is this normal?

[addoncase]

have a CT surgeon ( who is the ONLY CT surgeon for this hospital) who did a VATS with wedge resection and then went out of the county on vacation....the plan for any post op problems that need surgery are to.....ship the patient out to another hospital?

have you guys heard of anything like this before?

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[coffeebythelake]

have a CT surgeon ( who is the ONLY CT surgeon for this hospital) who did a VATS with wedge resection and then went out of the county on vacation....the plan for any post op problems that need surgery are to.....ship the patient out to another hospital?

have you guys heard of anything like this before?

Maybe they should have just transferred that patient out to the hospital and have their postop care there.

 

[NICMAN]

We had this come up recently in our hospital leadership so our CMO sought outside legal council and surveyed other hospitals to determine the prevailing practice. In our case we had a spine surgeon at one of my hospitals who did not have backup cross coverage with the same clinical privileges. And a cardiologist who did ablations and pacemakers whose cross coverage was a cardiologist who didn’t have electrophysiology privileges. It was determined that this practice was ok since it was critical to have access to care even if it is intermittent. This is pretty common practice in rural hospitals.

 

[coffeebythelake]

We had this come up recently in our hospital leadership so our CMO sought outside legal council and surveyed other hospitals to determine the prevailing practice. In our case we had a spine surgeon at one of my hospitals who did not have backup cross coverage with the same clinical privileges. And a cardiologist who did ablations and pacemakers whose cross coverage was a cardiologist who didn’t have electrophysiology privileges. It was determined that this practice was ok since it was critical to have access to care even if it is intermittent. This is pretty common practice in rural hospitals.

Well in the OPs case it is both intermittent and incomplete as the patient remained in the hospital postop and not discharged

Hospital leadership isn't going to do the best thing. They are going to do what makes money.

 

[gator2886]

Unfortunately, its getting more and more common with the increased number of locums physicians. I had to help take the staples out of my own father in law with his PCP, 4 weeks post sternotomy because there was zero follow up care after he was discharged. He had a Type A dissection, lived but the locums surgeon was back in Boca Raton or wherever.....

 

[pocafx]

Locum surgeons is interesting….. in a bad way

 

[Iso4ane]

Locum surgeons is interesting….. in a bad way

 

[addoncase]

Unfortunately, its getting more and more common with the increased number of locums physicians. I had to help take the staples out of my own father in law with his PCP, 4 weeks post sternotomy because there was zero follow up care after he was discharged. He had a Type A dissection, lived but the locums surgeon was back in Boca Raton or wherever.....

tell me this is a joke.....😡

 

[deleted1183938]

Locum surgeons is interesting….. in a bad way

Yeah. Ours likes to do stable Appys in the middle of the night. Why? Because it’s acute appendicitis he said. He’s 66 so maybe a little out of date. SMH.

 

[Ronin786]

I've had this happen at one of our satellite campuses. Surgeons like to go there because of PP feel and low acuity. If anything major is needed they just ship over to the mothership.

It's technically not the official policy and they're "on call", but nothing will bring them in and they just cite higher level of care as the reason for transfer. Mothership isn't going to turn down a transfer inter-system.

 

[Dr. Rude]

We had this come up recently in our hospital leadership so our CMO sought outside legal council and surveyed other hospitals to determine the prevailing practice. In our case we had a spine surgeon at one of my hospitals who did not have backup cross coverage with the same clinical privileges. And a cardiologist who did ablations and pacemakers whose cross coverage was a cardiologist who didn’t have electrophysiology privileges. It was determined that this practice was ok since it was critical to have access to care even if it is intermittent. This is pretty common practice in rural hospitals.

Lawyers are paid to figure out a way to rationalize anything.

 

[gator2886]

tell me this is a joke.....😡

I wish it was

 

[PpfSuxTube]

have a CT surgeon ( who is the ONLY CT surgeon for this hospital) who did a VATS with wedge resection and then went out of the county on vacation....the plan for any post op problems that need surgery are to.....ship the patient out to another hospital?

have you guys heard of anything like this before?

You won't like this but your hospital shouldn't be doing CT if your volume is this low sorry.
Yes that's very unusual.
No one should be on call 24/7

 

[Maverikk]

Worked at a place that didn't have urology or endo..on the weekends, everything was shipped out, kinda nice

Also worked at a place with one vascular surgeon who was prolific, supported his own office and staff, worked like a madman...vacation for him was such a relief for the anesthesia dept.

 

[pgg]

Worked at a place that didn't have urology or endo..on the weekends, everything was shipped out, kinda nice

Oh man

It's midnight on a Sunday night and I just did a cysto/stent for a stone. Short round OSA'er on Ozempic who got loaded up with Dilaudid in the ER. I gave her 200 of propofol and a tube and a bit of sevo and nothing else, and ended up having to give her Narcan to wake her up. Just would not breathe or stir.

So painful. Probably 1/3 of our weekend cases are inpatient EGDs that are always negative, and cysto/stents. Not as bad as the academic 2 AM appy but not far off in terms of unnecessary overnight work.

 

[Dr. Rude]

Oh man

It's midnight on a Sunday night and I just did a cysto/stent for a stone. Short round OSA'er on Ozempic who got loaded up with Dilaudid in the ER. I gave her 200 of propofol and a tube and a bit of sevo and nothing else, and ended up having to give her Narcan to wake her up. Just would not breathe or stir.

So painful. Probably 1/3 of our weekend cases are inpatient EGDs that are always negative, and cysto/stents. Not as bad as the academic 2 AM appy but not far off in terms of unnecessary overnight work.

I am more sympathetic to the off hours cysto/stents. I have seen one death in a previously healthy patient and several severe cases of urosepsis that were probably attributable to urologists delaying the procedure for a more convenient time.

 

[pocafx]

Oh man

It's midnight on a Sunday night and I just did a cysto/stent for a stone. Short round OSA'er on Ozempic who got loaded up with Dilaudid in the ER. I gave her 200 of propofol and a tube and a bit of sevo and nothing else, and ended up having to give her Narcan to wake her up. Just would not breathe or stir.

So painful. Probably 1/3 of our weekend cases are inpatient EGDs that are always negative, and cysto/stents. Not as bad as the academic 2 AM appy but not far off in terms of unnecessary overnight work.

Same. 6-7 ortho trauma. ~10 inpt scopes
5~ cystos. Each weekend day.

 

[pgg]

I am more sympathetic to the off hours cysto/stents. I have seen one death in a previously healthy patient and several severe cases of urosepsis that were probably attributable to urologists delaying the procedure for a more convenient time.

They're often in a lot of pain too so I don't mind it too terribly much. Doing anything in the middle of the night just grinds another microscopic layer of my soul away.

But I can dream of a hospital that doesn't have urology and ships those cases out. 🙂

 

[jwk]

I am more sympathetic to the off hours cysto/stents. I have seen one death in a previously healthy patient and several severe cases of urosepsis that were probably attributable to urologists delaying the procedure for a more convenient time.

Yep - a friend of mine went from first twinge of flank pain to a vent in less than 6 hours. I found a whole new respect for urosepsis after that.

That's not even counting my own cysto/stent on a Friday night. 🙂