S5987 Exploring the Role of RVUs in Financial Compensation and Effect of Maternity Leave for Women in Gastroenterology

Introduction: In medicine, we devote much of our lives to mastering the craft of patient care yet often neglect to develop our own financial literacy. Very few training programs incorporate information on physician compensation or personal finance. In the world we live in, financial knowledge profoundly impacts our well-being, illiteracy of the subject contributes to stress, anxiety, and burnout—exacerbating the challenges in this already demanding profession. An increased understanding of the system allows us to take greater control of our lives and better anticipate what may come. Case Description: Physicians who are compensated based on “productivity” metrics, such as relative value units (RVUs), can experience significant financial strain when taking time off for life events, like maternity leave. In highly procedural specialties, such as gastroenterology, this reliance on RVUs can lead to drastic income fluctuations. This poster aims to clarify how RVU-based compensation operates and highlights the financial gap faced during a leave of absence. In this example, RVUs are accumulated over a 6-month period, multiplied by a compensation factor, and then distributed evenly throughout the subsequent months. Consequently, maternity leave can result in a prolonged income loss, even after returning to full-time work with a full patient panel. Discussion: Over multiple discussions with female physicians, potential solutions were proposed, including paid extended parental leave for all physicians, implementation of a “shadow” RVU (similar to Scripps' model as presented in this poster), flexible work arrangements upon return, and establishment of a baseline salary with additional RVU compensation to mitigate the financial impact of low to 0 RVUs. While this paper specifically addresses the impact of maternity leave on a gastroenterologist’s income in San Diego, the revenue framework and discussion points are broadly applicable to all physicians, especially those in procedural specialties, facing a need for extended leave due to personal health, bereavement, or unforeseen circumstances.