[HSF] Standard of care for lawyers {OT}

[Michael Firstenberg]

Hal,
Part of the reason for my question - is that we do not have layers of
underlings to deal with the "crap" - we do most of it myself.  Yes, we have
2 fellows - and as good and helpful as they are - typically they spend all
day in the OR - and often with the more interesting cases and with my senior
partners who tend to let them do more than a youngster like me.  So in part,
we have all learned to a certain extent that we need to deal with everything
ourselves - with some great RT/PharmD/NP/PA support staff.  But, everything
is getting too complex these days (core measures, discharge planning,
medication reconciliation, P4P, present on admission, etc etc) and when
things get really busy we are all pulled in different directions and we are
trying to build in additional layers of support.  My concerns with
Intensivist models are: where do you find good one?  who pays for them?  who
are they accountable to? who manages them? what credentials are required?
How do you find a balance between a good strong individual who can work
closely with a surgeon - both in terms of taking "suggestions" and "giving"
them?

-michael


On 4/11/08, hgrmd at aol.com <hgrmd at aol.com> wrote:
>
> Michael,
> Believe me, I change and insert lots of lines and chest tubes myself.  I
> do have one of my P.A.'s who chips in as well.  Be glad that you've got
> layers of underlings to do the crap I have to deal.
>
> Hal
> Sent from my Verizon Wireless BlackBerry
>
> -----Original Message-----
> From: "Michael Firstenberg" <msfirst at gmail.com>
>
> Date: Fri, 11 Apr 2008 17:07:53
> To:OpenHeart-L at lists.hsforum.com <To%3AOpenHeart-L at lists.hsforum.com>
> Subject: Re: [HSF] Standard of care for lawyers {OT}
>
>
> hal
> how is it that with your patient load and accuity that you are not up
> all night and everynight.  who puts in and changes lines?
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