Current Volumes

[Backpack234]

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Had a job lead tell me they're losing docs now due to persistently low volumes with Covid. Seems odd b/c my shop has been back to normal patient numbers for a few months now. Made me wonder how things really are outside of my bubble. What are patient volumes like now at your shop?

 

[oldtown]

My shops are all at about 75% of pre-Covid volume. They were all around 50% in March/April and have slowly crept back up. My main site has probably had about 3 days total that have equaled or exceeded pre-Covid average. Staffing reductions remain in effect. Chicago suburbs.

 

[WheezyBaby]

Our downtown EDs are drowning, but COVID is surging like an mfer currently

 

[southerndoc]

Our downtown EDs are drowning, but COVID is surging like an mfer currently

I agree. Our admissions are up big time for COVID. We're also sending a ton of patients home. Yesterday, we had 1 ICU bed available in our hospital (90 ICU beds not counting IMCU) and none in a sister hospital in the same county (they have 35 beds). We've been boarding 30-65 patients in the ED, which usually get rooms <24 hours but the boarding is consistently peaking at the same number.

I will say that our ECMO team is probably loving the business.

 

[WheezyBaby]

I agree. Our admissions are up big time for COVID. We're also sending a ton of patients home. Yesterday, we had 1 ICU bed available in our hospital (90 ICU beds not counting IMCU) and none in a sister hospital in the same county (they have 35 beds). We've been boarding 30-65 patients in the ED, which usually get rooms <24 hours but the boarding is consistently peaking at the same number.

I will say that our ECMO team is probably loving the business.

We have people in tents. It's going to be a great winter!

 

[thegenius]

Had a job lead tell me they're losing docs now due to persistently low volumes with Covid. Seems odd b/c my shop has been back to normal patient numbers for a few months now. Made me wonder how things really are outside of my bubble. What are patient volumes like now at your shop?

Still low. About 75% normal

 

[alpinism]

Most NYC EDs are still about 80% normal volumes.

 

[cyanide12345678]

North West ohio - back to normal. A lot of upper respiratory disease, bigger hospitals in my area are filling up.

 

[Porfirio]

Still down 15-20%. We lost some docs, normal mid level hours though...

 

[Hercules]

My shops are all at about 75% of pre-Covid volume. They were all around 50% in March/April and have slowly crept back up. My main site has probably had about 3 days total that have equaled or exceeded pre-Covid average. Staffing reductions remain in effect. Chicago suburbs.

Pretty much the same here in an SDG on the Gulf Coast. We had a brief blip back closer to normal in the summer when COVID rates were bumping back up. We’re right around 75% right now. Since we have no corporate overlords, we set our own coverage and hours. We have trimmed our midlevel coverage by about 33%. We eventually decided to shave the most lifestyle valuable hours down (day shift ends in time to pick kids up from school, night shift starts later, swing shift ends earlier, etc) a bit so we could at least be home more if we aren’t going to be as busy at work. I would rather have the volume back, but I guess that’s the thin silver lining. I can say it feels different to adjust your own hours vs having an admin cut them.

 

[turkeyjerky]

Southwest here, working at multiple places. I'd say volumes are about nearly back to normal. Interestingly, CMG has stopped sending out details on daily volume while leaving staffing at about 57% of previous...

 

[pandahunter]

We’re at 60% normal volume

 

[trackrunner321]

Volumes are still down about 25% at my two inner-city Chicago hospitals. Physicians are still at a 20% pay cut since April....

 

[Cinclus]

Southwest here, working at multiple places. I'd say volumes are about nearly back to normal. Interestingly, CMG has stopped sending out details on daily volume while leaving staffing at about 57% of previous...

Yessss, so much this with the lack of increased staffing and the previous promises of bringing it back up when the volumes are back up...

 

[turkeyjerky]

I feel for you (especially given my familiarity with the region), but you are a physician. Why tolerate this? You are a leader, or at least you once were. Lead with your words and demands, or if it comes to it then lead with the actions of your feet. If you don’t have the power to dictate working in an appropriately staffed environment where you are appropriately compensated then it’s time to move on. A cooperation is putting you through the ringer of the pit to squeeze dimes out of your pocket. No location and job are impossible to leave. Don’t tell yourself otherwise. Just so you know, I partially direct this post at you, but more so in general to those that work for CMGs or consider it. We take back Emergency Medicine by being leaders like the founders of our specialty were.

Don't worry man, way ahead of you. Signed w/ a group last month.

 

[onemoretest]

North West ohio - back to normal. A lot of upper respiratory disease, bigger hospitals in my area are filling up.

Interesting, similar area and I am consistently being told that our volumes don't support bringing our mid levels back, I suspect they are just going to see how long we will put up with it so they can recoup losses from the spring/summer. I saw 4.6pph on my last shift, no midlevels or residents, but somehow "we can barely keep the lights on"

 

[RustedFox]

Interesting, similar area and I am consistently being told that our volumes don't support bringing our mid levels back, I suspect they are just going to see how long we will put up with it so they can recoup losses from the spring/summer. I saw 4.6pph on my last shift, no midlevels or residents, but somehow "we can barely keep the lights on"

Administrators gotta get their bonuses.
Plain and simple.

 

[BoardingDoc]

Interesting, similar area and I am consistently being told that our volumes don't support bringing our mid levels back, I suspect they are just going to see how long we will put up with it so they can recoup losses from the spring/summer. I saw 4.6pph on my last shift, no midlevels or residents, but somehow "we can barely keep the lights on"

**** everything about that. I read your post, turned to my wife and literally said "I can never practice emergency medicine outside of my current group." If this kind of crap is as pervasive among CMGs as it seems, I completely stand by that statement.

 

[The Knife & Gun Club]

South Florida reporting - 75% of normal at the county site.

Like 60% at the community site, but acuity is through the roof.

Peds volume is running at like 25% right now, all the pem people are freaking out.

 

[ERDude]

Interesting, similar area and I am consistently being told that our volumes don't support bringing our mid levels back, I suspect they are just going to see how long we will put up with it so they can recoup losses from the spring/summer. I saw 4.6pph on my last shift, no midlevels or residents, but somehow "we can barely keep the lights on"

yah that is depressing. Unless it's straight non procedural urgent care stuff i don't even see how 4.6pph is possible....I sure couldn't do that even if I tried. My absolute max of a reasonably high acuity ED mix is around 2.5pph and I don't feel comfortable above 2pph.

 

[cyanide12345678]

Interesting, similar area and I am consistently being told that our volumes don't support bringing our mid levels back, I suspect they are just going to see how long we will put up with it so they can recoup losses from the spring/summer. I saw 4.6pph on my last shift, no midlevels or residents, but somehow "we can barely keep the lights on"

My mid-level shift is essentially one hour less than pre-covid now. It was done after a lot of complaining to the medical director 😛 doc hours were always the same since it's a 24 hour doc coverage shop

 

[turkeyjerky]

yah that is depressing. Unless it's straight non procedural urgent care stuff i don't even see how 4.6pph is possible....I sure couldn't do that even if I tried. My absolute max of a reasonably high acuity ED mix is around 2.5pph and I don't feel comfortable above 2pph.

At my old shop we'd be semi-regularly seeing 4-5/hr on nights. Even w/ scribes and mostly having everything back before you'd see the patient it was insane. Can't believe it took me as long as it did to leave.

 

[carbonizedeyesockets]

Our 2 big EDs are still down 10%ish, but its variable. Some days we are at or above pre-covid numbers, and others we're below. However, we're boarding more than pre-covid days due to the hospital continuing elective procedures currently (unlike the spring). Our smallest ED is up 10-20% over pre-covid due to larger hospitals in the area being on divert and people coming in merely to be tested. We've been lucky in that our physician and PA coverage is unchanged (compared to pre-covid), though in the spring, PA shifts were cut and they delayed onboarding a couple of PAs that has been hired. We actually added attending night coverage a few months ago (though that had been delayed a couple months). My health system has a lot of physician involvement at the administrative level and they largely have been looking out for us. My pay so far is unchanged (including bonuses).