How many pph?

[ERDude]

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I'm curious as to what kind of volume other people are seeing (particularly community attendings).

I'm at a reasonably busy community shop (55K). I see on average about 2.2pph. Could vary on any given shift from 3 to under 2, depending on various factors.

I feel like I work my ass off 90+% of shifts.

What's it like for others?

 

[n2b8me]

😉

 

[Greenbbs]

120k community tertiary. 149 hrs/day of staffing. 9h shifts. I personally see 2.2/hr

 

[deleted109597]

1.8-2.2 pph (average monthly) at my old community shop. 45k stroke/heart center. 40 hrs of physician staffing, 9-16 hrs of midlevel, depending on if anyone felt like showing up to work that day.

30-40% admit rate though. Sometimes I felt like I was beat to death. Overnights, single coverage, I could hit 3pph if they were all the whiny level 4-5 "need work note" patients.

 

[tkim]

community, 40K, 55hr/24, 1.5-1.8/hr.

new EMR plus the sometimes hilarious Dragon dictation has brought all our pph down.

 

[RPedigo]

community, 40K, 55hr/24, 1.5-1.8/hr.

new EMR plus the sometimes hilarious Dragon dictation has brought all our pph down.

Dictation: "Slit lamp examination revealed synechiae."

Output: "Slit lamp examination revealed sneaky eyes."

 

[EvoDevo]

Brand new community attending here. Averaging 30k per year (estimated, new ED), 13 hours double physician coverage, no mid levels, scribes (but poorly trained right now so not much help). In this setting I am seeing 1.8 - 2.1 pph. Admission rate unknown yet.

 

[gutonc]

Dictation: "Slit lamp examination revealed synechiae."

Output: "Slit lamp examination revealed sneaky eyes."

On the same note from one of our attendings:

Dictation: "Recent echo showed global wall motion abnormalities."
Output: "Decent echo showed global warming ocean maladies."

Dictation: "I believe his severe GERD is the cause of his persistent poor eating."
Output: "I believe his severe bird is the cause of his persistent porn meeting."

 

[EvoDevo]

On the same note from one of our attendings:

Dictation: "Recent echo showed global wall motion abnormalities."
Output: "Decent echo showed global warming ocean maladies."

Dictation: "I believe his severe GERD is the cause of his persistent poor eating."
Output: "I believe his severe bird is the cause of his persistent porn meeting."

I know that this gets better over time, no?

I seem to remember that at one of my resiliency's community rotations, they used Dragon with an old version of Meditech and they claimed that the errors dramatically declined over time...

 

[WilcoWorld]

Yes, it gets better, but only if you catch its mistakes and correct them in the Dragon-specific way.

For me, the worst is when Dragon misses a "no". As in:
"There is no leg swelling" and "Patient has no chest pain" become "There is leg swelling" and "Patient has chest pain".

Seriously, proof-read your Dragon dictations.

As to the OP's question:
Academic setting where I supervise med students, residents and PAs - we go to single coverage for 5 hours at night - I typically see anywhere between 2-4 pph, but on really busy shifts I have topped 4 pph.

Seeing 2+ pph on my own is harder than seeing 3+ pph as a supervisor, but when seeing 4+ pph as a supervisor it often feels like the wheels are close to falling off.

 

[tkim]

Yes, it gets better, but only if you catch its mistakes and correct them in the Dragon-specific way.

"Correct that. Spell that." Then types word. No time saved.

 

[WilcoWorld]

"Correct that. Spell that." Then types word. No time saved.

And that's only after you said "scratch that" and then repeated it...3 times.

 

[RustedFox]

New community attending. 22K visits/year. Smaller place. 24 hours physician coverage + 10 hours midlevel coverage.

I hit just under 2 an hour, but this is the "offseason", as the Floridians say. No clue what's coming up.

I second the thoughts about EMR. It drags the old-timers down. They just look at it the wrong way. Instead of saying - "what will this put in my note for me?" and using the functions that they want... they think: "I have to fill out all these silly, irrelevant questions before I can go on to the next part of my chart."

 

[CraftyMed]

I cover at 2 hospitals:
1) smaller, community 24K/yr with 1 doc/1 PA doing 12hr shifts. Day shifts are usually 1.8pph, nights 1pph

2) big ol' academic main campus, >90K/yr with residents & students. Don't have to see many pts independently, but usually have 3pph supervising.

Dragon:

I CANNOT for the life of me get it to learn the word "will"

I keep saying "I will..blah blah" and Dragon types "We'll...blah blah" NOOOOO!! There is no WE in this business. It's only my butt going to court. I've had it for a few months now, and I've trained it, but it just won't fix that one word. Weird.

Otherwise, it does make my charts look more reasonable. I can dictate the whole HPI or MDM, with only having to correct 1 or 2 words. Most of the time its location-specific stuff or physician names.

 

[8654Marine]

....

 

[Zanegray]

Dictation: "Slit lamp examination revealed synechiae."

Output: "Slit lamp examination revealed sneaky eyes."

Dictation: "Patient is allergic to peanuts."

Output: "Patient is allergic to pen*s" (fill in the star to name body part)

 

[Hercules]

Community attending. 30k higher acuity. 30 hrs physician coverage and 12-16hrs MLP coverage, no scribes. Been on EMR for about a year now. Seeing 2.5-3.5 pph. Dragon is terrible. Of our 8 docs only one continues to use it at this point and he is the lowest producer of the group.

 

[gutonc]

Dictation: "Patient is allergic to peanuts."

Output: "Patient is allergic to pen*s" (fill in the star to name body part)

Both potentially legitimate reasons to visit the ED.

 

[pinipig523]

Very spotty at my full time gig - some days I see maybe 1.25pph, then some days I get bolused a 16 patient load in 4 hours...

Talk about the bus dropping off sickies. And these aren't level 4/5.... these are 1,2,3.

We are working on getting some double coverage.

 

[Arcan57]

My shop averages 2.54 pph, I'm around 2.2-2.3 pph in a 56k/yr community gig. My acuity is higher than average because I tend to work more mid-shifts and have MLPs picking up the easy stuff. So my RVU's track with the group average which is ~12.5-13 RVUs/hr depending on our volume that month.