Minimum work hours to keep skills up

[Red Beard]

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Chatting with the attending in our currently empty ED, he's telling me about how flexible the scheduling can be in this specialty. Apparently there are two physicians in his group who only work two 12's per month.

I would think that a lot of the specific skills that an EP must be comfortable with would require a certain frequency of use to maintain.

So, what do you think are the minimum practice hours, or number of patients seen per unit time, or whatever, for an EP to maintain their ability practice safely and efficiently?

 

[J ROD]

it really depends on the person I would think.....some need more; some need less.

 

[Jlaw]

Whatever the number is, I'm pretty sure you would get rusty fairly quickly with only 2 12's a month. Not all of those shifts are going to be wild or feature a wide range of problems so that would make it even worse.

I guess alot would also depend on what they do with the time off. If they are keeping up on their reading, teaching or doing something medically related it would be a big help. If they are lying on the beach somewhere then not so much.

 

[dikoerastenie]

Question: I understand that full-time work for EM is considered 12 -12hr shifts per month. So would it be possible to work 12days on a constant shcedule and have 18days off? I.e. all 6am-6pm one month and all 6pm-6am on a different month. Or if you have no seniority you are forced to work 6am-6pm 1 day, day2, day3 off, day4 6pm-6am. In this latter situation you basically have 0 vacation even though officially you work only 1 day out of 2. And it's even worse if you have 8hr shifts all over the place. Then you work more days and they still interrupt your vacation..

 

[Hawkeye Kid]

I think this would also be influenced by how much experience you have when you go to this type of schedule. People in admin roles (especially in academic settings) frequently work <6 shifts/month and, in my experience at least, seem to be pretty sharp clinically. These are also people who have worked a significantly more substantial schedule for several years and have seen thousands, if not hundreds of thousands, of patients in their careers. Trying to do this soon after residency would be much more difficult.

 

[The White Coat Investor]

I would put the minimum at 6 eights a month, or about 50 hours.

 

[deleted65604]

The more you work, the better you are going to be at what you do.

My least favorite attending in residency was great in discussion at M&M, and lectures. He had great insight into a lot of things. In clinical practice, he sucked rocks. He had a real hard time admitting that there were areas of gray, and did a lot of things very old-fashioned (refused to use anything other than fentanyl and versed for conscious sedation). He made no attempt at using ultrasound in clinical practice. He made sense in roundtable discussions, but his reasoning usually broke down when faced with actual patients.

In my opinion, he hated clinical practice, and that is why he went into administration. Half his shifts he pulled in a free-standing ER (a glorified urgent care), the other half, he pulled in the main ED. A total of 6-8 shifts really didn't keep his clinical skills sharp, and his bedside teaching suffered.

Book-reading only gets you so far. Knowledge is much deeper, and useful when gained from experience.