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Robert D. Gillette, MD
St Elizabeth Hospital Center Youngstown, Ohio

JAMA. 1992;267(21):2894-2895.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Dr Maloney¹ compared data on specialty-specific physician incomes² and working hours³ and concluded on the basis of his calculations that "Hourly reimbursement rates for surgical and nonsurgical specialties are not substantially different" and that "The 42% higher income of surgeons is explained by their longer working hours." He asserted that RBRVS, which is expected to alter income differentials by specialty, "is an inappropriate basis for reform of the physician reimbursement system." Recalling the observation of Spodick⁴ that "too often, the 'Conclusions' giveth, but the 'Materials and Methods' taketh away," I reviewed Maloney's "Analytic Methods and Assumptions" and found them inappropriate in the following areas:

1. He calculates from a table of reported working hours for institution-based physicians (reference 3 [Levy et al], Table 3.4) rather than one for all physicians (reference 3 [Levy et al], Table 3.1). If he had used the latter, he
   

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