Most physicians have no idea how much revenue they generate.
Not a rough sense. No idea.
I didn’t for years. I knew my salary. I knew my RVUs. I never connected those numbers to what the system was actually collecting because of my work.
When you finally do the math, it’s not a pleasant surprise. It’s a gut check. The gap between what you bring in and what you take home is not small, and nobody on the administrative side is going to walk you into that conversation voluntarily.
That’s by design.
We are trained to keep our heads down and trust that someone else is handling the business side fairly. And for a long time, I did exactly that. Signed contracts without understanding the real value of what I was trading.
RVUs are supposed to be the objective measure. But most of us learn what an RVU is worth to the system only after we’ve already locked in a number that undervalues it.
The negotiation happens once. The consequences compound for years.
Miguel and I got into all of this on the latest Life of Flow episode. How to actually calculate what you generate, why most contracts are structured to keep you from asking, and what changes when you finally have the numbers in front of you.
This is the conversation I wish someone had with me before I signed my first contract.
