Navigating the Clinical Component
You will practice elective and trauma hand surgery with a small general orthopedic component during call. The subspecialty mix starts at 50 to 60% hand, 40 to 50% general and moves to approximately 75% hand once your panel is established. There is no existing hand surgery panel to inherit, so volume will build from internal referrals, ED cases, and the group's relationship with Covenant Occupational Health. Once established, you will focus on 75% hand with general orthopedic cases handled primarily during call coverage.
Referral Sources
Hand traumas are currently transferred out of the system and will redirect to you. Microvascular cases performed today by plastic surgery are also available to the incoming hand surgeon. Referral inflow comes from:
- Primary care physicians within the Covenant network
- Covenant Orthopedics surgeons referring hand-specific cases internally
- Emergency Department, a Level II Adult and Pediatric Trauma Center
- Urgent care and Ortho Urgent Care
- Covenant Occupational Health, which directs most of its orthopedic referrals into the group
Common Procedures
High-Volume Procedures
- Carpal Tunnel Release
- Trigger Finger Release
- De Quervain's Release
- Ganglion Cyst Excision
- Dupuytren's Contracture Release
- Thumb CMC Arthroplasty
Fractures
- Distal Radius ORIF
- Metacarpal fractures
- Phalangeal fractures
- Scaphoid fractures
Tendon Procedures
- Flexor tendon repair
- Extensor tendon repair
- Tendon transfers
Nerve Procedures
- Cubital Tunnel Release
- Nerve repair
- Nerve grafting
Advanced and Specialized
- Wrist arthroscopy
- Microsurgery
- Replantation
- Complex trauma reconstruction
Volume Expectations
| Metric |
Range |
| Patients per Clinic Day |
25 to 30 |
| Clinic Days per Week |
2 to 3 |
| Cases per OR Day |
5+, higher on carpal tunnel and trigger finger days |
| OR Days per Week |
2 to 3 |
| Group Productivity Range (Annual wRVU) |
8,000 to 17,500 across providers |
New patients are directed to the physician while APPs manage follow-up visits, supporting efficient throughput.
Call Structure
| Call Type |
Detail |
| General Call Ratio |
1:11 |
| Annual Call Load |
~26 weekdays and ~22 weekend days |
| Monthly Call Average |
~4 call days |
| Hand-Specific Call |
~4 calendar days per month |
Clinical Support
Each physician is supported by:
- 2 dedicated medical assistants
- Clinic RN coverage
- 1 APP once fully ramped, with 2 APPs available for high-volume producers
- A dedicated scribe, with Dragon dictation as an alternative
- On-campus physical therapy in partnership with Mary Free Bed
Technology and Facilities
- EMR: Epic, with full mobile access including PACS
- Desktop computer in each exam room
- Hospital ORs: 9 total, all updated in 2022
- Surgery Center: 3 additional ORs
- Mako robot and two Da Vinci XI robots available system-wide
- New 25,700 sq ft orthopedic building opening 2027 with 44 exam rooms, 4 procedural rooms, 4 X-ray rooms, 2 casting rooms, and integrated Ortho Urgent Care