Rvu goal increasing

[Attending1985]

My rvu target was increased by 300 next year without any explanation per my rvu dashboard in epic. I’m confused because I know the number of rvus I need to make my base salary based on how much I’m paid per rvu is way below this new target. Does anyone else see arbitrary increases in their rvu goals?

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[TheRightMedication]

I assume at some point in a MBA program, there's a 9 week seminar in money-number-grow-good, followed by its companion seminar in money-number-not-grow-not-good.

I've had some success in sitting with them and saying I don't anticipate meeting that target and helping them think through it.

 

[comp1]

No, I don't get this. Your numbers are based on how your clinic grid schedule is setup. Unless you're somehow now working overtime or adding on clinic hours in some other manner, I'm not sure how your RVUs could "go up." They also shouldn't be going down year on year. Concur with above, have a meeting with your supervisor and explain that your scheduling grid didn't change, your RVUs also will not be changing.

 

[annoyedpsychiatrist]

No, I don't get this. Your numbers are based on how your clinic grid schedule is setup. Unless you're somehow now working overtime or adding on clinic hours in some other manner, I'm not sure how your RVUs could "go up." They also shouldn't be going down year on year. Concur with above, have a meeting with your supervisor and explain that your scheduling grid didn't change, your RVUs also will not be changing.

yeah exactly. Unless they start taking off patients that historically no show, and filling with 20 min zoloft med checks. Or perhaps you were like me, started a job and only had a small patient case load and had to build up overtime.

Can easily build rvus if your clinic cherry picks patients and throws them in 20 min med checks

 

[Attending1985]

Thanks guys. My rvu numbers have been pretty stable over the years but have bumped in the past two years a little with coding changes. I really have no interest in making more than my base salary so as long as they don’t decrease my rvu value I will just ignore it.

 

[PsyDr]

Contracts have to have consideration (bargain for exchange) to be valid. What are they offering you in exchange for increased work?

 

[psych_0]

My rvu target was increased by 300 next year without any explanation per my rvu dashboard in epic. I’m confused because I know the number of rvus I need to make my base salary based on how much I’m paid per rvu is way below this new target. Does anyone else see arbitrary increases in their rvu goals?

Without telling us what your original target was, we can't say whether this is fair or unfair. Need more context.

 

[Sushirolls]

*BIG BOX SHOPS*
Welcome to the mine boys. Here's your hat. Your pick. Your light. That there in the rock is what we call wRVU. Go get 'em.
I had a Big Box Shop job like this in the past, the wRVUs kept creeping up, that if you essentially took a vacation, you wouldn't hit the wRVUs metrics. AND if you fell too low, you would an even lower conversion factor.
Wasn't sustainable.
One of the many reasons I left.

Contracts have to have consideration (bargain for exchange) to be valid. What are they offering you in exchange for increased work?

Big Box Shops simply say, your contract can change. Now, whenever, or every year renewal. Oh, and if you don't like it, go away.
That's how Big Box Shops roll.

 

[PsyDr]

Big Box Shops simply say, your contract can change. Now, whenever, or every year renewal. Oh, and if you don't like it, go away.
That's how Big Box Shops roll.

Big box shops use attorneys to create contracts. Contract common law has a 700-800 year case history. One of the necessary components of contracts is “consideration” (e.g., payment for services). Without the necessary components, a contract cannot be enforced (e.g., I can’t offer you $0.00 with no other benefits for a lifetime of work). If someone enters into a contract, and the other person doesn’t do their part, it’s called “breach of contract”. Breach of contract is grounds for a lawsuit. If the parties never intended to abide h the contract, this is called “bad faith”.

Attorneys are licensed professionals who have to abide by their licensing laws. In contracts, those working under them are considered their agents for whom the attorneys are responsible. It is common courtesy to notify professionals of behaviors that could result in professional sanctions.

 

[Attending1985]

*BIG BOX SHOPS*
Welcome to the mine boys. Here's your hat. Your pick. Your light. That there in the rock is what we call wRVU. Go get 'em.
I had a Big Box Shop job like this in the past, the wRVUs kept creeping up, that if you essentially took a vacation, you wouldn't hit the wRVUs metrics. AND if you fell too low, you would an even lower conversion factor.
Wasn't sustainable.
One of the many reasons I left.

Big Box Shops simply say, your contract can change. Now, whenever, or every year renewal. Oh, and if you don't like it, go away.
That's how Big Box Shops roll.

That’s what I suspect this is. Trying to force me into taking less time off

 

[splik]

I think I mentioned before, a few years ago my wRVUs were increased by about 350, they cut the conversion factor, and claimed it was because the 2021 E&M changes made it easier to hit RVUs. Nevermind that I did inpatient and outpatient and inpatient RVUs hadn't changed so it was actually harder to hit the target. Those changes were supposed to reward physicians, not line the hospital executive's pockets. Then last yr, they increased my RVUs by over 1000! That was accompanied by about a 20% bump in my base salary but overall that was a big pay cut as there was no way I would be able to meet that goal and they also said that the first ?$5k over RVUs they would keep!! that was one of the final straws for me, and I handed in my notice that day.

 

[nexus73]

I've always wanted to talk to someone who just declined to sign the new contract. At my hospital, the system is so inefficient sometimes we're 2-3 months into the year before we get the updated comp agreements signed, and our hospital is good about covering back pay for the previous few months if the comp had gone up. But always wonder what to do if they propose comp reduction. Just don't sign and ride out existing contract until they fire you? Or bank on the whole place being so dysfunctional they just leave the old contract in place and give up on forcing a new lower paying agreement?

 

[Sushirolls]

Big box shops use attorneys to create contracts. Contract common law has a 700-800 year case history. One of the necessary components of contracts is “consideration” (e.g., payment for services). Without the necessary components, a contract cannot be enforced (e.g., I can’t offer you $0.00 with no other benefits for a lifetime of work). If someone enters into a contract, and the other person doesn’t do their part, it’s called “breach of contract”. Breach of contract is grounds for a lawsuit. If the parties never intended to abide h the contract, this is called “bad faith”.

Attorneys are licensed professionals who have to abide by their licensing laws. In contracts, those working under them are considered their agents for whom the attorneys are responsible. It is common courtesy to notify professionals of behaviors that could result in professional sanctions.

Contract breaches happen all the time. So what?

My current landlord in BFE just breached contract for their covered services. So I can quietly except this change. Or hire a lawyer, and stick it to the landlord for this breach and win. But then I don't get my lease renewed, or its gets jacked up in price or the costs associated with this breach get remedied but then get carried forward for the next year, which means I pay for it one way or another - but hey, I can teach the landlord a legal issue, and I get the pride/joy/justice of winning. Or, what I actually opted to do, weighed the pros cons, the money pros/cons, and simply let the breach slide.

Same thing with Big Box shops. You meet with a lawyer, and you'll get 6 different opinions depending on who you consulted with. Some say sue, some say write a letter, some say whatever. But one, is it worth the money, and two even if you prevail in the end is worth the cost/time/headache of it all? Then, once you open the lawyer can on your employer, will you even want to stay there? The fact that you are opening lawyer can on employer already shows they aren't a quality place, and won't be afraid to stoop to low levels to get rid of you...

Anecdote One:
HR departments protect the Big Box Shop, and conveniently you might find that you end up on a PIP [Performance Improvement Plan - i.e. paper trail to fire people and reduce post firing lawsuits]. I know of one doc, stellar, caring, professional, true passion for job. Had bad Mid manager and a bad Med Dir. Big Box Shop believed issues in department of mid manager and Med Dir, but yet accusations had no proof, Quality Doc had evidence of no proof to these accusations, too. But because Quality Doc had brought up issues of department and contract, etc, working with lawyer behind the scenes, which Big Box Shop quickly picked up on - they PIP'd the doc as strategic defense move. This doc, stellar for years and the usual hoops of rigorous studies, etc, got labeled as the bad apple and needed to improve performance and meet with HR to correct things. All light fluffy things - yet subjective - but meant to be the paper trail to fire this person and paint the Quality Doc as the bad apple to protect the Big Box Shop. The final outcomes, the Mid Manager was relocated to another department and continued reign of terror, Med Dir got into other trouble, and quit and moved across country, and frontline department breathed sigh of relief both were gone. However, Quality Doc was already the bad apple, and PIP continued to linger, and couldn't ever get meetings with HR to get it lifted or resolved. Quality Doc issues were legit, but conservative lawyer summarized issues were just short of winning in court - offered to proceed and waste money if wanted but routinely noted very low odds of progressing if filed with local court. Quality Doc moved on to greener pastures having learned the lesson of The Big Box Shop.

Remember Residents and Fresh Attendings, Human Resources is of no value except to insure your W2 is showing all the numbers correctly, and your withholdings are they way you want them. Other than that, they are not your friend, they are not a resource, they do not care about you but are a tool to swat you down to preserve the Big Box Shop.

*and to your point of professional sanctions for lawyers? LOL. That's like ARNPs getting sanctioned by their nursing boards. You hear about it, but I also hear about sasquatch in the woods, too.

 

[PsyDr]

Contract breaches happen all the time. So what?

*and to your point of professional sanctions for lawyers? LOL. That's like ARNPs getting sanctioned by their nursing boards. You hear about it, but I also hear about sasquatch in the woods, too.

1) I see you are not familiar with how disagreeable I am. I don’t argue with anyone who doesn’t have the juice to fix the problem. I’ll slowly go up the ladder until I find the person who can. If you’re wondering how far I’ll take it: I’ve literally bought a single share of stock, just to have standing to complain to the SEC.

2) if a licensed professional is messing with my livelihood, I’ll mess with theirs.

3) do you tell your patients “complaints will never work, so don’t bother”? How far do you take that recommendation? Unfair wages? Spousal abuse? What?

 

[sloh]

Anecdote One:
HR departments protect the Big Box Shop, and conveniently you might find that you end up on a PIP [Performance Improvement Plan - i.e. paper trail to fire people and reduce post firing lawsuits].

Remember Residents and Fresh Attendings, Human Resources is of no value except to insure your W2 is showing all the numbers correctly, and your withholdings are they way you want them. Other than that, they are not your friend, they are not a resource, they do not care about you but are a tool to swat you down to preserve the Big Box Shop.

This is a good lesson. If you're ever employed and put on a PIP it's time to start looking for a new job. Consider it a "Hey, we are going to let you go in about 2-3 months. And if you give us any trouble, we will crush you."

 

[clausewitz2]

Big box shops use attorneys to create contracts. Contract common law has a 700-800 year case history. One of the necessary components of contracts is “consideration” (e.g., payment for services). Without the necessary components, a contract cannot be enforced (e.g., I can’t offer you $0.00 with no other benefits for a lifetime of work). If someone enters into a contract, and the other person doesn’t do their part, it’s called “breach of contract”. Breach of contract is grounds for a lawsuit. If the parties never intended to abide h the contract, this is called “bad faith”.

Attorneys are licensed professionals who have to abide by their licensing laws. In contracts, those working under them are considered their agents for whom the attorneys are responsible. It is common courtesy to notify professionals of behaviors that could result in professional sanctions.

Your points about consideration is definitely correct, provided we are talking about modifying an existing contract. Unfortunately if all employment contracts are written to be strictly time-limited and renewal constitutes effectively signing a new contract every year, this doesn't prevent them from saying "well, the old terms have run the agreed upon course, you want to re-up with us, these will be the terms". The other party has the option to sign or not sign, just the same as when your mobile phone provider announces they are going to increase rates and give you the option of your contract simply not renewing.

 

[PsyDr]

Your points about consideration is definitely correct, provided we are talking about modifying an existing contract. Unfortunately if all employment contracts are written to be strictly time-limited and renewal constitutes effectively signing a new contract every year, this doesn't prevent them from saying "well, the old terms have run the agreed upon course, you want to re-up with us, these will be the terms". The other party has the option to sign or not sign, just the same as when your mobile phone provider announces they are going to increase rates and give you the option of your contract simply not renewing.

Yeah, I know. I was raising the point for a few reasons:

1) Part of negotiation is knowing the basics of contract law. It's like knowing the rules of the game. If you are familiar with the rules, you can see when something isn't correct.

2) Another part of negotiation is being willing to walk away. Your specialty is in high demand. Some of the responses are reflective of people not wanting to switch jobs, not about the correctness of changing RVU targets without compensation.

3) IMO: it is a mistake to negotiate with someone who does not have requisite knowledge of how things work. Your average annual salary means that any lawsuit will be worth a fair amount of money, especially if the breach of contract is purposeful, and if you live in a treble damages state. Personally, I'm not taking $800k worth of lawsuit advice from someone in HR with a BA.

 

[SmallBird]

Sometimes a good strategy is to figure out what parts of the system are flexible. This is particularly helpful if you're in a dynamic of 1) a reasonable relationship with your immediate supervisor, 2) doing a good job and are valued, and 3) bumping up against a rigid system issue that nobody seems to be able to change. We were trying to get our RVU rate increased for ages to no avail, and at some point it was pointed out that although there was no path to this, they did have the mechanism to pay us a 'market based hourly rate' non-billable work as long as we used the spreadsheet that one of the VPs had made for their QI initiative. I think we were able to get an extra $200k compensation across four providers and nobody said anything as middle management just wanted us happy and the bureaucratic appetite of the system was being satisfied.