what are your hours

[TransformerInWestVirginia]

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can someone do a day in the life post and also if youre at a community or at a university program

 

[NewYorkDoctors]

well I am pure private practice pulmonary now

I work 9-5PM though I am often staying after hours to write PFT/CPET reports, finish office notes, fill out DME/O2 forms etc...
My partners and I alternate going to the hospital before 9 and after 5 if we have patients hospitalized (we don't have too many patients hospitalized at any given time fortunately)

When i worked at a NYC community hospital with a fellowship program for a brief while before, the hours were 8AM to 4PM. When on ICU, the usual round with team from 9AM to 12PM. attend conference. do any bronchs in afternoon. attend fellows clinic. wrap up by 4PM. attending ICU call q8 days over night phone call with fellow in house on night float. no night intensivist coverage in this hospital.

 

[MikMik6]

well I am pure private practice pulmonary now

I work 9-5PM though I am often staying after hours to write PFT/CPET reports, finish office notes, fill out DME/O2 forms etc...
My partners and I alternate going to the hospital before 9 and after 5 if we have patients hospitalized (we don't have too many patients hospitalized at any given time fortunately)

When i worked at a NYC community hospital with a fellowship program for a brief while before, the hours were 8AM to 4PM. When on ICU, the usual round with team from 9AM to 12PM. attend conference. do any bronchs in afternoon. attend fellows clinic. wrap up by 4PM. attending ICU call q8 days over night phone call with fellow in house on night float. no night intensivist coverage in this hospital.

How do you like being private now, compared to being hospital employed?

 

[NewYorkDoctors]

How do you like being private now, compared to being hospital employed?

the small voice answer is "more money and more free time."

but the big voice answer (which is still a sincere answer) is I have more freedom and flexibility to do what I need for my patients more quickly and efficiently.

Need a PA for a biologic? My staff and I will do it on the spot / get the note uploaded / get an approval within 1-2 days / call the specialty pharmacy stat.
Do PFTs on the same day as the consult and get answers. Do a CPET for thoracic preoperative evaluation on the next day after a PFT is done and there is low ppoFEV1 ppoDLCO.
Radiology is next door - get PA (which is instantaneous for managed Medicare on the PA portals and no PA for straight medicare) and get scheduled for CT on one day - radiology writes a report same day follow up on the same day.

I have not had any private patients admitted to the local hospital for many months now. I ensure all patients get followed up frequently so they almost never have AECOPD or asthma exacerbations (unless they are nonadherent). My partner and I do not pick up new consults in the hospital since the local outpatient referrals are plentiful in our neck of NYC.

I no longer do ICU full time. but I do help my colleagues if they ever need a shift covered here or there like on vacation or during the Sabbath for my Jewish colleagues.

 

[MikMik6]

the small voice answer is "more money and more free time."

but the big voice answer (which is still a sincere answer) is I have more freedom and flexibility to do what I need for my patients more quickly and efficiently.

Need a PA for a biologic? My staff and I will do it on the spot / get the note uploaded / get an approval within 1-2 days / call the specialty pharmacy stat.
Do PFTs on the same day as the consult and get answers. Do a CPET for thoracic preoperative evaluation on the next day after a PFT is done and there is low ppoFEV1 ppoDLCO.
Radiology is next door - get PA (which is instantaneous for managed Medicare on the PA portals and no PA for straight medicare) and get scheduled for CT on one day - radiology writes a report same day follow up on the same day.

I have not had any private patients admitted to the local hospital for many months now. I ensure all patients get followed up frequently so they almost never have AECOPD or asthma exacerbations (unless they are nonadherent). My partner and I do not pick up new consults in the hospital since the local outpatient referrals are plentiful in our neck of NYC.

I no longer do ICU full time. but I do help my colleagues if they ever need a shift covered here or there like on vacation or during the Sabbath for my Jewish colleagues.

Wow, I guess being at a hospital makes it that much more inefficient. What about your procedure flow? How many more procedures are you doing while being private. While doing these procedures, do you also have to run your anesthesia as well or is there a CRNA/Anesthesiologist that can help you with this?

 

[NewYorkDoctors]

Wow, I guess being at a hospital makes it that much more inefficient. What about your procedure flow? How many more procedures are you doing while being private. While doing these procedures, do you also have to run your anesthesia as well or is there a CRNA/Anesthesiologist that can help you with this?

Well a hosptial clinic isn’t inefficient . It’s just when I run the business I am more motivated to get things done faster . There’s nothing stopping a hospital employed physicians from doing the PA himself or herself … but what’s the incentive ? The pA department will do it (when he she gets to it )

I do bronchs in the hospitals bronch suite
- hosptial staff present RN and RRT . No one does office based bronchs like an egd colonoscopy due to the higher risk of the airway being involved . I don’t need to do too many brinchs . Thoracic surgery and IR does a much better job at biopsying a mass or lesion than I can .

I only resort to bronchs if I need the bal to make a diagnosis (sarcoid HP NTM are common ones ) or if it’s an undifferentiated ground glass or consolidation that’s not clearly cancer and I can’t really ask thoracic for a procedure on


I have a RRT doing the pfts and cpets in the office