Stop using RVUs | LOF # 130

WARNING: RVUs may measure a physician's activity, but they can keep doctors from seeing the real money their work creates. Hospitals know the value of every procedure. Most physicians never see the numbers.Dr. Eric Smuclovisky is an interventional radiologist, former academic physician and independent physician-entrepreneur. After opening an OBL/ASC, he watched reimbursement cuts and negative media pressure threaten the model. He then found another route to autonomy: negotiating professional service agreements that allow physicians to work with hospitals without surrendering their independence as W-2 employees.In this conversation, Dr. Eric Smuclovisky reveals:⬛ Why physician fees collapsed while hospital facility fees expanded—and how that changed who controls American medicine⬛ Why he calls RVUs “monopoly money,” and how doctors can begin discovering what is actually billed under their names⬛ How the No Surprises Act, charge lists, payer contracts, and IDR expose the hidden economics behind a medical bill⬛ Why the physician shortage may finally give doctors enough leverage to negotiate from strengthEric explains why a hospital's charge list is its “dirty little black book.” Hospitals set prices then negotiate discounts with commercial payers; those deals are not simple multiples of Medicare. A summary of benefits might show an $80,000 charge, roughly $20,000 paid, and $1,000 owed by the patient. The gaps reveal the private contracts behind the bill. It matters.Follow Dr. Eric Smuclovisky:LinkedIn: https://www.linkedin.com/in/eric-smuclovisky-58206927b/Resources mentioned in this episode:🏢 Outpatient Endovascular and Interventional Society (OEIS): https://oeisweb.com/🔗 Stark Law, CMS: https://www.cms.gov/medicare/regulations-guidance/physician-self-referral🔗 No Surprises Act and independent dispute resolution, CMS: https://www.cms.gov/nosurprises🔗 CMS Physician Fee Schedule and CPT reimbursement lookups👤 Ross Perot, referenced during the discussion of RVU historyLife of Flow is hosted by Dr. Lucas Ferrer and Dr. Miguel Montero-Baker.🌐 Website: https://lifeofflowpodcast.com▶ YouTube: https://www.youtube.com/@LifeofFlowPodcast🎧 Listen: Spotify https://open.spotify.com/show/5GMv47SJ0ePxbjtIb1GZ5U · Apple https://podcasts.apple.com/us/podcast/life-of-flow/id1705596604📩 Partner with the show: [email protected] with the hosts:Dr. Lucas Ferrer — [Lucas LinkedIn]Dr. Miguel Montero-Baker — https://www.linkedin.com/in/miguel-montero-baker-a44354214/Follow Life of Flow:Instagram: https://www.instagram.com/lifeofflowpodcast/X: https://x.com/vascularpodcastLinkedIn: https://www.linkedin.com/company/lifeofflow