One of the residents at my program mentioned that he was looking into a job offer (an employment position) wherein his productivity was measured in RVU's. He said that referring a patient to the ER earned 3 RVU's. A 99214 E & M code, by comparison, was something like 1.5 RVU's. He didn't get into specifics, but the bottom line seemed to be a perverse incentive to turf most anything subacute to the ER. Can anyone here who may be familar with RVU based productivity confirm or deny the veracity of this type of contract structure? I hope this is some weird anomaly or urban legend of some sort. If many family doctors are actually getting paid MORE to abuse the ER, this fact just might be enough to drive me that last millimeter over the edge of sanity. I guess I can see the logic behind this type of contract structure, if you are being employed by the hospital. After all, the ER gets paid more to evaluate abdominal pain than a family doctor. I wonder what our ER brethren thinks of that crap, if actually true?