Show Notes

No day is ever the same for a nephrologist. Dallas Nephrology Associates’ Dr. Paul Skluzacek may see his kidney patients in the office, have hospital rounds, dialysis rounds and much more. In this episode of Let’s Talk About Kidneys, learn about Dr. Skluzacek’s busy days providing patient care and how his schedule changes from one day to another. 

What is a Nephrologist? 

Nephrologists are kidney doctors. They have special training that includes completion of medical school followed by a residency in Internal Medicine and then additional specialty training in Nephrology.

They treat systemic conditions affecting kidneys, such as diabetes, an autoimmune disease, as well as hypertension (high blood pressure) and electrolyte disturbances.

Reasons to see a nephrologist may include:

  • Protein or blood in the urine
  • Uncontrolled high blood pressure
  • Kidney stones
  • Chronic kidney disease (CKD)
  • Kidney failure
  • Vascular access management
  • Transplant care

What does a day in the life of a Nephrologist look like? 

For a nephrologist, each day is different. Hours may be spent seeing kidney patients in an office-based setting at the clinic, running tests as well as interpreting them. They also prescribe medicine and treatments, conduct hospital rounds and visit their patients at dialysis centers.

Nephrologists also spend time making notes on their patients’ physical conditions and advise them how to stay healthy. 

“The clinic patients are the outpatients that we see in the office,” says Dr. Skluzacek. “The focus there is to preserve their kidney function, protect their kidneys and keep them out of the hospital.” 

Patients who are admitted to the hospital are there because their kidney illness is more serious.

“They can be as sick as being on the ventilator in the ICU to patients that are there just for severe hypertension or high blood pressure control,” Dr. Skluzacek says.  

With a schedule that includes practicing at four locations across the Dallas-Fort Worth Metroplex, Dr. Skluzacek says he spends a lot of time on the road. He also sees his dialysis patients once a week.

“The vast majority of things we can handle over the phone now because we have access to the electronic health records through the Internet,” he says, “but probably about half of the time, I have to go in and see a patient.” 

The Business of Taking Care of People 

Dr. Skluzacek believes that compassion is an important part of being a physician, especially if you are a nephrologist. 

“Patients with kidney disease have complex illnesses, and it’s hard to navigate the healthcare system,” says Dr. Skluzacek,” so we as providers need to be compassionate, not only with the patients, but with their families and their other situations.”


Tiffany Archibald  00:02

Let’s Talk About Kidneys takes a deep dive into the chronic kidney disease patient journey. We’re here to inspire meaningful conversations and to help people living with CKD gain a full understanding of their disease. Join us today to find out what an average day and week looks like for nephrologist Dr. Paul Skluzacek. His busy day includes seeing patients in the office, hospital rounds, dialysis rounds, and much more. Plus, discover what he does for fun and why he loves his job and making a difference in the lives of patients with kidney disease. Hello, Dr. Skluzacek. We are so excited to have you today as our guest on our podcast. Are you excited?

Dr. Skluzacek  00:43

I am excited. Thanks for having me.

Tiffany Archibald  00:45

Good. Good. Yeah. So today’s topic is probably, the audience is going to love it whether you are a patient, staff, listener, because it gives an insight into the day in the life of a nephrologist. So I know that sometimes, you know, seeing a physician can be overwhelming. But I hope that today’s topic brings a little bit of humanity to what you guys do on a daily basis.

Dr. Skluzacek  01:14

Yeah, I think people may be surprised at all the different things we do in a day. So I look forward to talking about

Tiffany Archibald  01:20

All right, good. Let’s jump right into it. So when you get up in the morning, what time do you wake up? And what does your routine look like?

Dr. Skluzacek  01:30

Well, what time is O dark 30. Because that’s when we get up. For me most of the time, it’s just before 5am is when I wake up, and I do my exercising from five to six. So I try to be exercising at five in the morning. So I get up, exercise, then get ready. Usually I’m at work by seven.

Tiffany Archibald  01:53

Okay, so you mentioned exercise. Most people that know you know that you’re an avid runner, and you have all types of fitness interests. So now that we talked about your fitness, what are the things you like to do?

Dr. Skluzacek  02:09

Well, actually, I used to run a lot more when I was younger. But now I’ve turned more to biking. So I spend more of my time biking now than running. So three days a week, I do some sort of cycling training. So I’ll be on the trainer two days a week, and then on the weekend, I’ll go for an outdoor ride. I really like to do mountain biking more than anything else. And then on the other days, so three other days in between is when I do some sort of resistance training. So it’ll be like a p90x workout or a hiit workout or something to maintain muscle mass. As we get older, we lose our muscle mass if we don’t use it. So it’s important that we do some sort of resistance training. So that’s how I’ve incorporated that. Right? So 5 to 6 every morning, some sort of workout before I get to work,

Tiffany Archibald  02:57

So if you’re listening, you hear how active your physician is? That means you got to step it up people. All right.

Dr. Skluzacek  03:05

You have to make it fit into your schedule. For me, the best time is in the morning because if I don’t get it done first thing, then there’s too many other competing things the rest of the day and it’ll get put off.

Tiffany Archibald  03:16

Okay, good. So now that you’re done working out, can you walk us through your schedule on the days that you have clinic and just give us an idea of how your days flow each day?

Dr. Skluzacek  03:26

Sure. Actually, my role in our practice has changed recently. So I’m doing more administrative work, but I’ll give you an idea of what it was like when I was doing more clinical. And actually, each day is different. So I’m going to take it day by day. So Monday, I get up, do the workout, I usually eat breakfast on the way to the hospital. And every day I have hospital patients, so it’ll be five to 10 hospital patients that I’ll see. So Monday, I’ll see those hospital patients. And then on Monday afternoon, usually I have administrative meetings at our corporate office. So I drive downtown after I finish the hospital patients. Tuesday’s a different day. Tuesday I have clinic in the afternoon so I still have those hospital patients to see. So I’ll go to the hospital at seven to see those patients and then that morning, I’ll take new admissions from the emergency room.

Tiffany Archibald  04:19

Can’t stop you really quick. Can you tell us the difference between you said you see hospital patients and clinics for those that are listening that may not know the difference? What do you do when you see hospital patients versus the clinic patients?

Dr. Skluzacek  04:33

Sure. So hospital patients are ones that are admitted to the hospital for some serious illness. And they can be as sick as being on the ventilator in the ICU to patients that are there just for severe hypertension or high blood pressure control. So those are the ones that spend the night in the hospital are the ones that we see first thing in the morning. Usually they’re more critical and then the clinic are the outpatients that we see in the office. The focus there is to preserve their kidney function, protect their kidneys, keep them out of the hospital. So we see the hospital patients then take new ones that have come in through the emergency room and then in the afternoon I’ll drive to, now on Tuesday, I see the Midlothian office. So I’ll go to drive to Midlothian and see patients there. Wednesday is a little bit different Wednesday is more focused for me on dialysis. So I have four shifts of dialysis patients at four different dialysis clinics, and dialysis.

Tiffany Archibald  05:34

Wait a minute, four different clinics, four different shifts, like you’re just burning up the DFW highway obviously.

Dr. Skluzacek  05:41

We try to as a practice, we try to group them together so that we don’t have to drive as far but there’s a fair amount of driving from place to place. So as you know, when your kidneys stop working, you need your blood cleaned somehow. And that’s what dialysis is for. It cleans your blood when your kidneys stop working. And so there are dialysis clinics throughout the city where patients go to get their blood cleaned. And we see them once a week on dialysis. So I have four different shifts in four different clinics, some in Lancaster. So I’m in Waxahachie. So on Wednesday is really my dialysis day. So I’ll spend almost the entire time seeing those patients. And in between going to those dialysis clinics, I also have to stop by the hospital to see those patients that are still in the hospital.

Tiffany Archibald  06:26

Okay, so when when are you eating, when you’re taking a breath? That is a lot. Especially four different clinics.

Dr. Skluzacek  06:36

So what I normally do, and I don’t know what everybody else does, but I usually make my lunch and pack it in a cooler. And so I end up eating my lunch on the road while I’m driving from place to place. Other people may just skip lunch. In fact, that’s what I used to do when I was younger, but realized that by the end of the day, I’m too tired. Now I packed my lunch use on the way in between different places.

Tiffany Archibald  07:01

Okay, so that’s Monday, Tuesday, Wednesday, what are you doing on Thursdays and Fridays.

Dr. Skluzacek  07:06

So Thursdays and Fridays are more typical hospital and office days. So I’ll go in and see my hospital patients on Thursday, but I have clinic on Thursday morning. So I’ll see as many as I can before the clinic starts, then I’ll see the clinic. And then the afternoon, I’ll go back to the hospital to see the rest of the patients. And then we’ll take some new patients from the ER Thursday afternoon. And then Friday is very similar. My clinics in the afternoon, I see the hospital patients in the morning. But a couple of things that I didn’t tell you about the schedule is that I also have things to do for the hospital. So I’m on committees in the hospital and we have various meetings, usually either at seven in the morning or at noon or at five at night. So on some days, you have to go to those meetings. Once a week each night you’re on call overnight. So that means you’re taking calls and maybe going in to see patients overnight. So that’s in addition to everything else.

Tiffany Archibald  08:04

So talk about on call a little bit more, because I know that you get the calls, are you able to manage the patients just kind of virtually? How often are you getting those calls? And having to actually go into the hospital?

Dr. Skluzacek  08:20

Yeah, it’s quite variable, actually. And sometimes depends on the day of the week. So Monday, I’m on call tonight, so usually Mondays are pretty busy. And the vast majority of things we can handle over the phone now because we have access to the electronic health record through the internet, but probably about half of the time, I have to go in and see a patient a new consult – either the patient’s very sick, or the patient needs emergent dialysis and so we have to go in. So a lot of times if it’s before midnight, I’ll go in to see him that night. If it’s after midnight, I usually just get my morning workout and go in at four or five in the morning.

Tiffany Archibald  09:01

Okay, so you’re sacrificing for the patients

Dr. Skluzacek  09:05

get sacrifice. Yeah, that’s why I have so much gray hair.

Tiffany Archibald  09:09

It looks fantastic. How do you stay up to date on current events in the medical and healthcare industries?

Dr. Skluzacek  09:19

Well, that can be difficult with everything else that we have to do, as you saw. So traditionally, we go to an annual meeting. In fact, I just came back from the American Society of Nephrology meeting in Orlando a couple of weeks ago, where we learned about the latest updates. That meeting is only once a year though, and there are a lot of things that can happen in a year that develop or published in between that time so I subscribe to several medical journals that are nephrology related, and they send emails with new articles. And so if there’s a new article that applies to my patients, I read that. There are also podcasts so there’s something called Freely Filtered that kind of goes over these new, very important studies, and how it relates to patient care. So we listen to those sometimes when I’m exercising at five in the morning. And there are a lot of other webinars available online, too. So if there’s a topic, you can click on a scheduled webinar, or watch on demand. So there’s a lot of different ways, we need all those ways in order to fit it into kind of a complicated schedule.

Tiffany Archibald  10:24

Right. So next question, how do you handle stressful situations or pressure situations? I know, just going through your schedule, that’s a lot. Obviously, you’re a medical professional. But you know, do you ever get stressed? And if so how do you handle that?

Dr. Skluzacek  10:42

Like what this podcast you’re doing? You’re great. Well, I think I go back to when I was in the military and the military, the way they deal with things is try to predict what may come up and then practice things. So we do a lot of training. And we as medical professionals do a lot of training and education. And the more you can prepare ahead of time, the easier the stressful situations become. Now, if you’re exposed to a new situation that you’ve not trained for, I guess you just focus on that exclusively. You ignore the cell phone, the social media, everything else and you work with the other people around you. In fact, most situations, there’s a team of people around that can help so you work together with the team, and you focus on what’s the most important thing at that time.

Tiffany Archibald  11:37

What characteristics are important for health care professionals to possess?

Dr. Skluzacek  11:44

You know, we’re in the business of taking care of people. And so I think compassion is probably the most important thing. Patients with kidney disease have complex illnesses, and it’s hard to navigate the healthcare system. So we as providers need to be compassionate, not only with the patients, but with their families and their other situation. Okay, so I think that’s probably the most important. Second, I think it’s important that we are educators for our patients, and collaborators. So you know, because it’s complicated, I think it’s important for me to, to kind of teach my patients what’s going on with their illness and what the options are. I think the internet and some misinformation that patients are getting, both on social media and related to health care, is kind of a hurdle for providers. So patients will come in thinking one thing and, and I have no idea where that came from, because there’s data to show that’s completely false. So, so that’s kind of been a big hurdle for healthcare, as well. And then finally, part of my new role with with our practice is to help the practice transition into something called value-based care. So that’s where we focus more on the outcomes and the costs. So value is outcomes divided by cost. So traditionally, we see the patients when they come in and have a problem. But if we really want to provide good value to the patient, then we need to focus on keeping them healthy, keeping them out of the hospital, and being more proactive instead of reactive. And that change in mindset is difficult, because the whole healthcare industry is built on the previous thing. So so my role new role with our practice is to help us transition into that value-based care. So I guess that’s the third biggest hurdle.

Tiffany Archibald  13:40

All right, can you tell the audience what made you decide to become a physician and a nephrologist?

Dr. Skluzacek  13:47

I’ve kind of had a interesting path to become a physician. So you know, initially I was a math and physics major at undergrad, and I had a military scholarship. So the Air Force had me become a meteorologist. So I was a meteorologist for a few years but realized there was more to life than that and, and I followed my sister who was a dietitian, around in the hospital one weekend and realized that that was very rewarding and so that’s when I decided that I wanted to become a physician. So then I became a physician, worked in the military as a physician. As I was learning more and more, I realized that nephrology has a lot of math and some physiology and physics involved with it. So I really enjoy that aspect of nephrology. And not only that, but in nephrology, you get to follow very complicated patients, very sick patients in the hospital. You get to follow patients as an outpatient for a long period of time. Excuse me. For surgeons, for example, don’t get to do that and they fix the problem and then they don’t get to see the patient very long. But we follow patients and help them through prolonged course of chronic kidney disease, so I enjoy that longevity aspect. And then nephrology also crosses all different age groups. So you’ll take care of patients that are in their 20s and patients that in that are in their 80s. And so I enjoyed that as well. So that’s my path.

Tiffany Archibald  15:16

That is an awesome path. And can we touch again on the your military experience? You went in as math and physics and then what was a turning point? Do you remember? Was there a situation?

Dr. Skluzacek  15:35

Yeah, I have to attribute it to my sister who was working in the hospital. And I followed her around in the hospital and met some of her health care providers and the doctors that she worked with. And I’d always liked physiology, human physiology. But it wasn’t until then that I realized that, that I could be a physician, or that I wanted to be a physician. Before I was turned off by all of the training, you know, it is a long course of training. But after I had some experience as a meteorologist, and didn’t want to do that long term, I realized it was worth the extra training to become a physician.

Tiffany Archibald  16:11

Actually, this is going to be our final question. And I think it’s going to kind of give us more insight into you personally. So what do you do in your spare time at home? I know we talked about fitness and we talked about your involvement in the community, but what’s what’s home life like for physician?

Dr. Skluzacek  16:30

Is there any spare time? No, actually, we do have some weekends off. So we’re only on call one weekend out of the month. But during my spare time, I mentioned before that I like to do cycling, so I like to go mountain biking in the local trails. Once a year, I go on a about a week long bike ride with my brother. And this year, we went to Colorado where every day you go for one of the mountain peaks in Colorado. So that was fun. And then we do some traveling, you know all my relatives live in a different state it seems, so in order to visit them, we have to travel. And then we live on an acreage. So like this weekend, I spent time trimming trees, putting out mulch, all that kind of stuff that everybody normally does at home. My wife likes to go to musicals. So last night we went to the musical. And sometimes she makes me go dancing. Don’t want to advertise that.

Tiffany Archibald  17:28

Let me catch Dr. Paul on the dance floor.

Dr. Skluzacek  17:32

I can barely do the two steps so don’t expect anything more than that.

Tiffany Archibald  17:38

All right, awesome. Well, we are so thankful that you did take that path because you are one of the most detailed and passionate and caring physicians that we have at DNA. So we appreciate you.

Dr. Skluzacek  17:53

Yeah, I love my job despite how complicated it is in the long hours. It’s worth it in the long run.

Tiffany Archibald  17:59

Yes, yes. And that comes across in everything that you do. So thanks again for being our guest and this was an awesome, awesome interview. Appreciate it. Thanks for tuning in today learn more about Dallas Nephrology Associates at And if you found the information valuable, be sure to share with those who are impacted by chronic kidney disease.


Dallas Nephrology Associates’ (DNA) podcast series, Let’s Talk About Kidneys, is provided for general information purposes only and does not replace the need to talk with a healthcare professional about your unique situation, care and options. Our goal is to provide you with as much information as possible so you can be as informed as possible. Reference to any specific product, service, entity or organization does not constitute an endorsement or recommendation by DNA. The views expressed by guests are their own and their appearance on the program does not imply an endorsement of them or any entity or organization they represent. The views and opinions expressed by DNA employees, contractors or guests are their own and do not necessarily reflect the views of DNA or any of its representatives. Some of the resources identified in the podcast are links to other websites. These other websites may have differing privacy policies from those of DNA.  Please be aware that the Internet sites available through these links and the material that you may find there are not under the control of DNA. DNA shall have no responsibility for the accuracy, legality or content of the external site or subsequent links. Contact the external site for answers to questions regarding its content. The resources included or referenced in the podcasts and on the website are provided simply as a service.  DNA does not recommend, approve, or endorse any of the content at the linked site(s).  The content provided on this website and in the podcasts is not medical advice and should not be used to evaluate, diagnose, treat, or correct any medical condition. The content is solely intended to educate users regarding chronic kidney disease, end-stage renal disease (“ESRD”), end-stage kidney disease (“ESKD”) and related conditions, and ESRD/ESKD treatment options.  None of the information provided on this website or referenced in the podcasts is a substitute for contacting a healthcare professional.