Evaluation of Nonclinical Activities of Emergency Medicine Specialist Using Relative Value Unit: Pilot Study

PURPOSE: Emergency medicine (EM) specialists in training hospitals perform not only clinical practice, but also nonclinical activities, such as education, administration, and research. The types and amounts of nonclinical activities are increasing, but the activities have not been evaluated. This study applied the concept of the relative value unit (RVU) and conducted a pilot study to calculate the total nonclinical activities of EM specialists in training hospitals. METHODS: The one year nonclinical activities of the eight EM specialists working in training hospitals were analyzed retrospectively. The nonclinical activities were divided into three areas: education, administration, and research. The types of activities, and effort and time spent were collected and the RVU was calculated. RESULTS: The time spent on the education and administrative tasks ranged from 92 to 1,094 hours (average 348.8 hours) and 19 to 1,018 hours (average 207.8 hours), respectively. The average annual workload for education was 324.9 RVUs. The average annual administrative workload was 115.6 RUVs. The average time spent in education and administration was 556.6 hours and clinical practice was 1,904.8 hours. CONCLUSION: Nonclinical activities are essential for the operation of EM departments. If the necessary manpower for the EM is to be calculated, it will be important to calculate the workforce of the specialists, including the nonclinical workload.

The significance of fundus photographs during health mass screening

BACKGROUND: Fundus photographs performed during health check-up were reviewed to determine the usefulness in mass screening. METHODS: Subjects consistine of 3017 people who had undergone physical health check up at the Health Clinic, Dong-Eui Medical Center in 1997 and whose fundus photographs of both eyes were taken showing clearly visible posterior pole and optic disc were chosen as subjects. Medical records which included cases of reported close exam and causes, actual cases of close exam and final diagnoses. RESULTS: Of the 3017 people, reported close exam was performed in 665 (22.0%). Among them glaucoma was suspected in 460 retinal hemorrhagic lesion in 63, retinal degenerative lesion in 67 and others in 75. There were 187 actual cases(28.1%) of close exam including glaucoma suspect in 79, retinal hemorrhagic lesion 47, retinal degenerative lesion 34 and others 27. Among 187 actual cases of close exam, 140 people (1.3%) were eventually diagnosed as glaucoma suspect (60), retinal hemorrhagic lesion (38), retinal degenerative lesion (21) and others (21). CONCLUSIONS: Fundus photographs are useful in mass screening, but performing close exam to enhance the usefulness of the fundus photographs is necessary.