Echo

[CrazyJake]

Have an Echo elective coming up in 2012 and I'm just really confused on Echo - specifically certifications, what you can and can not do in private practice, billing, basic certification vs advanced, what do groups/hospitals/insurance companies want or expect.

Tried searching..couldn't find any clear answers.

I know there are 2 certification levels for us - Basic vs Advanced.

I know Advanced allows you to be able to bill for an intra-op exam and make a diagnosis...But, is this common in PP? Is this really that marketable?? How much does an intraop TEE reimburse??? Would you legitimally have time with a fast surgeon to do a complete exam while managing a cardiac case???? At this point as a Ca2 I'm pretty comfortable with most straight forward cardiac cases (CABGs, valves, etc) and know how to use TEE, place/remove, find standard images, assess for wall motion abnormalities, valve function, etc. Can definitely learn way more, but think I've got the basics down.

I know that to get the Advanced certificate you really need more Echo's and that most do this via Cardiac fellowship. Can you get your #'s and sit for the Advanced certification after an ICU fellowship? I've seen ICU fellowships advertise "TEE certification", but they don't clarify if it's the Basic or the Advanced. My program has an ICU fellowship and I think they'd let me hustle to get the Echo #'s in over the ICU year, if it was even possible or allowed.

What can one do in private practice with just the "Basic" certification? Is this valuable at all honestly? Would this enhance marketability if you were comfortable/willing to do Cardiac and had the "Basic" level certificate???

I fully realize that the 'certificate paper' is just that, a paper. If you're good at Cardiac or good with TEE that is going to stand out, but in this environment I think it's advantegous to have every degree, diploma, certification, qualification, title to differentiate ourselves.

Really appreciate any insight or advice.
Happy New Year!

CrazyJake

---

Members don't see this ad.

 

[bullard]

It all depends on the group you're interested in. Some are only gonna let you "join the heart team" if you've got advanced certification because everybody else on the team has advanced cert, and the cardiac surgeons rely on your expertise to decide whether to repair/replace the mitral valve on a patient who was scheduled for a mere CABG, for instance. In other groups, almost everybody does their turn in the heart room, nobody is certified (or in the future, they have just basic cert), you put the probe in and make simple diagnoses like hypovolemia or tamponade, look for wall motion abnormalities, etc. And the cardiac surgeon calls in a cardiologist if he's got questions about a valve.

I think the trend is towards the first situation as more hearts get done in higher-volume centers.

I'm biased, of course, because I passed the advanced test and am awaiting certification.

You can do a complete exam even when you're working with a quick surgeon. It takes time to harvest saphenous and LIMA.

 

[urge]

Have an Echo elective coming up in 2012 and I'm just really confused on Echo - specifically certifications, what you can and can not do in private practice, billing, basic certification vs advanced, what do groups/hospitals/insurance companies want or expect.

Tried searching..couldn't find any clear answers.

I know there are 2 certification levels for us - Basic vs Advanced.

I know Advanced allows you to be able to bill for an intra-op exam and make a diagnosis...But, is this common in PP? Is this really that marketable?? How much does an intraop TEE reimburse??? Would you legitimally have time with a fast surgeon to do a complete exam while managing a cardiac case???? At this point as a Ca2 I'm pretty comfortable with most straight forward cardiac cases (CABGs, valves, etc) and know how to use TEE, place/remove, find standard images, assess for wall motion abnormalities, valve function, etc. Can definitely learn way more, but think I've got the basics down.

I know that to get the Advanced certificate you really need more Echo's and that most do this via Cardiac fellowship. Can you get your #'s and sit for the Advanced certification after an ICU fellowship? I've seen ICU fellowships advertise "TEE certification", but they don't clarify if it's the Basic or the Advanced. My program has an ICU fellowship and I think they'd let me hustle to get the Echo #'s in over the ICU year, if it was even possible or allowed.

What can one do in private practice with just the "Basic" certification? Is this valuable at all honestly? Would this enhance marketability if you were comfortable/willing to do Cardiac and had the "Basic" level certificate???

I fully realize that the 'certificate paper' is just that, a paper. If you're good at Cardiac or good with TEE that is going to stand out, but in this environment I think it's advantegous to have every degree, diploma, certification, qualification, title to differentiate ourselves.

Really appreciate any insight or advice.
Happy New Year!

CrazyJake

Sounds like you are considering doing cardiac in private practice. Why not do a cardiac fellowship instead of the icu fellowship?

 

[Stank811]

I am also thinking of doing CCM fellowship and hope to do hearts likely in a PP group based on were the fam wants to move and think it will be a great mix. Like noted above most PP groups do basic hearts that do not necessarily require a fellowship and havent historically (not that this cant change) so my thought is a CCM fellowship brings the added CC background/flexability and if one were to pass the basic exam they could easily jump into the PP group and do cardiac as well.

 

[Stank811]

Good website below for those interested
http://www.echoboards.org