There aren’t many endocrinologists in our area. Well, there aren’t many endocrinologists, period.
There are only about 5,000 board-certified endocrinologists in the U.S., and so even if they all saw patients (as opposed to being in academia, research, or administration) that would only mean an average of 100 per state. Which is probably why, in my experience, in any given hospital, there is only one group of endos who goes there.
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My former practice of three pretty much had a monopoly on inpatient consults at the hospital we worked at. OK, technically there was another endo who had privileges, but she was limited to only seeing her own patients should they be admitted, i.e. she could not see new patients. Don’t ask me how that happened. That was in place before I got there.
The hospital I now have privileges at had one pair of endocrinologists for the longest time. I was told that there was a need for another because the two who were there were so busy. However, I had been “warned” that there was no way I would be able to get in, that they would see to it that I would not get privileges. But as fate would have it, here I am, the first crasher of this private party. And I was told that I was eagerly awaited.
I got a call to see a patient the week before I was officially approved. I apologized and explained that I did not have privileges yet. And I thought to myself, “Yes, consult requests will be flying in.” How could it be easier?
But then the first two weeks went by, no consult. And that was after I gave grand rounds, sent out letters, and hung out in the physicians’ lounge. Then I got one, from a doc who just happened to be a former resident. Another week, one more — from the same doc. I realized that no matter how eager they sounded about my arrival, there’s something to be said for being the guys that everyone know, something to be said for the comfort of using what (or who) you already know.
I did get four consults this week. Maybe, this will be the beginning. In the meantime, I’ll visit the lounge, I’ll attend grand rounds, I’ll smile, and I’ll schmooze (ugh, I hate doing that), and I’ll try to get my name out there.
Melissa G. Young, MD, FACE, FACP, is an endocrinologist in private practice, an assistant clinical professor at Robert Wood Johnson, and a working suburban mother of two in Freehold, N.J.
Monday, November 9, 2009
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Isn't it a shame that political allegiances get in the way of good patient care? You won't get many referrals because the docs are afraid they will be the next to be "driven" out of business by "invading forces."
ReplyDeleteDon't forget to treat the nurses well- they are the unheralded source of many referrals.
I am going to disagree. I have been in practice for 17 years. I have been in your similar situation - i.e. the new kid on the block about 3 times.
ReplyDeleteThere is no monolopy in patient care.
Hang in there!
Thanks. I don't think it is an intentional attempt to maintain a monopoly (at least not by the referring physicians). But they know who they know and are confortable with that. I'm sure I will gradually make headway. I just foolishly thought it would happen sooner.
ReplyDeleteOn the subject, just being available and responsive to calls helps. Does anyone hang out in Doctor's lounges anymore? They are always empty @ my local hospitals. What about trying to meet with some IM groups & shake hands -especially the newer members who probably just ask their colleagues, which Endo do you/we use? Off the topic & not a criticism but I attended a lecture last night where the topic of how Yiddish words like "schmooze" have had their true meanings altered by english speakers. "Schmooze" in Yiddish means friendly/amiable socialization whereas in english it has taken on the meaning of socialization for a purpose/benefit. Good luck!/A Gutten Mazel
ReplyDeleteThere's usually one or two docs in our lounge. I've met a couple of people there. I also made sure that I was at the medical staff meeting where the newly credentialed physicians were introduced. Funny, out of the 30 or so new docs, only about 5 of us were there.
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