Hello,
Need advice on job situation. I did an advanced endo fellowship and joined hospital employed position to build basic advanced endoscopy practice. Referral base is from 6 general GIs and some surgery groups around.
Last year did close to 250 EUSs and 150 ERCPs. Few stenting, 10 Axios, lots of EMRs and almost no Barrett's.
Other partners do ERCPs and place plastic stents but do not know how to do Spy, remove larger stones or deal with complex stricture. They do most of their ERCPs when covering the inpatient hospital week. I'm the only one who is doing EUS, Spy and luminal stents. I was hoping to do more ERCPs as sometimes they do cases which I feel need an EUS or SpyGlass but they end placing plastic stent and refer as outpatient. I'm usually at the hospital and available to do these cases but they just proceed and do them. On some months, they seem to even do more ERCPs than me as the volume of ERCPs come from inpatient not outpatient cases and it depends on the week. On my inpatient week last time, I did 2 ERCPs only. Other colleagues can do up to 10 as it all varies depending on the week. I'm dissatisfied with the ERCP volume and don't want to just do the re-do and stent pull. It also feels odd someone who did not do advanced endoscopy to do more ERCPs in a week than an advanced endoscopist. I complained about this and about my ERCP volume but essentially nothing changed as everyone wants to do them and keep up with their skills. Initially they used to refer all non-stone cases to me when there is concern for malignanbcy but now they just do the ERCP, place a stent and refer as outpatient even for cancer patient. We are RVU based model and we are all meeting our targets. Any help appreciated.
Need advice on job situation. I did an advanced endo fellowship and joined hospital employed position to build basic advanced endoscopy practice. Referral base is from 6 general GIs and some surgery groups around.
Last year did close to 250 EUSs and 150 ERCPs. Few stenting, 10 Axios, lots of EMRs and almost no Barrett's.
Other partners do ERCPs and place plastic stents but do not know how to do Spy, remove larger stones or deal with complex stricture. They do most of their ERCPs when covering the inpatient hospital week. I'm the only one who is doing EUS, Spy and luminal stents. I was hoping to do more ERCPs as sometimes they do cases which I feel need an EUS or SpyGlass but they end placing plastic stent and refer as outpatient. I'm usually at the hospital and available to do these cases but they just proceed and do them. On some months, they seem to even do more ERCPs than me as the volume of ERCPs come from inpatient not outpatient cases and it depends on the week. On my inpatient week last time, I did 2 ERCPs only. Other colleagues can do up to 10 as it all varies depending on the week. I'm dissatisfied with the ERCP volume and don't want to just do the re-do and stent pull. It also feels odd someone who did not do advanced endoscopy to do more ERCPs in a week than an advanced endoscopist. I complained about this and about my ERCP volume but essentially nothing changed as everyone wants to do them and keep up with their skills. Initially they used to refer all non-stone cases to me when there is concern for malignanbcy but now they just do the ERCP, place a stent and refer as outpatient even for cancer patient. We are RVU based model and we are all meeting our targets. Any help appreciated.