Criticizing relative value units as a measure for a physician’s productivity is nothing new. A quick Google search reveals editorials and blog posts saying RVUs have created a hospital environment where doctors keep one eye on a patient and the other on the clock.
RVU critics can now point to research showing that Sir William Osler (1849-1919)—widely considered the father of modern medicine and a groundbreaking medical educator—wouldn’t have made the cut under modern standards. That stirred up a bit of noise on Twitter.
Dr. Howard Weitz, a cardiologist at Thomas Jefferson University Hospital, evaluated Osler’s productivity based on his biography, The Life of Sir William Osler, and archives at the University of Pennsylvania, leading to an opinion piece published in the Annals of Internal Medicine.
“If one were to use today’s metrics to assign value to Sir William’s work as a clinician-educator in 1884 to 1889, would he have been labeled a success?” Weitz wrote. “I found that he was an underachiever.”
Weitz focused on Osler’s time at the University of Pennsylvania, which Osler referred to as among his most productive periods. During that time, Osler taught and trained students, performed dissections and autopsies, and wrote editorials and book reviews for Medical News, none of which would earn him clinical RVUs.
“100 years since Sir William died, it is time we step back and refocus on what the real values of the master clinician-educator should be: teaching, mentoring, collegiality, research, and care of the patient,” Weitz wrote.