Advisor(s)
Bunyamin Ozaydin
Committee Member(s)
Monica Aswani
Patrick Grusenmeyer
Steven Rothenberg
School
School of Health Professions
Document Type
Dissertation
Department (new version)
Health Professions
Date of Award
9-11-2025
Degree Name by School
Executive Doctor of Science (DSc) School of Health Professions
Abstract
ABSTRACT Radiologist productivity in the United States is traditionally measured by thework Relative Value Unit (wRVU). However, wRVUs fail to capture several criticalaspects of radiologic work, including study complexity, patient characteristics, andfacility factors. This study evaluated the statistical significance of wRVUs as a measureof productivity and proposes an alternative model grounded in ascribable time—themeasurable duration a radiologist takes to interpret and report a study.A comprehensive literature review highlighted the inadequacy of wRVUs inaccounting for technological advances, case complexity, and workflow differences.Applying contingency theory as the guiding framework, this study posited that radiologyproductivity must be tailored to institutional and contextual variability. Two datasets wereconsidered: one from Wake Radiology, a non-academic outpatient group, and one fromthe University of Alabama at Birmingham, an academic medical center.Hypothesis 1 tested whether wRVUs had a significant relationship withascribable time. The results showed that RVUs were statistically significant; however,their effect size and level of significance decreased as additional variables were added tothe model. Hypothesis 2 examined whether a multivariable model—including patient age,number of diagnoses, referring physician type, exam priority, and location—betterpredicted ascribable time for Chest CT exams. Regression analyses revealed that multipleivvariables were statistically significant, and inclusion of these variables beyond wRVUalone improved model fit .Key findings suggest that the complexity of the case, patient demographics, andinstitutional setting significantly influenced the time required to interpret radiologicexams. These findings support a shift toward a more nuanced model that incorporatesmultiple predictors of radiologist effort. Such a model could improve staffing forecasts,reduce system gaming through cherry-picking, and support fairer compensationstructures.Future work should aim on replicating this study in other institutions andmodalities and incorporating non-interpretive tasks into ascribable time. A revisedproductivity metric informed by study, patient, and facility characteristics may enhanceboth operational efficiency and equity in radiology.
ProQuest ID
Approval form
Recommended Citation
Dewey, Alfred Matthew, "Evaluating Relative Value Units And Its Alternatives Inradiology" (2025). All ETDs from UAB. 7446.
https://digitalcommons.library.uab.edu/etd-collection/7446
