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Pain Staffing Survey for Academic Practices. Society of Academic Anesthesia Chairs Association of Academic Program Directors November 5, 2004. Loyola University Medical Center. All Anesthesiology Department chairs are faced with the operational conundrums of their pain clinics.

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pain staffing survey for academic practices

Pain Staffing Survey for Academic Practices

Society of Academic Anesthesia Chairs Association of Academic Program Directors

November 5, 2004

Loyola University Medical Center

slide2

All Anesthesiology Department chairs are faced with the operational conundrums of their pain clinics.

slide3

Part procedural, part clinic based, these programs can be problematic since faculty are hard to recruit and retain. In addition, ancillary staff can consume a huge amount of monetary resources and clinic space may be difficult to acquire.

Part procedural, part clinic based, these programs can be problematic since faculty are hard to recruit and retain. In addition, ancillary staff can consume a huge amount of monetary resources and clinic space may be difficult to acquire.

slide5

Each anesthesiology department pain group and staffing model may be unique. The adage “when you see one pain program, you’ve seen one pain program” may apply.

slide6

This survey attempts to gather information on patient volumes, procedural activity, staffing, funding and coverage sites to determine a common model, if any, for academic pain programs across the country.

slide7

A total of 48 programs or 36% of the membership responded to this survey with most areas of the country represented.

slide8

Patient Volumes

E&M VisitsProceduresAPS

3,959 2,388 3,650

504 – 8,590 800 – 24,469 830 – 14,000

Represented as median values with ranges

slide9

Patient Volumes

Interventional Conscious Average

Pain Procedures SedationLength Mins.

150 538 45

9 – 5,065 16 – 4,800 20 – 60

Represented as median values with ranges

slide10

Staffing for Pain Clinic

Total Staff Full Time

in ClinicsStaff

4.5 3.2

0 – 21

slide11

Staffing for Pain Clinic

PhysiciansFellowsResidentsRN’s

3.0 3.0 1.0 2

1 – 15 0 – 7 0 - 3 0 - 7

Represented as median values with ranges

slide12

Ancillary Staff

Patient Care Techs 3 programs

Physician Asst. 4 programs

Nurse Asst. 4 programs

Medical Asst. 3 programs

Radiology/Fluoroscopy 4 programs

slide13

Acute Pain Service Staffing

PhysiciansFellowsResidentsRN’s

1.1 1 0.5 1

0 – 7 0 – 5 0 - 3 0 - 4

Represented as median values with ranges

slide14

Other Personnel

Physician Asst. 1 program

Nurse Asst. 1 program

Medical Asst. 1 program

slide15

Funding for Pain Service

Hospital Support (%)

Physician 14

Clinic Staff 55

APS Staff 32

slide16

Funding for Pain Service

Dept. Support (%)

Physician 82

Clinic Staff 59

APS Staff 59

slide17

Salary Model for Pain Staff

Based on SAAC/AAPD Survey 38%

Salary with incentives based on

number of RVU’s over baseline 33%

Combination of both 8%

Total production benchmarked on

professional activities 8%

No response 13%

slide18

If hospital funded, what benchmark is used to staff RN’s in clinic:

  • Number of E&M visits
  • One RN / FTE physician adjusted by productivity
  • Staff to workload time/task analysis
  • Staff to number of procedures and visits
slide19

Pain physician provides coverage in operating room

Yes – 50%

No – 50%

All staff may provide operating room coverage or as little as one out of group may provide coverage

slide22

Does your academic pain group receive a high number of referrals for chronic pain patients on high dose opioid therapy?

Yes – 83%

No – 17%

slide23

Does your Pain Program have a multidisciplinary addiction center for detoxification of pain patients?

Yes – 8%

No – 92%

slide24

Multidisciplinary Pain Program Composition

  • Psychiatry
  • Family Medicine
  • Rehab Medicine (PMER)
  • Neurology
  • Neurosurgery
findings
Findings
  • Most pain clinics staff with full time physicians, fellows, residents, and RN’s
  • Funding for physicians comes primarily from departmental support while 50% of pain department clinical staff are supported by anesthesiology department, half are supported by the hospital
  • Salaries are based either on standard formats for academic faculty or salary plus incentives based on RVU’s
  • Pain physicians provide OR support in 50% of programs while 50% work exclusively in pain related clinical activity
  • 25% of program have affiliations with private pain groups
  • Only a few programs have multidisciplinary pain programs