The Effect of Emergency Medicine Residents on Clinical Efficiency and Staffing Requirements.

Conference Paper

OBJECTIVES: The effect of emergency medicine (EM) residents on the clinical efficiency of attending physicians is controversial. The authors hypothesized that implementing a new EM residency program would result in an increase in relative value units (RVUs) generated per hour by attending physicians and decrease staffing requirements. METHODS: This was a retrospective observational analysis of an emergency department before, during, and after the establishment of a new EM residency program. We analyzed the change in RVUs billed, patients seen, and hours worked by attending physicians, midlevel providers (MLPs), and residents, and addressed potential confounding factors. RESULTS: The clinical efficiency of attending physicians increased by 70%, or 4.98 RVUs/hour (from 7.12 [SD ± 1.4] RVUs/hour to 12.1 [SD ± 2.2] RVUs/hour, p < 0.001) with the implementation of an EM residency program. Overall, net department RVU generation rose by 32%, even as attending physician coverage decreased by 6.3% (p < 0.05), and MLP coverage dropped by 60% (p < 0.05). We estimated that the implementation of the residency saved 4,860 hours of attending physician coverage and 5,828 hours of MLP coverage per year. This represents an estimated $1,741,265 in annual staffing savings, comparable to the residency program's annual operating cost of $1,821,108. CONCLUSIONS: The implementation of an EM residency program had a positive effect on the clinical efficiency of attending physicians and decreased staffing requirements.

Full Text

Duke Authors

Cited Authors

  • Clinkscales, JD; Fesmire, FM; Hennings, JR; Severance, HW; Seaberg, DC; Patil, N

Published Date

  • January 2016

Published In

Volume / Issue

  • 23 / 1

Start / End Page

  • 78 - 82

PubMed ID

  • 26714030

Electronic International Standard Serial Number (EISSN)

  • 1553-2712

Digital Object Identifier (DOI)

  • 10.1111/acem.12834

Conference Location

  • United States