What’s your average census in the community?

[Dr.CCM]

Starting to look for jobs right now.

In the community, what’s considered an average patient census for one doc? 15-20 pts usually?

Is there a specific patient number where you should definitely be staying away from if advertised?

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[CCMEM]

Starting to look for jobs right now.

In the community, what’s considered an average patient census for one doc? 15-20 pts usually?

Is there a specific patient number where you should definitely be staying away from if advertised?

I’m one year out and have been wondering if my census was normal as well. Range 20-36 average 28.

Acuity is relatively high. 2-10 admits a day and similar number of transfers to floor.

Have residents and a fellow for 10-15 patients, then see the rest by myself. Takes me the full day to get to them all. I definitely worry my quality of care suffers when the census gets over 22.

Interested to see how many patients others are seeing.

 

[Psai]

I’m one year out and have been wondering if my census was normal as well. Range 20-36 average 28.

Acuity is relatively high. 2-10 admits a day and similar number of transfers to floor.

Have residents and a fellow for 10-15 patients, then see the rest by myself. Takes me the full day to get to them all. I definitely worry my quality of care suffers when the census gets over 22.

Interested to see how many patients others are seeing.

Hope you're getting paid a mil for that kind of work and patient load.

 

[deleted547339]

Starting to look for jobs right now.

In the community, what’s considered an average patient census for one doc? 15-20 pts usually?

Is there a specific patient number where you should definitely be staying away from if advertised?

The two private practice jobs I looked at were under 18.

 

[CCM-MD]

Hospital employed, non-academic: I see 14-16 in a day.

 

[psychbender]

The job I start next month at a community hospital ha an average daily census of 8-10.

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[joeDO2]

I'm at a mid size community hospital. 15 unit beds. 1 24-hour attending, 1 additional attending during daytime only (approx 8a-4p). 24 hours of coverage by senior resident (EM or IM) and daytime (12hr) intern coverage.

 

[Hamhock]

I can describe three jobs for you. It seems crazy to me to see >15 "real ICU" patients; unless you have a full resident staff or are paid >750K/year.

Pure community. Mid-sized city. Mixed ICU, but mostly medical (multi-disciplinary intensivists, but more IM docs than the rest of us). Range 3-12 ICU patients but typically 5-8 real ICU patients and 1-2 "floor" patients managed by the intensivist. 24h coverage, 7a-7p and then 7p-7a shifts. Pay is shift-stipend plus fee-for-service.

Pure academic. Real city (>300K). MICU. Fellow and three residents. 12-20 ICU patients per day. Attending is in-house for 10h and then available overnight for issues the residents and fellow can't handle (haven't seen this yet). Pay is salary. Pay and advancement is not really based on teaching or clinical work.

Academic-community shop in a mid-sized city (95K) with both a MICU and SICU. The MICU attending has 3-4 residents and "sees" 10-15 patients but writes notes -- and bills -- on 8-10 per day. Pay is a low shift-stipend and fee-for-service (with excellent payor mix). Research is non-existent and teaching requirement is minimal.

I hope that helps. I have contributed this information because its seems like the OP and the early posters are seeing/living offers from contract management groups; which I have seen start to attack medical fields (eg anesthesiology, EM). Although I may be a lucky bastard, there are plenty of jobs out there -- all along the community to academic spectrum -- that are easily available and would never require 15 "real ICU" patients to be seen per day without residents or appropriate pay (as above).

I am not much of a personal/instant message person, but I will respond on this topic.

HH

 

[Bostonredsox]

My shop is midsized, academic community shop. one attending. 7a-7p with residents. night managed by hopsitalst and pgy3 from team. day icu doc avaiable by phone at night. census as low as 6, high as 18 (18 bed closed unit). we lost our CTS program for a bit as both surgeons relocated so numbers dropped exacerbated by nursing shortages but in general total encounters 9-12 on average, more in winter months/flu season. 400kish. other docs are also Pulm and do consults/office, sleep so paid differently.

IMO, when its busy and census is 15-16-17 with 9-10 vents, another 3 off vent but on pressors, DKA or 2 and a post CABG or stemi/iabp, the workload would be impossible in terms of the encounters, documentation, family discussions and procedures WITHOUT having residents. If it was just me doing all of the procedures, admissions, transfers and documentation that number would need to be 8-10 to do a good and still safe job. with the residents 15-20 is really busy and im here late until 830-9 occassionally, but not unmanageable. as we all know, if their 'stable' MICU pts, no one codes, and the new procedure total for the day is low than the day isnt too bad even with 18+. but if their are 3 codes, a ton of procedures and CMO talks, 10 can take forever.

 

[CCM-MD]

Residents usually make me slower and sometimes create more problems than the amount they help.

 

[chocomorsel]

My shop is midsized, academic community shop. one attending. 7a-7p with residents. night managed by hopsitalst and pgy3 from team. day icu doc avaiable by phone at night. census as low as 6, high as 18 (18 bed closed unit). we lost our CTS program for a bit as both surgeons relocated so numbers dropped exacerbated by nursing shortages but in general total encounters 9-12 on average, more in winter months/flu season. 400kish. other docs are also Pulm and do consults/office, sleep so paid differently.

IMO, when its busy and census is 15-16-17 with 9-10 vents, another 3 off vent but on pressors, DKA or 2 and a post CABG or stemi/iabp, the workload would be impossible in terms of the encounters, documentation, family discussions and procedures WITHOUT having residents. If it was just me doing all of the procedures, admissions, transfers and documentation that number would need to be 8-10 to do a good and still safe job. with the residents 15-20 is really busy and im here late until 830-9 occassionally, but not unmanageable. as we all know, if their 'stable' MICU pts, no one codes, and the new procedure total for the day is low than the day isnt too bad even with 18+. but if their are 3 codes, a ton of procedures and CMO talks, 10 can take forever.

So you went back and did your fellowship after all I see.

 

[alphaholic06]

So you went back and did your fellowship after all I see.

I was wondering about that.

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[Nephro critical care]

My gig 10 bed ICU . Smaller city . Average census is 8 but all real ICU pts with average 2-3 admissions. At least 2-3 end of life family discussions every day. I have NP on weekdays but not nights or weekends. I must be rather slow but 10 ICU pts wear me out. We do have 3-5 moveouts every day.

 

[jdh71]

I probably see 10-15 per day most days M-F. Usually at least 5 are the vented and or pressor type. Usually 2-3 sick heads. And the rest made up of patients that need transfer out, that are a bit too much for our medical floors and or a hyponatremia patient that the hospital has decided need to be dealt with in the unit. We cover pulmonary consults too but I don't see those every day. I work with a resident during the days who will see 2-4 depending on their strength and a NP 24/7 who will usually see the transfers out maybe 2-3 patients. I do most of the admits.

The numbers double for Sat/Sun because there is only one of us on rather than two during the day. On the weekends I lean more heavily on my NP. W do have a "semi" back up system and if it's stupid busy we do come in and help the weekend guy for four to six hours.

 

[chocomorsel]

I was wondering about that.

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Or did he? I am thinking he got a job doing ICU without the fellowship.

 

[IMGASMD]

I’m one year out and have been wondering if my census was normal as well. Range 20-36 average 28.

Acuity is relatively high. 2-10 admits a day and similar number of transfers to floor.

Have residents and a fellow for 10-15 patients, then see the rest by myself. Takes me the full day to get to them all. I definitely worry my quality of care suffers when the census gets over 22.

Interested to see how many patients others are seeing.

For a second I thought you were talking hospitalist job.... even for hospitalist, 28 sounds nuts. If you have few rocks, fine. But active ICU, even with the support you have, that doesn’t sound good.

 

[Bostonredsox]

So you went back and did your fellowship after all I see.

You are correct in your assumption, I did not go back. When the time came my wife said no. too many kids, too many bills. i stayed on as faculty medicine attending where I trained for 2 years then had a transition time to the ICU and for the last 2 years have been part of the ICU rotation with the 3 pulm/cc docs. Somewhat unique situation. The AOA (prior to ACGME merger) allowed for "adjusting of rotations" in the curriculum so I ended up doing almsot 12 months of MICU during residency and between that, my procedural counts and my attendings comfortability with me, eneded up being allowed to be the "4th attending" in the icu rotation. at somepoint, when the kids are gone, i will go back for the 2 year fellowship probably as it bugs me not being able to be a board certified intensivist

 

[chocomorsel]

You are correct in your assumption, I did not go back. When the time came my wife said no. too many kids, too many bills. i stayed on as faculty medicine attending where I trained for 2 years then had a transition time to the ICU and for the last 2 years have been part of the ICU rotation with the 3 pulm/cc docs. Somewhat unique situation. The AOA (prior to ACGME merger) allowed for "adjusting of rotations" in the curriculum so I ended up doing almsot 12 months of MICU during residency and between that, my procedural counts and my attendings comfortability with me, eneded up being allowed to be the "4th attending" in the icu rotation. at somepoint, when the kids are gone, i will go back for the 2 year fellowship probably as it bugs me not being able to be a board certified intensivist

Nice