Locum – Physician – Gastroenterologist Petoskey, MI
Palm Careers
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1/21/22, 10:56 AM Gastroenterology Physician Practice Description (Edit) Microsoft Forms
Respondent ? 13:30 ?
? 9 Anonymous Time to complete
1. Placement Type *
Locum
Locum to Perm
Perm
Other
2. Coverage Location (Facility Name, City, State): *
McLaren Northern Michigan Digestive Health, Petoskey, Michigan
3. Requestor Information (First, Last, Email, Phone): *
4. Practice Setting (Office/Clinic (Outpatient)/Hospital-Based Practice): *
Hospital/Endo coverage
5. Reason for Coverage:
Physician expecting
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1/21/22, 10:56 AM Gastroenterology Physician Practice Description (Edit) Microsoft Forms
6. Dates of Coverage: *
3/4-3/10/2022, variable
7. Schedule (Shifts and Hours): *
on-call
8. Call Schedule:
9. Call Ratio:
10. Clinical Areas:
Adult
Pediatric
Neonate
Office/Clinic
Hospital
Gastro
Other
11. Onsite Lab?
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1/21/22, 10:56 AM Gastroenterology Physician Practice Description (Edit) Microsoft Forms
Yes
No
12. Onsite X-Ray?
Yes
No
13. Will Outpatient Gastroenterology and Internal Medicine be Required?
Yes
No
14. Average Number of Office/Clinic Patients Per Locum Per Day:
15. Average Number of Hospital Based Patients Per Locum Per Day:
16. How Many Physicians in Your Group?
3
17. Average Number of Patients Per Day:
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1/21/22, 10:56 AM Gastroenterology Physician Practice Description (Edit) Microsoft Forms
18. Documentation System/EMR:
CERNER
19. Trauma Level/Designation:
20. Board Requirements (Board Certified/Board Eligible): *
Board Certified
21. Will you Accept Providers Needing to Obtain State License?
22. Certification Requirement (BLS, ACLS, etc.): *
ACLS
23. Required Procedures:
Esophageal Dilatation/Manometry
Esophageal Manometry Interpretation
Small Bowel Biopsy
Lower GI Endoscopy
Sigmoidoscopy
Colonoscopy
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1/21/22, 10:56 AM Gastroenterology Physician Practice Description (Edit) Microsoft Forms
Endoscopic Ultrasound (EUS)
Liver Biopsy
Insertion/Management of Sengstaken/Blakemore Tube
Other
24. Required Types of Upper GI Endoscopy:
with Biopsy
with Foreign Body Removal
with Fulguration of Bleeder (Cautery vs. Laser)
with Injection of Varices
with Banding of Varices
with ERCP (Endoscopic Retrograde Cholangiopancreatography)
Diagnostic
Therapeutic
with PEG (Percutaneous Endoscopic Gastrostomy)
Other
25. Please List Any Additional Required Procedures:
26. Estimated Credentialing Timeframe:
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1/21/22, 10:56 AM Gastroenterology Physician Practice Description (Edit) Microsoft Forms
27. Please List Credential Staff Contact Including Email and Phone Number:
28. Will Your Facility Reimburse for the Following Costs? *
Flight
Hotel
Rental Car
Mileage Billed at the IRS Standard Rate
Provider Must be Local – Only Mileage is Reimbursed
29. Additional Notes:
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