Published in the April 2008 issue of Today’s Hospitalist
AS THE HOSPITALIST PROGRAM at St. Joseph’s Hospital in St. Paul, Minn., considers expanding its role in perioperative care, it has the benefit of having a man on the inside. One day every week, hospitalist David A. Frenz, MD, who is 38 years old, scrubs in and acts as second surgeon on complicated spine surgery cases.
A hospitalist who functions as a surgeon is unusual, but the job makes perfect sense for Dr. Frenz. At one time, he says, he considered becoming a general surgeon, and he spent a lot of time in the operating room during medical school and his family medicine residency.
Today’s Hospitalist talked to Dr. Frenz about his unique role at St. Joseph’s.
How has working as a surgeon changed your perspective?
Surgeons have slightly different priorities than non-surgeons when it comes to patient care. A good example is DVT prophylaxis. Spine surgeons may agree that a clot in the lung is bad. However, a clot around a nerve root post-operatively because of anticoagulation is devastating because it can cause a compressive neuropathy leading to foot drop and possibly re-operation.
How does the group financially justify your work as a surgeon?
My fees offset some of the lower paying floor care. As a second surgeon, I bill a percentage of the primary surgeon’s fee. That’s in addition to what he is billing, so my fee is not carved out of his fee.
What would you say to people who think you’re nothing more than a surgical assistant?
These are technically demanding procedures, so I like the work. It allows me to circle back to things I wanted to do in my career without having to go through the pain and suffering of a surgical residency.
What do you enjoy about surgery?
I joke that surgery is my oasis. A lot of hospital-based medicine is chaotic. Pagers are going off and you’re often reacting to events, so you don’t feel totally in control. In the operating room, there’s a certain amount of serenity that comes from taking off your pager, turning on the radio and working in an extremely structured environment.
Do you plan to work as a surgeon full time?
I don’t think so. I’m pretty young, and that might not be the best career move. Our hospitalist group is hoping to create a new division that would focus exclusively on perioperative care, so I plan to get involved with that.