Private Practice IP

[kushr88]

I know most IP jobs are at big academic centers but are you guys starting to see IP at private practice/community hospitals? I have seen a couple out where I am out, they get much better and still have complex cases. I'm debating whether to do IP eventually and wanted to see how the landscape was changing.

---

Members don't see this ad.

 

[jdh71]

Define "IP"

 

[Pccm21]

Also in the same boat. thinking of applying for interventional pulmonary and wondering if people currently in IP fellowship or done with it have any insight regarding the lifestyle and job market both at academic center and private practice.
Thanks

 

[jdh71]

Again: define "IP"

 

[deleted547339]

So I’m not even pulm, I’m EM/CCM but trained at a program with a strong IP program. It seems like everyone who trained their took academic jobs doing a mix of IP and gen pulm, IP and MICU or IP and some other pulm subspecialty.

I know PP jobs in IP exist, but are relatively rare. I can say that an n of 1 showing this, one of the faculty I knew was getting recruited heavily to go to a large community hospital with a robust cancer center. They were outpacing what their gen pulm folks could do in the way of biopsies and had limited advanced bronch abilities, so they wanted to bring him on. I believe this is a relatively niche market (large PP cancer centers), but seems like they have a need for IP.

 

[jdh71]

I’m still waiting for someone to define “IP”.

Bottom line you can’t totally kill what you eat just doing bronchs not in a community setting.

 

[jdh71]

So. Where I work which is a nonprofit religious hospital serving as one of the Tertiary referral hospitals for the area and we have maybe 6-8 cases per week that could arguably classify as “IP”. These are cases where we are doing bronchoscopic biopsies almost always EBUS and very often NAV or radial U/S some endobronchial biopsies. Our catchment area is a population of near one million. I figure there are a few cases over at the other hospital. They have fewer people doing these cases. So let’s say there are 10 cases for a week. And let’s say you somehow did them all. That ONE busy day or two medium days. Max RVU on all of those cases is 12-15, minimum probably around 5. So IF you are doing that many cases a week for ~46 weeks per year it’s good RVU on the top end and pretty low on the low end. None of that requires an “IP” fellowship. The amount of cases that wold require stents, lasers, or valves are much fewer and far between and will also require you have a thoracic surgeon on board to assist with complications. These last few you do need an IP fellowship. If your thing is per cutaneous trachs still not a bunch in any week and you don’t need an IP fellowship. The bottom line is there is very few places where you might be able to make a pure practice work based on the procedures themselves. Maybe a cleveland clinic. Otherwise you won’t be able to regularly kill what you eat. Or you could just work a pure RVU salary I suppose.

 

[SRT 1983]

It is a good field with lots of innovations in the pipeline( just like any other field) but does not make much financial sense in private practice. EBUS/Nav/perc trachs /chest tubes are not IP anymore and I lose money most of the times I am doing these over CC/outpt.
You will still be required to take ICU call , so you work harder overall and generate less revenue.