MEDICINE, DOLLARS & DECISIONS
Medicine, Dollars & Decisions is a podcast about the life and business of medicine. Clinicians receive little education on physician compensation, RVUs, contracts, leadership, investing, and the financial decisions that shape their careers. Hosted by Dr Bruno Casanova, a gynecologic surgeon and Department Chair at one of New York City's largest multi-specialty physician groups, each episode explores the life and business of medicine in clear, practical language. Whether you're a medical student, resident, fellow, physician, nurse practitioner, physician assistant, or healthcare leader, you'll gain the knowledge needed to make smarter career and financial decisions.
Episodes
What Are Bonuses? | Compensation & Contracts | MD&D # 34
Physician bonuses can look simple on the surface, but the details matter. In this episode of MD&D, we break down signing bonuses, productivity bonuses, retention bonuses, and the clawback provisions that may require physicians to repay money. Learn what to look for before signing a contract and why the bonus amount alone may not be as important as the strings attached to it. Read mo
How to Use RVUs? | RVU | MD&D #28
Understanding RVUs is only the first step. In this episode, Dr. Bruno Casanova explains how physicians and other medical professionals can use RVUs to understand coding, productivity, compensation, benchmarks, and employer expectations. Learn how to estimate the work RVUs needed to support your income, evaluate productivity goals, and make better career and compensation decisions.Read the
Nurse Practitioners, Physician Assistants & RVUs | RVU | MD&D # 25
How do nurse practitioners and physician assistants fit into RVU-based physician compensation? In this episode of Medicine, Dollars & Decisions, Bruno F. Casanova, MD, MSCE, MA, FACOG, explains how NPs and PAs generate RVUs and wRVUs, how healthcare organizations evaluate APP productivity and reimbursement, and how advanced practice providers fit into the broader RVU compensation mode
The Falling Value of RVUs | RVU | MD&D #17
Physician reimbursement has been losing ground for years. In this episode, Dr. Bruno Casanova explains how declining Medicare payment, changing RVU values, efficiency adjustments, and budget neutrality can force physicians to work more simply to maintain the same income. He also explains why understanding these changes matters when evaluating productivity targets, compensation formulas, a
Hiring. The Employers Perspective | Contracts | MD&D #14
How do healthcare organizations decide what to pay clinicians? In this episode of The Truth About RVUs, Dr. Bruno Casanova looks at compensation from the employer’s perspective. We discuss the costs of hiring and onboarding a new clinician, staffing and support, credentialing, practice growth, productivity expectations, and the time it can take before a new hire becomes financially produc
Evaluation a Job Offer | Contracts | MD&D #12
A high physician starting salary does not always mean a better job offer. In this episode of Medicine, Dollars & Decisions, Dr. Bruno Casanova explains how physician compensation works beyond the headline salary, including work RVUs, productivity bonuses, compensation thresholds, inflation, geographic differences, and what happens after an initial salary guarantee ends. Learn the ques
Location, Supply/Demand & Your Pay | Compensation | MD&D #9
In this episode of The Truth About RVUs, we look at something physicians often underestimate when thinking about compensation: the physician job market. Your salary and RVU rate are not determined by productivity alone. Specialty demand, geographic location, physician supply, recruitment difficulty, competition between employers, and local market conditions can all affect what an organiza
Experience, Past-Productivy & Your Pay | Compensation | MD&D #8
RVUs are only part of the physician compensation equation. In this episode, Dr. Bruno Casanova explains how experience, productivity, professional history, reputation, and organizational value can influence how much a physician is paid per work RVU.Learn why two physicians in the same specialty, working in the same region and even within the same organization, may receive very different c
MGMA and Other Production Benchmarks | Compensation | MD&D #7
Your income isn't determined only by your employer or your productivity. In this episode, Dr. Bruno Casanova explores the organizations, What really determines physician compensation? RVUs and productivity matter, but they are only part of the story. The episode explains how employers, reimbursement systems, and market forces can influence what physicians ultimately earn.Understanding the
Pay Differences Between Specialties | RVU | MD&D #6
Why do some medical specialties earn significantly more than others? In this episode, Dr. Bruno Casanova explores the key factors that influence physician compensation, including supply and demand, training, productivity, reimbursement, and market forces. Understanding these differences can help you make more informed career decisions. MD&D is a platform for medical professionals who
Same RVUs. Different Pay. The Effect of Geography | RVU | MD&D #5
In this episode Dr Casanova discusses how your location in the United States affects your income. Why two providers in different parts of the country may provide the exact same services and get very different compensation.MD&D is a platform for medical professionals who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.Free RVU
Budget Neutrality and Specialties RVU Value | RVU | MD&D #4
Why do specialties compete for a portion of the same pie? In this episode, Dr. Bruno Casanova explains the principle of budget neutrality. Why increases in payment for one specialty can lead to reductions for another specialty. And how this policy continues to shape physician reimbursement across the healthcare system.MD&D is a platform for medical professionals who want to better und
The RUC Committee and Your Work Value | RVU | MD&D #3
Who decides how many RVUs a procedure or encounter is worth? In this episode, Dr. Bruno Casanova explains how physician work is valued, the role of a committee called RUC, and how those decisions ultimately influence compensation across the healthcare system.MD&D is a platform for medical professionals who want to better understand RVUs, physician compensation, medical finances, caree
Why Were RVUs Created? | RVU | MD&D #2
Why were RVUs created in the first place, and why do they continue to shape modern healthcare? In this episode, Dr. Bruno Casanova explores the history behind the RVU system, the problems it was designed to solve, and how it evolved into the foundation of physician compensation in the United States. Understanding where RVUs came from is the first step to understanding how they influence y
What is an RVU? | RVU | MD&D #1
What are RVUs, and why do they matter? Dr. Bruno Casanova introduces the fundamentals of Relative Value Units and explains how they shape physician compensation and the financial side of medicine.MD&D is a platform for medical professionals who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.Free RVU Playbook: playbook.mddecis
The Truth About RVUs: Trailer - Introduction
Welcome to MD&D: Medicine, Dollars & Decisions. Discover why this podcast was created and what you'll learn about physician compensation, contracts, RVUs, leadership, and the business of medicine, helping you make smarter career and financial decisions.Dr Bruno Casanova shares why he created this podcast and what you can expect from future episodes. Together, we'll explore physici
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