Adrian,
Its not crazy in that all the patients are seen by a junior and
senior Dr - a decision a long time ago that high level of senior supervision
was safer and cost-effective.
SHO's work about 37 hours week, and 1/4 of them are PRHO's - who need almost
100% supervision.
Pretty much 24/7 (accept for 2 nights only 1 registrar) there is 2
registrars and 4 SHO's - but during late am and afternoon and into the early
hours there is 8-12 SHO's on the floor. 2 Consultants on the floor 8-6 and
one until 10pm and then on-call overnight.
Specialists = Consultants. FTE works 40 hours a week - 25 clinical and 15
non-clinical
Im sure the SHO's dont get dropped in the deep end the same way they do in
the UK, but they are well supervised and well supported and well taught, and
this enables us to assess and manage patients in-house until they are ready
for admission or discharge - rather than forced early referral because you
dont have the time to do everything well.
If you took away the senior review of all patients and the main job of your
seniors was seeing new patients, then you could slash the numbers of SHO's.
Craig
>From: Adrian Fogarty <[log in to unmask]>
>Reply-To: Accident and Emergency Academic List <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: We need 8
>Date: Thu, 14 Aug 2003 07:28:40 +0100
>
> > Gosh the UK still depresses me.
> > 55,000 new patients. 32 SHO's, 12 Specialists, 9 Registrars. Your only
>solution is to migrate.
> >Craig
>
>Remarkable, but isn't 32 SHOs a bit over the top? You'd have a full time
>job just keeping track of them all. Well, of your 12 specialists I suspect
>2 or 3 of them will be doing precisely that! Seems to me Craig, that 21
>"seniors" and 32 "juniors" is a crazy way to run a department (although a
>lot better than Danny's, I hasten to add). There would be so much admin
>involved just organising everyone, that you'd use another few of those
>specialists just doing that alone!
>
>I can understand the need to have 8 to 10 middle grades to produce
>comprehensive 24-hour shop floor cover, but surely double that number of
>SHOs would more than suffice, unless all of them are only working around 30
>hours per week. And why do you need 12 specialists (I presume these are
>consultants or their equivalent) unless they're also rostered for shop
>floor sessions round the clock?
>
>Good luck to you anyway!
>
>Adrian Fogarty
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