Background A comprehensive performance management system is a key component to a healthcare organization’s success in providing financially sustainable quality care. It supports the recruitment and retention of competent and motivated clinical staff by allowing for a system of accountability that can support deficiencies, compensate for shortcomings, and invest in successes. Privatization, increased patient health demands and expectations, rapid technological advancements and medical science developments have improved the quality and longevity of life, but nonetheless, pose serious financial challenges for healthcare organizations. An academic center in a high-income country explored the impact of relative value units to measure productivity and assist with resource planning as a possible solution to market competitivity. Case To implement the initiative, the teaching hospital associated all non-medication orders with the relevant current procedural terminology codes and associated the codes with relative value units. The overall implementation of the performance system was divided into multiple phases, where the first constituted the technical software builds and integrations, followed by a pilot phase, and finally, a phase for outlining and defining the administrative requirements, including guidelines, methods, policies, and rules that would govern the layers and mechanisms of accountability surrounding the use of relative value units in managing clinicians’ productivity, specifically physicians. The case focuses on the technical setup of the management system that entailed a series of validations and verifications to confirm the accuracy of the integration and communication between the electronic medical record (EMR) and the organization’s data extraction and representation software, as well as ensuring all data generated by the software matches the data available on the physician interface of the EMR. Conclusion A universally recognized approach developed by medical personnel to manage physician performance contributes to and improves and organization’s resource planning and decision-making capacities, especially in targeted recruitment and effective retention strategies. Other benefits of adopting such systems are their compatibility with modern EMRs and their potential to reduce resistance to change, due to the objectivity associated with adopting a system that quantifies physicians’ work based on time and complexity reviewed and determined by physicians rather than persons outside the medical field.