Do Private Practices Have PreOp Clinics?

[ERRES2288]

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We have them in residency, but not sure if anything is actually billed for or money collected. Do private groups have them?

 

[agammaglobulin]

Only if you want to: (1) lose money or (2) motivate one of your partners to retire early.

 

[Urzuz]

We have a preop clinic that is staffed by nurses that are employed by the hospital. Any questions/patient issues they have are referred to one of us.

 

[Psai]

I think it's a waste of time. "Perioperative home!" "Show our value to the hospital!" "True perioperative physician!"

Then they fill the clinic with nurses and nurse practitioners because all you really need is to set up a process/guidemap for which patients need preoperative labs, imaging, consults, testing (not many).

The latest issue of A&A also questions the value of preoperative cardiac testing. We've known about the lack of value just like we know about the lack of value of cardiac catheterization and stenting in improving morbidity/mortality and yet we still do it. In this era of cost cutting and containment I doubt that it will be seen as valuable.

A Questionable Return on Investment: Assessing The Cost of... : Anesthesia & Analgesia
Does Following Perioperative Cardiovascular Evaluation... : Anesthesia & Analgesia

 

[Modanq]

So basically the ASA has spent the last 10 to 15 years advancing anesthesiologists and it has been useless.

It's time to critically think in ways to actually advance the field.

My hat is in for expanding procedural scope of practice.
TEE, Nuclear Stress, Neuromonitoring, ECMO, vascular access, tracheostomy, Interventional pain, Interventional spine, ICU
Ain't no RN jumping on that.
Until they do.

 

[2Fast2Des]

So basically the ASA has spent the last 10 to 15 years advancing anesthesiologists and it has been useless.

It's time to critically think in ways to actually advance the field.

My hat is in for expanding procedural scope of practice.
TEE, Nuclear Stress, Neuromonitoring, ECMO, vascular access, tracheostomy, Interventional pain, Interventional spine, ICU
Ain't no RN jumping on that.
Until they do.

I thought CRNAs already do chronic/interventional pain and TEE... ICU is already taken over by mid-levels, not really sure what the utility of doing an ICU fellowship is anyway except for co-sign their notes (if that)

 

[IMGASMD]

We don’t.

During residency we had one that was managed with NPs and residents, and an attending.

I did interview at one place who says they see ALL their patients..... so they do exist.

 

[Mr.S]

Just think, some people are doing periop surgical home fellowships.
Theyre doign a fellowship for a job regular RNs are doing.
How is that for the shaft from the program directors?

 

[nimbus]

I thought CRNAs already do chronic/interventional pain and TEE... ICU is already taken over by mid-levels, not really sure what the utility of doing an ICU fellowship is anyway except for co-sign their notes (if that)

Only a tiny fraction of CRNAs are doing this just as a minority of anesthesiologists do this.

 

[Psai]

Just think, some people are doing periop surgical home fellowships.
Theyre doign a fellowship for a job regular RNs are doing.
How is that for the shaft from the program directors?

Anyone stupid enough to do one of those fellowships deserves it

 

[deleted171991]

I thought CRNAs already do chronic/interventional pain and TEE... ICU Anesthesiology is already taken over by mid-levels, not really sure what the utility of doing an ICU fellowship anesthesiology residency is anyway except for co-sign their notes (if that)

Fixed that for you.

 

[2Fast2Des]

Anyone stupid enough to do one of those fellowships deserves it

I remember a guy who did one of those scam fellowships and tried to talk it up at a state anesthesia conference get reamed about what exactly he brought to the table that an NP couldn't do. He kept going on about how the surgical home made sure patients were maintained on the ERAS pathways and they rounded on patients and kept them on the multimodal regimen. And apparently these were your the usual healthy orthopedic population... Not exactly ground breaking

 

[Psai]

I remember a guy who did one of those scam fellowships and tried to talk it up at a state anesthesia conference get reamed about what exactly he brought to the table that an NP couldn't do. He kept going on about how the surgical home made sure patients were maintained on the ERAS pathways and they rounded on patients and kept them on the multimodal regimen. And apparently these were your the usual healthy orthopedic population... Not exactly ground breaking

Hah you don't even need an NP for that. Just a bunch of prechecked boxes in EPIC. What a waste of your life.