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AMSPDC Virtual Membership Gathering - Shared screen with speaker view
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Welcome to the AMSPDC Virtual Membership Gathering sponsored by the Clinical Care Committee!
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Mary Ottolini
Can we get a copy of these slides?
Jeanne James, MD
Agree - trying to take notes and am failing to capture it all.
Mary Ottolini
I am doing well- would love to catch up!
Joseph P Neglia
What do you mean by "normalized"?
Ann Reed
@Joe when someone is .5 clinical they will normalize to a 1.0 to be able to compare all individuals reported
Joseph P Neglia
thanks; wondered if it was more complex
Ann Reed
I believe it is why the hours reported when normalized is not reasonable and what Liz and Melody are talking about
Keith Mather, MD (he/him/his)
again.....did the data include call hour equivalents if done from home?
Ann Reed
@Keith no it does not include call in what is being shown but there is additional data to share call hours both in hospital and at home
Keith Mather, MD (he/him/his)
Liz McCarty
Our survey did not include call hours or PRN
Liz McCarty
AAAP survey asked the question on how call hours were counted - as part of defined cFTE, or not? Data collected will be presented in a narrative format in the white paper.
Rashmin Savani
What are the various approaches to cover overhead costs for a department? Is that why there is a push to have higher effort to compensation percentiles?
David Gozal
Any recommendations regarding measures of call intensity in the calculation of cFTE; also, what percentiles of ranges of inpatient service weeks do you use for each relevant sub-specialty and do you include intensity or size of such inpatient services
Doug Carlson
Calculating call is clearly the hardest to measure and standardize. Not only type of specialty but size of program. Small programs have huge call responsibilities.
Chuck Mullett
Not a recommendation, but I use the following for home call from an AMSPDC presentation a few years ago:Easy 0.1 hour call credit per clock hourLight 0.2Moderate 0.3Heavy 0.5
Joseph P Neglia
Is there a discrepancy between Lucky's approach and AAAP. I thought Lucky was looking at 1800 hours = 0.8 clinical appointment. I think AAAP says 1800 is a full FTE. Is that correct?
Sherin U. Devaskar, UCLA (she, her, hers)
Difference between weekday vs weekend calls?
Joseph P Neglia
Are we giving credit for clinic follow up? For example, we give 5 hours of clinical credit for a 4 hour clinic.
Evelyn Montalvo Stanton
How do you calculate for teaching?
Manu Sood
1 cFTE in purely ambulatory setting is 5 half day clinics per week as per the survey data. I assume rest of the time is accounted for by on call cover, admin work, non face to face patient care responsibilities, professional development and teaching...… ?
Susan Kline (she/her/hers)
@Joseph Neglia - there is not a discrepancy but rather an opportunity to try to standardize around. I am not aware of AAAP saying a full FTE is 1800 so would be good to know where that was mentioned.
Bob Vinci
The data on the cFTE is helpful, but I wonder if we need to combine cFTE with whether this cFTE/clinical effort comes with any expectation for productivity or clinical revenue, etc. For instance we modify clinical time expectation at the Divsion level so that each Division can be “productive" as measured by wRVU in comparison to their specialty specific benchmarks. Not sure how others who are here decide clinical workload.
Chuck Mullett
45 weeks/year x 40 hours per week is 1800. But does a doctor work 50 hours/week instead? I'm finding that if the doctors' feet are stapled into a clinic they feel very strong about 40 hours is a workweek. But if location is flexible (finishing notes at home) they don't push back on 50 hours/week.
Ann Reed
When we did the original work to start this process we said on average people work 46 weeks a year @50 hours per week which is 2300 total hours a year. Clinical FTE is only a piece of the 2300
Joseph P Neglia
agree with Ann; we use 50 hours per week and 44 weeks/year. We test it against expected RVUs based on our cFTE and it usually comes out near the AAAP "expected"
Susan Kline (she/her/hers)
While the small AAAP/AMSPDC did provide a recommendation based on some of the feedback we got from our first national joint meeting, that is fine but was not necessarily validated by what we collected nationally in the AAAP meeting.
Susan Kline (she/her/hers)
As for direct and indirect patient care definitions, there is no standard across any specialty across the US as there has not been a lot of work done at a national level via the national surveys on this to really get to some more details.
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Susan Kline (she/her/hers)
@BobVinci - regarding your productivity question, I would be just as interested what the chairs vs the institution determine as productive. wRVUs and receipt generation are not the only metrics to use (especially since they are not the best).