Inpatients at your program?

[DubZteR]

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Don't think this question has been asked on here before.

I was curious if most rad onc residents have inpatient responsibilities? Do rad oncs at your center have admitting privileges or do they function strictly as consultants?

 

[yeasterbunny]

I think I interviewed one place (Cleveland Clinic I think? correct me if I'm wrong or if that has changed) where they actually managed inpatients, but this is definitely not the norm. We definitely don't do this at my program. We will occasionally write post-op orders for LDR cases we do, but then the gyn onc team usually changes them so as to prevent us from killing anyone.

 

[DubZteR]

I think I interviewed one place (Cleveland Clinic I think? correct me if I'm wrong or if that has changed) where they actually managed inpatients, but this is definitely not the norm. We definitely don't do this at my program. We will occasionally write post-op orders for LDR cases we do, but then the gyn onc team usually changes them so as to prevent us from killing anyone.

So does your program use more of a hospitalist based model?

I agree with you that it's rare to see inpatients admitted under a rad onc as the MRP for appropriate reasons.

I asked this question because I know of a rad onc program where patients are admitted under radonc MRP but the staff do not see their patients. This program has no GPO/hospitalist to cover the ward so the only doctor the patient sees while admitted is a randomly assigned rad onc resident who usually has not been involved with their care at all and who still has full clinical duties which means many times they don't end up seeing the patient until the end of the day. Putting aside the fact that this is inadequate patient care, it's also a big law suit waiting to happen!

 

[Gfunk6]

On the HDR brachy service we had inpatient responsibilities. The hospitalist would manage emergencies but we were responsible for selecting all the scheduled meds, PRN meds, diet, discharge summary, etc.

Nothing is more frustrating then getting a call from a RN at 3:30 AM asking, "You wrote the patient should have Zolpidem 5 mg po qhs prn. However, 'qhs' is no longer a JHACO approved abbreviation, did you mean to write 'at bedtime.'?"

 

[mikedc813]

On the HDR brachy service we had inpatient responsibilities. The hospitalist would manage emergencies but we were responsible for selecting all the scheduled meds, PRN meds, diet, discharge summary, etc.

Same here, the on call resident takes care of any inpatient stuff for the brachy patients overnight at our program.

 

[yeasterbunny]

So does your program use more of a hospitalist based model?

Our patients are generally admitted to either the med onc service or one of the surgical specialties. We have a pretty strong gyn onc program that takes care of all the brachy inpatients. The only call responsibilites we have are to actually come in and remove the LDR implant if it is scheduled to happen outside of business hours, or to deal with other aspects of the sources or T&O themselves. If the patient needs an ambien the nurse pages gyn onc.

 

[DubZteR]

Thanks everyone 🙂