The skeleton hanging in his office stays. So does the crash-test dummy named after his brother, Jorge Martinez, a physician.

But today, Ricardo Martinez, administrator of the National Highway Traffic Safety Administration, leaves to become vice president of health affairs for Web MD Inc., an Atlanta online health-care company. It will be far from the inside-the-Beltway battles he has fought over the past five years, trying to convince the many groups and companies involved in auto manufacturing and safety that vehicle fatalities are a public health issue--the leading cause of death to children, teenagers and young adults.

Martinez, an emergency-room physician who was affiliated with Emory University, brought a singular mind-set to the job of running NHTSA, an agency that sets the safety rules and performance standards for car and truck makers. He linked medicine and vehicular safety, insisting that engineers design safety features with people, not crash dummies, in mind. One of his favorite rejoinders to anyone who questioned his regulatory philosophy was "We aren't protecting crash-test dummies, we're protecting real people."

Or, as one source close to the agency said, Martinez considered himself the "surgeon general of highway safety."

As such, Martinez put a lot of energy into the medical aspect of his job. He urged his staff at NHTSA to accompany him on late-night visits to trauma centers, where they waited for accident victims to come in for emergency treatment.

"This was so engineers could understand when all was said and done, people suffer the consequences of a crash," said one NHTSA staffer who went on a trip to the trauma center.

Martinez counts as one of his most significant accomplishments the establishment of eight trauma centers, called the Crash Injury Research and Engineering Network, where researchers analyze every facet of a crash, its cause, the roads involved, the vehicle and the injuries to the occupants. Then the information is computerized and shared among car manufacturers and others on the network.

"He brought it [NHTSA] closer to being a health agency," said Stephen Hargarten, an emergency-room physician in Milwaukee. "The intent is to save people from car crashes."

That ambitious approach had its downsides, Martinez's critics said.

Numerous sources who either worked for NHTSA or now work closely with the agency said Martinez has a lightning-fast mind, but his approach of advancing multiple ideas at one time often resulted in confusion among NHTSA staff and incomplete results.

"He's like the college athletic prospect: long on potential, short on accomplishment," said Clarence Ditlow, director of the Center for Auto Safety, a consumer safety group that frequently disagreed with Martinez's regulatory strategy.

Auto-safety groups credited him for broadening the debate on auto safety, but some are disappointed that the agency did not produce rules to prevent rollovers in sport-utility vehicles, that progress has been slow on developing a new rule to improve air-bag safety, and that the agency chose to ask the auto industry to develop a voluntary standard for new side air bags.

There was disappointment within the safety advocacy community that Martinez relied on the bully pulpit and letters to automobile manufacturers reminding them of their responsibilities when it comes to safety, rather than proposing new standards. His view was that it took too long to regulate, and that technology was moving faster than NHTSA could keep up with it.

"Our view is industry can't sit back and wait for government to tell them what to do," Martinez said in an interview. "They need to come up with best practices, voluntary guidelines, do research."

Auto companies have embraced the approach taken by Martinez and one industry source said they had few differences with Martinez because he was not a heavy regulator in the traditional sense.

Despite the differences of opinion about the effectiveness of his overall approach, he gets generous praise for improving the safety of children by stressing that they need to be buckled up in the back seat. On his watch, the agency issued a rule calling for a new universal child restraint system that will secure child safety seats with standardized anchors that are independent of the vehicles' seat belts. One of his last pronouncements this week was to advise parents to deactivate side air bags if their children are sitting near them.

The agency also improved head-injury protection in cars and issued several truck safety rules.

Martinez's unconventional approach to regulating also surfaced in the way he ran the agency. He tried to change the agency's culture after he arrived in 1994, introducing management concepts that were supposed to empower lower-level employees and improve working relationships and communication within the agency. He favored workshops and teamwork at an agency that he characterized in a speech as having "many tribes and much tribal warfare."

One former employee of NHTSA said the effort "shook up the agency." Others reacted to the change by leaving, creating what they called a "brain drain" of seasoned top officials and engineers.

Martinez shrugs off the criticism.

"I strived hard to keep focused on the big picture," he said. And, reflecting his medical training, he added: "I'm actually worried about whether the patient gets better."

CAPTION: Outgoing NHTSA Administrator Ricardo Martinez tried to make auto safety a public health issue.