What is the best practice model for pain? Three days of office with two procedure days? Two procedure room What is considered a very busy block day?

[gator2886]

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Curious what is the best practice mode? Two procedure rooms? Three “office days” with two procedure days? Three exam rooms and on procedure rooms with doing blocks while also seeing patients?

 

[BobBarker]

Nobody needs two procedure rooms unless you have two physicians there at the same time.

 

[emd123]

I start with 2.75 days clinic and 1.75 days procedures per week. Actually, it ends up being 2.5 clinic and 2.0 days procedures often, since if I have some longer procedures I'll add a little procedure time and block off some clinic hours.

I have one procedure room for 1 Pain doc. I get by with 2 exam rooms and 1 very good nurse. On a clinic day, I'll close the schedule at 23 patients. I could do many more, but more makes the day miserable. On my procedure days I'll block it after 19 procedures, often less if I have some longer ones. It all depends on how hard you want to work. It ends up being about 36 hours per week for me. I'm not rolling in dough compared to many people, but I'm not starving, either. It's a marathon, not a sprint.

 

[Sadder]

On a clinic day, I'll close the schedule at 23 patients. I could do many more, but more makes the day miserable. On my procedure days I'll block it after 19 procedures, often less if I have some longer ones. It all depends on how hard you want to work. It's a marathon, not a sprint.

Can you describe the list of procedures per day?

 

[gator2886]

Would you not want two procedure rooms if all you were doing is procedures on a particular day? Ie to “flip”?

 

[Ducttape]

not really, unless you staff with 2 separate staff. otherwise, the same staff have to go from room to room and still turn over the room and set up for the next procedure. cant really do that while you are doing a procedure (they are in the room with you!)

you could do that in an ASC, but not in an office.

 

[BobBarker]

It is not necessary.

Finish injection. Go to computer and punch in templated note. Patient off bed and gone. Staff removed sheet, wipes oakworks down, new sheet. New patient directed to lay down. Start next injection.

 

[emd123]

Can you describe the list of procedures per day?

It's random. It could be anything from an L ESI, to cervical RF, to stim trial, kypho, MBBs, knee/hip injection, etc. It changes constantly, but I imagine it's similar to the typical procedures most interventional people are doing.

 

[emd123]

Would you not want two procedure rooms if all you were doing is procedures on a particular day? Ie to “flip”?

If I had the volume to go over 20, then yes. But to use a second procedure room (which I don't have) I'd have to add another nurse, which I don't want to do because I don't always need a second or even part time nurse. So, the way I handle weeks where I have more procedures than slots, I simply block off some clinic time and add more procedure time. Since I enjoy the procedure time more than clinic, I'm always happy to skew the ratio a little bit in that direction. Plus, since I'm the only Pain guy in a primary care group, my procedure suite sits empty when I'm not in it, and so do my exam rooms, so I can change it on the fly.

 

[blockstar]

I start with 2.75 days clinic and 1.75 days procedures per week. Actually, it ends up being 2.5 clinic and 2.0 days procedures often, since if I have some longer procedures I'll add a little procedure time and block off some clinic hours.

I have one procedure room for 1 Pain doc. I get by with 2 exam rooms and 1 very good nurse. On a clinic day, I'll close the schedule at 23 patients. I could do many more, but more makes the day miserable. On my procedure days I'll block it after 19 procedures, often less if I have some longer ones. It all depends on how hard you want to work. It ends up being about 36 hours per week for me. I'm not rolling in dough compared to many people, but I'm not starving, either. It's a marathon, not a sprint.

Best way to do it! Enjoy your life!

 

[SSdoc33]

Since I enjoy the procedure time more than clinic, I'm always happy to skew the ratio a little bit in that direction

clinic will suck away your life force if you try to be high volume. i can do high volume injections without feeling like a hamster on a wheel. with injections, you are in control. like flying a plane. in clinic, you are more like a passenger

 

[pmrmd]

Best practice model is integration. Intermix OVs with procedures. No “clinic day” or “procedure day”. Every day is all that. New pt eval, image review, inject if they need or want. FUs the same. Opens up a slot the next day. Patients like it. Heavy on -59 modifier though.

 

[callmeanesthesia]

Best practice model is integration. Intermix OVs with procedures. No “clinic day” or “procedure day”. Every day is all that. New pt eval, image review, inject if they need or want. FUs the same. Opens up a slot the next day. Patients like it. Heavy on -59 modifier though.

How to do work the schedule for that, if you might do an injection on every new patient and follow-up? How long per appointment?

 

[nvrsumr]

I also do procedures and injections intermixed. Never on same patient on same day though. This way you are more available than the guy down the street who only has tuesdays and thursdays at the asc across town available three weeks from now for their injection.

 

[lobelsteve]

NP, OV, PR slots on my schedule at random. OV, ESI, MBB, IA, SIJ = 10min NP=20min RF=20-30min SCS/Kypho 60min slots.

 

[Bsb2015]

NP, OV, PR slots on my schedule at random. OV, ESI, MBB, IA, SIJ = 10min NP=20min RF=20-30min SCS/Kypho 60min slots.

PR?

 

[lobelsteve]

PR?

Procedure

 

[Bsb2015]

Procedure

Gotcha. Thanks!