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What's in your bag of tricks when you practice as an Attending (generalist)?

Discussion in 'Otolaryngology' started by HEENTdude, Aug 6, 2011.

  1. HEENTdude

    2+ Year Member

    Feb 27, 2011
    Likes Received:
    Med student here. I've heard that surgeons and ENT's specifically should have about 25 - 30 procedures they are comfortable performing to make a living after residency.

    Obvious answers from what I can tell and have read are: T&A, BMT, neck dissections, parathyroid, thyroid, lump and bump excisions, non-complicated head and neck cancer resections, mastoidectomies, tympanoplasties, DL's with nodule and polyp excisions and/or lasering, possibly simpler flaps?, FESS, septoplasty, rhinoplasty, Zenker's, trachs, laryngectomies?

    That's all I can think of off the top of my head although I know I'm missing a bunch. Is the list more extensive or less extensive. I know its case by case depending on the surgeon's experience and comfort level with the procedure. I can't wait to begin learning them!
  2. OtoHNS

    OtoHNS ENT Attending
    7+ Year Member

    Aug 16, 2010
    Likes Received:
    Attending Physician
    In private practice, you can really do whatever procedures you want. As an ENT, you can make a pretty good living just seeing patients in the office alone, so I wouldn't say that anyone HAS to do a particular number of procedures. I've seen one person who only does tubes, T+A, and septoplasties. Others may do advanced cancer cases, ear cases, or whatever else that they want to do. One of the joys of private practice is that you are in charge of what you do.

    I focus my practice on bread and butter stuff, sinus cases, thyroids and parotids, and am working on building up my facial plastics. I don't particularly like ears, so I generally send any ear cases to a couple of my partners who like to do them.

    I personally refer most cancer cases- not because I can't do the surgery, but because the reimbursement and enjoyment of doing a big whack are not worth the time and effort of having high-risk patients in the hospital for 5-7 days postop (if you are lucky and there's no complication). There's not a team of residents doing the rounding for me.
  3. neutropeniaboy

    neutropeniaboy Blasted ENT Attending
    10+ Year Member

    Feb 10, 2002
    Likes Received:
    Attending Physician
    There is no set number.

    As a generalist, however, you should be able to do the following:
    simple mastoidectomy
    basic tympanoplasty
    turbinate reduction
    basic sinus surgery
    VC injections
    LN excision

    But, like the previous poster said, you can make a very good living just seeing patients in clinic and never doing a procedure.

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