Being floor manager

[bullard]

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Seemed like a pretty stressful job on my second anesthesia rotation. I was almost afraid to talk to the dude/dudette for fear of causing a stroke or something. Conversely, on my first rotation, running the ORs seemed to involve a lot of coffee, chit-chat, and the Wall Street Journal. 🙂 This wasn't a dinky joint either -- 20+ ORs plus maybe 10 other anesthetizing locations. Which impression is more reflective of reality?

 

[adleyinga]

Seemed like a pretty stressful job on my second anesthesia rotation. I was almost afraid to talk to the dude/dudette for fear of causing a stroke or something. Conversely, on my first rotation, running the ORs seemed to involve a lot of coffee, chit-chat, and the Wall Street Journal. 🙂 This wasn't a dinky joint either -- 20+ ORs plus maybe 10 other anesthetizing locations. Which impression is more reflective of reality?

I am confused. Are you talking during residency or the real world?

Running the floor is a thankless job. Everyone tends to hate you especially the surgeons if you actually tell them they can't do cases because of provider shortage or nurse shortage.

 

[bullard]

Real world.

I am confused. Are you talking during residency or the real world?

Running the floor is a thankless job. Everyone tends to hate you especially the surgeons if you actually tell them they can't do cases because of provider shortage or nurse shortage.

 

[militarymd]

In the Navy, it was a piece of cake.

At my current job, it is very hard.

 

[zippy2u]

In smaller hospitals and surg. centers like 4-7 rooms you stay away from playin' that floor manager gig. Dude do you want to spend your time answering phones and callin' around looking for surgeons? Bookin' cases and all that entails. My fee is $200/hr. Now Mr. CEO choke on that rate. Let the OR nurse manager deal with all that crap. While I'm on my spiel, Oh Mr. CEO you want me to be the medical director of your surg. center? that'll be $100,000/year on top of what I bill the pts. When it comes to gettin' your coin you have to be brutal, merciless... Regards,----- Zippy

 

[jetproppilot]

In smaller hospitals and surg. centers like 4-7 rooms you stay away from playin' that floor manager gig. Dude do you want to spend your time answering phones and callin' around looking for surgeons? Bookin' cases and all that entails. My fee is $200/hr. Now Mr. CEO choke on that rate. Let the OR nurse manager deal with all that crap. While I'm on my spiel, Oh Mr. CEO you want me to be the medical director of your surg. center? that'll be $100,000/year on top of what I bill the pts. When it comes to gettin' your coin you have to be brutal, merciless... Regards,----- Zippy

Ole Zippage knows the anesthesia BIZness...

Regards,-----Jetty

 

[bullard]

In smaller hospitals and surg. centers like 4-7 rooms you stay away from playin' that floor manager gig. Dude do you want to spend your time answering phones and callin' around looking for surgeons? Bookin' cases and all that entails. My fee is $200/hr. Now Mr. CEO choke on that rate. Let the OR nurse manager deal with all that crap. While I'm on my spiel, Oh Mr. CEO you want me to be the medical director of your surg. center? that'll be $100,000/year on top of what I bill the pts. When it comes to gettin' your coin you have to be brutal, merciless... Regards,----- Zippy

Dr. Zip,

Well, they say you don't get what you deserve, you get what you can negotiate. Did Mr. CEO give in and pay up? What kind of stipends are common for medical directors at surgicenters? Do groups demand more coin for covering floor intubations, cardioversions, etc? How much more? Is this more of a South and Midwest thing?

Thanks.

 

[jwk]

Dr. Zip,

Well, they say you don't get what you deserve, you get what you can negotiate. Did Mr. CEO give in and pay up? What kind of stipends are common for medical directors at surgicenters? Do groups demand more coin for covering floor intubations, cardioversions, etc? How much more? Is this more of a South and Midwest thing?

Thanks.

Anything clinically you do outside the OR is something for which you should be compensated. Floor/ICU intubations? Cardioversions in CCU? Absolutely, and it's perfectly legit. Write a note in the chart (we have a pre-printed A-Line/CVP/Swan/ETT/Blood patch note), get your billing info and charge away. There are plenty that charge for doing IV's on the floor as well (not as part of the anesthesic) when the RN or IV service can't get it. Hey, if you're using your experience and expertise, it should be compensable.

 

[bullard]

Anything clinically you do outside the OR is something for which you should be compensated. Floor/ICU intubations? Cardioversions in CCU? Absolutely, and it's perfectly legit. Write a note in the chart (we have a pre-printed A-Line/CVP/Swan/ETT/Blood patch note), get your billing info and charge away. There are plenty that charge for doing IV's on the floor as well (not as part of the anesthesic) when the RN or IV service can't get it. Hey, if you're using your experience and expertise, it should be compensable.

Right, but suppose your group is the only one in town and you're busy enough as it is with OR work (which I imagine is at least a somewhat common scenario in some parts of the country). I'm wondering what kind of additional stipends are available from the hospital for covering these extra services on top of what is billed for by the individual physician. $50k/yr? $500k/yr?

 

[jetproppilot]

Anything clinically you do outside the OR is something for which you should be compensated. Floor/ICU intubations? Cardioversions in CCU? Absolutely, and it's perfectly legit. Write a note in the chart (we have a pre-printed A-Line/CVP/Swan/ETT/Blood patch note), get your billing info and charge away. There are plenty that charge for doing IV's on the floor as well (not as part of the anesthesic) when the RN or IV service can't get it. Hey, if you're using your experience and expertise, it should be compensable.

JWK's right. Theres only one problem.

You canBILL for whatever you want.

What you are COMPENSATED from the insurance company/medicare is another story.

Starting an IV on the floor from a compensation standpoint is not worth the time. I forgot what it is, but its ridiculous.

And mor importantly,f your group starts responding to IVs on the floor, its like a snowball...pretty soon IM docs start writing IV Start By Anesthesia in their notes.

And there is no middle ground. No "OK, just this once". Because abuse of your skill is just around the corner.

If you're in a fee for service group, tell them you're sorry, but you are not an IV starting service and to call the radiologist's PA to start a PIC line.

Its either that or get ready for the 2 am-peripheral-iv-onslaught.

 

[Laryngospasm]

Its either that or get ready for the 2 am-peripheral-iv-onslaught.

We do that at my residency program..it SUCKS 😡