Is this anywhere typical of what most ENTs do?

[brent311]

So Right now Im doing an ENT rotation split 2 wks with one guy and 2 with the other. They are both older guys (late 50's and 70's) and it seems they barely work. Office 4 days a week that last only about 3 hours (about 10 patients) . Surgeries in the mornings are short(15 min-1 hour) and will usually have 0-3 surgeries. So far Im enjoying it alot and the lifestyle is making it seem even better but I think I might be getting the wrong impression of What I would most likely be doing if I do ENT.

So my first question is how much does the average ent work?

Also, after Gsurg I thought I would never be able to do surgery b/c I have some mild scoliosis that really bothers me when I stand in one place for 2+ hours. This hasnt been a problem for me on this rotation since everything is pretty short. So I guess My 2nd question is: Can most ENT surgeries be done in about an hour or are these the rare ones?

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[Leforte]

Does not sound typical from what I have seen of the private guys. Most are working pretty hard. I think I have seen #'s that the average ENT works ~50 hrs per week. Most are in clinic ~3 days and 1.5 days in surgery

There are many surgeries that last <= 1 hr and many that last > 1 hr. If you want to do short cases, you could do only those once you've finished your residency and send the rest on.

The problem would be residency, where cases can easily be several hours and if you go to a program that is heavy in H&N can exceed 12 hrs.

My guess is that the people you are rotating through with are set financially and don't mind the decreased reimbursement for the limited time they are in clinic and OR.

 

[brent311]

Thanks Leforte, I was kind of expecting something along those lines. I probably need to do another rotation with either a younger ENT or a place with a residency program to see if I like it and if my back can take it.

 

[resxn]

My guess is that the people you are rotating through with are set financially and don't mind the decreased reimbursement for the limited time they are in clinic and OR.

My thoughts exactly.

My week this week:
Monday - did 4 surgeries in the morning (all tubes and tonsils), 21 patients for the rest of the day. That was after spending from 0230-0430 reattaching a crack addict's ear that got bit off by someone he was in a fight with. Great story for another post. (10 hour day if you don't count the call for the ear).
Tuesday - 28 patients in clinic, 2 in-house consults that easily took up an hour (1 for epistaxis, 1 for angioedema with resp distress). (10 hour day)
Wed - 3 surgeries in the morning (1 completion Thyroid, 1 FESS/Balloon Sinuplasty, 1 MDL w/ microflap for non-responsive TVF polyp). 12 patients in the afternoon. (10.5 hr day).
Thursday - 8 surgeries (all tubes and tonsils) (8 hour day). 1 In-house consult for MRSA facial abscess.
Friday (today) - 9 patients in the morning. Afternoon off. (5 hour day)

Total hours - 43.5 not counting call time or work I brought home (probably close to 60 all together). 15 cases mostly all small, but still that's more than usual for me. Bumped up by the 8 case day of tubes and tonsils.

I would say that there are 9 ENT's associated with my hospital or the one down the street. I'm the newest and youngest of them (34yo) and the only one who takes trauma call. Only one is over 50yo though. I'd say all of these ENT's are working at least 45-50 hours a week. Three of us are solo. There is one partnership and one group of 4.

that's my life. I think it's good. I think the lifestyle of the guys you are following is boring. I'd shoot myself if that's all I was doing in a week. Also, I'd never cover my overhead.

 

[Pir8DeacDoc]

Thanks for sharing. I've never seen an ENT in private practice and was curious what a "week in the life" might look like too.

 

[brent311]

My thoughts exactly.

My week this week:
Monday - did 4 surgeries in the morning (all tubes and tonsils), 21 patients for the rest of the day. That was after spending from 0230-0430 reattaching a crack addict's ear that got bit off by someone he was in a fight with. Great story for another post. (10 hour day if you don't count the call for the ear).
Tuesday - 28 patients in clinic, 2 in-house consults that easily took up an hour (1 for epistaxis, 1 for angioedema with resp distress). (10 hour day)
Wed - 3 surgeries in the morning (1 completion Thyroid, 1 FESS/Balloon Sinuplasty, 1 MDL w/ microflap for non-responsive TVF polyp). 12 patients in the afternoon. (10.5 hr day).
Thursday - 8 surgeries (all tubes and tonsils) (8 hour day). 1 In-house consult for MRSA facial abscess.
Friday (today) - 9 patients in the morning. Afternoon off. (5 hour day)

Total hours - 43.5 not counting call time or work I brought home (probably close to 60 all together). 15 cases mostly all small, but still that's more than usual for me. Bumped up by the 8 case day of tubes and tonsils.

I would say that there are 9 ENT's associated with my hospital or the one down the street. I'm the newest and youngest of them (34yo) and the only one who takes trauma call. Only one is over 50yo though. I'd say all of these ENT's are working at least 45-50 hours a week. Three of us are solo. There is one partnership and one group of 4.

that's my life. I think it's good. I think the lifestyle of the guys you are following is boring. I'd shoot myself if that's all I was doing in a week. Also, I'd never cover my overhead.

I like that kind of schedule. I like to see lots of patients, get in and get out with mostly routine surgeries. The occasional odd ball like you had monday is ok too. What I dont care for are very long surgeries, bad trauma(really stress' me out), and the bad prognosis pts. In Gsurgery I had a few patients that had come in with MVAs that didnt get better for the entire month.

 

[Pir8DeacDoc]

I like that kind of schedule. I like to see lots of patients, get in and get out with mostly routine surgeries. The occasional odd ball like you had monday is ok too. What I dont care for are very long surgeries, bad trauma(really stress' me out), and the bad prognosis pts. In Gsurgery I had a few patients that had come in with MVAs that didnt get better for the entire month.

You better think a little more about all of this. Keep in mind that resxn is an attending. As a resident you'll see plenty of long cases in ENT especially if your department does the recon after large cancer whacks (which mine does). We've had cases that start at 8 or 9 in the morning and end at 2 or so the next morning. We (my program) don't see awful trauma stuff but you will see some ugly facial fractures as an ENT resident. Finally, you'll see plenty of patients with an AWFUL prognosis. Unlike cancer of the abdomen or some other region, head and neck cancer is much more outwardly disfiguring. Imagine a patient with dry mouth who can't swallow, can't talk, and has a trach. That's an awful prognosis and a bad way to die.

All that said, you don't have to treat those patients once you make it through residency. However, you need to know that this patient population exists and you will deal with them a lot depending on where you think about doing residency.

 

[resxn]

You better think a little more about all of this. Keep in mind that resxn is an attending. As a resident you'll see plenty of long cases in ENT especially if your department does the recon after large cancer whacks (which mine does). We've had cases that start at 8 or 9 in the morning and end at 2 or so the next morning. We (my program) don't see awful trauma stuff but you will see some ugly facial fractures as an ENT resident. Finally, you'll see plenty of patients with an AWFUL prognosis. Unlike cancer of the abdomen or some other region, head and neck cancer is much more outwardly disfiguring. Imagine a patient with dry mouth who can't swallow, can't talk, and has a trach. That's an awful prognosis and a bad way to die.

All that said, you don't have to treat those patients once you make it through residency. However, you need to know that this patient population exists and you will deal with them a lot depending on where you think about doing residency.

No doubt, life as a private attending is FAR different than it was as a resident. Long cases (not unsual for me to be in a 12 hour case 2-3 times a week or more), pt's who stay in the hospital like it's a hotel, and really messed up disease, including some incredible trauma were the standard as a resident.

You can still have that life as an attending if you want, I choose not to.

 

[Pir8DeacDoc]

You can still have that life as an attending if you want, I choose not to.

Amen, brother.

 

[TheThroat]

My week (having not looked at my schedule, so a little guestimatin'):

Monday: just an ESS in the morning, got some office work done, then 10-12 patients in clinic in the afternoon (9 hr day)
Tuesday: clinic all day with a 2 hr practice meeting in the middle, 22-24 patients or so (9 hr day).
Wednesday: clinic in AM (14 patients, I think) and then helped out my partner with a little parathyroid in the afternoon (for fun). 9 hr day.
Today: 5 cases in the morning (tonsil x 3, lipoma exc, and an ESS), then about 12 or so pts in the PM, then an add-on trach. (11 hr day)
Tomorrow: nasal fx case in the AM, then clinic all day. Something like 26-28 pts. Prob will be a 10-11 hr day.

About 45-50 hr week. Pretty average week.