08/16/2021    Christopher Lotufo, DPM

Five Questions to Ask About wRVU Compensation

I read with interest regarding the topic “Five
Questions to Ask About wRVU Compensation”. Having
been employed by a multi-specialty group and
compensated under a wRVU system for the last 7
years, I have come to realize a few things
specifically regarding DPM compensation. Ultimately
it is the conversion factor (CF) that drives a
physician’s pay, and this is what needs to be
negotiated. Medical groups, hospitals and academic
institutions use data from the MGMA and AMGA to
calculate physicians pay and conversion factors for
all medical specialties. The data they gather is
mostly from surveys of these institutions and it is
my belief that the data regarding DPMs is lacking.

A busy DPM performing all aspects of foot and ankle
surgery can generate productivity numbers on par or
in some cases exceed productivity numbers of an
orthopedic foot and ankle surgeon, yet the current
conversion factor difference for a DPM vs an
OrthoF&A surgeon is roughly $10. That means an
orthopedic F&A surgeon will receive $10 more per
wRVU for the same procedure performed by a DPM.

This can amount to a significant difference over
the course of a year. I also believe administrators
know this and are hiring DPM’s to perform their
institutions F&A work as it is a cost savings to
them. The negotiated contracts and reimbursements
these institutions receive is the same whether a
DPM or an ortho F&A surgeon does the work. This
discrepancy will continue unless more DPM’s are
surveyed and MGMA/AMGA is able to gather better
data on the production of surgical DPMs.

Christopher Lotufo, DPM, Vancouver, WA

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