Work relative value units undervalue the clinical effort associated with teaching cases: An ACS-NSQIP analysis

Work-relative-value-units (wRVUs) are a core metric of faculty effort but do not account for the additional work associated with intraoperative teaching. This study introduces and assesses an indexed effort, wRVU per minute (wRVU index). We hypothesize that there is a significant decrease in the cal...

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Bibliographic Details
Published in:The American journal of surgery 2024-01, Vol.227, p.117-122
Main Authors: Nwokedi, Ugoeze, Graviss, Edward A., Nguyen, Duc T., Pei, Kevin Y.
Format: Article
Language:English
Subjects:
Academic Medical Centers
Acute Care Surgery
Appendectomy
Cholecystectomy
Emergency procedures
Faculty
Generalized linear models
Health care policy
Humans
Laparoscopy
Physician compensation
Postoperative Complications
Productivity
Statistical models
Surgeons
Surgery
Surgical training
Teaching cases
United States
Variables
wRVU
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Summary:Work-relative-value-units (wRVUs) are a core metric of faculty effort but do not account for the additional work associated with intraoperative teaching. This study introduces and assesses an indexed effort, wRVU per minute (wRVU index). We hypothesize that there is a significant decrease in the calculated wRVU index among teaching cases. We queried the ACS-NSQIP database for 7 core Emergency General Surgery procedures and records were stratified into teaching vs non-teaching, and emergent vs non-emergent procedures. We utilized multivariable generalized linear models to determine factors associated with increased operative time and decreased wRVU index. Data were available for 953,967 cases from 2005 to 2010. For all cases, teaching vs non-teaching, the median wRVU index was 0.16 vs 0.21 (p ​
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2023.09.051