Neurohospitalist vs Queen of efficiency

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  • Avatar jm129 
    Status: Physician
    Posts: 34
    Joined: 12/29/2018

    Currently, we have one active thread about a new neuro-hospitalist and the struggle this physician has with efficiency.

    It reminded me one more long thread about hospitalist hours. One physician spoke about the ability to see 40-50 up to 84 patients a day and still be at home by 2-3 pm and described herself as “queen of efficiency”.

    I feel that practising medicine the “right way” is becoming expensive to physicians. It involves lots of non-billable work and takes a great toll on the physician.

    We are so much focused on efficiency that we try to spend lesser and lesser time with the patients. We get ultra-focused on billable work and do not realize that it can affect the quality of care significantly.

    It is lucrative to just stay in the flow and follow a cookie cutter approach.

    We will have a better relationship with the administration if we don’t push for change and just be more “productive” in terms of wRVUs; we risk a lot if we do otherwise.

    no wonder medicine is becoming so ineffective these days.

    is there any middle ground?





    #230163 Reply
    Avatar Panscan 
    Status: Resident
    Posts: 1092
    Joined: 03/18/2017

    There is no one capable of seeing 50 patients by 2 pm and rendering good care.

    Unless they’re a bunch of healed fracture follow ups, ok see ya bye. Bur actually being a doctor for 50 people over 6 hours? I’ll pass

    #230167 Reply
    Liked by iradoc, CM, Tim, nfldoc, Eye3md
    Avatar Allixi 
    Status: Physician
    Posts: 111
    Joined: 03/16/2016

    You can be both efficient and thorough; they are not opposite ends of the spectrum. But, there are upper limits to the number of pts you can see in a day and still provide quality, comprehensive care. It depends on the culture and the issues you are responsible for. There are doctors in other countries (especially Asia) who really do see 100+ pts a day.

    Not everything is about money. Some of the “non-billable work” provides job-satisfaction, or peace of mind, because it’s the ethical thing to do. You have to decide for yourself how much you want to get paid for it on top of that.

    #230194 Reply
    Liked by Anne, jm129, wonka31
    Avatar Tim 
    Status: Accountant
    Posts: 3088
    Joined: 09/18/2018

    “queen of efficiency”
    You mean the one working two hospitals at the same time ? I think she had a third gig AND was finishing some degree program and thoroughly enjoyed her life of leisure. Maybe I’m mistaken.

    Excuse me. Carryon.

    #230342 Reply
    jfoxcpacfp jfoxcpacfp 
    Status: Financial Advisor, Accountant, Small Business Owner
    Posts: 8141
    Joined: 01/09/2016

    This one?

    Johanna Fox Turner, CPA, CFP, Fox Wealth Mgmt & Fox CPAs ~ ~ [email protected]

    #230358 Reply
    Liked by Tim
    Avatar trebizond 
    Status: Resident
    Posts: 131
    Joined: 12/31/2017

    That’s malpractice. But you’re right, we aren’t paid to be the best doctors, we’re paid to move the meat.

    #230369 Reply
    Liked by Lordosis
    Avatar jm129 
    Status: Physician
    Posts: 34
    Joined: 12/29/2018

    Yes that is the one jfoxcpacfp.


    my intention is not to point finger at someone but examine the extremes.


    I hope we all lean more towards neurohospitalist but also find a way to make it more efficient and not get burned out.



    #230432 Reply
    fatlittlepig fatlittlepig 
    Status: Physician
    Posts: 1200
    Joined: 01/26/2017


    #230439 Reply
    Avatar AR 
    Status: Physician
    Posts: 850
    Joined: 03/10/2016

    This one?

    Click to expand…

    So I read through that whole thread, and I never saw an actual concrete number of patients seen in a day.

    One post mentioned a theoretical maximum of 84, but it doesn’t sound like it ever got anywhere near that.    Also the poster seem to suggest she could do it if needed. However, I didn’t see any of these high numbers of patients actually seen in one day.   Can anyone direct me to that specific part?

    #230454 Reply
    Avatar burritos 
    Status: Physician
    Posts: 494
    Joined: 04/23/2018

    In a 12 hour urgent care shift I once saw 90 patients. I would have gotten out in time too except a laceration walked in 5 minutes till closing. I was too delirious to care that point.

    #230458 Reply
    Avatar Jackmomma 
    Status: Physician
    Posts: 37
    Joined: 01/26/2016

    Doesn’t seeing like 80 patients in a day in a hospital setting basically start setting you up for CMS audits or even OIG investigations?

    Remember a lawsuit not long ago where US Govt accused IPC physicians (before bought out) that their doctors if they saw that many patients driving between 2-3 hospitals would have had 20 hour work days.

    I think it got settled and went away. Will try and find link.

    #230540 Reply
    Avatar jacoavlu 
    Status: Physician, Small Business Owner
    Posts: 2382
    Joined: 03/01/2018

    is there a point to this thread other than (pointless) discussion about a prior thread and bagging on other users?

    The Finance Buff's solo 401k contribution spreadsheet:

    #230594 Reply

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