RVU production early on

[Fission Chips]

I'm sure the answer to this will be "It depends on you," but I'm curious what a reasonable productivity would look like in years 1 and 2 of practice? I've interviewed with a couple places:

1) PP, large wait list for new patients, PAs run ball pain and rUTI clinics, see some minor post-ops and patients on surveillance. Current partners see either new patients in clinic or bigger post-ops (only see returns if they want to), sounds like there is plenty to go around. Set your own schedule but Partners currently are working M-F.

2) Hospital employed, new patients are added on to your schedule, only one other FTE Urologist with two locums. M-F as well. Sounds like a very standard hospital employed model.

My question is... in your first year out in either of these settings, what is a reasonable RVU to hit? Would 7-8k be unrealistic given I won't be very efficient coming out of residency? How hard would it be to hit 10k in second year?

---

Members don't see this ad.

 

[cpants]

10k is cranking it pretty hard. Would, in general, be hard to get that high in year 2 unless its a special situation. 7-8k isn't that hard year 1 if they are filling your clinic time.

 

[DoctwoB]

Depends on the patient backlog. If you’re walking into a clinic that has the pent up demand to book you out for months then 8-9k first year, 10k second year is quite doable, though you’re working for that 10k.

If you’re taking time to ramp up and get referrals, those numbers will be lower.

Edit: if you assume 2.5 RVUs/patient (mix of old and new, some cysto, etc), 20 patients a day is 50 RVUs/day. * 5 days/week * 48 weeks = 12000 RVUs.

Now in real life there will be non productive time mixed in, mix of case/clinic, but just to show with a full schedule 10k/year is quite attainable.

For me with a 4 day workweek (but supplemented with RVUs from hospital call/consilts) I was around 9k year 1 and 10k year 2.

 

[cpants]

2.5wRVU per patient would be very high. Level 3 and 4 follow ups which will be vast majority of patients for most urologists are 1.3 and 1.9 wRVU respectively. Level 4 new patient is 2.6 wRVU. Even a cystoscopy is only worth 1.5 wRVU. Unless you are doing a lot of more complicated procedures in the office (vasectomies, bladder biopsies, stent/stone removals, etc), it would be hard to average 2.5/patient.

For a realistic expectation of what you could make, you should request more data from both jobs. They should be transparent with what current urologists are doing for production numbers both in terms of wRVU and salary over the past few years. That will be a much more accurate way to set expectations for what you could expect to produce than what we are speculating here. You should expect it will take a few years to ramp up to what everyone else is doing. If they won't provide you this data that is a giant red flag, and frankly would be a deal breaker for me.

For general reference, MGMA 65th percentile for urologists is around 9000 wRVU, so 10k is definitely well above average for what people are bringing in nationwide.

 

[DoctwoB]

2.5wRVU per patient would be very high. Level 3 and 4 follow ups which will be vast majority of patients for most urologists are 1.3 and 1.9 wRVU respectively. Level 4 new patient is 2.6 wRVU. Even a cystoscopy is only worth 1.5 wRVU. Unless you are doing a lot of more complicated procedures in the office (vasectomies, bladder biopsies, stent/stone removals, etc), it would be hard to average 2.5/patient.

For a realistic expectation of what you could make, you should request more data from both jobs. They should be transparent with what current urologists are doing for production numbers both in terms of wRVU and salary over the past few years. That will be a much more accurate way to set expectations for what you could expect to produce than what we are speculating here. You should expect it will take a few years to ramp up to what everyone else is doing. If they won't provide you this data that is a giant red flag, and frankly would be a deal breaker for me.

For general reference, MGMA 65th percentile for urologists is around 9000 wRVU, so 10k is definitely well above average for what people are bringing in nationwide.

I’ll have to pull my data to see what mystery true average is, now I’m Curious.

I find going by guidelines, E3s (and E5s) are rare. Vast majority of patients are either E4s, N4, or C4. So assuming 2 established for every new that’s an average of 2.1 (excluding consilts). Throw in a ultrasound for .5 RVU, cysto for 1.5 or stent removal for 2.5 and it will bring the average up.

In reality though, we all also have non productive time. Some visits are non billing post ops. Patients no show appointments, we have slow OR days that we leave early, or OR days doing poor paying cases like circs or hydroceles, meetings, etc.