Hourly wages of physicians within medical fees based on the Korean relative value unit system

Background/Aims: It is difficult to reach a social agreement on the appropriate level of compensation for professionals. This study was performed to examine the physician fee embedded in the relative value unit (RVU) system in comparison with the Korean hourly minimum wage. Methods: The Health Insurance Service Price and the Korean Classification of Procedural Terminology were used to obtain the hourly wages of physicians for designated health care services. In addition, the physician fee schedule at the United States Centers for Medicare and Medicaid Services and the Organisation for Economic Co-operation and Development (OECD) report on minimal wage were used. Health care service fees were selected based on laboratory, pathology, imaging, and procedure codes as well as examination fees. For calculation of physician labor costs per hour, physician workload × conversion factor was divided by the time involved. To calculate the proportion of physician labor fee in the total fee, the physician workload RVU for each service fee was divided by the total RVU. Results: A total of 27 physician fee codes were selected. Compared to the Korean hourly minimum wage in 2015, the average physician wages were greater by 2.80- fold for primary care and by 3.05-fold for tertiary care. The mean proportion of physician labor cost in the total cost was 0.19, which was significantly lower than that of corresponding procedures in the United States RVU (mean, 0.48). Conclusions: The average Korean physician wages compared to the hourly minimum wage were disproportionately low compared to the USA and other reference OECD countries.