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  • Productivity by subspecialty in large PP groups

    Posted by coricsmd_0408 on July 23, 2023 at 11:49 am

    I would be interested to hear what kind of avg daily RVU productivity large PP groups are seeing , based on subspecialty . From mammo all the way down

    Thnks

    khodadadi_babak89 replied 1 year, 3 months ago 9 Members · 17 Replies
  • 17 Replies
  • cody.a.keller_68

    Member
    July 23, 2023 at 1:59 pm

    It varies for us based on our rotation sites, but in body imaging we average about 62, with a a range from 55 (hospital including IR procedures) up to 70 for home slots. A lot of complex inpts and cancer f/u.

    • g.giancaspro_108

      Member
      July 23, 2023 at 2:06 pm

      Be careful how you track and use such data.  
       
      We track but do not disclose unless there is an extreme outlier, like 3x standard deviation without any explanation.  The other time we have disclosed it was when one person would not stop talking about how they were generating so much more than everyone else and they should be paid differently because of it.  So we showed them the numbers that they were very, very average.
       
      I have seen obsessions with “how much RVU should this person be reading” and “how much should we pay based on RVU” destroy groups.
       
      having said that, the answer to your question is 40-50.  mammo and IR shouldn’t even be tracked because their RVU is so skewed relative to their work.

      • amotter

        Member
        July 23, 2023 at 4:00 pm

        As a group we average 65 wRVUS with bump up for plain films/peds. 

      • cody.a.keller_68

        Member
        July 23, 2023 at 5:20 pm

        So you don’t have minimum rvu’s that someone needs to reach by the end of their workday? we do and it has ruined morale. 
         
        Still, a lot of applicants ask the rvu question to gauge how demanding a job is. and  a lot of pp’s offering tele positions are trying to exact as much rvu while paying as little as possible ($25-30 per rvu). These pp’s are trying to maximize their profit while not offering partnership. Younger rads have gotten smart, recognizing their value and asking for more. 

      • fatemeheskandar

        Member
        July 24, 2023 at 6:56 am

        Ditto.  We track it looking for outliers and once made the mistake of publishing everyone’s data.   Amazing how quickly everyone weaponized the data.  Now we only share individual production with the rad.
         
        If people spent less time worrying about what everyone else was reading, they’d free up enough time to improve their own numbers.

        • khodadadi_babak89

          Member
          July 27, 2023 at 9:47 am

          Quote from CU88

          Ditto.  We track it looking for outliers and once made the mistake of publishing everyone’s data.   Amazing how quickly everyone weaponized the data.  Now we only share individual production with the rad.

          If people spent less time worrying about what everyone else was reading, they’d free up enough time to improve their own numbers.

          That was my experience. Prior to tracking RVUs we got along well, after that, the fights never ended. So very happy to be out of there. 

      • ruszja

        Member
        July 24, 2023 at 7:18 am

        Quote from sandeep panga

        We track but do not disclose unless there is an extreme outlier, like 3x standard deviation without any explanation.  The other time we have disclosed it was when one person would not stop talking about how they were generating so much more than everyone else and they should be paid differently because of it.  So we showed them the numbers that they were very, very average.

        So it’s being used in a arbitrary manner by those ‘in the know’ to punish people felt to be complainers.
        That’s probably the worst possible way to use productivity data.

        I am all for full transparency. This data is not hard to collect and to feed into a dashboard that should be visible to everyone.

        High outliers can be as much of a problem as slackers. I have seen chest thumping by high producers but I also knew their reports were sh¡t.

        • fatemeheskandar

          Member
          July 24, 2023 at 7:25 am

          I didn’t get that impression from his post.  It sounded like they were just making sure there were no outliers.  It wasn’t punitive, just making sure that everyone is giving a minimum amount of effort.
           
          To me the approach he was talking about sounded like they were more of an actual group, not just a collection of individuals working at the same place.

          • cody.a.keller_68

            Member
            July 24, 2023 at 7:37 am

            The interesting thing is most people talk, appropriately so, about the damage that rvu based work can do. But so many PP’s are now trying to exact as much work from their remote readers while trying to pay them around 30/rvu so they can pocket a big difference. The market is changing though and younger telerads aren’t going for it. Be fair to your employees or they won’t stick around long and you will continue to be shortstaffed and overworked. 

          • ruszja

            Member
            July 24, 2023 at 7:43 am

            Quote from CU88

            I didn’t get that impression from his post.  It sounded like they were just making sure there were no outliers.  It wasn’t punitive, just making sure that everyone is giving a minimum amount of effort.

            To me the approach he was talking about sounded like they were more of an actual group, not just a collection of individuals working at the same place.

            He talked about selective use as a tool to knock down people who were speaking up. If everyone can see everyone else’s productivity per assignment, you never get any of that.

            • g.giancaspro_108

              Member
              July 24, 2023 at 10:04 am

              I’m sorry you feel that way.  I suppose I can see how you might interpret what I said to line up with that.
              I gave an example of the [i][b]one [/b][/i]time in many years that we used the individual data.  (“I am doing 10x the work of everyone else, I want to be paid 10x everyone else.”  “Here is the data, over half the group read more than you. If we pay based on production your pay will go down.”  “Oh.  nevermind.”)
              In general we feel it does more harm than good to publish individual data.  Yes, we collect it but except for the one very glaring exception above we do nothing with it.  We feel there are better things to focus on like quality, service and radiologist contentment.  I think all three of those things suffer when paying attention to RVUs.
               

              Quote from fw

              Quote from CU88

              I didn’t get that impression from his post.  It sounded like they were just making sure there were no outliers.  It wasn’t punitive, just making sure that everyone is giving a minimum amount of effort.

              To me the approach he was talking about sounded like they were more of an actual group, not just a collection of individuals working at the same place.

              He talked about selective use as a tool to knock down people who were speaking up. If everyone can see everyone else’s productivity per assignment, you never get any of that.

              • alex.nieto_484

                Member
                July 24, 2023 at 10:18 am

                Quote from sandeep panga

                I’m sorry you feel that way.  I suppose I can see how you might interpret what I said to line up with that.
                I gave an example of the [i][b]one [/b][/i]time in many years that we used the individual data.  (“I am doing 10x the work of everyone else, I want to be paid 10x everyone else.”  “Here is the data, over half the group read more than you. If we pay based on production your pay will go down.”  “Oh.  nevermind.”)
                In general we feel it does more harm than good to publish individual data.  Yes, we collect it but except for the one very glaring exception above we do nothing with it.  We feel there are better things to focus on like quality, service and radiologist contentment.  I think all three of those things suffer when paying attention to RVUs.

                Quote from fw

                Quote from CU88

                I didn’t get that impression from his post.  It sounded like they were just making sure there were no outliers.  It wasn’t punitive, just making sure that everyone is giving a minimum amount of effort.

                To me the approach he was talking about sounded like they were more of an actual group, not just a collection of individuals working at the same place.

                He talked about selective use as a tool to knock down people who were speaking up. If everyone can see everyone else’s productivity per assignment, you never get any of that.

                 
                I wouldn’t worry about. I also did not read your post the way FW did. 
                 
                I think you may have accidentally triggered a slow rad who thinks a lot about RVUs lol 

                • khodadadi_babak89

                  Member
                  July 25, 2023 at 9:05 am

                  Every time I read a post about RVUs and in particular, comparative RVUs between different people, I come away with one over-riding thought. 

                  What a better place the world would be if we could convert the time spent validating, tweaking, arguing about RVUs into productive areas. Even baking cookies. The time spent arguing about, adjusting and otherwise trying to deal with this inappropriate system is  impressive, and depressing. 

              • ruszja

                Member
                July 25, 2023 at 4:19 pm

                Quote from sandeep panga

                I’m sorry you feel that way.  I suppose I can see how you might interpret what I said to line up with that.

                 
                No worries, my feelings are entirely unhurt. I just went by what you stated.
                 

                In general we feel it does more harm than good to publish individual data.  Yes, we collect it but except for the one very glaring exception above we do nothing with it.  We feel there are better things to focus on like quality, service and radiologist contentment.  I think all three of those things suffer when paying attention to RVUs.

                 
                I have done the big group thing, and in my experience NOT paying attention to individual production has a potential to harm radiologist contentment. Our ‘leadership’ either didn’t pay attention to the issue or more likely was too spineless to act on the data. If everyone gets paid out of the same pot, the assumption is that everyone puts in a similar level of effort. We clearly did not have that and as a result, we accumulated a few epic slugs. Most of them were very nice people, but if you came in on second shift and you followed someone who had read a grand total of 16 CTs in a 8 hr shift, it got a bit tiring (and if you looked closer, they were not N/CAP with s/p change from chemo to immune therapy, no they were heads and kidney stones from primary care). Gets old pretty quick if you know he gets the same paycheck as the people who had to catch up the list. On the other end, you have the ‘RVU wankers’ who boasted with how they keep the place afloat, but if you ran a report, all they did was poach studies with a high RVU/effort ratio (nurse practicioner spines, psych heads, kidney stone follow-up etc.) out of other peoples worklists and issued 1 paragraph reports that often prompted an over-read by someone else in the group.
                 
                But then you also have the unwarranted griping. ‘X always takes a 2hr lunch and goes to the gym when he is on screening mammo’. Well X also stays an hour later than normal and leaves breast center cleaned up by the time he goes home.
                 
                We are talking a ‘big group’ setup here. With different ‘seats’ that different subsets of rads rotate through. If you are on ‘CT-2’ without procedural requirements and you are expected to read the ‘all comers’ mix of general CT of a typical a hospital + OP department, your numbers should be within somewhat of a standard deviation of others in your group who man the same post. If the group mean is 65 wRVU in a particular seat and you persistently come out at 40, no amount of verbosity in your reports is going to make up for that shortfall. At the end of the day, we also have a business to run.
                 
                Make it transparent. Not on a day by day level, but a rolling average for the last 3 months. Break it down by rad x assignment to account for the fact that different people may have different frequencies of covering a particular high or low production slot (100% mammo screeners vs. fluoro and ultrasound). Dont be afraid to call out both the slugs and the poachers.
                 
                The original question was ‘by subspecialty’ which in a large practice is not really the relevant differentiator. ‘Neuroradiologist’ can be at the main hospital getting his ear bent by the ENTs and neurologists all day, and it can be at a outlying hospital cranking through the near normal outpatient spines. ‘Breast’ can be a slot that is ‘all screeners’ vs. ‘MRI biopsies, holding hands and tumor board’. If someone ends up preferentially on one rotation vs. the other, the numbers are going to look drastically different.

  • 22002469

    Member
    July 23, 2023 at 5:46 pm

    Quote from mdiddy

    I would be interested to hear what kind of avg daily RVU productivity large PP groups are seeing , based on subspecialty . From mammo all the way down

    Thnks

     
    Very hard to generalize between practices for a variety of reasons. Need to know level of complexity and also if the fluoro/procedures/X-Rays are split evenly. 
     
    If it’s truly a LARGE practice with people reading almost all sub-specialized cases, as a ballpark (wRVU) per shift:
     
    Mammo: 100+
    Neuro: 80
    MSK/Body:60
    Peds/generalist (XR heavy): 50
     
    You can multiply by 200 shifts to get a ballpark wRVU/year. These are more like an “average” than a “minimum” expectation, some good rads will be less and that’s OK.
     
    You end up with roughly 60-70 wRVU average per shift and 12-14K wRVU per year.
     

    • DanielQuilli

      Member
      July 24, 2023 at 3:39 am

      Quote from Radsoxfan

      Quote from mdiddy

      I would be interested to hear what kind of avg daily RVU productivity large PP groups are seeing , based on subspecialty . From mammo all the way down

      Thnks

      Very hard to generalize between practices for a variety of reasons. Need to know level of complexity and also if the fluoro/procedures/X-Rays are split evenly. 

      If it’s truly a LARGE practice with people reading almost all sub-specialized cases, as a ballpark (wRVU) per shift:

      Mammo: 100+
      Neuro: 80
      MSK/Body:60
      Peds/generalist (XR heavy): 50

      You can multiply by 200 shifts to get a ballpark wRVU/year. These are more like an “average” than a “minimum” expectation, some good rads will be less and that’s OK.

      You end up with roughly 60-70 wRVU average per shift and 12-14K wRVU per year.

       
      this is fairly close to what Ive seen as well. Except mammo which is typically much much much higher in my group.

      • 22002469

        Member
        July 24, 2023 at 6:39 am

        Thats why I said 100+ 🙂