An innovative approach for calculating the work relative value units of clinical activities otherwise concealed

Since the introduction of work relative value units (wRVUs), academic institutions have increasingly relied on them as a means of assessing clinical productivity. However, wRVUs do not capture all activities performed in the academic setting. Although proposals exist for converting teaching, research, and administrative activities into wRVUs, certain clinical activities-deemed "special services" at the University of Kentucky-remain unrecognized by this metric. For instance, wRVUs do not capture activities which include clinical work performed on a contractual basis, nor do they capture medicolegal activities. Yet, these and other special services often represent an important stream of revenue for an academic department. Because of both the significant dependence of wRVUs in determining clinical productivity and the failure of wRVUs to capture special services, the authors propose a formula that converts these clinical efforts into wRVUs.