physasst Posted April 20, 2012 Share Posted April 20, 2012 Has anyone made the jump from ED to internal medicine? I am contemplating this now. Eventually, I want to transition into full time faculty as a researcher, but I need more post-doc experience and a record of some grant funding to make this jump. For right now, an interesting opportunity has presented itself. Our Internal Medicine department has a new, transformational care team model, using PAs and NPs to deliver ongoing care to specialty patients who do not have acute, active illness. These are people who do not live in the area, and do not have a local PCP, but want to maintain continuity of care with our Center. They are looking for another provider and I have already informally interviewed. My wife despises my ED schedule, and it is hard on the whole family. I've been wanting to get back to a M-F stable 8-5 schedule. The kicker is, they are willing to give me some protected time to work on research, which the ED would not do. I'm 90% convinced to go there. I'd have 30 minute recheck slots and 60 minute multisystem eval slots. I'm just wondering if anyone else has made that jump from ED to internal medicine, and if so, how hard was it? Link to comment Share on other sites More sharing options...
marilynpac Posted April 20, 2012 Share Posted April 20, 2012 I don't know very many IMPAs that are on that kind of schedule as far as 8-5...most work from 7-7:30am to about 6:30pm...our society is living longer thus...more in their PCP office to make sure it stays that way... Link to comment Share on other sites More sharing options...
physasst Posted April 20, 2012 Author Share Posted April 20, 2012 This is a very controlled schedule. 6-8 patients per day. No more. In fact, right now, they are only about 50% full on most calendars. Link to comment Share on other sites More sharing options...
primadonna22274 Posted April 20, 2012 Share Posted April 20, 2012 Duh Mike, do it! Good luck. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted April 20, 2012 Moderator Share Posted April 20, 2012 Agreed- this seems like a cherry gig Link to comment Share on other sites More sharing options...
physasst Posted April 20, 2012 Author Share Posted April 20, 2012 Duh Mike, do it! Good luck. I don't know.....I guess I'm nervous about chronic illness management. Haven't done it in so long...I need to do some serious studying. I even remarked to someone else...."SIXTY minutes...with one patient????? I don't think I've ever spent 60 minutes with a single patient unless they were crashing"..... Link to comment Share on other sites More sharing options...
Joelseff Posted April 20, 2012 Share Posted April 20, 2012 I don't know.....I guess I'm nervous about chronic illness management. Haven't done it in so long...I need to do some serious studying. I even remarked to someone else...."SIXTY minutes...with one patient????? I don't think I've ever spent 60 minutes with a single patient unless they were crashing"..... With a schedule that light I guess you can have 60 mins with pts....I usually do 15-20 for f/u and 30-45 for New pts,and hnps. My schedule usually runs in 2 x15 min slots for the first half of the hour and leave the second 1/2 for the long visits. So about 2-3/hr from 8-knockoff which is about 530. So about 20 pts a day. In starting at a brand new practice in a few weeks and my schedule nxt month is about 8 per day. I hope it lasts..LOL good luck phyasst! Welcome to IM/PC Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
marilynpac Posted April 21, 2012 Share Posted April 21, 2012 Then go for it Michael...and good luck with your new adventure... Link to comment Share on other sites More sharing options...
Contrarian Posted April 21, 2012 Share Posted April 21, 2012 Yeah... Better do it now... while you still can... before a $300 test is required before they will even consider interviewing you for the job... :sadface: Link to comment Share on other sites More sharing options...
deborah212 Posted April 23, 2012 Share Posted April 23, 2012 "SIXTY minutes...with one patient????? I don't think I've ever spent 60 minutes with a single patient unless they were crashing"..... I also thought this when transitioning from hospitalist medicine to primary care that 40 minutes (in my case) seemed like a whole heck of a lot of time for an annual. What I'm finding now is that by the time the patient has arrived and been roomed, around 10 minutes has passed leaving me with 30 minutes. What takes so long are the psychosocial issues. I'd say that at least 80% of the patients I'm seeing have depression/anxiety in addition to and compounding their chronic medical problems. I'm also seeing much more than I anticipated severe mental health problems including passive suicidal ideation in relatively young patients. Our practice is actively trying to screen for this, so my sample is biased. I can no longer say "f/u with your PCP" with regards to those issues because I'm that person! It's tough to balance. In any case, this sounds like a great opportunity and fits nicely with the direction your life is heading. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 23, 2012 Administrator Share Posted April 23, 2012 ...by the time the patient has arrived and been roomed, around 10 minutes has passed leaving me with 30 minutes. A bit off topic, perhaps, but... Why does that setup time take away from your patient time? If the MA/nurse can be rooming the next patient while you're working, then everything should be able to be offset by the per-patient setup time. In other words, if you have a first appointment at 8:00, and second at 8:30, but actually see the patients at 8:10 and 8:40 respectively, how are you off schedule? That is, of course, assuming that the scheduling and rooming can happen without your needing to supervise them... Link to comment Share on other sites More sharing options...
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