Being the "procedure guy"

[deleted19731]

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The other day I was talking to one of my senior residents and an interesting topic came up that I thought I'd share with everybody else...

We we discussing procedures (most my love of performing office procedures) and she mentioned that some large single specialty groups will occasionally hire a "procedure guy". She said that basically the doc runs a procedure clinic 3 or 4 days a week and the rest of the group sends him pts so that they can keep that revenue within the group instead of referring out.

Does anybody happen to know more about this type of practice setup? I find it very very very interesting...

 

[Hamhock]

The other day I was talking to one of my senior residents and an interesting topic came up that I thought I'd share with everybody else...

We we discussing procedures (most my love of performing office procedures) and she mentioned that some large single specialty groups will occasionally hire a "procedure guy". She said that basically the doc runs a procedure clinic 3 or 4 days a week and the rest of the group sends him pts so that they can keep that revenue within the group instead of referring out.

Does anybody happen to know more about this type of practice setup? I find it very very very interesting...

typically, in my experience (easy guys!), the procedure guy in urban and suburban areas is located in the ED (except for non-urgent derm procedures)

HH

Yes, I know that doesn't answer your question, but I work in an area where FM program and primary care in general are "opposed"...that, and I'm a bit tired of both being mocked and/sued and depended upon for more than the most simple abscess, LP, diagnostic thoracentesis, etc

 

[deleted19731]

I completely understand that (especially since I'm at an "opposed" program). I'm just wondering about the future... My goal is to do as much as I can do in the clinic.

If I need to refer then no problemo... But if it's a procedure that I'm well trained in and is in the fm scope then I wanna knock it out of the park... Every time,; all the time.

 

[deleted87716]

I've never heard of anyone hiring a "procedure guy." Most people would likely prefer to do it themselves, and get paid for it.

Some people have an interest in something that others don't do, and may get referrals from other physicians for that particular thing. For example, one of my former partners used to perform vasectomies (until the malpractice premiums forced him to stop), and I would usually send my patients to him for that. Another did colposcopy. I used to do flex sigs occasionally for a couple of the other docs in the office who didn't want to bother with them.

It's hard to imagine that you'd get enough of that sort of thing to fill an entire day, however.

 

[deleted6669]

some practices hire a pa to do this. they spend their whole day doing punch biopsies, I+D's, lac repair, cyst removal, toenail removal, fb removal(multiple sites), arthrocentesis, etc
if you have a group of docs who don't like doing procedures and prefer to see 4 pts/hr instead this can be a big money maker.
there are also inpatient services that hire pa's to just start central lines, etc all day long.
I have never heard of a doc having one of these "procedure only" jobs but I don't see why they couldn't if that was their desire(although they would quickly forget a lot of their other skills and knowledge)

 

[montessori2md]

I've never heard of anyone hiring a "procedure guy." Most people would likely prefer to do it themselves, and get paid for it.

Some people have an interest in something that others don't do, and may get referrals from other physicians for that particular thing. For example, one of my former partners used to perform vasectomies (until the malpractice premiums forced him to stop), and I would usually send my patients to him for that. Another did colposcopy. I used to do flex sigs occasionally for a couple of the other docs in the office who didn't want to bother with them.

It's hard to imagine that you'd get enough of that sort of thing to fill an entire day, however.

I've found most of the larger practices I've rotated through have been like this. Everyone does procedures, but certain procedures tend to be done by certain folks within the practice. This has the added bonus of a guaranteed limit to your visit time/#of complaints per visit. ("Gee, Mrs. M, I agree, you should get that lipoma removed, but Dr. Z down the hall does a really great job with those, why don't you come see him next week?"). It also allows a couple of MDs to be the guinea pig with a new procedure/technique -say, those new mini upper gi scopes, or ultrasound guided injections- and then if it doesn't pan out from a billing/utility perspective, you haven't all wasted your time with the learning curve.