I am thinking about becoming a doctor (and perhaps a surgeon). I have a number of questions.
1. Someone has a sore shoulder. They go to a family physician. the FP is unable to make a diagnosis and refers the patient to an orthapaedic surgeon. Does they orthopaedic surgeon diagnose ailments or just do surgeries.
Any decent FP should be able to diagnose the majority of complaints in their patients. Being a good diagnostician is the hallmark of a good physician, regardless of specialty. Obviously there will be obscure problems, but these are few and far between. Even if the FP cannot pin down the exact problem, he should order a few basic tests to try and delineate it and refer, when necessary, to the appropriate specialist.
Orthopaedic surgeons DO diagnose problems, confirm, deny or further delineate diagnoses from outside physicians, operate and provide pre and post-operative care for their patients. All surgeons evaluate patients sent to them before deciding on whether or not surgery is warranted (many surgeons are insulted by getting consults which say "do operation X on this patient", as if the surgeon has no part in the evaluation as to whether or not "operation X" is appropriate or the best choice, or whether the patient will tolerate it).
2. What does an average day look like for a surgeon in a group practice in a small city? Are they ever on call? How often do they travel between the office and the hospital? To they do rounds?
It can vary greatly from practice to practice and what your specialty is. But lets assume a general surgeon practicing in a multi-specialty or surgical group. He/she might operate 2 - 2.5 days per week, generally starting around 0730 (in OR time, you'll have to be there a bit earlier) and finishing whenever the cases are done. The other 2 or 3 days per week are probably spent in the office, seeing new patients, pre and post op patients.
I would say that in general for most surgeons the day begins at the hospital or office between 0630 and 0700 (again depending on census and whether or not you round before the OR, or between cases), and generally ends somewhere distant of 5:00 pm. Depends on your practice, the length of cases, possible complications, etc. Some days I am done in the mid afternoon and some days the cases don't end until 7 pm or later...you CANNOT control the variability to the ORs. Someone else runs late, so do you. A patient shows up late, you either cancel or just grit your teeth and do the case late. Weekends will depend on whether or not you are on call, how many patients (if any) you have to round on, whether or not you have residents to assist with the work or you have to do all the discharges, paperwork, etc.
If you have patients in the hospital, you will see them generally once a day, although you may check in more often if you are concerned about them (but not generally more than twice a day). So the surgeon will round on his patients who are hospitalized once a day, perhaps twice (but in private practice, once a day is more common, except for the more critically ill patients). The weekends and holidays may be split amongst the group members, so that the surgeon only has to come in and round on his patients once a month (depends obviously on the size of the group).
Most surgeons take call - it can be in house for a busy trauma center, but generally is from home. Whether or not you come in from home to see patients in the ED or operate depends on the busyness of the particular ED and just luck of the draw. The frequency of call will vary with regard to the number of group members you split it with. Some surgeons will take call every night on THEIR patients (ie, if someone they've operated on has a problem or comes to the ED, they want to be called rather than the partner on call). It would be unusual not to take call, except in the case of a very senior, almost retired partner who had "paid his dues". Surgeons in smaller towns, with less coverage, may find they are on call and have less time for vacation than those in larger communities with more back-up.
You would want to locate your office near the hospitals you operate in, to reduce driving time. "Time in the car, is money lost" You would want to arrange your schedule so you aren't going back and forth. If you are on call for the ED during the day, you may go back and forth, especially if at a hospital without resident coverage for you. The frequency of going back and forth really depends on patient census, the severity of their illnesses and again, luck of the draw.
Sorry if my questions are stupid, I don't know that much.
No apologies necessary - its what these forums are for. Hope this helped.
