and individual productivity because of differences in duty assignments. In a relatively homogeneous group of radiologists/practitioners, such a comparison should be done within a duty service, or a correcting methodology should be used, because assignment to duty services rarely is equalized across physicians.