The Podcast by KevinMD Hidden financial dangers of wRVU thresholds in medical employment agreements
Jan 26, 2026
Dennis Hirsch, a health care attorney who advises on physician contracts and wRVU-based pay. He breaks down risky wRVU thresholds, the need for realistic benchmarks and ramp-up guarantees, pitfalls like billing-date crediting and clawbacks, and key negotiation priorities to protect income.
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WRVU Clauses May Be Symbolic
- WRVU clauses can be meaningless if they merely state assumptions without enforcement.
- Examine the actual effect of WRVU language before relying on a stated salary.
Base Targets On Historical Ramp-Up
- Negotiate thresholds based on your historical production, not arbitrary increases.
- New physicians should get a guaranteed salary for at least one year to allow ramp-up.
Verify Your Productivity Data
- Insist on the right to audit and confirm your production data regularly.
- Keep clear records so you can dispute inaccurate administrative reports.