Should I do STEMI call?

[TAVR4life]

New attending. Joined private practice group filled with general cardiologists. Im only IC for the group. Three year partnership track with a buy in. The group wants me to do general cardiology, IC, start their vascular program including ultrasound program and endovascular interventions including venous ablations and do TAVR. Once a partner everyone gets paid the same even the general cardiologists who don't do any procedures (they justify it by saying that being in clinic generates more money). They want me to do STEMI call for 4 weekends a year plus 4 weekends of general call (everyone elses does 8 weekends of general call). I don't get paid extra for STEMI call. Feel like my scope of practice is much more than everyone else, and I'll be spreading myself thin and there's no real incentive for me to do STEMI call. Should I just do the 8 weekends of general call like everyone else instead of 4 weekends of STEMI call plus 4 weekends of general cardiology? Should I ask them to pay me for STEMI call?

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[Medstart108]

:O can't give advice because don't understand the field, but damn sounds pretty unfair if you ask me. You are going to be working way worse hours for the same pay.

 

[timpview]

Weird set up..

- general call is typically “worse” than Stemi call. The bad part of stemi call is the frequency or having to do general plus stemi when the others have general only. So if you’re going 8 weeks total either way I would stick with 4 Gen plus 4 stemi

- clinic does typically generate more RVUs which many people don’t get. The kicker is the value and profit you’re providing to the hospital/facility with your procedural RVUs is exponentially higher. So you’re kind of right but it depends on who is recognizing your value and whether they care to show you.. cms and insurance companies aren’t the ones.

- a busy general cards guy brings in more rvus in my experience than a cath lab only guy.. so they’re likely right.. the busy clinic guy who also caths however trumps all. So if you’re going general, imaging and all those procedures you’ll likely be the highest rvu generator at sone point.

- it does sound like they’re trying to milk ya. Depends on what leverage you have and other options you have if you’re willing to leave.

 

[aafisahar]

you can get like 7 rvus for a simple new visit for most patients. just about every new patient i see is an automatic ekg+echo+level 4-5 office visit = ~7-8 rvus. i can see a new patient in about 10-20 minutes, and typically have between 6-10 new patients a day.

add in stress testing, holter/event monitors, etc and you can easily rack up the rvus in clinic. on imaging days, probably make >100 rvus between ttes, tees, stress echoes, and nukes. i am credentialed to do lefts/rights, but it's not worth it to schedule a day in the lab over a day of clinic or imaging.