The RVU productivity compensation model incentivizes doctors to treat a larger volume of more complex patients. In surgery, the more complex cases we perform, the more we are paid and the more money the health care system collects. New this year, my health system is putting up an RVU ranking of each surgeon against our peers as a PowerPoint slide in our monthly meetings. I finished last in terms of RVU production in 2024 but interestingly had the highest number of patient encounters meaning I saw the most patients. Why? The answer is because I view surgery as a last resort and try to find other ways to help these patients. I only recommend surgery when there are no other options! There’s no incentive for that type of care!