ALTorGT

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Hi there
my chief resident said in private practice he'd be able to do 35-40 Gas/colons a day easy on a 9-5 list with an efficient OR setup. Has anyone seen this being done. He said when hes's done with his residency he could pull in 15-20Gs a day doing just gas colons. sounded a little outlandish.
thanx.
 

blue2000

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My experience is limited, but right now I'm on a GI elective on a very busy service. The set-up seems very efficient, and there is no way that they're moving 35 people in and out in a day. That's more than 4 an hour. I guess it technically could be done, but I have to think you'd be sacrificing something in the process (quality of care maybe?)
 

droliver

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That does not sound realistic. I just can't envision that kind of efficiency or such a low prevalence of difficult scopes or accessory procedures required (biopsies,polypectomies) to do that.

For that matter, I find it hard to believe that there is one person with that many patients needing endoscopies laying around where they all go to one endoscopist. You've got to play pretty fast & loose with indications for a scope to get that volume in most scenarios I can imagine
 

Bovie9

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wipe the scope clean and do it over? I think those scopes are expensive.. sounds like you would need a ton of em to get the job done.
 

s204367

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As an anesthetist, I am joining a private group this summer which covers a GI group. 30-40 colonoscopies is indeed very doable. More than a few groups I interviewed at were involved in this, as it is very lucrative for anesthesia as well the GI docs. These places are very efficient, and need to have a very good phase II recovery protocol in place. Some GI docs still sedate themselves, using an opioid plus a benzo. However, it takes time to titrate to effect safely, and recovery may be up to a few hours in older patients. The centers doing 30-40 cases per room per day uses an anesthesia staff, and use, for the most part propofol only. 50-100mg of propofol iv, is sufficient for most colonoscopies with no other meds given. A good colonoscopist is done in less than 10 minutes, often 5 from the time the scope goes in. The anesthesia bill is separate from the GI docs bill, so once the GI doc sees how efficient this is, how much happier the patients are, and mostly how much cash they are raking in, they love having anesthesia handle the seadtion. It can be a very nice way to offset non-insured patients and can boost an anesthesia practice's income tremendously. Typical reimbursement is 500-1100 in the greater NYC area.
 

tripod

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a single practice could do 30-40 scopes a day. a SINGLE person most likely could not do that unless they were working 5-9. Not all scopes are straight forward and one tortuous colon wiht polyps could take over an hour. At a really efficienct center (turnover <10 mins) the most i've seen a single GI guy do (chairman of GI) was 20-25 scopes in a whole day.

35-45 scopes? sounds like your chief needs a bowel prep cuz he's full of s#!+.
 
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s204367

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He is in no way FOS.......A single person can do 30 -40 scopes per day. I am telling you.....a majority of scopes are screening scopes, and take 5 minutes......the next pt is in and you can easily do 5-7 cases per hour. I have seen this. It is a very busy day, and do not forget, like a surgeon, GI doctors do not scope every day. Usually only 1-2 days per week. 25-30 is very easy to do in a well functioning private practice. Get out in the real world, out of academia, and you will see this for yourselves..Breaking upwards of 40 scopes requires lots of committment and a very good functioning clinic....But 30 is easy for a good colonoscopist......
 

s204367

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Oh so bright....nothing better to do????????? i figured some fuc*&ing fool would bring that up.......
 

Winged Scapula

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s204367 said:
Oh so bright....nothing better to do????????? i figured some fuc*&ing fool would bring that up.......
No reason to be nasty about it...I was just trying to add a bit of levity to the thread.

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ALTorGT

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So as far as moolah for the procedures is concerned, is it better off to be the GI guy doin the scope or the gas guy putting them to sleep.
thanks.