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June 3, 1992

A Critical Analysis of RBRVS

Author Affiliations

Veterans Affairs Medical Center Menlo Park, Calif

JAMA. 1992;267(21):2894. doi:10.1001/jama.1992.03480210051025

To the Editor.  —Dr Maloney's article reads more like a thoracic surgeon trying to defend his high income than a scientific critique on the resource-based relative value scale (RBRVS).1 His assumption that physicians should be paid time and a half after 40 hours of work per week, and double time after 48 hours, sets the analysis up to support his side of the debate. Since when do professionals receive overtime? Many, if not most, professionals with advanced degrees in the United States work quite long hours, with no additional compensation.The effect of overtime is incorporated into the study by adjusting the hours worked per week. Since all of the specialties in this study averaged over 48 hours per week, this assumption doubles the reported 8.6-hour average difference in hours worked per week between surgical and medical specialties. This larger increase in the average hours worked per week for