Academic Hospitalists: Procedures

[MilMed98745]

Hey all!

Currently debating between hospitalist jobs and pursuing pulm/crit fellowship. I'm in the military reserves, and thus am planning to stay in the academic medicine environment for my love of teaching and for easier balancing with military commitments. For those of you in academic hospitalist roles, do you still have the opportunity to perform procedures at all? Or is that all done by dedicated IR teams/residents these days in major metro areas?

---

Members don't see this ad.

 

[DrMetal]

Hey all!

Currently debating between hospitalist jobs and pursuing pulm/crit fellowship. I'm in the military reserves, and thus am planning to stay in the academic medicine environment for my love of teaching and for easier balancing with military commitments. For those of you in academic hospitalist roles, do you still have the opportunity to perform procedures at all? Or is that all done by dedicated IR teams/residents these days in major metro areas?

Mostly IR. (you shouldn't be doing procedures unless your credentialed and competent, and competence require doing them often, not just once or twice a year). If you supervise residents, they may still have to get some procedures in (I think the ACGME IM recently eradicated this requirement?), in which case you might have to back them up, or call in someone to do so.

For the most part, hospitalists don't do many procedures. If that's your bent, go for a supspec like PCC.

 

[end stage fibro]

The flagship hospital in my system has a hospitalist procedure shifts where you go around doing Thora para LP i&d etc. It's actually pretty popular as you get to hone pocus skills at the same time. Rvu wise it's a wash or even negative ( i would rather churn out a couple acs r/o).

Otherwise, i agree with dr metal. Hospitalists are rounding and moving the meat, not sticking tubes and needles in people. If I am touching a patient during a shift, something has gone horribly wrong. instead, I can offload my work by ordering someone else to do it. Critical patients are different and I'm more inclined to pull out the US wand. In the last 5 years I've done one needle decompression as an emergency and am probably uncomfortable even doing that now. Everything else can wait for ed/intensivist/stat ir.

 

[DrMetal]

If I am touching a patient during a shift, something has gone horribly wrong.

So true! Even with respect to the physical exam!