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Francis O. Walker, MD
Wake Forest University Medical Center Winston-Salem, NC

JAMA. 1994;271(6):425.

	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.

—In their article on a fee-for-time system, Drs Wachtel and Stein¹ argue for the controversial proposal that physician compensation should be based solely on time. The approach is inherently counterintuitive. Should a talkative dermatologist who sees 20 patients a day be paid the same as a terse one who sees 60? Is 2 hours spent replacing a hip equivalent to four half-hour sessions demonstrating back exercises? Is 1 hour spent doing laparoscopic tubal ligation worth the same as time spent discussing the use of birth control pills? Given such obvious shortcomings of the feefor-time proposal, one wonders how it merits serious consideration. Perhaps the authors were so concerned with pay differences between specialties that they overlooked the adverse effects of a fee-for-time system within specialties.

Attempts to define relative value by formula, although new to medicine, are not new to the workplace. Rhoads, in one of . . . [Full Text PDF of this Article]

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