ROP Contracts in Retina - Is that a thing.... seriously

[linevasel]

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I happen to be at a program with strong ROP. I also went to a residency with excellent peds exposure. I believe I could be comfortable seeing Premies and treating them as an ROP provider. I have been encouraged to consider taking on an ROP contract at my next position. I would see retina patients as part of the clinic group on weekdays and then spend every sat (or sun) morning rounding on the premies at the NICU for additional $. I haven't really seen that model in real-life, though I hear it exists. The advisors directing me to see these patients on my weekend argue that it would enable me to negotiate a contract separately with the hospital and not have to share the contract with my colleagues (assuming the group is agreeable with this arrangement).

Business/logistic Questions:
1-Has anyone come across this model ?
2-How much are these ROP contracts typically worth ?

Perspective Question:
1-Is this really a good use of my weekend time. I have lots of educational loan debt and am older than the average graduate (yes i know.... it's terrible...) and did extended training taking away time from my family. Is it smart to try and do Retina/Uveitis and ROP in my first year out or is that a recipe for disaster ?

I wanted to get some perspective on these decision so that I can think and talk about these options intelligently if the matter is raised again.
Thanks for reading

 

[RetinaDude]

If you are going to take care of ROP, I'd focus squarely on what type of liability protection the hospital will help you with beyond your practice provided malpractice coverage. No further discussion until you get this cleared up. And if your practice tells you they have you covered with their 3M/5M policy, tell tO think again.

There's not a lot of ROP related malpractice cases but when they do occur, you better be prepared to open up the checkbook.......sometimes in amounts way above what your "typical" malpractice coverage allows. Look thru the OMIC site and you will find jury awards in the multi-millions......I believe I saw one or two at $9M and/or $18M. Also, in many states, it's not like there is an expiration date where you can't be sued anymore for these preemies. For kids, even if something is discovered when they are 17yo, you could still be sued (for adults, it's usually only 2-3 years after the incident but for kids it's usually until 18th birthday).

Also, be prepared for follow up when the baby leaves the hospital. The baby doesn't show up for an appointment, guess who's job it is to track them down and make sure they get seen? You! If you don't, and that baby progresses to blindness, it's not going to be the fault of the poor mom and dad, it will be your fault for failing to make sure the baby was properly seen once they left the hospital. Make sure someone on your staff has follow up checks as their job! Also, these babies (and their parents) can take a lot more time in the office than in the NICU. Not always, but be prepared. Some of the parents are young, and not so bright, so you have to do a lot of hand holding to explain how the exam is NOT hurting the child, the exam is to detect problems so they don't go blind, etc...