Bender

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Somewhere in one of these forums I saw a link to a training program/facility out west. It was a pay to play sort of thing where you could take a week long course in say, colonoscopy and get some sort of certificate. Is anyone familiar with the link or the actual facility? Is this a viable way to get certified in a particular procedure? I know getting permission to do the procedure in a given hospital is a whole different story so I'm wondering if it would even be worth the effort as a FP.

Thanks!
 
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zambo

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Speaking of procedures,

I realize it's a regional thing (ie more procedures for FPs in underserved regions than in regions saturated with specialists), but do FPs still do procedures like hernias and appendectomies anymore?
 

Blue Dog

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zambo said:
I realize it's a regional thing (ie more procedures for FPs in underserved regions than in regions saturated with specialists), but do FPs still do procedures like hernias and appendectomies anymore?
AFAIK, there are a handful of programs out West (I don't know them by name) that include training in emergency surgery intended to prepare family physicians to function in remote areas. That sort of thing is definitely more the exception than the rule.
 

ntubebate

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zambo said:
Speaking of procedures,

I realize it's a regional thing (ie more procedures for FPs in underserved regions than in regions saturated with specialists), but do FPs still do procedures like hernias and appendectomies anymore?
Yea, we still do them :)
Did an appy this morning actually.

As someone said though, definately isn't the norm. You've gots to live WAY out there before hospitals give you surgical privilages as an FP. That said, I live WAY WAY WAY out there.

ntubebate
 

George85

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No matter what procedures people say they are doing now you need to consider what the trend is. To do more or less procedures? I think we all know the answer to that one.

So if it's not the "norm" now what do you think it will be like in 5 or 10 years time?
 

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George85 said:
No matter what procedures people say they are doing now you need to consider what the trend is. To do more or less procedures? I think we all know the answer to that one.
I'm betting you don't. :laugh:
 

George85

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Margaritaville said:
I'm betting you don't. :laugh:
In many places thoracentesis is no longer done at the bedside, the ER doesn't do LP's, and picc lines are used when cental lines would have been used before. IR are doing all those procedures now - and this will become the standard of care, simply because it's safer for the pt. Even in our ICU the use of SiteRight ultrasound is mandatory when placing lines - this dumbs down the technical and clinical skill needed - but is safer for the pt.

So, please tell me what information convinces you that we will be doing more procedures in the future.
 

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George85 said:
In many places thoracentesis is no longer done at the bedside, the ER doesn't do LP's, and picc lines are used when cental lines would have been used before. IR are doing all those procedures now - and this will become the standard of care, simply because it's safer for the pt. Even in our ICU the use of SiteRight ultrasound is mandatory when placing lines - this dumbs down the technical and clinical skill needed - but is safer for the pt.
One's ability to acquire procedural skills varies somewhat from institution to institution. If you're in a large, academic medical center, with lots of residents from different specialties competing for procedures, FM residents will likely get fewer procedures in the hospital than they would get at an unopposed residency program in a smaller hospital.

None of the procedures you mentioned are done in the outpatient setting, incidentally, which is what most people are talking about when they refer to family medicine procedures.

As a practicing physician, you're free to perform whatever outpatient procedures you wish to incorporate into your practice, assuming that you have acquired the skills and equipment to perform them. Your ability to perform certain hospital procedures in private practice (assuming you do hospital medicine) will be contingent upon local standards of care, and your ability to obtain credentialing for those procedures in that facility.
 
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Bender

Bender

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KentW said:
......As a practicing physician, you're free to perform whatever outpatient procedures you wish to incorporate into your practice, assuming that you have acquired the skills and equipment to perform them. Your ability to perform certain hospital procedures in private practice (assuming you do hospital medicine) will be contingent upon local standards of care, and your ability to obtain credentialing for those procedures in that facility.

So if I had were comfortable doing colonoscopy in my outpatient office all I would have to do is buy the equipement and start doing them?
 

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Bender said:
So if I had were comfortable doing colonoscopy in my outpatient office all I would have to do is buy the equipement and start doing them?
Theoretically, yes. Of course, you'd also have to meet any regulatory requirements regarding facility certification, etc., and you'd have to inform your malpractice insurance carrier that you're doing them. Colonoscopy typically involves conscious sedation. Flex sigs are a different matter.

Most family physicians who perform colonoscopies do so in a hospital or outpatient surgical center endoscopy suite, as the cost to acquire the necessary equipment and hire appropriately-trained staff is prohibitive unless you're doing a very high volume of procedures.
 
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