The Primary Care–Specialty Income Gap
Authors: Thomas Bodenheimer, Robert A. Berenson, Paul Rudolf
Journal: Annals of Internal Medicine (2007)

Letters19 June 2007The Primary Care–Specialty Income GapThomas Bodenheimer, MD, Robert A. Berenson, MD, and Paul Rudolf, MD, JDThomas Bodenheimer, MDFrom the University of California, San Francisco, San Francisco, CA 94110.Search for more papers by this author, Robert A. Berenson, MDFrom the University of California, San Francisco, San Francisco, CA 94110.Search for more papers by this author, and Paul Rudolf, MD, JDFrom the University of California, San Francisco, San Francisco, CA 94110.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-12-200706190-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We are glad that Dr. Rich has entered into a dialogue about the RUC's role in the multifactorial causation of the primary care–specialty income gap. He is correct that relative value units (RVUs) for E&M services have increased while values for some procedural codes have decreased. However, in its 2007 report to Congress, MedPAC states (1): “The three five-year [RUC] reviews, completed in 1996, 2001, and 2006, led to substantially more recommendations for increases than decreases in the relative values of services, even though many services are likely to become overvalued.”The RUC's method for estimating procedure times—a ...References1. Medicare Payment Advisory Commission. Report to the Congress: Medicare Payment Policy. Washington, DC: Medicare Payment Advisory Commission; 1 March 2007. Google Scholar2. Barclay RL, Vicari JJ, Doughty AS, Johanson JF, Greenlaw RL. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med. 2006;355:2533-41. [PMID: 17167136] CrossrefMedlineGoogle Scholar3. McCall N, Cromwell J, Braun P. Validation of physician survey estimates of surgical time using operating room logs. Med Care Res Rev. 2006;63:764-77. [PMID: 17099125] CrossrefMedlineGoogle Scholar4. Goroll AH, Berenson RA, Schoenbaum SC, Gardner LB. Fundamental reform of payment for adult primary care: comprehensive payment for comprehensive care. J Gen Intern Med. 2007;22:410-5. [PMID: 17356977] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Thomas Bodenheimer, MD; Robert A. Berenson, MD; Paul Rudolf, MD, JDAffiliations: From the University of California, San Francisco, San Francisco, CA 94110.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Primary Care–Specialty Income Gap: Why It Matters Thomas Bodenheimer , Robert A. Berenson , and Paul Rudolf The Primary Care–Specialty Income Gap William L. Rich III Metrics Cited byProspects For Rebuilding Primary Care Using The Patient-Centered Medical HomeRevenue-Based Cost Assignment: A Potent but Hidden Threat to the Survival of the Multispecialty Medical Practice 19 June 2007Volume 146, Issue 12Page: 896KeywordsAgingColonoscopyConflicts of interestCurrent procedural terminologyDiagnostic medicine ePublished: 19 June 2007 Issue Published: 19 June 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...