Do hospitalists do procedures

[MelMcT2009]

one of the reasons I liked my IM month so much was the procedures I got to do.

1. I'm at a small community program for rotations. Has no other residency programs besides IM. The residents do central lines, art lines, intubate, chest tubes, run codes, etc. Is this standard even at big places with a bunch of other programs?

2. Is there opportunity for hospitalists to do procedures when they're done with residency? If not, how about if you specialize in CC?

---

Members don't see this ad.

 

[Siggy]

1. Yes, some procedures are more common than others. I did a transitional (TRI) year at a county hospital with EM, IM, FM, gen surg, optho, and OB and the only procedure I don't normally see the IM teams do that's on your list are chest tubes (no real need) and intubations (anesthesiology). The on-call IM team was the default responders for all codes and rapid responses above the 1st floor until the primary team arrived (and some of the other services would request that the IM team continue to run the code or rapid response).

At the community hospital I'm doing my residency at, the IM attendings specifically do not do procedures, but I can normally snag procedures from the intensivists, EM, and IR attendings. Over the past 6 months alone, I've done multiple paras, thoras, intubations, and 2 chest tubes (1 proper chest tube and 1 pig tail). I had multiple procedures from my 1st year of IM residency as well. Just about the only procedure I haven't done yet that I need experience doing are a-lines, but we really just don't have that many a-lines to be honest.

2. Depends. Some hospitals have the IM attendings do procedures. Some don't. Some attendings just don't do procedures. Some ICUs have no or limited intensivist coverage. However all intensivists do procedures. One of the intensivists at our sister hospital is even credentialed for bedside trach placement.


My advice is to get comfortable with procedures as a resident. It's much easier to get competent during residency than to pick up a procedure after residency.

 

[Crayola227]

not a good reason to pick IM unless you know there's a subspecialty with more procedures that you want
it depends on the practice setting how many procedures hospitalists do
it's not that you do zero procedures, but if they are very important to you or you want a lot of them....

if there's an open ICU, then it will be more
if it's closed, less

outpatient you can do many that say, an FM doc might do but they are minor (some suturing, placement of IUD, skin biopsy, I&D)
inpt there's paracentesis and thoracentesis, but more & more it's going to rads, same with LPs

 

[jacksparrow82]

At our facility hospitalists can do procedures if they want. You could do central lines, thora and paracentesis, lumbar punctures, joint aspirations, I&D's, and probably more that I'm not thinking of. I personally don't like doing procedures so I do ZERO. But, that's by choice. Some programs will require procedures (intubations and central lines are probably the most common). But, talk to your employer when you're applying. Its different everywhere you go. Smaller programs in the middle of nowhere are going to probably need you for procedures. Larger hospitals probably won't, but might let you.

 

[Pisiform]

Would you get paid more if you do procedures as a hospitalist? Unless if one makes more RVU or set amount extra for doing procedures, I don't see why anyone would stay extra time in the hospital doing procedure instead of consulting IR etc. and going home

 

[rokshana]

Would you get paid more if you do procedures as a hospitalist? Unless if one makes more RVU or set amount extra for doing procedures, I don't see why anyone would stay extra time in the hospital doing procedure instead of consulting IR etc. and going home

for locums many time those positions that require procedures, they do indeed pay more (easily 200/hr)

 

[PlutoBoy]

Would you get paid more if you do procedures as a hospitalist? Unless if one makes more RVU or set amount extra for doing procedures, I don't see why anyone would stay extra time in the hospital doing procedure instead of consulting IR etc. and going home

Not to mention the liability. **** happens even during minor procedures!

 

[jacksparrow82]

Would you get paid more if you do procedures as a hospitalist? Unless if one makes more RVU or set amount extra for doing procedures, I don't see why anyone would stay extra time in the hospital doing procedure instead of consulting IR etc. and going home

You would certainly be able to bill for whatever procedure you do. Procedures generally pay well on the RVU front. So, yes, you could make a little more money doing procedures. Personally, the time it takes isn't worth it in my opinion. I'm typically too busy to stop and do procedures. Plus, my pager would be going off like crazy the whole time.