Evaluating RVUs as a measure of workload for use in assessing fatigue

Elizabeth A. Krupinski, Lea MacKinnon, Karl Hasselbach, Mihra Taljanovic

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Scopus citations


Physician work is not well defined and does not take into account all of the activities and tasks involved in interpreting cases. We observed 3 MSK radiologists reading 100 cases. We recorded types of cases, whether residents/fellows were present, total time per case, time spent teaching, and time for interruptions. There were residents/fellows present for 65% of the cases. On average, when residents/fellows were present it took significantly longer to read a case. Overall, prior studies were accessed for 25% of the cases, with radiographs and CT accessing them more than MRI and US. Time per case was significantly longer when prior studies were included. In terms of interruptions, 9.24% of the time was taken up by calls to/from other clinicians, talking to technologists, discussing case protocols, and technical problems. All interruptions occurred during a case review. We downloaded RVU data for the 3 radiologists and correlated them with the actual times per case. The overall correlation was 0.215. For a given RVU, the actual amount of time spent on the case varies. Radiologists spend more time per case than assigned RVUs account for. This underestimation contributes to expectations of increased workloads, leading potentially to more and more cases being read in shorter amounts of time leading to increased fatigue and stress that could lead to increases in error rates. In order to better address fatigue and stress in the radiology department we need to better understand the pressures radiologists face and possibly reevaluate the RVU system.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2015
Subtitle of host publicationImage Perception, Observer Performance, and Technology Assessment
EditorsClaudia R. Mello-Thoms, Matthew A. Kupinski, Claudia R. Mello-Thoms
ISBN (Electronic)9781628415063
StatePublished - 2015
EventMedical Imaging 2015: Image Perception, Observer Performance, and Technology Assessment - Orlando, United States
Duration: Feb 25 2015Feb 26 2015

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2015: Image Perception, Observer Performance, and Technology Assessment
Country/TerritoryUnited States


  • Workload
  • fatigue
  • relative work units

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging


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