Question(s) for Hospital-employed MD's

[buddababa]

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i knew a pain doc that did all injections in just the AP view. TF, ESI, RF, all in AP view.

35-40 procedures a day.

i question anyone who can go faster...

this is why we get a bad label

 

[mille125]

If bilateral RFAs take 30 minutes then you are limited by that.

With multi-lesion generators unilateral take me 5-6 minutes and bilateral 9-11 minutes.

You gave thumbs down club. How long do you think that these procedures take on average?

 

[BoardingDoc]

Just do a real sloppy job. Place all 6 needles in AP, touch os somewhere around the pedicle and burn. I have a partner that does an exorbitant amount of procedures and this is what his RFs look like. Cervical RFs even worse

I think of him when I hear people bragging about doing 20 procedures in a morning. Only possible way to do a good job is if you have unbelievably good staff or two rooms and two c-arms

I assume you are talking about a HOPD? I definitely couldn't get 20 patients in a half day during fellowship because turnover took forever.

I routinely do 20 patients in a half day now in PP because I have good staff and not unionized hospital nurses. It certainly gets tight if I have more than 2 or 3 RFs mixed in there, but on days when I have none? Doing 25+ in a morning wouldn't be hard. Good staff (and helping flip the room yourself) makes all the difference.

 

[clubdeac]

I assume you are talking about a HOPD? I definitely couldn't get 20 patients in a half day during fellowship because turnover took forever.

I routinely do 20 patients in a half day now in PP because I have good staff and not unionized hospital nurses. It certainly gets tight if I have more than 2 or 3 RFs mixed in there, but on days when I have none? Doing 25+ in a morning wouldn't be hard. Good staff (and helping flip the room yourself) makes all the difference.

Yep, staff slowly rolls in around 1pm. Get first patient on the table sometime between one and 115. Everyone out the door between 4 and 430. So I’m referring to essentially 3 hrs of block time

 

[Dr. Ice]

The most I’ve done is 45 procedures in a day including 5 rfas. I really have no interest in being more productive than that

 

[SSdoc33]

the dream is to start at 7 am, end at 7-8 pm and bang out all of the week's procedures in 1 day. i could do probably 60 in that time. cant get the staff/admin to agree

 

[buddababa]

the dream is to start at 7 am, end at 7-8 pm and bang out all of the week's procedures in 1 day. i could do probably 60 in that time. cant get the staff/admin to agree

dream, offer the staff 1.5x after 3pm and then they would do it

 

[SSdoc33]

dream, offer the staff 1.5x after 3pm and then they would do it

do i pay off the admin as well? and the nursing union? and the rad tech union? and the janitors?

 

[hyperalgesia]

do i pay off the admin as well? and the nursing union? and the rad tech union? and the janitors?

They just have to work in shifts. The union has no objection to a shift from 3-8p. Throw in some benefits and you're in business.

 

[buddababa]

do i pay off the admin as well? and the nursing union? and the rad tech union? and the janitors?

i will run your c-arm and recover your patients, just put a lead curtain in between, we can work pretty fast

 

[Gauss]

i knew a pain doc that did all injections in just the AP view. TF, ESI, RF, all in AP view.

35-40 procedures a day.

i question anyone who can go faster...

same, I used to do procedures after a guy who did exactly this - AP Blobogram, never ever saw him use a lateral view. Was told directly I was an outlier, had to hit the eject button on that place long ago

 

[nvrsumr]

These type of docs do well $ and they have a good bedside manner and the 40 procedure a day volume proves it

placebo and horseshoes are a lot of pain medicine

Docs are better trained now but most of the same patients got better in the past with questionable techniques

 

[mille125]

What I was mentioning was my HOPD. They do a lot of things poorly but they do this right.

It is all about where you place incentives. Everyone is incentivized to get done and so they do it.

Same with the office. Treat them well and you will do well. Turnover is like divorce. Financial disaster for the owner.

Find good people. Treat them better than the average doctor does. They will reward you handsomely.

 

[SpineandWine]

What I was mentioning was my HOPD. They do a lot of things poorly but they do this right.

It is all about where you place incentives. Everyone is incentivized to get done and so they do it.

Same with the office. Treat them well and you will do well. Turnover is like divorce. Financial disaster for the owner.

Find good people. Treat them better than the average doctor does. They will reward you handsomely.

Recently learning this the hard way
And jumping on to hire someone who is bad just to fill a spot

 

[Dr. Ice]

These type of docs do well $ and they have a good bedside manner and the 40 procedure a day volume proves it

placebo and horseshoes are a lot of pain medicine

Docs are better trained now but most of the same patients got better in the past with questionable techniques

This job is at least 50% doctor personality

 

[mille125]

Well just when I bragged about them...

Travelling nurse filled in for one of the main nurses. 12 cases including 2 RFAs took 3 hours. Usually can do 20 cases in that time .

Shows that one person can make a difference..good or bad.

 

[lobelsteve]

Well just when I bragged about them...

Travelling nurse filled in for one of the main nurses. 12 cases including 2 RFAs took 3 hours. Usually can do 20 cases in that time .

Shows that one person can make a difference..good or bad.

Make sure to let that one person know how helpful they are, or they will be gone....

 

[mille125]

Make sure to let that one person know how helpful they are, or they will be gone....

I do everyday and I got them a raise.