I worked for TPMG (Kaiser) as a 4/5 pain doc for about 15 years, and full time pain doc for another 10 years.
Sounds like the VA... with a lot worse pay that is
The Kaiser in my area pays 300+ to start. Their pension is more than double the VA at 2% annual salary x years worked. If you take the "lump sum" when you retire, they throw in 100k+ to offset your taxes. This amounts to way more than the VA. If you work at the VA for 20 years, you make only 20% of your salary compared to 40% at Kaiser.
Southern Ca Kaiser is not the same as Northern California Kaiser. For one thing, Socal's MD retirement money is not separate from non MD Kaiser employees. In Norcal they are two distinct entities. Also - FYI in Norcal - my procedure times were typically 30 minutes for most lumbar ESI, RF times were determined by how many nerves i burned, but i did get 60 minutes for CESI which i always thought was generous. Also 60 minutes for any sympathetic plexus blocks. definitely 40 hours per week of patient contact time, and consult times were 45 minutes for everything except CRPS which were 60 minutes. 40 hours of patient contact time = minimum of 55 hours actual work. no way i could get everything done in 40 hours. typical 10 hour days and worked through lunch.
My experience, limited to one interview and friends working at the same place, is that procedures are completely voluntary. Pain docs start out their young professions anxious to do all kinds of procs and within a few years, some don't do ANY (by choice). There is no financial incentive to do them and it's more radiation and stress for the doc. Instead the docs do lots of clinic and some find a way to substitute power point presentations for seeing pts.
This could not happen where i worked (NCAL TPMG) because in addition to doing procedures on patients i worked up, i did procedures on patients that my colleagues worked up. For example, a PCP would refer a patient to a PMR doctor for eval, PMR doc would do the workup, read the MRI, etc. then refer the patient for a procedure which i would be expected to do in 30 minutes for a lumbar TF ESI, or 60 minutes for a cervical. A lot of my time was spent the day before the procedure reviewing the MRI's and history of patients i would be doing procedures on the next day. The best thing about this system is that you do not have any responsibilities for these procedure only patients other than immediately after or during the procedure. FOr this to work well you need a good EMR and standardized routines (for example coumadin protocalls) and of course good communication. I very rarely cancelled procedures, maybe one a month.
This sounds like an awesome set up...
i always thought 60 minutes was a lot of time for a CESI seeming i can do one in 15 minutes but i feel like i got shorted on some other procedure times so it made up for the ones i got shorted on. and i had to talk to the patient, IV has to go in, etc.
Well someone has to pay for your Admin supervision, insurance staffing and real estate, etc and you're the only one adding any value to the system so... Get up there and dance b!tch!
i am retired now. as i mentioned, great retirement benefits with TPMG.
I do bust my butt and make way more money. However, in maybe 10 years I'd be all for 1 hr CESI and 1 hr NP visits. I can definitely see the benefits in that type of system with the low pay and good retirement.
Like how you think, but 30 min turnover time kills your plan to make it to brunch.
At the VA you can do 20 cases in the AM but be prepared to stay until 4:30 (or whatever the end of your "tour of duty" is). At some point, you can sometimes use your productivity to justify a higher salary...
What slowed me down doing procedures was the way the staffing and physical arrangement was done. I get one procedure nurse, one xray tech, one recovery area room, one procedure room. If i had two procedure rooms, two preop rooms a two bed recovery area and two xray techs and my own preop, post op and two procedure nurses i could easily go at least twice as fast, probaby three times faster. Another problem is scheduling. Patients cannot come in early for appointments. So you can be as fast as you want, you are still going to wait for the next patient, whom often is late anyway. Finally, it never happened that i had more than three cervical ESI in a row. Normally there is a lot of other stuff that takes more time. For example, i got 30 minutes for SI joint injections. Now sometimes i can get a nice arthrogram in 10 minutes especially a repeat customer but just as many take 45 minutes.
Dude..you make 350/year and your wife is the primary earner?! This sounds amaze balls...I'm officially jealous. Sign me up! Congrats..
If that were my situation, my post would sound something like. "I work as a stay at home dad. We travel internationally once a month."
bottom line - kaiser jobs are all different. you cannot generalize between medical centers. you cannot generalize between Kaiser systems - Socal works 35 hours a week, Nocal works 40 hours for full time. Socal is different than Nocal, and within Nocal different medical centers do things differently. It would be equally wrong to say all Kaiser jobs are similar as to say all private practice jobs are similar.
Wow! Working for a biomed dvice company pays that well?! Which company? I'm assuming she's more than a device rep
Can't believe that organization varies so much from site to site and that your chiefs have that much autonomy. Sounds like a great job.
This is slower than the VA! That's amazing
trying to get in the joint. i must not understand your question.
i think the relevant quote here is "it is not how hard you work, it is how smart you work". another one is "**** rolls downhill".
If you have not gained access to the SIJ after trying for 15 min, what are you doing different over the next 30 min?
there are three different areas of the si joint, and six different c arm angles that i can try for each area , so that would be 18 possible strategies.
