To conclude 2019, I posted on Instagram my personal statistics/procedure log from my job as an Intensivist in a non-academic facility. I am a private practice physician. The vast majority of the time, I do not work with an NP nor a PA. I have been collecting the data regarding how many encounters I have as well as procedures.
How do I collect my procedure logs?
We all typically print out a patient list every day. During the course of the day, I take notes on this one page list. We all know that our lists are our brain and we cannot lose it or else we lose our minds. I put my billing data on the list as well as write out the MRN’s of the patients who have procedures performed on them.
At the end of each day, I print out a fresh list including all the new consults/admissions with the billing info and submit that to my office staff. I take a picture (deleting all the confidential patient information) of the list for my records. At a later time, most likely when I am on night shift and therefore get compensated to do such accounting, I have a spreadsheet where I tally this information. I have been doing it since I completed my training and recommend that you do the same. If you want to come work at my shop, this is what you can expect to perform.
2017 is the year I finished my fellowship training so the numbers reflect half a year of work.
Intubations
Some people might look at these numbers as say that it’s not a lot. On the other hand some might say that it is a lot. It all depends on perspective. For example, if you are in academia, chances are that you are not going to do many intubations yourself because you need to train interns, residents, and fellows to perform the intubation. If you are an anesthesiologist, you’re playing an entirely different game and therefore this does not apply to you. One needs to remember that many of the patients who come to the ICU come from the ED where our colleagues down there typically establish an airway prior to being transferred to the ICU. Here are the results from my procedure log.
2017: 21 (half year)
2018: 42
2019: 57
2020: 49
Central Lines (& dialysis catheters)
2017: 23
2018: 52
2019: 51
2020: 67
Arterial Lines
2017: 14
2018: 22
2019: 28
2020: 51
The trend in a-line placement seems to be going up for 2020. Much of that has to do with the pandemic. These patients with severe ARDS need frequent blood gas monitoring as well as hemodynamic monitoring. An arterial line facilitates life for both our nursing staff as well as the respiratory therapists.
I would like to mention that I perform all of my arterial lines with ultrasound guidance. Patients who require arterial lines are almost exclusively hypotensive in my practice and palpating pulses well enough to nail a tiny vessel is honestly not time efficient. I’d rather get out the US and get it done in one shot.
ACLS
This could be a sensitive one with many variables to the practice of each person. I respond to all codes at my institution then they page it overhead and I am on service. I was awfully tempted to respond to a code in the floor right above where my dad was admitted to and I was spending time with him. These numbers reflect the number of codes that I have personally run myself. I have to say that I enjoy running codes and taught ACLS for a company called MedTrain for the gap between finishing medical school and starting residency.
2017: 17
2018: 39
2019: 51
2020: 52
Patient encounters
Level 2 or 3
Critical Care: 99291 and 99292 Billing Codes
99291
2017:
2018:
2019:
2020:
99292: This billing code
2017:
2018:
2019:
2020:
Non-Critical Care Consults
These are patients for whom I am consulted for Critical Care evaluations who, being completely honest, didn’t actually need require critical care billing services. Fraud is bad. Never commit fraud to increase your personal revenue. Bill honestly or you will regret it when you get audited one day. Hope you all gained something from my procedure log.
2017:
2018:
2019:
2020:
Although great care has been taken to ensure that the information in this post is accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
