Abstract
To the Editor. — The determination by Hsiao et al1of the resource-based relative value (RBRV) of a given medical service can be summarized as: RBRV = (TW)(1 +RPC)(1 +AST) whereTWis the total work input by the physician,RPCis an index of relative specialty practice costs, andASTis an index of amortized value for the opportunity cost of specialty training. Logically, one would assume that, on the whole, theRPCfactors for a given specialty should reflect the cost of providing the work of that specialty, in the same way thatTWrepresents the work provided by that specialty. Instead, Hsiao et al have built their scheme on anRPCfactor that represents the cost of generating a given amount of revenue in 1983. A problem arises in that anRPCbased on the fraction of 1983 gross revenues will be meaningless and inapplicable
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