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
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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
www.drjennifercook.com
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
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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