Family Physicians See Culture Improve, Challenge RVU System

Family care physicians are seeing steady or gradual improvements in several key aspects of running their practices, according to the “Family Medicine Practice Issues Report 2024” by Medscape Medical News.

The report was based on data from several Medscape surveys conducted between January and June 2024.

Among the report’s findings: Family medicine physicians (23%) were more likely than doctors overall (16%) to report improvements in the quality of their workplace culture.

Another 48% of the family medicine physicians surveyed said the quality of their workplace culture was holding steady, and 29% said it was declining.

Santina Wheat, MD, MPH, a family physician and associate professor at Northwestern University Feinberg School of Medicine in Chicago, told Medscape Medical News these findings reflected a growing investment in primary care.

“Organizations have demonstrated — with words and actions — that primary care is important, and they have to invest in improving the culture and happiness within the clinic space,” Wheat said. “Some of it is reducing the administrative burden; some of it is helping to dial back the work tensions that grew during COVID.”

However, challenges still remain in the way physician productivity is assessed, according to the report.

About 7 in 10 family physicians said the approach based on relative value units (RVUs) was at least “somewhat” misguided in measuring their work output.

When family physicians were asked how well RVUs measured their productivity, 49% answered “somewhat poorly,” and 19% replied “very poorly.” In contrast, only 1% believed RVUs measured productivity “very well,” and 31% said “somewhat well.”

Linda Girgis, MD, a family physician in South River, New Jersey, said the RVU-based system often pushes physicians to prioritize seeing more patients over taking time to deliver quality care.

“I think RVUs incent you to deliver a higher number of services rather than provide quality care and quality outcomes,” Girgis said.