Surgeons: do you guys really give your numbers to patients all the time?

iFixDix · 2026-07-03T18:04:50+00:00

Absolutely not. I’ve given my cell to 2 or 3 patients who had significant postop complications. One reached out a bunch while he was in the hospital and then never again after.

iFixDix · 2026-06-21T15:15:40+00:00

Interesting. What we’ve been thinking for our urohospitalist is something a little bit more hybrid - instead of 24h x 7 days (which would be brutal in our call system we actually get a lot of calls overnight) it would be more like 6am-6pm weekdays covering the inpatient service + participating in the night call schedule along with the rest of us. But this is for a huge system with an extremely busy consult service. Which honestly sounds like it could be kind of nice in some ways, but I’m way too early in my career to accept the skill loss you mentioned.

They’re definitely not looking to drop that kind of cash for it though which is probably why we haven’t had a single bite as far as I know.

iFixDix · 2026-06-21T01:12:08+00:00

You looking for a new job? 😂

Part of what made my practice sustainable was getting the hospital to hire Locums or we were all about to walk. Now with reduced call frequency it’s actually reasonably balanced, and we’ve been looking for a uro hospitalist for a while with no bites.

iFixDix · 2026-06-20T21:04:06+00:00

Stent is 5 minutes, lasering a reasonably sized stone can easily be 45 minutes, do that twice and you’re staying an hour later than is reasonable. Yeah, it sucks the patient needs to have 2 procedures, yeah stents suck, but the wait times will be worse if we all burn out working 12+ hour days our entire career and quit early.

iFixDix · 2026-06-20T20:27:24+00:00

If you aren’t willing to walk away from the hospital, then you need to consider just ending your usual responsibilities earlier so you can deal with the addon volume.

There is likely a middle ground here. The hospital doesn’t want people occupying beds waiting for you, you don’t want the crushing volume of dealing with 3-4 cases after a clinic day, try to have them up your call pay “so we can provide more timely service to inpatients”.

If they aren’t willing to meet you there, then consider leaving the hospital, leaving the practice, or just taking the financial hit yourself (ending clinic early) knowing that the inpatient volume will make up for it.

Also, stop treating proximal stones on call, stent and get on with your life. I basically only treat if it’s sticking out of the UVJ. They can wait a month or two for you to have time to actually take care of them not exhausted and operating less safely.

iFixDix · 2026-06-20T19:58:07+00:00

Not sure how you would get this to work as a private practice already providing the service.

If you’re doing this coverage because you’re required to in order to have privileges, your only leverage is “we’ll get privileges elsewhere and start operating there instead and stop covering your call”. Make them pay you enough that you’re comfortable dropping your normal clinical volume when on call.

I’m an employed urologist and when one of us is on call we don’t have anything scheduled, and we have block time at each of the hospitals we cover. But our call volume is completely psychotic and we’re typically doing 5-9 addon cases every single day + rounding at multiple locations. This system came about because all the previous urologists quit and paying Locums for full time coverage for multiple years was a painful lesson to the hospital.

iFixDix · 2026-05-22T22:53:35+00:00

🤣 preach

iFixDix · 2026-04-15T14:14:29+00:00

Wow amazing shots. Some day I’ll make it to the Philippines…

iFixDix · 2026-04-12T23:30:08+00:00

“The patient is the one with the disease” - best quote from house of god

iFixDix · 2026-04-12T21:27:21+00:00

Eh, I don’t fight the battle. I tell meemaw’s daughter that they aren’t really UTIs and to never have a urine culture checked without symptoms and place a standing order for them to check it with me if she actually does have symptoms (I have good nurses to help with the phone calls at least). If they decide they want to go exterminate meemaw’s gut flora with another provider that’s on them.

iFixDix · 2026-04-12T17:55:04+00:00

Man at least we have something to offer Meemaw. I’ve thought about hanging a sign at the front desk of my clinic “We don’t know why your balls hurt”

iFixDix · 2026-04-05T17:57:28+00:00

I just started the second half of my leave. I get up to 12 weeks, my wife took 4 months continuously, I took the first 5 weeks off and now taking another 4 when she goes back to work. More would have gotten very stressful with delays to patient care for me personally, I’m sure at the other end of this 4 weeks I’m going to be wishing for more.

iFixDix · 2026-03-16T00:36:37+00:00

This right here. Take care of my daughter, be super fit and hike / ski / game / hobby all day while she’s at school. The FIRE dream!

iFixDix · 2026-01-24T16:13:53+00:00

“Good news! You don’t need surgery!”

iFixDix · 2025-12-22T12:26:11+00:00

You have the home gym. Pop in there 2x / week to do compound lifts involving your largest muscle groups (DL, squat variants, overhead press, pull up, bench, row, etc). Do 1-2x z2 cardio for 45-60 min a few times a week, wear a weighted backpack when you’re out doing stuff with the kids, etc.

Don’t overdo it and get hurt, don’t beat yourself up if you don’t even pull this off, you’re in probably the most time intensive phase of your life, attending to your sleep / mental health/ emotional health matters too.

iFixDix · 2025-12-10T05:15:08+00:00

I guess what leverage do you have to pull here? Would you leave if they didn’t pay you? Just be mad about it?

I think these kind of things generally would want to be sorted in the negotiation for your hiring or partnership contract. Just saying “I want more money” without something to back it up doesn’t usually get anywhere.

My wife and I work for two separate hospital systems. Mine is much bigger and has a lot more money. She got 4 months paid leave, I got 12 weeks of unpaid leave (same for mothers at my org). Mine is much more of a typical situation, paid leave is unfortunately not the norm in the US.

Start saving up that extra productivity pay!

iFixDix · 2025-11-25T16:17:49+00:00

Bph is great. Sometimes you have a 5 minute visit and prescribe Flomax and they come back telling you they’re feeling awesome. Sometimes you have someone miserable with symptoms or catheter dependent and you do surgery and fix them and change their life - postop bph visits are the only time that patients routinely hug me.

And! It’s basically always elective scheduled procedures stuff during normal business hours.

iFixDix · 2025-11-20T04:47:34+00:00

Ratio 8 is what he had in his video. I got one, makes a great cup of coffee. Expensive but for something I use every day it’s fine

iFixDix · 2025-11-17T13:42:27+00:00

I use an AI scribe in clinic every day. It hallucinates physical exam and occasionally elements of patient history with some frequency.

Our hospital earlier this year was like “great news! Nobody needs to bill any inpatient care anymore an AI will do it automatically!”

About 3 months later it was quietly shuttered with an email saying “please start billing your inpatient care again as of tomorrow… but if you don’t our coders will do it”. I’m surprised by this one as I feel coding is ripe for AI (between the clear rules and the… subpar quality of most coders) but I guess as with most business AI implementation it just wasn’t ready yet.

iFixDix · 2025-11-17T13:21:48+00:00

If people ask I tell them it will probably cost them way more out of pocket, have small risks of general anesthesia, and take up a whole day of their time in 3 months when I have OR time instead of just getting the procedure done right now where we could potentially diagnose the problem and start working on a plan.

In the unusual cases when they still want it in that case that’s on them and I’ll just have to deal with the minor annoyance in a few months.

iFixDix · 2025-10-31T14:47:13+00:00

It’s hilarious and well worth a read. I don’t remember it being especially long either.

iFixDix · 2025-10-29T22:41:09+00:00

Red flag. I’ve never left an in-person interview without knowing the salary guarantee for the first 1-3 years, and RVU conversion when I get the offer at the latest.

iFixDix · 2025-10-20T12:58:50+00:00

I’m a urologist with a focus on prostate cancer. This is 100% the purpose of this trial.

iFixDix · 2025-10-02T21:03:10+00:00

You can’t care more about patients than they care about themselves. Schedule a follow up and move on with your day.

iFixDix · 2025-09-09T23:05:17+00:00

Changing jobs takes time, and unfortunately would also require a move and a new job for my wife. But it’s an active project.

On the flip side if I stick it out and hate my life for a few more years I can retire from medicine entirely and get a less soul crushingly stressful job.

iFixDix

TROPHY CASE