Emergency Physicians Who Produce Higher Relative Value Units Per Hour Spend Similar Amounts of Time at Patient Bedsides as Their Colleagues

• Published in: The Journal of emergency medicine 2017-11, Vol.53 (5), p.765-770
• Main Authors: Breyer, Michael, Farley, Heather, Neyman, Greg, Nichols, Wendy, Kendall, John
• Format: Article
• Language: English
• Subjects: Adult; Cohort Studies; Efficiency; Emergency Medicine - manpower; Emergency Medicine - statistics & numerical data; Emergency Service, Hospital - organization & administration; Emergency Service, Hospital - statistics & numerical data; Female; Humans; Male; Physician-Patient Relations; Physicians - standards; Physicians - statistics & numerical data; productivity; Prospective Studies; Quality of Health Care - statistics & numerical data; RVUs; teaching; Time Factors
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2017.08.010

Emergency physicians (EPs) are expected to deliver quality care while maintaining high levels of efficiency and productivity as measured by the relative value unit (RVU). We sought to determine whether academic EPs with higher RVUs spend less time at the bedside than their colleagues. This was a prospective, observational, cohort study. A 13-item task list was generated, pilot-tested, and placed onto a computerized tablet. There was no difference among EPs in terms of time spent at bedside, 26.7% of total time, 17.31 min (95% confidence interval [CI] 14.43–20.19), p = 0.052; resident interaction 13.1%, 8.46 min (95% CI 4.68–12.25), p = 0.959; charting, 11.1%, 7.17 min (95% CI .746–5.65), p = 0.055; information search, 10.5%, 6.80 min (95% CI 0.84–8.52), p = 0.320; walking, 9.0%, 5.86 min (95% CI 5.17–6.54), p = 0.112; consultant interaction, 8.2%, 5.28 min (95% CI 3.18–7.40), p = 0.404; writing orders, 6.5%, 4.19 min (95% CI 3.22–5.15), p = 0.109; nursing interaction, 5.6%, 3.65 min (95% CI 2.54–4.76), p = 0.260; other, 5.2%, 3.65 min (95% CI 1.76–5.02), p = 0.785; medical student interaction, 4.2%, 2.75 min (95% CI 0.53–4.97), p = 0.102; physician assistant interaction, 2.8%, 1.79 min (95% CI 1.08–2.50), p = 0.959; clerical interaction, 1.7%, 1.13 min (95% CI .69–1.57), p = 0.335; and electrocardiogram interpretation, 0.7%, 0.45 min (95% CI .32–.58), p = 0.793. Despite differences in RVU-based productivity data, academic EPs spend similar amounts of time involved in the daily tasks of taking care of patients, underscoring that direct physician–patient interaction is one practice parameter that is not compromised among these EPs.