Common Mistakes in PP and how to avoid them

Not in practice yet (or soon), but at our place we do not do a block until surgical site/side is marked, thus hopefully preventing block on wrong side.

I second tim's hunt for tips. I am already getting nervous about being an attending when I talk to some of our attendings that are fresh out of training and I still have a long ways to go.

timtye78 said:

In the spirit of helping one another, and not telling stories with the intention of bashing others, can anyone offer any friendly advice and suggestions for new attendings on how to not look bad in their first position?

There have been random tidbits of advice all over the forum, but I think it would be nice for people to share their experience/others experiences and what they learned from these experiences.

So maybe a better title might be
"How to look good in Private Practice" minus all the derogatory bashing.

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TrustMe said:

Not in practice yet (or soon), but at our place we do not do a block until surgical site/side is marked, thus hopefully preventing block on wrong side.

I second tim's hunt for tips. I am already getting nervous about being an attending when I talk to some of our attendings that are fresh out of training and I still have a long ways to go.

Click to expand...

nice new thread timtye...
well, this is not about looking good , but rather useful knowledge for people new to private practice:
1 realize that everything is a lie unless proven not to
2 do not buy a big house until #1 is proven wrong (i.e . after a few years )
3 don't put your heart in a place, it might not last
4 making you a partner does'nt mean anything (yes , really) until your partners respect your opinion if you disagree with them
sorry for suonding that cynical but i learned it the hard way, so take the cue...
fasto

Choose your battles wisely, especially for the first year. At the same time, don't take garbage like you used to in residency. What I mean is the scutwork is over, but keep a low profile on administrative/policy matters. Let your partners handle that and try to just go with the flow. If someone is demeaning or ridicules you for something, or if you feel a patient's care is jeopardized, say something if it is serious.

Also, try to get a handle on the "culture" of the group and hospital in terms of what kinds of anesthetics are routine, and what is weird. Don't do weird stuff early on - just go with the flow. At the same time, don't do things you aren't comfortable with just because everyone else does.

Use common sense and good judgement. And try not to panic if things go sour with a patient. After just a short time, you'll be comfortable.

Best advice I can give you: always do what's right for the patient.

Dude,

As the new guy, there is only one thing that your partners want from you. Don't F*ck up. In other words, I would advise being very conservative. Your partners do not want you to make waves and the best thing to be is inconspicuous. It's a tough balance trying to satisfy different masters and you've got a bunch as the new guy.

a) be nice to your partners i.e. hey bud, you need me to take your call? NO probs

b) be nice to your surgeons i.e. they are your clients

c) be nice to your OR staff. Don't be a dick, you'll be surprised how EZ or not EZ life can be with a helpful OR staff


Just be nice.

When you are partner...depending on your organizational structure and the political standing of your group. You can let the beast come out then

Peace and good luck

Gas said:

Choose your battles wisely, especially for the first year. At the same time, don't take garbage like you used to in residency. What I mean is the scutwork is over, but keep a low profile on administrative/policy matters. Let your partners handle that and try to just go with the flow. If someone is demeaning or ridicules you for something, or if you feel a patient's care is jeopardized, say something if it is serious.

Also, try to get a handle on the "culture" of the group and hospital in terms of what kinds of anesthetics are routine, and what is weird. Don't do weird stuff early on - just go with the flow. At the same time, don't do things you aren't comfortable with just because everyone else does.

Use common sense and good judgement. And try not to panic if things go sour with a patient. After just a short time, you'll be comfortable.

Best advice I can give you: always do what's right for the patient.

Click to expand...

Great advice.

-copro

I've been an attending now for 3 months, and chose to do locums at different hospitals to get some more exposure to different practice settings.

Here's my advice/experience from being the "very" new guy at three different hospitals so far.

1) Go by the book. An attending told me that in his first six months as an attending he had about half a dozen complications, and all of them were from making a decision to "push the envelope" a bit. He told me to simply not do anything daring, keep it simple and straightforward when you just start out. I did just that and highly recommend it. Your life is going to change a lot in the first few weeks, adjusting to a different practice setting, different equipment, different drugs, different procedures. Keep one thing consistent, the way you practice.

2) Don't assume anything about the surgeons. When you get a list of patients for the next day, talk to the other attendings and the nurses. Ask how long they generally take, and how good they generally are. I just did a TVH, which always took 2-3 hours where I trained, and this guy was done, skin to skin, in 30 minutes. You look stupid if you're waiting half an hour for the patient to wake up because you assumed wrong.

3) Get three phone numbers. You're on your own, even though there's lots of other attendings around you, you won't know them as well and may be more reluctant to ask questions and advice straight off. Set up three friends who you trust clinically so you can call each other, night or day, set it up so you've got a good support network that you can bounce ideas off of. A buddy of mine, who's been an attending now for two years, just sent me a text asking for key things to keep in mind for mandibular resections. BAM, a quick refresher and he's rocking! I just did a cardiac case, called a buddy the night before to make sure I still was thinking about it the right way. Gives you a lot more confidence and cuts out a lot of stress.

4) Live like a resident for a while. I know a lot of friends that spent half their first year's salary before they even had it. You've been living on a much smaller budget for a while, slowly ease into your new circle of wealth, it'll leave you a lot more financially sound and less stressed about your billing.