Patient Volumes

[GeneralVeers]

The problem with this model though is that our volume isn't just creeping back up. If it's just busy all day we can expand hours as needed. But we're getting hit with huge surges of critical patients. With the shorter hours there are periods of single coverage and if you get a surge while you're on your own it can be really tough.

Working in the same market, as you know our difficulty is the "bus stop" phenomenon. We'll have a huge sudden surge in ambulances and walk-ins, leading to the doctor/PA team on duty getting overwhelmed. By the time I've called someone in early to help, the surge is gone and we are sitting around doing nothing.

The current intermittent volume makes it nearly impossible to staff appropriately.

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[RuralEDDoc]

Intermittent surges are really tough to manage, both in the moment as well as for staffing planning. We’ve seen a a similar phenomenon, and it’s a real challenge to respond to. The doc who experiences the surge and 3 patients per hour including critically ill patients naturally wants to upstaff. The next two docs who just saw 0.7 patients per hour do not want to up staff. We’ve discussed a call system where people can be called in to manage surges but it was decided against - too many of us can’t leave the house on a moments notice as schools are closed.

 

[GeneralVeers]

Saw 29 patients in 4 hours yesterday with my PA. All non-covid normal patients. They are coming back!

 

[Dr Mantis Toboggan]

Old fashioned high acuity beat down shift yesterday. Felt good to get smoked again.

CARES stimulus round 2 is in for our group this morning.

Gonna be a good day.

 

[GeneralVeers]

Old fashioned high acuity beat down shift yesterday. Felt good to get smoked again.

CARES stimulus round 2 is in for our group this morning.

Gonna be a good day.

Problem is re-learning how to do it. After 2 months of seeing single digit patients, and spending most of my time on IG or Snap, it's hard to go back to the old mindset.

 

[Hercules]

Problem is re-learning how to do it. After 2 months of seeing single digit patients, and spending most of my time on IG or Snap, it's hard to go back to the old mindset.

No kidding. I think my pph muscle has significantly atrophied. Hopefully there’s some muscle memory and it will come back quickly.

 

[skougess]

Wanted to bump this. The news keeps saying ED volumes are still down, but both my shops are bursting at the seams now.

 

[WildEMDoc]

20-30 deep in our waiting room most of the time and our inpatient is full, no longer covid mostly

 

[Porfirio]

We are still down about 15-25 patient visits a day from normal. This is about 15-20%, and physician hours are down 25%.

 

[Hercules]

Wanted to bump this. The news keeps saying ED volumes are still down, but both my shops are bursting at the seams now.

If your monthly volume is significantly over what it was this time last year, you should count yourself as ridiculously blessed. Most EDs in my area are still down a good 25% from this time last year.

 

[Rekt]

Wanted to bump this. The news keeps saying ED volumes are still down, but both my shops are bursting at the seams now.

Volumes back to normal but staffing isn't so boarding and left without medical screenings is an all time high.

 

[thegenius]

We are down prob. 10-20%, here in NorCal.

 

[WilcoWorld]

Volumes back up in my corner of flyover country.

Over a dozen in the waiting room when I finished up after midnight this morning.

 

[GeneralVeers]

Volumes back to 80% or so, however we are still down to 8 hour shifts so effectively a pay cut is continuing.

 

[Fox800]

Still hovering at about 60% of pre-COVID volumes. Pay is the same (hourly) which is nice.

 

[Groove]

We're still at about 75-80%

Yeah, these 8 and 8.5 hour shifts suck when you've been used to working 9 and 10 hour shifts. I've never worked 16 shifts, then looked at my pay check and gone "wtf?". My new gig with TH will be paying me a little bit more and the shifts are 9 hours which is tolerable. I still think 10 is the sweet spot, regardless of volume and acuity. 12h in a low volume/lower acuity ED is gravy but I can't seem to scalp those in this region anymore.

 

[Porfirio]

I can’t find high paying 12 hr shifts anywhere near me. All the single doc 12 hr shops are paying $50-90 less per hour than my full time spot. Sad part, on a “per shift” basis they basically all pay the same thing. 14-17 shifts per month sucks for no money...

 

[Fox800]

I can’t find high paying 12 hr shifts anywhere near me. All the single doc 12 hr shops are paying $50-90 less per hour than my full time spot. Sad part, on a “per shift” basis they basically all pay the same thing. 14-17 shifts per month sucks for no money...

What region?

 

[Porfirio]

What region?

Midwest

 

[Fox800]

Midwest

I mean, are we saying Midwest like Kansas City and STL? Or like rural Indiana, ND, MN. Big difference. You can still pull north of $250 in those places.

 

[Zebra Hunter]

My numbers are down about 20% still. Weirdly, my critical patients are waaay down. I’ve admitted 2 patients to the ICU in the last 2 months, and outside of helping a colleague with their own patient who they couldn’t get an airway on, I haven’t intubated an ER patient in 3-4 months. I don’t think I’ve placed anyone on pressors in about 3 months. I haven’t coded anyone in the ER in about 4 months. Haven’t had a STEMI in about 3 months. I’ve seen numerous colleagues with all of these, but I’m seeing nothing but worried Wells, borderline admits, stable admits, and the chronically sick. It’s a nightmare. I feel like an urgent care doctor at the moment, except without the volume. My primary site is a 60k/yr community gig, in a very large city, that has every specialty under the sun.

 

[southerndoc]

For August, our overall volume was down 18% but our critical care (ESI 1) patients were up 28%.