MD&D | Medicine, Dollars & Decisions is a free educational platform about life and finances in medicine. For residents, fellows, and recent graduates. Understand job offers, physician compensation, contracts, and personal finances. Build your career with confidence through clear, practical explanations in everyday language.
Hosted by Dr. Bruno Casanova, award-winning, MIGS surgeon, and Department Chair in NYC.
New episodes every week.
Full articles and free resources: mddecisions.org
Disclaimer: The content reflects Dr. Casanova's personal views and professional experience and does not represent his employer or any affiliated institution.
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.
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27 Sept 2026
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 full article at MD&D:
https://read.mddecisions.org (https://read.mddecisions.org)
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https://mddecisions.org (https://mddecisions.org)
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 model. Learn why RVU attribution, billing, productivity, and compensation matter for physicians, nurse practitioners, physician assistants, and healthcare leaders.
13 Sept 2026
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, and employment contracts.
6 Sept 2026
Why Employers Care About Your RVUs | MD&D #11
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 productive.
Understanding the employer’s side of the equation can help you better evaluate salary guarantees, RVU rates, productivity thresholds, and long-term compensation structures and negotiate with a clearer understanding of what the organization is trying to accomplish.
Learn more at MDDecisions.org
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
30 Aug 2026
Physician Salary vs. RVU Compensation: How to Evaluate a Job Offer | MD&D #10
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 questions residents, fellows, and physicians should ask before signing an employment contract and why understanding the structure behind your compensation can matter as much as the salary itself.
23 Aug 2026
The Physician Job Market: How It Affects Your Salary & RVU Pay | 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 organization is willing to pay.
Understanding the job market gives you important context when evaluating a physician contract, negotiating compensation, or comparing your RVU rate with national benchmarks.
In this episode, we discuss:
How physician supply and demand influence compensation
Why the same physician may be paid differently in different markets
How geography affects salary and RVU rates
Why national compensation benchmarks do not tell the whole story
How understanding your market can strengthen contract negotiations
Medicine, Dollars & Decisions
A free educational platform for residents, fellows and early-career physicians
Life and Finances, in Medicine.
Educational content only. This is not legal, financial, or employment advice.
16 Aug 2026
What Else Determines Physician Pay? Experience, Productivity & Value
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 compensation. We also discuss how productivity benchmarks, including MGMA data, can affect negotiating power, and why understanding your own RVU production is essential when evaluating compensation, bonuses, and future job offers.
9 Aug 2026
Who Decides What Physicians Earn? Beyond RVUs and Productivity
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 these forces can help residents, fellows, and new attendings better evaluate compensation models, job offers, and career decisions.
MD&D is a FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
2 Aug 2026
Why Do Some Medical Specialties Make More Money? | Physician Compensation
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 FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
26 Jul 2026
Why Two Doctors Can Have the Same RVUs but Different Pay
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 FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
19 Jul 2026
Why One Specialty’s Gain Can Be Another’s Loss | RVU Budget Neutrality Explained
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 FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
12 Jul 2026
Who Decides What an RVU Is Worth? How Physician Work Is Valued
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 FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
5 Jul 2026
Why Were RVUs Created? Why They Still Shape Physician Compensation
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 your career today.
MD&D is a FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
5 Jul 2026
What Are RVUs? How They Affect Physician Compensation
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 FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
5 Jul 2026
The Truth About RVUs: Trailer - Introduction
Welcome to 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 physician compensation, RVUs, contracts, investing, leadership, and the finances side of medicine
MD&D is a FREE platform for residents, fellows, and early-career attendings who want to better understand RVUs, physician compensation, medical finances, career decisions, and leadership.
Free RVU Playbook:
playbook.medicinedollarsanddecisions.com
Website:
medicinedollarsanddecisions.com
Newsletter:
newsletter.medicinedollarsanddecisions.com
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