RVG working groups were given definitions of direct patient care and support time to help them estimate how much time is spent on patient care. Activities such as travel and administrative work were to be excluded. Mental effort and judgement, technical skill or physical effort, and psychological stress were human-resource components used to estimate the intensity associated with providing a medical service. After reviewing original ratings of medical services, working groups will refine the ratings and "hardlink" unrated tariff items. In the MMA newsletter Inter-Com, committee chair Dr. William Rennie said the project offers a unique opportunity to update the fee structure and the rules that govern physician payment.