I am sure that you can try to negotiate - whether or not the institution will budge is another thing - but I would try to get a sense of the volume of the service and what kinds of clinical responsibilities you are expected to take on. I do a lot of ECT on a very busy service. Things that I would want to know:
- How many patients are you treating each day? Unless there's an extremely efficient process in place or you're doing nothing other than the actual treatment itself, expect to spend 15-20 minutes of procedure time per patient. For our service, we typically treat somewhere around 15-20 patients/day, which typically translates to back-to-back treatment from 8am to 12pm or 1 pm.
- How many days a week are you doing treatments? Is this a typical MWF type of set up or are there additional treatment days as well? If you're only treating 3 days/week, what other clinical responsibilities, if any, are you going to have for the other two days?
- What kind of clinical support do you have? Is there a midlevel or nurse to deal with patient calls, medication refills (if that's something that your service offers), etc., or is that something that you're going to have to take care of on your own? Even if you're treating a relatively small number of patients, these issues can easily suck up a lot of your time, which may not be feasible if you have other clinical responsibilities that the institution is expecting that you keep up with on non-treatment days.
- How do patients get referred to the ECT service, and what's the process for getting treatments started? Are you expected to staff a clinic or something similar to assess patients before starting treatments? Or do you accept all referrals without assessment first?
If you're being asked to "take over" the ECT service, I assume you have some experience in this area. Get additional details about how the service actually runs - hell, maybe even see if you can observe the clinical process in place for an hour or two - so that you know what to ask for and what you're ok with accepting. At our institution, we have a rotating schedule where all of the inpatient unit faculty rotate on the ECT/"interventional" service, and the person working on that service does not have other clinical responsibilities. Given the volume of our service and the need to staff our treatment-resistant depression/interventional psychiatry clinic on non-ECT days, there is enough clinical responsibility to make it a full-time job for the person on that service. I couldn't imagine doing all of that and still being asked to see patients on an inpatient unit, work in a general psychiatry clinic, etc.
