Clock in and out

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Realgassy said:
Do tell where are these wonderful jobs to be found? I make a bit over half of this taking call at the 45hr a week range. Nothing like this in my market or a few others I’ve investigated in different states.
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That sucks. It’s in the south. A few jobs like that.

I’m only making 450k base. I’m done between 11am- 3pm almost every day depending on my leave order. If I’m late doc/backup call doc. I’m done 5-6pm but off the next day. But no weeknights.

Weekends I get compensated extra on top of the base but someone will do it if I don’t want to do it. So I can make an extra 60-100k but I don’t think it’s worth it.

We are moving to pure permanent night float completely. So no overnights period. Maybe a 7-3pm weekend day shift every 2 months at most.
 
lotsapain said:
Nothing comes out of nothing... meaning that there must of been a reason this has happened such as providers disappeared etc. and no one was available to take care of patients... Nothing happens for no reason.... it is easy to blame terrible administrators - and yes many of them are just that but often there has to be an underpinning why this happened?
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Have you met the typical new-age hospital admin? Their MO is to figure out how to control physicians and squeeze them dry. To say that logic or patient care has any bearing on their decision-making ability could not be farther from the truth. These aren't people that were head of their class at Harvard B School. Most of them have failed upwards and have no idea what they are doing.
 
aneftp said:
That sucks. It’s in the south. A few jobs like that.

I’m only making 450k base. I’m done between 11am- 3pm almost every day depending on my leave order. If I’m late doc/backup call doc. I’m done 5-6pm but off the next day. But no weeknights.

Weekends I get compensated extra on top of the base but someone will do it if I don’t want to do it. So I can make an extra 60-100k but I don’t think it’s worth it.

We are moving to pure permanent night float completely. So no overnights period. Maybe a 7-3pm weekend day shift every 2 months at most.
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How are you going to compensate the night float? Or everyone take even amount?
 
Shimmy8 said:
How are you going to compensate the night float? Or everyone take even amount?
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4 or 5 guys will do the night float for full salary.

So each will do 7-8 shifts a month. It’s not an easy job at nights in house. So their reward will be to have more time off

This is just the future. Either pay guys 700k to work 65 hours a week to take calls q6 in house plus lates q6.

Or

Pay guys (and gals) 450k to work 40 hours a week. The money is roughly the same per hours worked at the end of the day. And go with night float system.

Locums crna’s are making 325-350k working essentially 40 hours a week with 8 weeks off already with no nights and weekends.
 
We’re toying around with night float for some of our busier trauma/OB hospitals, and then also discussions of actual nocturnist opportunities if anyone wanted them.
 
There is absolutely no positive reason they would ask you to punch in and out, esp if you are partially productivity based. It is also highly demeaning. I would leave a job before doing that. We are professionals for goodness sake, highly in demand, and highly marketable.
 
NitroS said:
This is not true
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if your room is done and you have no cases left can you leave 2-3 hours early? I know the CRNAs can without issue, but docs have been audited. Not only for anesthesia but for other specialties too.
 
GaseousClay said:
if your room is done and you have no cases left can you leave 2-3 hours early? I know the CRNAs can without issue, but docs have been audited. Not only for anesthesia but for other specialties too.
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We work with some Kaiser bariatric surgeons. If they finish their 5 cases before 3pm, they need to check in to see if they are needed in clinic. So they always take a leisurely lunch and they slow down if it is looking like they’ll finish before 3pm 😂
 
GaseousClay said:
if your room is done and you have no cases left can you leave 2-3 hours early? I know the CRNAs can without issue, but docs have been audited. Not only for anesthesia but for other specialties too.
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At the site where they forced us to clock in and out we were required to just sit there after our cases finished till the “shift” ended. So they’d have a bunch of us just sitting there from noon to 5pm or so. If anyone left before that the hospital overlords would complain. It was insulting.
 
kidthor said:
At the site where they forced us to clock in and out we were required to just sit there after our cases finished till the “shift” ended. So they’d have a bunch of us just sitting there from noon to 5pm or so. If anyone left before that the hospital overlords would complain. It was insulting.
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Yup. Makes one want to give the most expensive care possible. Especially for no pay patients.
 
nimbus said:
We work with some Kaiser bariatric surgeons. If they finish their 5 cases before 3pm, they need to check in to see if they are needed in clinic. So they always take a leisurely lunch and they slow down if it is looking like they’ll finish before 3pm 😂
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5 before 3pm?? Yesterday, one of our bariatric faculty was only 3/4 through his second roux-en-y at 3pm, and most of his sleeves take well over 2.5 hrs also
 
kidthor said:
At the site where they forced us to clock in and out we were required to just sit there after our cases finished till the “shift” ended. So they’d have a bunch of us just sitting there from noon to 5pm or so. If anyone left before that the hospital overlords would complain. It was insulting.
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I must say, the more I read about your job, the more I’m wondering just how long anbuitachi will hold the title for worst job.
 
vector2 said:
5 before 3pm?? Yesterday, one of our bariatric faculty was only 3/4 through his second roux-en-y at 3pm, and most of his sleeves take well over 2.5 hrs also
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Worked with a friend who did bariatrics.. of course he requested me for all of his cases. He had a couple of bad outcomes that shattered his confidence and he went for 5 cases by 3pm to halfway done with the 3rd case by 5pm. Clamping and unclamping the stapler 10 times for each cut.. it was just painful. I started putting myself on call the day before his OR days so I wouldn’t have to be there. Hospital eventually clamped down and limited him to 2-3 cases a day - which delivered yet another blow to his confidence and slowed him down even more. I dodged that poor bastard for the last year I was there. I think his past few bypasses were 5-6 hours with the occasional redo because he wasn’t happy how things looked right before he closed. I feel for the man but I was happy to let the other docs in my group play therapist while he struggled.
 
That’s a lucrative line. They pay 11 units I think (maybe 13- i can’t remember off the top of my head).
 
sevoflurane said:
Lap sleeves are 1.25 hr case here with 2 of our surgeons. 6 by 3pm is the norm and that’s only with one room. A lot more when they are running 2 rooms.
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So you start at 6am or have 10 minute turnovers? Yeah, right.

Check your math next time. The chest puffing on this forum is absurd sometimes.
 
aneftp said:
That sucks. It’s in the south. A few jobs like that.

I’m only making 450k base. I’m done between 11am- 3pm almost every day depending on my leave order. If I’m late doc/backup call doc. I’m done 5-6pm but off the next day. But no weeknights.

Weekends I get compensated extra on top of the base but someone will do it if I don’t want to do it. So I can make an extra 60-100k but I don’t think it’s worth it.

We are moving to pure permanent night float completely. So no overnights period. Maybe a 7-3pm weekend day shift every 2 months at most.
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u covering 4 crnas? how you generating that much income when you leave 11-3.
 
thinkorswim said:
So you start at 6am or have 10 minute turnovers? Yeah, right.

Check your math next time. The chest puffing on this forum is absurd sometimes.
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Stop hating. No reason for it. It’s exactly what is happening today. LMAO.
And yes, teams are hand picked.
 
thinkorswim said:
So you start at 6am or have 10 minute turnovers? Yeah, right.

Check your math next time. The chest puffing on this forum is absurd sometimes.
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How many of these have you actually done? It’s the easiest procedure in the world. Induce, place a bugie, trochars in, make your sleeve with 2 staple lines, tac down the omentum- done.
 
GaseousClay said:
if your room is done and you have no cases left can you leave 2-3 hours early? I know the CRNAs can without issue, but docs have been audited. Not only for anesthesia but for other specialties too.
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Yes. if our room is done or get relieved early by the late/call person, we can leave early (and we still get paid for the entire shift). Very rarely I have to stay the entire shift unless we're on call.
 
I think clocking in and out is absurd and condescending as a physician. It’s never been like that before. I had to do it in the past for a few months and it was demoralizing.
 
anbuitachi said:
u covering 4 crnas? how you generating that much income when you leave 11-3.
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Usually cover 3 crna ((2) 730am starts and third room starts 8-830am 70% of the time so hardly 3 rooms Starting at the same time. The third room usually flip room

5-8% solo cases
15% (cover 2 rooms)
So i rarely cover 4 rooms to start a day. I rarely have 3 730am starts.

Maybe cover 4 rooms mid day as we send docs home. I don’t even remember the last time I had 4 rooms starting between 730-8am
 
aneftp said:
Usually cover 3 crna ((2) 730am starts and third room starts 8-830am 70% of the time so hardly 3 rooms Starting at the same time. The third room usually flip room

5-8% solo cases
15% (cover 2 rooms)
So i rarely cover 4 rooms to start a day. I rarely have 3 730am starts.

Maybe cover 4 rooms mid day as we send docs home. I don’t even remember the last time I had 4 rooms starting between 730-8am
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Not big on ACT, but your setup sounds like a great lifestyle option for 450k.
 
sevoflurane said:
I think you need to settle down 😂😂
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I'm pretty settled. You seem to be the one who has had a nerve struck.

sevoflurane said:
How many of these have you actually done? It’s the easiest procedure in the world. Induce, place a bugie, trochars in, make your sleeve with 2 staple lines, tac down the omentum- done.
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I'm well familiar with the procedure. And for what it's worth, I've probably done more bariatrics and worked with a greater number of different bariatric surgeons than most on this forum. Although, as I'm sure you'll be quick to point out, not nearly as much as you of course!

I have also worked with the two surgeons nimbus refers to above, and they are indeed the quickest I have ever worked with. But even then, their lap sleeves have an average total OR time of about 60-65 minutes and they are hampered with 30 minute turnovers. The whole done by 3pm is a good day, which is why I'm pretty confident calling you out on your seemingly absurd and insecure claim. And a cropped photo of 45 minute blocks doesn't mean anything to me. I'm working with a surgeon right now who for some reason gets 2 hours of block time for a case that routinely takes him over 3 hours.

I'm not here to get into a pissing contest, so I'm just going to leave it at this and move on with my day.
 
thinkorswim said:
I'm pretty settled. You seem to be the one who has had a nerve struck.



I'm well familiar with the procedure. And for what it's worth, I've probably done more bariatrics and worked with a greater number of different bariatric surgeons than most on this forum. Although, as I'm sure you'll be quick to point out, not nearly as much as you of course!

I have also worked with the two surgeons nimbus refers to above, and they are indeed the quickest I have ever worked with. But even then, their lap sleeves have an average total OR time of about 60-65 minutes and they are hampered with 30 minute turnovers. The whole done by 3pm is a good day, which is why I'm pretty confident calling you out on your seemingly absurd and insecure claim. And a cropped photo of 45 minute blocks doesn't mean anything to me. I'm working with a surgeon right now who for some reason gets 2 hours of block time for a case that routinely takes him over 3 hours.

I'm not here to get into a pissing contest, so I'm just going to leave it at this and move on with my day.
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You seem upset. The puffing comment is just not necessary so I am going to defend myself.
That is our schedule, I don't know how else to tell you that we get 6 done by 3 and more if they are running 2 rooms (given straight forward cases).
Sorry you are so fragile. Take a deep breath and move on.
 
Also, you YOURSELF are saying that you get them done in about an hour. Our turnovers are much faster due to the crew we put in there.
So we are not that far off from ea. other. So what gives? We arguing over 15 minutes? C'mmon man... I don't see why you are so bent up over this.
 
Finishing their 3rd sleeve now. 7am start.
So please be a little open minded friend.
I am not the enemy here.
 

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sevoflurane said:
Finishing their 3rd sleeve now. 7am start.
So please be a little open minded friend.
I am not the enemy here.
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Right, so 3 sleeves in under 3 hours? By my math, you should be out of there after your 6 sleeves and on the slopes by 1pm.

Your claims are becoming even more ridiculous. I don’t know why you feel the need to continue with this, but whatever. Keep blasting me away, I’ll continue to think you’re full of it.
 
I said finishing… anyways.
I’m done with you.
No need to take this further buddy.
And if you think I fabricated a schedule and a text you are f’n crazy! LMAO.
 
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I worked with a group that did sleeves in 1 hr or less on average, and when the chair of the group was scrubbed, done in 45 minutes. Like you said those teams are hand-picked to be able to work well with regularity of speed
 
thinkorswim said:
So you start at 6am or have 10 minute turnovers? Yeah, right.

Check your math next time. The chest puffing on this forum is absurd sometimes.
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We had sub 14 minute turnover for most rooms at my previous employer. People who try at work that aren't doctors are still out there lol.

Edit: often 10 minutes wheel out wheel in.
 
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sevoflurane said:
Not big on ACT, but your setup sounds like a great lifestyle option for 450k.
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It's not a bad deal. I like to call it the VA on steroids with limited calls. Can't get sued working for the state. With state benefits and pension. But quasi private practice model with some flexibility to make a little extra. This week (and it's not cause it's a holiday week). It's a typical week. I've averaged around 35-37 hours a week the past half of the year. Some weeks can be as low as 30 hours, some weeks can be 42 hours. So overall I think it's fair compensation.

I worked
4 hours
7 hours
7 hours.
Today I worked 5 hours.

Monday was paid holiday so I didn't work.

The original group before they sold out made between 700-800K but they hustled q4/5 24 hour calls at busy trauma place plus lates. Working 65 plus hours a week covering way more than 4 rooms.

It's busy at work don't get me wrong. I call it a sprint especially in the mornings. Any call outs, we become super tight.
 
When I was a med student we rotated through a private hospital where a bariatric surgeon would do 12-13 cases before 5pm with split rooms and a lunch break. It would be 10-11 sleeves and then a couple appys or choles.
 
NitroS said:
Yes. if our room is done or get relieved early by the late/call person, we can leave early (and we still get paid for the entire shift). Very rarely I have to stay the entire shift unless we're on call.
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are you at SCPMG?
 
kidthor said:
Yeah we're in a tight competition. West coast vs east coast style.
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Made me think of this

B8050462-B878-44BB-AA5F-423681A9C209.jpeg


In regards to clocking in and out, I never understood the rationale for it since all it does is force people to find ways to become less productive. It’s similar to my pet peeve with the “time spent with patient” documentation. If I spend an hour talking to a patient about football, why is that more important then me spending 15 minutes talking about their cancer diagnosis and treatment plan?

Admins are always looking for new ways to justify their roles by limiting and trying to control the docs. This is something that effects all of the medical fields and not specific to anesthesiology.
 
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