Abstract
<h3>To the Editor. —</h3> The determination by Hsiao et al<sup>1</sup>of the resource-based relative value (RBRV) of a given medical service can be summarized as: RBRV = (<i>TW</i>)(1 +<i>RPC</i>)(1 +<i>AST</i>) where<i>TW</i>is the total work input by the physician,<i>RPC</i>is an index of relative specialty practice costs, and<i>AST</i>is an index of amortized value for the opportunity cost of specialty training. Logically, one would assume that, on the whole, the<i>RPC</i>factors for a given specialty should reflect the cost of providing the work of that specialty, in the same way that<i>TW</i>represents the work provided by that specialty. Instead, Hsiao et al have built their scheme on an<i>RPC</i>factor that represents the cost of generating a given amount of revenue in 1983. A problem arises in that an<i>RPC</i>based on the fraction of 1983 gross revenues will be meaningless and inapplicable
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