Wow you’re busy, working 5 days a week that’s 36 patients a day? How? This includes NP supervision?
With 12k+ rvu/year are you netting 1.2M a year? What part of country is this? How can we become this busy?
Some NP supervision.
Paying your NPs is paramount to allowing certain types of billing. I work 4.75 days a week. Fridays til 2.
Netting 1.2…not after Uncle Sam. Grossing that.
Southeast.
You work hard. There is a point of diminishing returns. I’m over that but I enjoy what I do. You have to learn how to balance schedules and how to deal with needier patients. I schedule them at times where I can start seeing them a little early or right before lunch or right after lunch so I can start early there. If you get ahead great. If not you can catch up on easier treatment patients…keytruda etc or heme patients.
It takes effort to balance the schedule to allow seeing that many people so it’s work on top of work. Having good NP support is paramount for TLC.
Shooting for a salary threshold is not a recipe for happiness. You have to see patients you enjoy. See things you are good at. Try to have a niche if possible. Map things out for patients honestly and compassionately so they understand upfront. Clear goals of care make treatment more realistic and outcomes less surprising. The sequence of response and progression becomes more linear for patients. I never walk out of a room without asking patients for questions. I run late sometimes. Mostly though I don’t. Divide difficult patients on different days.
Everything about practicing takes work. You need to train your nurses and MAs to know what you need. Make sure your employer or practice has enough help. Paying an extra nurse or Ma to do clerical stuff (NGS, PA’s) etc without their constantly having to ask for help makes life so much better in the lung run.
Don’t expect palliative care to do your difficult discussions but know who needs their extra TLC along the way.
Surround yourself with good partners who will be a good ear.
Realize early that guidelines are guides and that your gut is important but that inexperience shouldn’t lead to fear. Ask your older more experienced partners for advice often. Regimens you perceive as “hard” as a fellow because you haven’t written for much shouldn’t become things you avoid. Become comfortable with all the drugs and preemptively give meds for diarrhea etc and take the time to explain when to use and what to expect. It saves phone calls and admissions later. Have formal NP educations/chemo teachings about when to call and side effects to really expect. All of these things set you up for success to focus on the patient in front of you in the room and not the million other things going on.
See your patients frequently. It avoids smaller problems from becoming larger and they feel cared for. Be aggressive with fluids and day 3 supportive meds for pumps (folfox, folfiri etc).