How to Shift Clinical Focus

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JBM16BYU

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For those of you who have switched around what you do in your clinical practice throughout the years, like the title says, if you are in an established clinic or department how do you go about shifting your clinical focus to better meet your personal interests and strengths? This can be applied to both procedural and/or the types of pathologies and patients you see in clinic. Does it just come with time? For example: if you are trained in ultrasound-guided injections but were not initially hired to do them, how can you begin to incorporate them into your practice? Thanks in advance.

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Depends on the setting and what you are trying to incorporate.
Easiest way I have found is find a need in your system or area that hopefully lines up with a strength of yours or something you like doing.
If you want to add in u/s-guided injections, but don't do them right now and there are others in the group that do a lot of them, its an uphill battle to grab some of that and you might make enemies on the way. That being said, you can always start with your own patients, and if you are good it may grow. That's assuming you have access to an u/s.

Another thing to keep in mind - if you were hired to see a certain population and then with your shift you have less time to see that population, someone has to pick up your slack. All things to keep in mind.
 
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Pathology would likely be easier to get some variety - reach out to your PCPs and/or referral sources and let them know you treat what you are wanting to see. Procedures can be trickier - especially spine/fluoro. If it has been a long time probably need a preceptor and will need to find block time.

Overall I think it is fruitful if the effort to expand will not cause you burn out. Especially if you want to broaden your procedure tool bag -- your patients likely will be very thankful to not have to see another person for these procedures.
 
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I mean you just get the equipment you need and train your staff then market your skill set. Assuming you are already credentialed or easily credentialed. If you have to buy your own equipment it can become expensive, but some of the handheld U/S are more affordable. If you already have access to the equipment then no problem.

The problem we run into is the admin doesn’t support your decision or doesn’t help you get referrals. Then maybe you will have to look for a new employer. I worked somewhere that promised me that I could do anything when I started and then when I tried to expand they basically threw up roadblocks and excuses. Went on for years. Had to move on to get what I wanted.
 
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