Navy small hospital ICU

[grotto]

looking for some info on small hospital ICUs in the Navy- specifically Jax, Lejune, Pendleton type places. I know Guam and Oki have ICUs but less interested. How many Pulm/crit per small hospital, patient load(I imagine low), moonlighting potential would be helpful as well. Specifically interested in thoughts on Jax for family reasons. Need to spend a few years in the wilderness for promotion reasons before going back to a medcen.

Surprisingly little info out there and will be needing to make some career decisions in the next year or two(no, getting out is not an option).

Thanks in advance.

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[psychbender]

I don't have any personal knowledge of any of those places, but it may be that there are no actual intensivists there. I know at some small Army hospitals, the ICU is open, and there is no dedicated intensivist presence. One of my residency classmates found out that he was the default consultant for anything vent-related (or line-related, blood and fluids, really anything related to sick patients) when he showed up to his first post-residency assignment where he was the only anesthesiologist on post.

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[Gastrapathy]

Prior to the small hospital study, there was at least one pulm/cc MD at each of those locations. They aren't really running an ICU though. At most its a step-down (stable GI bleeds were too sick for the one that I know best). The problem for moonlighting is that you are a 1:1 so you are on call a lot. Its up to the command but the ones I know had the single specialists taking call for all but 2 weekends a month. Makes moonlighting very difficult except on leave. I think its mostly an outpatient Pulmonary practice.

Not sure if this is current info.

 

[Homunculus]

Prior to the small hospital study, there was at least one pulm/cc MD at each of those locations. They aren't really running an ICU though. At most its a step-down (stable GI bleeds were too sick for the one that I know best). The problem for moonlighting is that you are a 1:1 so you are on call a lot. Its up to the command but the ones I know had the single specialists taking call for all but 2 weekends a month. Makes moonlighting very difficult except on leave. I think its mostly an outpatient Pulmonary practice.

Not sure if this is current info.

I found even moonlighting in primary care was difficult. when you are on call 2 weekends a month, do you really want to use one of your off weekends to moonlight? I did it a few times and found the money, while good, wasn't worth it. in a larger department with a less onerous call schedule it's easier.

sort of apples/oranges but our "ICU" at our MEDDAC (community hospital setting) was not staffed by an intensivist. I considered our "ICU" more of a monitored bed than an ICU. I had an IVIG infusion there once for kawasakis and you'd thought I was performing a transplant or something.

upside though is the places you mention are probably bigger and may warrant more resources. if you hit the staffing model at the right time and they are a little fat, you can probably have a nice go of it there. hopefully someone here has some current or recent knowledge of the places you mention.

--your friendly neighborhood no credit for "backup call" but still can't leave the area caveman

 

[grotto]

Yeah, its weird. It seems like absolutely no one knows anything about specialty care at the small navy hospitals (I've been asking around as well).

 

[McCheese]

At the places you mention above, there is a small, combined ICU / step-down unit. ~6 beds in mine. Mostly step-down patients which are "open", though the intensivists at least chart check them and weigh in sometimes. ICU is closed, at least in my facility. We've had one to two pulm / CC folks depending on the year. They seem to mostly do outpatient pulmonology. Really sick folks get shipped out quickly. Hope this helps.

 

[grotto]

Appreciate the info above.