2024 Senior Fellows Program (2nd & 3rd Year) | September 2024-Adler Endoscopic Efficiency 2024

Adler Endoscopic Efficiency 2024

Pdf Summary

In this detailed analysis, Dr. Douglas G. Adler elaborates on the importance of efficiency in endoscopic practice. He underscores that, as an attending physician, time is equated with financial gain and career success, contrasting with the slower pace permissible during fellowship training. Efficiency becomes crucial, particularly given the prevalent RVU (Relative Value Unit) model in both academic and private practice settings.<br /><br />Adler emphasizes that, as attendings, practitioners have significant control over aspects like the number of cases, case complexity, scheduling, and anesthesia choices, which come with heightened responsibilities and potential repercussions if inefficiencies abound. Inefficiency can lead to unhappy patients, decreased revenue, overtime staffing, and negative feedback.<br /><br />Adler delves into the roles of different anesthesia methods, advocating for effective communication with anesthesia providers to balance safety and efficiency. He notes the potential pitfalls with providers who are not accustomed to the fast-paced environment of endoscopy, recommending a tailored, often team-based, approach involving Certified Registered Nurse Anesthetists (CRNAs) and Anesthesia Assistants (AAs).<br /><br />Operational strategies include possibly employing two procedural rooms to maximize throughput, although this approach demands high stamina and rapid pace. Breaks, particularly lunch, are debated; while they can disrupt momentum, they are also vital for maintaining overall performance and morale.<br /><br />Practical recommendations on procedure timelines are given, from standard endoscopies to more complex cases, factoring in all procedural components. Building catch-up periods into the schedule is advised to handle potential delays effectively.<br /><br />Adler addresses the physical toll of endoscopy, noting common musculoskeletal injuries among gastroenterologists, particularly in mid-career, and underscores the long-term need to balance pace with personal health.<br /><br />Lastly, the pros and cons of working with fellows are discussed, weighing the educational and logistical benefits against the slowdown they introduce. He concludes by urging continuous process evaluation and adjustment to enhance efficiency, which directly correlates with financial and professional success.

Keywords

endoscopic practice

efficiency

RVU model

anesthesia methods

Certified Registered Nurse Anesthetists

operational strategies

procedure timelines

musculoskeletal injuries

fellowship training

process evaluation