dialogue
16
MAY / JUN 2017
I
Healthcare Journal of Baton Rouge
hire more help in order to make sure this
was done beforehand, otherwise, you can’t
do the surgery. You go through a long list
of things you just have to do. We also have
to document things very well; much more
than we used to have to. Now there are CMS
requirements. I do a very involved history
or physical before you go to surgery; there
is a long checklist. That just takes a lot more
administrative time, both for private prac-
tice and the hospital, just to get a procedure
done in the operating room.
Editor
Has the scope of practice changed at
all for physicians, because of financing or
other reasons like non-surgeons becom-
ing more involved?
Olinde
Yes, I think so since I have been in
practice. Nowadays all of themajor hospitals
have hospitalists that basically spend 24/7
at the hospital. It’s unusual now for a pri-
vate internist or family doctor to go to the
hospital and see their patients. They basi-
cally hand them over to hospitalists that
take care of these patients. Which I think is
a better thing—they do this all day long, they
are more familiar with it, they’re there all
the time. If there is an emergency or medi-
cal problem, they take care of it quickly. We
also have physician extenders. That’s a lot
more common. I can tell you for the sur-
geon on call, it’s not infrequent I get called
by the physician assistant, by the nurse prac-
titioner, or by the resident. I don’t get called
by attending physicians. So they can see a
lot more patients, more quickly, and cover
more ground with these physician extend-
ers and residents. That has changed a lot the
last few years.
Editor
I am sure managing innovation is
part of what you do as Chief Medical Offi-
cer. Can you talk a little bit about how tech-
nology has improved and innovations have
come about? How do you filter through
that and make those decisions?
Olinde
Sure, there are some innovative new
things in surgery. One of the major ones I
can think of is robotics. Robotic surgeries
have gotten very large. It used to be that the
robot was used almost exclusively for Urol-
ogy and nowGeneral Surgery uses it, Gyne-
cology uses it, Plastic Surgery. In fact, for
me it’s sometimes a headache in that I’ve
got to find room for surgeons to use that
robot. Even some surgeons at other hospi-
tals will want to have operating room time
here at our hospital, just so they can use the
robot. That’s a big, very expensive piece of