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June 3, 1992

A Critical Analysis of RBRVS

JAMA. 1992;267(21):2895. doi:10.1001/jama.1992.03480210051028

To the Editor.  —The article "A Critical Analysis of the Resource-Based Relative Value Scale" by Dr Maloney1 is surprising. It attempts to disprove the general perception that procedural medical services are reimbursed at an inappropriately greater rate than cognitive services. However, the way he puts the data together is misleading, the numbers he shows us prove just the opposite of what he says, and there are some disturbing undertones in what he does say.His first deception is the number of hours supposedly worked per week: surgical (87.8) vs medical (70.6). Patient care activities, on-call time, other professional and administrative activities according to Mendenhall2 actually average: surgical (81.2) vs medical (79.1) for all comers or 81.2 and 74.9, respectively for just the groups included in Maloney's RBRVS critique. That comes to a 6.3-hour difference at the most (very different from the 17 hours he claims), which makes the