examples of surgery jobs

[joejabjab]

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I'm an MS3 interested in gen surg. New to the forum

I'm wondering what types of options surgeons have in practice.

Anyone have examples of different types of jobs that gen surg attg's have in private practice regarding:

1. Scope of practice (what types of operations performed)
a. Rural vs urban practices
b. Hospital vs surgicenters
2. Gen surgeons doing operations outside the abdomen
3. Size of groups/examples of call schedules
4. Compensation, different examples of hours worked/wk, vacation




Ex: flitesrgn recently wrote-- My partners and I all operate Monday through Friday. We each work 4 1/2 days per week. Currently, I have clinic one afternoon per week plus 2 hours in the morning of my 1/2 day.

For example, today was my half-day, I did a lap inguinal hernia and a trach/PEG then 2 hours in the office. We're off for the Holiday and I'm back on Monday with a lap inguinal hernia, 2 lap ventral hernias, an umbilical hernia, a lap chole, a venous access port, and a colon resection. I'll be done by 3pm. Our overhead is very low. That all adds up to lucrative income potential. I've billed over $250k since starting in September...and I'm complaining that I'm not busy enough. I could add quite a bit of surgical volume without sacrificing my time at home with the wife and kids.

 

[joejabjab]

Any thoughts?

Thanks for the insight for us younger ones.

 

[Enough]

I'm an MS3 interested in gen surg. New to the forum

I'm wondering what types of options surgeons have in practice.

Anyone have examples of different types of jobs that gen surg attg's have in private practice regarding:

1. Scope of practice (what types of operations performed)
a. Rural vs urban practices
b. Hospital vs surgicenters
2. Gen surgeons doing operations outside the abdomen
3. Size of groups/examples of call schedules
4. Compensation, different examples of hours worked/wk, vacation




Ex: flitesrgn recently wrote-- My partners and I all operate Monday through Friday. We each work 4 1/2 days per week. Currently, I have clinic one afternoon per week plus 2 hours in the morning of my 1/2 day.

For example, today was my half-day, I did a lap inguinal hernia and a trach/PEG then 2 hours in the office. We're off for the Holiday and I'm back on Monday with a lap inguinal hernia, 2 lap ventral hernias, an umbilical hernia, a lap chole, a venous access port, and a colon resection. I'll be done by 3pm. Our overhead is very low. That all adds up to lucrative income potential. I've billed over $250k since starting in September...and I'm complaining that I'm not busy enough. I could add quite a bit of surgical volume without sacrificing my time at home with the wife and kids.

You don't get it. You are an indentured servant of the insurance companies and the federal government that continues to cut your reimbursement. And your answer is that you want to work more and harder like a good "slave". Wake-up.

And by the way it is not what you bill out; it is what you collect you should focus on.

See: http://forums.studentdoctor.net/showthread.php?p=4396400#post4396400

for entire article to which this author refers to (again)

 

[joejabjab]

Thanks, Enough. I read that thread already.

Still wondering though, what kind of work are people doing?

If it's dealing with insurance companies and the gov't, that's fine. Just looking for examples.

And, Enough, I'm picking up on your point, but don't think you're the only one with those issues at the forefront of your mind. I certainly never said I wanted to work beyond reason as a mindless slave. You're awfully quick with your accusations

 

[supercut]

If it's dealing with insurance companies and the gov't, that's fine. Just looking for examples.

Actually, I don't think this is "fine". Google "pay for performance". You will learn that soon insurance companies will dictate what you can do in addition how much they will pay. One of the first performance indicators is going to be volume. It will start as a "bonus" payment to those with the highest volumes. Most believe it will morph into a penalty for those who are below a certain volume, with no bonus for anybody, and ultimately into not paying you at all for a procedure unless you have done more that the minimum.

I certainly never said I wanted to work beyond reason as a mindless slave.

Nobody WANTS this. But for many of this, after a while, we certainly feel like that's what's happened. It takes some time and some pounding to get to this point, but many, many surgeons feel this way. Ask around.


That said, you are probably finding that your question isn't answered becasue it's just too broad. In my program, for example, we work with many attendings who have a wide variety of practice. Some do just breast surgery. Some are solo private practitioners who do almost anything..from hernias to AAA repairs. Most of our surgical oncology attendings also do some basic general surgery (lap chole, hernia) and until a couple of years ago also took some trauma call.

 

[Enough]

Thanks, Enough. I read that thread already.

Still wondering though, what kind of work are people doing?

If it's dealing with insurance companies and the gov't, that's fine. Just looking for examples.

And, Enough, I'm picking up on your point, but don't think you're the only one with those issues at the forefront of your mind. I certainly never said I wanted to work beyond reason as a mindless slave. You're awfully quick with your accusations

I apologize if my words were a little too harsh, but we need to get out of this mind set that we need to work harder and harder to make up for the constant decrease in reimbursement for our hard work as surgeons.

The older generations of surgeons have given up and some are going into early retirement. It is up to us to fight back and maybe even strike as a group.

 

[Winged Scapula]

As others have noted, its likely that you haven't gotten any responses to your original question, because it is simply too broad and would take considerable amount of time to answer. In addition, since most of us are in academia, we might not be the best poised to answer your query about the private practice of surgery. But I will try and at least answer some of them...

Anyone have examples of different types of jobs that gen surg attg’s have in private practice regarding:

1. Scope of practice (what types of operations performed)

Many general surgeons in private practice perform a wide range of operations; how wide depends on what you are comfortable with, referral patterns and other available specialists. But you can expect to be proficient in:

cholecystectomy
appendectomy
breast biopsies/mastectomies (partial or total) (may be referred to a breast surgeon)
hernia - inguinal, femoral and ventral/incisional
thyroidectomy/parathyroidectomy (although many will refer this to an ENT)
soft tissue mass excision/biopsy
sigmoid and other colectomies (again, if for cancer may be referred to CRS)
gastric resection (again, if for cancer may be referred to surg oncologist)
endoscopy (upper and lower)

a. Rural vs urban practices
- in more rural areas, you probably won't have access to as many specialists and therefore can expect to do a wider variety of cases

b. Hospital vs surgicenters
- anything that you want to do outpatient you can do in a surgicenter (usually - especially if it just requires local with sedation); depends on what you get priviledges for

2. Gen surgeons doing operations outside the abdomen
- sure, as long as you are comfortable and get priviledges. There are lots of non-abdominal procedures out there.

3. Size of groups/examples of call schedules
-ranges from 1 to I've seen as many as 15 in a group, and some large cities may have more. Call can range from every night (if you are in solo practice) to less frequent, depending on the group, their specialties, your rank in the pecking order etc. Anything you can imagine can happen.

4. Compensation, different examples of hours worked/wk, vacation
- that will vary widely. There are lots of websites out there with average compensation for general surgeons. Salaries can be straight pay for performance, an actual salary, etc. based on if you are private practice, \work for an HMO, etc. Average hours worked is generally in the 60-70 hrs per week but may not include work done at home. Vacation will vary greatly with group as well - too much variability in all of this to give you an average.