For hospital employed physicians, are you expected to take chronic pain inpatient call at your institution in addition to your clinic/procedure days? If yes, is there always midlevel coverage including weekends?
Inpatient Call
- Thread starter nynydoc
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Not only no, but heellllll no.
They tried to rope us in to that when the old guys retired. We agreed the palliative service could eval and triage patients, and we will fast track the appropriate folks for an outpatient visit. IR can do an injection if needed in house.
They tried to rope us in to that when the old guys retired. We agreed the palliative service could eval and triage patients, and we will fast track the appropriate folks for an outpatient visit. IR can do an injection if needed in house.
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I have a job with weekend call, every 6 weekends, shared with other pain doc and palliative care service. Go in for new consults only, usually amounts to few hours total between Sat-Sun. At least I get some RVUs for it. Sometimes I don’t go in.
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I do. I take call for a week at a time every 11 weeks. Consults are few and far between, maybe a couple a month. No mid-levels, but our fellows typically evaluate the pt first.
It's funny you say that. I know hospital employed rheumatologists, dermatologist, endocrine, orthos and they all have to take inpatient call and understand its comes with being hospital employed. Why would it be different for hospital employed pain
Disclaimer- I am not hospital employed
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Absolutely not. Inpatient (chronic) pain is a time, money, and soul sucking job. It'll be 99% opioid management and 100% of the time the primary team will tell them to follow up with you outpatient for medication management upon discharge.
We do offer to do injections on inpatients if needed, as determined by neurosurgery or ortho, but the patient is transferred to the professional building for the procedure then go back to the floor. They follow up outpatient.
We do offer to do injections on inpatients if needed, as determined by neurosurgery or ortho, but the patient is transferred to the professional building for the procedure then go back to the floor. They follow up outpatient.
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8+ yrs hospital employed. 16th year at this hospital. No call. Consults rare and usually discharged home before I would see them. None in last 5 years.
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"Hospital" employed in that I'm part of the physician system associated with the hospital. The hospitals are 5, 25 and 30 miles away from my clinic. There is little reason for my skill set to be used in the hospital setting. (I'm PM&R not anesthesia)
And also the reasons mentioned above. I go to the hospital about twice a year, usually for a patient they won't allow in my HOPD for a procedure. I've consulted on my existing patients in an extremely rare circumstance, often more as a goodwill gesture and/or social visit than being medically necessary.
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Absolutely not. Have done maybe 2 inpatient injections for acute radic in a hospitalized patient, both at personal request from a neurosurgeon in my practice. I wouldn't take a job with inpatient call.
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If the hospital is right adjacent to your clinic it may not be a bad way to meet and build good will with referring doctors when starting. Need to have clear parameters that you don’t enter orders, you don’t write discharge meds, follow up rounding is up to you, and you’re not on call, but respond when available.
But after about a year, you’ll probably want to stop even that.
But after about a year, you’ll probably want to stop even that.
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You can make a living at it. You have to keep a full list. We have guys on our staff that do it with a NP. I’m HOPD employee and it specifically states in my contract no call. I’m in the adjacent building and don’t do any consults. If you are busy it’s a loser
Hospital employed. On call 26 weeks/weekends a year. No mid level. Go in almost 85% weekends (1orboth) days. Get paid stipend for call plus rvu. Majority injection evals or post op pain. Do about 5 -15 inpatient injections a month combined with partner
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I can’t think of a high enough stipend for me to go in the hospital on a weekend essential half the year. How high is it?
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Would need a big stipend to consistently go in on weekends.
9am Saturday consult on post op day 5 ankle ORIF heroin addict asking for more dilaudid. Get old real quick.
9am Saturday consult on post op day 5 ankle ORIF heroin addict asking for more dilaudid. Get old real quick.
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and discharge pain planning. If they bounce back for uncontrolled pain it's a black mark on you.
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Post op pain…so, acute pain. is your anesthesiology department totally useless or just run by a bunch of CRNAs?
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Just no.. as others have said.
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i take inpatient call for interventional pain management. no med management questions - those go to palliative care. office is essentially a separate part of hospital. monday through friday, do the consults in between office visits or lunch. they are brought to office for procedure.
have had roughly 300 patients in past 10 years, so not a lot.
some of them do become "chronic" patients, but not from opioid management. that is a hard line no.
no NP. no additional pay - i get rvus from the e/m and from the procedure.
have had roughly 300 patients in past 10 years, so not a lot.
some of them do become "chronic" patients, but not from opioid management. that is a hard line no.
no NP. no additional pay - i get rvus from the e/m and from the procedure.
totally useless
of the 26 weekends, i go in 70% of the time, try to go in max 1 out of the 2 days, but sometimes will have to go in both days - its just we have locums rotating hospitalists who have never been to a hospitalist with a pain management service so they get trigger happy with consults. it was wayyyy worse before we had a stern conversation with administration
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Yikes. Way worse than going in for 70% of your weekends on call? 18 weekends a year is rough. That's worse than fellowship.
