by Jennifer L. Cook, M.D. Florida Joint Care Institute

What time do you get up?

Monday 6:30 AM

What is the first thing you do in the morning?

Monday SNOOZE!

Monday Head to the hospital for rounds at 7:30 AM See and examine all patients Review labs Review X-rays See any new consults

Monday PA, physician assistant accompanies me on these rounds Writes a clinical note in computer which I cosign

Monday 7:50 AM clinic starts Last patient at 3:50 PM Typically see 45 patients a day 6 patients an hour

Monday Fractures Sports medicine Arthroscopy knee Arthroscopy shoulder Joint reconstruction Knees Hips Shoulders

Monday New patient Takes longer Needs x-rays Complete history and physical exam EMR documentation Medical assistant and x-ray technician help

Monday Follow up Post surgical Cast check After injections/therapy

Monday Meetings Home by 5 PM

Tuesday Up at 6:15 A.M. At hospital by 7 A.M.

Tuesday Surgery!!!!!!

Tuesday 2 Operating rooms Flip back and forth In-patient surgeries TKR THR TSR Most fractures Ill patients

Tuesday 3-8 surgeries per day Can be done by noon or rarely 7 P.M., usually around 4 P.M. Lunch between cases Post-op orders Talk to families Mark site

Tuesday Many preparations to have a successful surgical day Patient is safe for surgery – no infection, medically cleared, NPO X-rays reviewed – discussion with vendor about instruments Discussion w/ anesthesia re special circumstances, length of case

Tuesday Post-op Rounds Review X-rays Examine patient and talk to families Communicate with nurses

Wednesday 6:30 AM

Wednesday Surgery!!!!!!!

Wednesday Outpatient surgery – Surgery Center Day surgeries Knee arthroscopy – ACL, meniscus Shoulder arthroscopy – Rotator cuff, impingement, labral tear Fractures – wrist Shorter, less involved surgery, medically safe patients

Wednesday Still need to prepare for surgery Discussion with surgery center, reps Review labs/films Patients may need medical clearance

Wednesday 3-8 surgeries Mark site Time out Dictate operative note, write post-op orders Talk to family Examine patient prior to discharge Discharge with instruction sheet

Wednesday Post op Protocols PT guidelines Bio

Wednesday Head back to hospital to round on patients, see new consults Go to office to do paperwork, billing, go through inbox

Thursday 6:30 A.M.

Thursday Hospital rounds at 7:30 A.M. Clinic starts at 7:50 A.M. Same clinical schedule

Friday Catch up Day!

Friday Hospital rounds at 7:30 (or later) Surgery Clinic Paper work/return phone calls Meetings PT Home Health Care Office Admin Partners Hospital

Weekend Practice call Emergent surgeries referred to practice Evaluate ER/floor patients referred to practice Rounds

Weekend ER Call 5 days a month All traumas/infections/orthopaedic issues that come into hospital Must be in town and available via cell phone at all times Rare to have to go in (3-5x/year)

Summary Busy schedule Work as much as you want 2 weeks of vacation year Conferences WOGO charity work Outreach work Plenty of time for family, friends, hobbies