A surgeon’s view on RVUs and moral injury

For over forty years, I worked as a general and vascular surgeon. For the last ten of those years, I was employed under an RVU-based compensation model. That period is when my dissatisfaction with medicine truly began. Complex, life-saving operations were reduced to “productivity units.” The pressure was relentless, the system unforgiving.

And unlike primary care physicians, surgeons do not have the option of concierge or direct-pay models. We are necessarily …

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