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One RVU in 1992 was worth $31. Adjusted for inflation the RVU in 1992 is worth $71 today. Congress said the RVU today is worth $33. That’s a 56% pay cut. It doesn’t matter how good AI is. The house always wins. Billing through insurance is a suckers game you will never win as long as you continue to accept RVU coupons as payment. Most specialty care can give affordable cash prices, and go direct to the patient. We are already doing this here. We have Cash Endocrinology, Cardiology Pulmonology,. The Cash neurologist is full and no longer accepting new patients. We have Cash PM&R. For yourselves. There was a time before insurance took over that everyone paid cash. It can be done. We are doing it. Stop making excuses why it cannot be done and give me one why it can be done. #Healthinsurance #scam #CORRUPTION

I interviewed an internal medicine physician who says the medical system relies on a massive amount of unpaid labor to function. We call it "taking call." Dr. Corinne Sundar Rao joined me to discuss why the traditional model of physician on-call compensation is a primary, yet rarely discussed, driver of burnout. For decades, taking call was simply baked into the job. You worked your full clinic day, you were on standby all night for the hospital, and then you worked a full schedule again the next day. It was justified by the "calling" of medicine. But as Dr. Rao points out, the complexity and volume of modern medicine make this model unsustainable. Other high-stakes professions, like commercial airline pilots, have federally mandated rest periods. Yet surgeons and physicians are routinely expected to make life-and-death decisions on zero sleep, often for little or no extra pay. Dr. Rao argues that "call" is a euphemism for extracting free labor from physicians to cover the hospital's unassigned patients. We have seen successful solutions before. The hospitalist and laborist models proved that we can turn endless, tethered responsibility into defined, compensated shifts. But many specialties are still trapped in the old paradigm. The result? Physicians aren't complaining; they are simply disappearing. They are dropping out of traditional practice, moving to concierge models, or leaving medicine entirely. If hospitals want to solve the staffing shortage, they need to stop relying on altruism to subsidize their 24/7 operations. Call is labor. And labor must be paid fairly, transparently, and with built-in rest protections. 🎙️ Listen to "Physician on-call compensation: the unpaid labor driving burnout" on The Podcast by KevinMD. 📷 Search "The Podcast by KevinMD" on Apple or Spotify. #KevinMD #PhysicianBurnout #HealthcareWorkforce #MedicalCulture #PhysicianCompensation #PatientSafety #HealthcareLeadership






















