How much time do you spend working outside of clinic?

[unleash500]

I have been in fellowship for roughly a month now and I feel like I am spending a lot of time doing work outside of clinic on my own time. Eg I always prep the night before for clinic the next day. I understand that for part of this is because I am still learning oncology. Along with the prepping, I am also dealing with my in basket and answering patient messages. Is this the reality as an attending also? Do you find yourself taking a lot of work home?

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[HemeOncHopeful19]

I work a s**t-ton outside of clinic.

I also started fellowship a month ago, I am with you brother (or sister).

I'd be interested in more experienced answers, but I would imagine as an attending there while there are still lots of pages/inbox questions the prep work for clinic is lower because a) you know what you're doing, b) you know your patients better and c) you aren't having to prep every little detail of each case in case your attending asks

 

[whoknows2012]

I work a s**t-ton outside of clinic.

I also started fellowship a month ago, I am with you brother (or sister).

I'd be interested in more experienced answers, but I would imagine as an attending there while there are still lots of pages/inbox questions the prep work for clinic is lower because a) you know what you're doing, b) you know your patients better and c) you aren't having to prep every little detail of each case in case your attending asks

It gets a lot easier and less time consuming

 

[gutonc]

As an experienced attending (8 years out), I typically spend an hour or so a day outside of clinic hours dealing with work stuff. Some of this is notes, some is InBasket management, some is calling patients/consultants. I only see patients 2 days a week (I'm mostly administrative at this point) so if I had more clinic time, I might do more of it.

As a first year fellow, I'd say it was probably 3-4 extra hours a day. Probably 2-3 hours during my first few years out of fellowship. At this point, I've got the skills to review most new patient cases in 5-10 minutes before I walk into the room. For the follow up patients I just look at my last note and figure out what's up from there. I have more than enough time between patients (even with 15 min appointments, seeing 18-23 patients a day) to do this and stay on schedule. 95% of my notes are done before I leave the office.

This week I saw 45 patients (5 new) in 2 days and when I left my office at 5 today, I had 1 open note on a new patient that was such BS I'm still pissed I even had to see them (mild thrombocytopenia for 20+ years, previously seen by 4 other hematologists with 3 normal bone marrow biopsies).

It gets better.

 

[CatFactorial]

3rd year fellow, about an hour or two per non clinic days.

 

[MD46]

I am about 3-4 years into being attending, typically prep my next morning new patients and active chemo ones the night prior if i can.
At times takes up to an hour.

But allows me to be done with notes, orders etc and be out by 5p the next day.

 

[lulu09]

Last year (first year) spent a lot more time prepping patients because on outpatient clinic blocks had clinic 8 sessions (out of 10) a week. Used at least 1 of the remaining 2 as "admin time" (answering in-baskets and patient calls). Usually stayed 1-2 hours after clinic ended (~6-7 pm) to finish notes, and then didn't have to take any work home.

Now as an upper year fellow, I only have 2 clinic sessions a week (back-to-back), and I spend the night before prepping. It's pretty consistently 3 hours for total of 8 patients (1-2 new patients). Once I build up my panel with returns in a few months, it should be even faster.

It definitely gets faster. Initially I remember spending a lot of time pulling up NCCN and UTD, and now it's just..."uh huh...another stage IV NSCLC...histology? EGFR? ALK? BRAF? PD-L1?..." etc etc.

 

[QuizzicalApe]

As an experienced attending (8 years out), I typically spend an hour or so a day outside of clinic hours dealing with work stuff. Some of this is notes, some is InBasket management, some is calling patients/consultants. I only see patients 2 days a week (I'm mostly administrative at this point) so if I had more clinic time, I might do more of it.

As a first year fellow, I'd say it was probably 3-4 extra hours a day. Probably 2-3 hours during my first few years out of fellowship. At this point, I've got the skills to review most new patient cases in 5-10 minutes before I walk into the room. For the follow up patients I just look at my last note and figure out what's up from there. I have more than enough time between patients (even with 15 min appointments, seeing 18-23 patients a day) to do this and stay on schedule. 95% of my notes are done before I leave the office.

This week I saw 45 patients (5 new) in 2 days and when I left my office at 5 today, I had 1 open note on a new patient that was such BS I'm still pissed I even had to see them (mild thrombocytopenia for 20+ years, previously seen by 4 other hematologists with 3 normal bone marrow biopsies).

It gets better.

What did your fourth bone marrow show when you got it?

 

[gutonc]

What did your fourth bone marrow show when you got it?

I just discharged her from clinic.

 

[QuizzicalApe]

I just discharged her from clinic.

Surely the splenectomy arranged by the 5th heme/onc consult will fix this...