TEE resource

[apma77]

anyone know a good website or book which has a basic review of TEE or "TEE for dummies " type review?

the typical texts have complicated reviews of this topic

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[Gern Blansten]

Board Stiff-TEE by Gallagher seems to be what you are describing. It is certainly not all inclusive and is a rather silly book in the way that it is written. But it does bring it down to an understandable level. Once you master that, you could move on to the SCA's TEE DVDs which can be found at:
http://www.scahq.org/

Good luck

 

[UTSouthwestern]

A Practical Approach to TEE by Perrino is a good read and a little more extensive, but it is worth the knowledge you gain on cardiac physiology and anatomy.

 

[apma77]

just curious..how much can one bill for intra-op TEE?
is it a skill that pays well financially as an anesthesiologist?

 

[UTSouthwestern]

just curious..how much can one bill for intra-op TEE?
is it a skill that pays well financially as an anesthesiologist?

Intra op TEE isn't a goldmine. In fact, you will probably spend more preparing for the test than you will make doing TEE's in 5 years of practice.

If you get reimbursed, $80-130 is what you get for a complete examination of the heart that is documented in the chart.

I always felt that the benefits of learning about the heart's structure along with the ability to image it with TEE far outweighed the cost of learning to use the probe and the test.

 

[TIVA]

If you do locums, the going rate for a general anesthesiologist is $1000 per 8 hour shift. If you know how to do TEE, then you know cardiac anesthesia, and the reimbursement for a cardiac anesthesiologist is $1500 per 8 hour shift. So, yeah, knowing how to do TEE does pay better.

Of course, this is on a locums basis. If you go into academics or private practice, cardiac anesthesiologists do make more than general anesthesiologists, but I'm not sure by how much.

 

[sevo85288]

A TEE exam and documentation is valued at 6 units per ASA Value Guide. Units billed and collected vary from insurance co, medicare, etc... We charge $65/unit. We collect about half of that. Less with medicare.
You can't get rich with TEE but it is a must have tool in cardiac anesthesia.

 

[cfdavid]

Gents,

Correct me if I'm wrong, but don't they do TEE during most cardiac procedures, including when they use fluoroscopy as in angioplasty and stent placement?? Forgive my ignorance.

Also, to the pros out there, I've always been interested in the heart. But, I know that CABG rates have really slowed down over the past 10 plus years due to less invasive cardiac procedures, like drug eluting stents etc.

So, what do you think the prospects are for a fellowship trained cardiac anesthesiologist?? I know that "heart centers" seem to be money makers, since they are proliferating so much (and, yeah, I know the implication that could have on future demand).

 

[UTSouthwestern]

A TEE exam and documentation is valued at 6 units per ASA Value Guide. Units billed and collected vary from insurance co, medicare, etc... We charge $65/unit. We collect about half of that. Less with medicare.
You can't get rich with TEE but it is a must have tool in cardiac anesthesia.

Medicare pays $15/point if certain criteria are met, Medicaid varies by state, but is usually less.

 

[UTSouthwestern]

Gents,

Correct me if I'm wrong, but don't they do TEE during most cardiac procedures, including when they use fluoroscopy as in angioplasty and stent placement?? Forgive my ignorance.

Also, to the pros out there, I've always been interested in the heart. But, I know that CABG rates have really slowed down over the past 10 plus years due to less invasive cardiac procedures, like drug eluting stents etc.

So, what do you think the prospects are for a fellowship trained cardiac anesthesiologist?? I know that "heart centers" seem to be money makers, since they are proliferating so much (and, yeah, I know the implication that could have on future demand).

TEE is not used in angioplasty or stent placements. The fluoro is enough.

If you had asked me what the prospects of cardiac surgery were last year, I would have said dim, but we are seeing more and more patients coming in with occluded, failed, or migrated stents coming back for surgery. Who knows what the future will hold.

 

[cfdavid]

TEE is not used in angioplasty or stent placements. The fluoro is enough.

If you had asked me what the prospects of cardiac surgery were last year, I would have said dim, but we are seeing more and more patients coming in with occluded, failed, or migrated stents coming back for surgery. Who knows what the future will hold.

Interesting. I know there's been some controversy relative the overuse of drug eluting stents, as well as long term re-stenosis. I agree, we'll just have to wait and see.

Perhaps with the aging population (and increased life expectancy), we may be seeing more CABG's and other cardiac surgical procedures, even if the rate tapers off. Who knows.

 

[The_Sensei]

If you do locums, the going rate for a general anesthesiologist is $1000 per 8 hour shift. If you know how to do TEE, then you know cardiac anesthesia, and the reimbursement for a cardiac anesthesiologist is $1500 per 8 hour shift. So, yeah, knowing how to do TEE does pay better.

Of course, this is on a locums basis. If you go into academics or private practice, cardiac anesthesiologists do make more than general anesthesiologists, but I'm not sure by how much.

Where the hell are you getting these numbers!?! My buddy refuses to do any locums assignment at a rate less than $1500 per 8 hour day. I'm sure you DO get more if you are a cardiac anesthesiologist, but brother, if you are working for $1k/day, then something is wrong!

 

[TIVA]

Where the hell are you getting these numbers!?! My buddy refuses to do any locums assignment at a rate less than $1500 per 8 hour day. I'm sure you DO get more if you are a cardiac anesthesiologist, but brother, if you are working for $1k/day, then something is wrong!

It's okay! ... It's okay ... breathe ... good ... now, doesn't that feel better?

Relax, buddy. If your friend is making more, then kudos to him for stick'n it to the man.

 

[johankriek]

If you do locums, the going rate for a general anesthesiologist is $1000 per 8 hour shift. If you know how to do TEE, then you know cardiac anesthesia, and the reimbursement for a cardiac anesthesiologist is $1500 per 8 hour shift. So, yeah, knowing how to do TEE does pay better.

Of course, this is on a locums basis. If you go into academics or private practice, cardiac anesthesiologists do make more than general anesthesiologists, but I'm not sure by how much.

you have to get paid more.. just for being in the room with a cardiac surgeon all morning..