Roy Peter Clark, in the book Writing Tools, has a chapter called “Climb Up and Down the Level of Abstraction”, in which he discusses how powerful concrete words (the bottom of the ladder) and abstract words (the top of the ladder) are versus the bureaucratic, “in-between words” (my term).
The acronym RVU, which stands for relative value unit, is one of these in-between words which pervades healthcare. Developed in the 1980s by Medicare as an accounting tool to help give some flexibility in adjusting reimbursement for different services based on geography, it now has a life of its own.
Physicians are judged on how many RVUs they generate. Departments become RVU centers for the business. And services (more accurately described as patient interactions, including both exams and procedures) are often described as high RVU vs. low RVU.
Effectively, an entire healthcare system has been developed around efficient RVU extraction, where now patients are just raw material for these magical RVUs.
This is bad enough, but keep in mind with the integration of the EHR into every facet of the patient interaction, patients have become a valuable source of a different type of raw material: data.
All we need now is a new acronym for patients as data sources, a new in-between word.
Then let the extraction begin.