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anniec

New Position - How to make a schedule

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I just graduated in May & accepted a job in Transplant Surgery, and I need advice/suggestions for forming my work schedule. There are 3 surgeons, and I am the only midlevel. I work almost exclusively in the OR - assisting on recipient operations, and I go on procurements as well. In a few months we are adding 2 more surgeons.

The surgeons have never had a PA before, so they don't know how to make a schedule for me. They basically asked me to make up a draft and we'd try it out. Right now, I am pretty much on call 24/7 in case we find a donor & have to go on a procurement. It is understood that I won't be on call every day once I have a somewhat set schedule, but I'm not sure how to structure this.

Maybe it will be impossible to make a schedule, since the majority of transplants are not scheduled. But if we determine that I will be taking a lot of call, how should I ask to be compensated for it? Right now I'm on salary, with the understanding that every 2 months we'll look at my actual hours and my revenue to determine bonuses.

Any ideas or suggestions? I would really appreciate any help!

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I just graduated in May & accepted a job in Transplant Surgery, and I need advice/suggestions for forming my work schedule. There are 3 surgeons, and I am the only midlevel. I work almost exclusively in the OR - assisting on recipient operations, and I go on procurements as well. In a few months we are adding 2 more surgeons.

The surgeons have never had a PA before, so they don't know how to make a schedule for me. They basically asked me to make up a draft and we'd try it out. Right now, I am pretty much on call 24/7 in case we find a donor & have to go on a procurement. It is understood that I won't be on call every day once I have a somewhat set schedule, but I'm not sure how to structure this.

Maybe it will be impossible to make a schedule, since the majority of transplants are not scheduled. But if we determine that I will be taking a lot of call, how should I ask to be compensated for it? Right now I'm on salary, with the understanding that every 2 months we'll look at my actual hours and my revenue to determine bonuses.

Any ideas or suggestions? I would really appreciate any help!

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This is almost impossible without some more data.

 

Probably the safest way is to generate a standard " 9-5 " template, m- f, for 3 months to see how you are utilized...

 

You should be able to get an idea how much you will be in. The OR by asking the office manager for a template of each surgeon's OR time for the previous 6 months.. And see if you can use that as a predictor of daily OR demand.

 

The problem of course is the variability of donor organs...

 

What will you be doing in OR down time?

 

Rounding?

Seeing follow up patients?

 

Or, is the practice busy enough that everyday at least 2 transplants are done...

 

If the service uses te OR daily, and hasvenough cases , then is easy, ...surgical 9-5 is usually considered 6-4 or 5-3.... You 'll have to ask when they usually book their rooms for elective cases.

 

Call should probably be one day a week when they can call you in.

 

Another option would be to assign yourself to each surgeon on a weekly basis.. You work when he works, with salary asa base and "x " dollars/ hour for hours over 40 hrs/ week.

 

My guess is that they will soon want at least daily coverage, which means that you will need to hire one more PA and schedule a 3pm 4 off, 4 on 3 off, 7 on, 7 off, etc schedule.

 

A lot here will depend on you.. YOU will define the job...rounding? Office work? Prep physicals? Post op follow up? First call? Travel to harvest? Harvest on site? Transplant labs analysis? Immune suppression/ rejection call?

Etc..

 

If you would just list a few more ways they have told you what they want, beyond the usual ubiquitous surgeon " we'll just use you as the need comes up", then I might be able to help you tailor a call schedule.

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This is almost impossible without some more data.

 

Probably the safest way is to generate a standard " 9-5 " template, m- f, for 3 months to see how you are utilized...

 

You should be able to get an idea how much you will be in. The OR by asking the office manager for a template of each surgeon's OR time for the previous 6 months.. And see if you can use that as a predictor of daily OR demand.

 

The problem of course is the variability of donor organs...

 

What will you be doing in OR down time?

 

Rounding?

Seeing follow up patients?

 

Or, is the practice busy enough that everyday at least 2 transplants are done...

 

If the service uses te OR daily, and hasvenough cases , then is easy, ...surgical 9-5 is usually considered 6-4 or 5-3.... You 'll have to ask when they usually book their rooms for elective cases.

 

Call should probably be one day a week when they can call you in.

 

Another option would be to assign yourself to each surgeon on a weekly basis.. You work when he works, with salary asa base and "x " dollars/ hour for hours over 40 hrs/ week.

 

My guess is that they will soon want at least daily coverage, which means that you will need to hire one more PA and schedule a 3pm 4 off, 4 on 3 off, 7 on, 7 off, etc schedule.

 

A lot here will depend on you.. YOU will define the job...rounding? Office work? Prep physicals? Post op follow up? First call? Travel to harvest? Harvest on site? Transplant labs analysis? Immune suppression/ rejection call?

Etc..

 

If you would just list a few more ways they have told you what they want, beyond the usual ubiquitous surgeon " we'll just use you as the need comes up", then I might be able to help you tailor a call schedule.

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Well, you got it exactly right in terms of what the surgeons told me they wanted :)

Currently for every liver transplant, they have to have 2 surgeons in house for the operation. Their goal is to train me so I can be first assist, freeing up the other surgeon. Right now, as I'm still learning the operating procedure, I've been 2nd assist on every case so I can learn the ropes. Which is part of the reason I need to be on call 24/7 right now, so I'm able to get as much learning time as possible. Also, they've already made me 1st assist on procurements, so I'm on call for those.

I think the biggest issue is how unpredictable the OR schedule is: sometimes we'll get several donors at the same time, which means 24-36 hours straight in the OR, while other times we go a couple days without a recipient operation. The surgeons do have general surgery cases - each of them are in the OR for that twice a week - but they have a resident who usually does the general cases (unless of course there's more than 1 surgeon operating at the same time). During OR down time, I attend multidisciplinary rounds at 1230 every day, but besides that, I don't round individually or follow patients. And transplant clinic is only Monday mornings; there's no office hours besides that.

I'm not sure if I helped clarify my situation or just made it more difficult. But I sincerely appreciate your input! I do think once we add the other 2 surgeons it might get a little easier, since there will be more surgeries scheduled, and we'll likely add another PA to split time.

And thanks for the suggestion of speaking with the office manager; I will definitely be doing that.

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Well, you got it exactly right in terms of what the surgeons told me they wanted :)

Currently for every liver transplant, they have to have 2 surgeons in house for the operation. Their goal is to train me so I can be first assist, freeing up the other surgeon. Right now, as I'm still learning the operating procedure, I've been 2nd assist on every case so I can learn the ropes. Which is part of the reason I need to be on call 24/7 right now, so I'm able to get as much learning time as possible. Also, they've already made me 1st assist on procurements, so I'm on call for those.

I think the biggest issue is how unpredictable the OR schedule is: sometimes we'll get several donors at the same time, which means 24-36 hours straight in the OR, while other times we go a couple days without a recipient operation. The surgeons do have general surgery cases - each of them are in the OR for that twice a week - but they have a resident who usually does the general cases (unless of course there's more than 1 surgeon operating at the same time). During OR down time, I attend multidisciplinary rounds at 1230 every day, but besides that, I don't round individually or follow patients. And transplant clinic is only Monday mornings; there's no office hours besides that.

I'm not sure if I helped clarify my situation or just made it more difficult. But I sincerely appreciate your input! I do think once we add the other 2 surgeons it might get a little easier, since there will be more surgeries scheduled, and we'll likely add another PA to split time.

And thanks for the suggestion of speaking with the office manager; I will definitely be doing that.

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