I've heard as little as 1 day a week. I don't know much about this, so I thought I might ask. How is your day/week typically lined up?
How often do you go into the OR?
- Thread starter JP2740
- Start date
- Joined
- Mar 27, 2004
- Messages
- 1,642
- Reaction score
- 417
You mean as residents or attendings?
In residency I operated generally 4 days a week and did clinic one day a week. That could change depending on rotation. Otology was more like 2-3 in clinic and 2-3 in OR depending on the week.
In practice now I operate one day a week at a surgery center (do 12-16 cases or so) and 1 day a month at a main operating room (2-5 cases) of sicker patients and "bigger" cases like thyroids and parotids. So in a month I am in the OR at least 5 days, more if call issues arise. I spend 3 days a week in the office. I spend one day a week with my wife/on the golf course
In residency I operated generally 4 days a week and did clinic one day a week. That could change depending on rotation. Otology was more like 2-3 in clinic and 2-3 in OR depending on the week.
In practice now I operate one day a week at a surgery center (do 12-16 cases or so) and 1 day a month at a main operating room (2-5 cases) of sicker patients and "bigger" cases like thyroids and parotids. So in a month I am in the OR at least 5 days, more if call issues arise. I spend 3 days a week in the office. I spend one day a week with my wife/on the golf course
You mean as residents or attendings?
In residency I operated generally 4 days a week and did clinic one day a week. That could change depending on rotation. Otology was more like 2-3 in clinic and 2-3 in OR depending on the week.
In practice now I operate one day a week at a surgery center (do 12-16 cases or so) and 1 day a month at a main operating room (2-5 cases) of sicker patients and "bigger" cases like thyroids and parotids. So in a month I am in the OR at least 5 days, more if call issues arise. I spend 3 days a week in the office. I spend one day a week with my wife/on the golf course
Good stuff, exactly what I was looking for. I was thinking more along the lines of attending. Thanks a lot. Anyone else free to chime in
You mean as residents or attendings?
In residency I operated generally 4 days a week and did clinic one day a week. That could change depending on rotation. Otology was more like 2-3 in clinic and 2-3 in OR depending on the week.
In practice now I operate one day a week at a surgery center (do 12-16 cases or so) and 1 day a month at a main operating room (2-5 cases) of sicker patients and "bigger" cases like thyroids and parotids. So in a month I am in the OR at least 5 days, more if call issues arise. I spend 3 days a week in the office. I spend one day a week with my wife/on the golf course
This sounds pretty typical for a busy private practice general ENT. We do spend a lot more time in clinic than other surgeons, however we also do a lot of in-office procedures, especially now with the growth of in-office balloon sinuplasty.
- Joined
- Mar 27, 2004
- Messages
- 1,642
- Reaction score
- 417
Have you started doing this? I only did this in the OR during residency. I know coding has made it a good office procedure but I just haven't done it in the office. I know in the properly selected patient it can be a great case in the office, but I just fear I could never quite get them numbed up enough to make it tolerable. If you'd rather you can PM me. Office procedures I do are skin cancers and other little lumps and bumps as well as tubes/myringotomy.
I'll send you a PM.
- Joined
- Feb 11, 2002
- Messages
- 948
- Reaction score
- 219
I have two full days of operating per week and two full days of clinic. The remaining day is flex -- either research, admin, day off, or call-related issues.
Ok this sounds awesome. How long have you been working for?
- Joined
- Oct 2, 2006
- Messages
- 912
- Reaction score
- 29
In practice now for 8 years. Typically I'll do two half days of outpt stuff in my surgery center--BMT's, T&A's, septo/turbs, FESS. I'll then do either a half day or two half days of overnight stuff (thyroids, parotids, etc). In other words, 1.5-2 days of OR/week.
I decided I hated clinic all day and would rather spread the love out a bit.
I do BSP in office as well--along with all the other in office procedures that we have at our disposal. However, I think this is a slippery slope. You can easily look back at how long I've advocated on this forum for BSP to be a good option, but my rate of in-office procedures has not increased at all in the last 2 years. There are ENT ****** doing this on everyone who walks in the door and it makes me just plain sick. I'm disgusted repeatedly by the person who comes in for a 2nd opinion on allergic rhinitis and was told they need IOBSP by an ENT money ***** somewhere else. It's an embarrassment to our profession and the surest way for it to get us more regulation.
I decided I hated clinic all day and would rather spread the love out a bit.
I do BSP in office as well--along with all the other in office procedures that we have at our disposal. However, I think this is a slippery slope. You can easily look back at how long I've advocated on this forum for BSP to be a good option, but my rate of in-office procedures has not increased at all in the last 2 years. There are ENT ****** doing this on everyone who walks in the door and it makes me just plain sick. I'm disgusted repeatedly by the person who comes in for a 2nd opinion on allergic rhinitis and was told they need IOBSP by an ENT money ***** somewhere else. It's an embarrassment to our profession and the surest way for it to get us more regulation.
- Joined
- Mar 27, 2004
- Messages
- 1,642
- Reaction score
- 417
Thanks for your thoughts. You have a better mix of "big" cases than I do. I can do all my bigger stuff once a month.
I agree on the balloon front with the shady business. I like to think of us as professionals but I guess there are shady folks in every line of work. As you saw above I am considering getting involved in doing these in my office. Though I am not sure how it will work out financially and time wise just yet. We have a ton of allergies in this region and I've found that testing and treating people with medications or immunotherapy really slows the need for FESS. I don't do as much sinus surgery as I thought I would coming out of residency. But I do enough that it keeps my hands in it and I feel confident with it.
Yeah, there is one ENT in my city that I'm aware of who is reportedly doing lots of in office balloons for questionable indications. It's unfortunate that some folks will put their wallet ahead of patient benefit. In-office balloons have the tempting combination of being highly profitable, fairly easy to do, and having a miniscule risk of serious complication.
That being said, I think the in-office balloon is a significant advance in sinus treatment in appropriate patients. With the new Acclarent device (not the older one which you need 3 arms to work properly IMO) and the Entellus device, it is pretty easy to do the procedure. The benefits of FESS remain but the potential risks of CSF leak and orbital injury are much lower. And the perioperative discomfort from the procedure and anesthesia is less or zero. My patients have been able to go back to work the same day or following day typically rather than being out a few days.
My philosophy is to make sure my patients know IOBSP is an option and encourage appropriate candidates to have the procedure. We keep brochures and other promotional materials in our waiting room and exam rooms. I think there is a substantial population out there who are getting recurrent sinusitis or CRS and would rather just "suck it up and deal with it" than get a "risky" operation. Most patients think they'll have their nose packed off for a week and other horror stories if they have nasal surgery. A lot of people are very intrigued about an in-office option.
- Joined
- Jan 6, 2010
- Messages
- 137
- Reaction score
- 3
On the flip side, some of my H&N attendings in academics are running multiple rooms 2-3+ days per week. But it sounds like you were more interested in the community lifestyle.
I'm interested in general ENT and neurotology. Not sure whether I'll be in academics or community but leaning towards academics. I've been exposed to the field through shadowing and such and will be starting 3rd year in July, so this might be a little bit premature.
- Joined
- Feb 11, 2002
- Messages
- 948
- Reaction score
- 219
I am a 3rd year applying for ent. I cn see myself practicing in a variety of settings but right now I'm particularly interested in head and neck. Do private guys do there cases? Also I will be in the army so if anyone knows anything about life of an army ent that would be great.
- Joined
- Jan 6, 2010
- Messages
- 137
- Reaction score
- 3
My impression from my >5 friends in ENT that are military is that you dont' really get to choose. Several of them wanted to do a sub-specialty and were told either no or they had to wait. Thus if you have your heart set on a subspecialty, it may not pan out (at least immediately) as you want.
