Chicago Asa

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
narcusprince

narcusprince

Rough Rider
Verified Member
20+ Year Member
Joined
Dec 3, 2003
Messages
1,646
Reaction score
1,065
Who is attending? Sound off.
Members don't see this ad.
 
Hell no! Hanging out with a bunch of hard on anesthesiologists (>98% of ASA attendees) is certainly not my idea of a good time.
 
  • Like
Reactions: 1 user
Members don't see this ad :)
Consigliere said:
Hell no! Hanging out with a bunch of hard on anesthesiologists (>98% of ASA attendees) is certainly not my idea of a good time.
Click to expand...

Knowledge is good. Some of the educational offerings are useful.
Reconnect with fellow residents.
Pay for a trip to a cool city with CME money.
 
  • Like
Reactions: 1 user
Any M4 students going to meet and greet with residency program directors? Planning on bringing resumes?
 
ERRES2288 said:
Any M4 students going to meet and greet with residency program directors? Planning on bringing resumes?
Click to expand...

Would highly suggest this for med students attending, it's very laid back and almost all program PDs/PCs are there with several residents. I went a few years ago and helped man the table, was pretty fun. LOTS of free swag (not really found elsewhere :/)

Be friendly and chatty, but no begging.
 
  • Like
Reactions: 1 user
AdmiralChz said:
Would highly suggest this for med students attending, it's very laid back and almost all program PDs/PCs are there with several residents. I went a few years ago and helped man the table, was pretty fun. LOTS of free swag (not really found elsewhere :/)

Be friendly and chatty, but no begging.
Click to expand...

Cool thanks. Do most students give a little speal about why they want to go to program? Or is it just casual convo ?
 
  • Like
Reactions: 1 user
Any thoughts on the conference. There is a huge push on value, perioperative home, expanding role of the anesthesiologist,etc. The stuff that outrages the large majority of what I read online and yet in person I don't see the same outrage. Is this a case of a vocal minority online or a case of anesthesiologists being the stereotypical spineless anesthesiologist in person? I'll admit I'm the latter.
 
Probably due to the audience the conference attracts.
 
  • Like
Reactions: 1 users
Members don't see this ad :)
Pinkegg said:
Any thoughts on the conference. There is a huge push on value, perioperative home, expanding role of the anesthesiologist,etc. The stuff that outrages the large majority of what I read online and yet in person I don't see the same outrage. Is this a case of a vocal minority online or a case of anesthesiologists being the stereotypical spineless anesthesiologist in person? I'll admit I'm the latter.
Click to expand...

The people who are the most vocal against the perioperative home have been insulated from the changes happening in healthcare (so far). These are the people who are still making a lot of money by doing a high volume of OR cases. They haven't seen the consolidation of hospitals and medical practices yet. The people most supportive of the perioperative home are those that are now part of much larger organizations, such as academics or large hospital systems. They are fighting for a seat at the table and making a case to be seen as something more than just a technician who pushes the anesthesia "on/off" button.
 
  • Like
Reactions: 4 users
Like they said the guys who are doing lots of cases do their cme elsewhere. Academics and "administrative anesthesiologists" are the most common attendees.
 
FFP said:
Can you smell the stink of the future?

Michael Porter at the ASA: Is anesthesiology a specialist silo?
http://apennedpoint.com/michael-porter-at-the-asa-is-anesthesiology-a-specialist-silo/
Click to expand...

That is actually somewhat of an optimistic vision. He envisions a world where we broaden our skill set and utility to maintain a seat at the table. The less enviable and more likely alternative for most of us is to continue our traditional role which is on the path to be a less well paid widget/technician.
 
Pinkegg said:
Any thoughts on the conference. There is a huge push on value, perioperative home, expanding role of the anesthesiologist,etc. The stuff that outrages the large majority of what I read online and yet in person I don't see the same outrage. Is this a case of a vocal minority online or a case of anesthesiologists being the stereotypical spineless anesthesiologist in person? I'll admit I'm the latter.
Click to expand...

I last went to the ASA meeting in 2013. Some of the panels were good but overall I was a little disappointed. I went to the SCA Echo Week last year and it was much better, possibly because I had specific goals for attending rather than my ASA schedule which was a hodgepodge of whatever looked like it might be relevant to my practice. I'm not sure I'll ever go back to ASA, except possibly to reconnect with people.

There's a deeper problem with the ASA though. I don't know what the future will bring. But I let my ASA membership lapse and I quit giving to ASAPAC. Their vision of our future outside the OR isn't what I want to do.

The ASA has made no effort at all to defend our role in the OR. I haven't seen an effort from ASAPAC to publicize our importance and keep us involved with every anesthetic. I see posters on the walls of hospitals extolling the virtues of radiologists reading your X-ray (not another doctor) and how your colon cancer should be cut out by a colorectal surgeon (not a general surgeon). Our society can't even be bothered to argue that we are better than nurses, because it's run by people who are still making a ton of money off the backs of those nurses. Can't offend, can't defend.

Instead I hear more of this crap about "top of license" practice which is essentially conceding the OR to CRNAs.


At this point I feel like I'm on my own and the best thing I can do is obtain subspecialty certification via fellowship and later on, be geographically flexible and willing to earn less to work in an environment that's acceptable to me. Cardiac volume might be shrinking nationwide despite an older fatter sicker population, and we might be overproducing cardiac fellows, but at least I'll be competing with other doctors and not nurses for those jobs.
 
  • Like
Reactions: 2 users
pgg said:
At this point I feel like I'm on my own and the best thing I can do is obtain subspecialty certification via fellowship and later on, be geographically flexible and willing to earn less to work in an environment that's acceptable to me. Cardiac volume might be shrinking nationwide despite an older fatter sicker population, and we might be overproducing cardiac fellows, but at least I'll be competing with other doctors and not nurses for those jobs.
Click to expand...
Don't count on it. The Cleveland Clinic in Ohio is already advertising to CRNAs (on their website) that they will be allowed to practice cardiac anesthesia.
A variety of job opportunities are available to CRNAs at Cleveland Clinic. Job opportunities include, but are not limited to the following areas: Cardiothoracic Anesthesiology, General Anesthesiology, Pediatric Anesthesiology and Regional Practice.

Cardiothoracic Anesthesiology
Cleveland Clinic's Department of Cardiothoracic Anesthesiology provides anesthesia each year for more than 4,000 heart surgeries and 1,500 thoracic procedures. Surgical procedures performed in this area include, but are not limited to transplantation, congenital repairs and corrections, ventricular remodeling, dysrhythmia surgery, and thoracic aorta surgery.
Click to expand...
http://my.clevelandclinic.org/services/anesthesiology/for-medical-professionals/careers
 
FFP said:
Don't count on it. The Cleveland Clinic in Ohio is already advertising to CRNAs (on their website) that they will be allowed to practice cardiac anesthesia.

http://my.clevelandclinic.org/services/anesthesiology/for-medical-professionals/careers
Click to expand...

"Practicing" cardiac anesthesia is probably a stretch....I had several attendings from the clinic and those CRNAs are on a tight leash. That program is in no way allowing them to develop skills to function independently in a heart room.
 
pgg said:
I last went to the ASA meeting in 2013. Some of the panels were good but overall I was a little disappointed. I went to the SCA Echo Week last year and it was much better, possibly because I had specific goals for attending rather than my ASA schedule which was a hodgepodge of whatever looked like it might be relevant to my practice. I'm not sure I'll ever go back to ASA, except possibly to reconnect with people.

There's a deeper problem with the ASA though. I don't know what the future will bring. But I let my ASA membership lapse and I quit giving to ASAPAC. Their vision of our future outside the OR isn't what I want to do.

The ASA has made no effort at all to defend our role in the OR. I haven't seen an effort from ASAPAC to publicize our importance and keep us involved with every anesthetic. I see posters on the walls of hospitals extolling the virtues of radiologists reading your X-ray (not another doctor) and how your colon cancer should be cut out by a colorectal surgeon (not a general surgeon). Our society can't even be bothered to argue that we are better than nurses, because it's run by people who are still making a ton of money off the backs of those nurses. Can't offend, can't defend.

Instead I hear more of this crap about "top of license" practice which is essentially conceding the OR to CRNAs.


At this point I feel like I'm on my own and the best thing I can do is obtain subspecialty certification via fellowship and later on, be geographically flexible and willing to earn less to work in an environment that's acceptable to me. Cardiac volume might be shrinking nationwide despite an older fatter sicker population, and we might be overproducing cardiac fellows, but at least I'll be competing with other doctors and not nurses for those jobs.
Click to expand...

The surgical home thing is less about our fight with CRNAs and more about getting a bigger slice of the proverbial pie when things like bundled payments are introduced. The surgical home was never meant to be the battle cry of our fight against CRNAs. It is just meant to show the value that the specialty of anesthesiology can provide to larger entities. Truth be told, we are not practicing at the "top of our license" by just sitting in the OR banging out knee replacements. We do learn and (hopefully) know a lot of internal medicine and the idea behind the perioperative home stuff is to show the payers and decision-makers that we have value beyond just putting people off to sleep.

I am a defender of the idea of the perioperative home stuff. Although, I do think it can be communicated better by the ASA. The idea is to get anesthesiologists to become more like leaders within a hospital, and to become decision makers that can greatly affect the course of a patient's care. In essence, the idea is to have a more vested interest in the entire perioperative period and to be more influential in the care of patients.

I do agree with you that the ASA does a terrible job marketing what we do. In the end we make everything look so easy, which does us a disservice. I also think, current medical students should understand that anesthesiology is an evolving field and that the old days of parking your butt on a stool or signing CRNA charts all day and making bank are over.
 
FFP said:
Don't count on it. The Cleveland Clinic in Ohio is already advertising to CRNAs (on their website) that they will be allowed to practice cardiac anesthesia.

http://my.clevelandclinic.org/services/anesthesiology/for-medical-professionals/careers
Click to expand...
Hospitals are trending toward a demand for CT fellowship trained anesthesiologists in order to credentialed for hearts. If regular anesthesiologists aren't good enough for them, CRNAs won't be.

Now, an ACT model where a "cardiac CRNA" helps kick off the case, sits there while on pump, and pushes the bed to the ICU. Sure. CRNAs will "practice cardiac anesthesia" ...

The risk to us in cardiac surgery is declining volume and lots of fellows, not CRNAs.
 
pgg said:
Hospitals are trending toward a demand for CT fellowship trained anesthesiologists in order to credentialed for hearts. If regular anesthesiologists aren't good enough for them, CRNAs won't be.

Now, an ACT model where a "cardiac CRNA" helps kick off the case, sits there while on pump, and pushes the bed to the ICU. Sure. CRNAs will "practice cardiac anesthesia" ...

The risk to us in cardiac surgery is declining volume and lots of fellows, not CRNAs.
Click to expand...
I expect the ACT model to extend to cardiac as soon as the transcatheter procedures start eating into open heart surgeries. But that was not your initial point.

Your point was that at least you will be competing with other doctors, not CRNAs, but that applies to most good anesthesiologists, cardiac or not. My guess is also that most of us will have to be both good generalists and good perioperativists. My guess is that the Harvard professor is right, and the suits think exactly like him. My guess is that most of us will practice in an ACT environment in the whole country, even cardiac trained people (especially if open hearts numbers go down). My guess is that most of us will be seen like little more than the combination of a sedation nurse and a surgical hospitalist, and the latter part will become more important than ever for many anesthesiologist jobs.

We have made anesthesia far too safe for our own good, we are too expensive, and they will replace us with cheaper providers everywhere they can, including in the ASA (which makes its money from big corporations, not membership fees). The big changes will come once we get into bundled payments, which is 5 years or so. There is no way in hell we will ever make the same money while doing what we do today, because we are seen as among the least important around that pie. I am just sad it's so friggin obvious to the suits, but not to the ASA membership.

Hospitals are asking for fellowship-trained anesthesiologists just because slowly there are more of them than mosquitoes. But don't expect them to pay for the lost revenue during the extra year in the future. As somebody wisely said on this forum: why would I do a tougher fellowship when the regional guy leaves at the same time and gets paid the same as the cardiac guy with no calls?
 
Last edited by a moderator:
GravelRider said:
the old days of parking your butt on a stool or signing CRNA charts all day and making bank are over.
Click to expand...


Are the patients going to anesthetize themselves?

How can solo or supervision ever stop? Makes no sense what you are saying.

The PSH is smoke and mirrors. We do not add any meaningful value by doing stuff surgical PAs are currently doing.

What we should be focusing on is on having zero complications. The patients keep getting sicker and complications are on the rise. Long gone are the days when pulse oximetry and capnography decreased bad outcomes. Nowadays intubating the trachea correctly will not prevent someone from dying, because our patients now have multiple severe comorbidities that they didn't use to have before.

We should be focusing on improving outcomes on sick patients, not on taking over physician extender roles.
 
Carbocation1 said:
Forbes
Can An Investment In This New 'Home' Reduce Healthcare Costs?
OCT 23, 2016

http://www.forbes.com/sites/robertg...ew-home-reduce-healthcare-costs/#7e25e471af3a
Click to expand...
People read studies like this and think that the PSH was the reason for any benefits.

The way I see it the benefit, if any, comes from having the stubborn old school anesthesiologist let go of their malpractice neuroses. We have seen a few guys insist on patients having echo, and some times stress test with cardiology consults, or all sort of lab test because they are afraid of a lawsuit in case of a bad outcome. With the "PSH protocols" they think they can blame the system if there is a bad outcome. Of course you will have less spending by telling these guys they cannot insist on 20 tests for a low or medium risk case.

It is the periop protocol that drives the savings when you have anesthesiologists who cannot see the light temselves, not the rounding on patients afterwards.
 
FFP said:
But don't expect them to pay for the lost revenue during the extra year in the future. As somebody wisely said on this forum: why would I do a tougher fellowship when the regional guy leaves at the same time and gets paid the same as the cardiac guy with no calls?
Click to expand...
'Cause you love it, that's why. :)

Even now in this tough fellowship I'm only logging low-mid 60s hours. Plus reading on the outside, of course. It's a lot of work but it's not an 80-100 hour internship chasing scut. 1/3 down and I'm still happy I'm here.

And in my case there's no opportunity cost, so it was a total no brainer to do it.

Anyway, you could be totally right in all regards. But I still believe that in the end that there will be good opportunities for well trained, well credentialed, good clinicians, so my plan is to be one and see where things go.

And if it sucks and I hate my life then I'll quit and take my ball and go home. I'm rapidly approaching the point where the bills will get paid even if I just sit around and do nothing.
 
urge said:

Are the patients going to anesthetize themselves?

How can solo or supervision ever stop? Makes no sense what you are saying.

The PSH is smoke and mirrors. We do not add any meaningful value by doing stuff surgical PAs are currently doing.

What we should be focusing on is on having zero complications. The patients keep getting sicker and complications are on the rise. Long gone are the days when pulse oximetry and capnography decreased bad outcomes. Nowadays intubating the trachea correctly will not prevent someone from dying, because our patients now have multiple severe comorbidities that they didn't use to have before.

We should be focusing on improving outcomes on sick patients, not on taking over physician extender roles.
Click to expand...

The key part of the phrase that you quoted is the "...making bank." Of course you will need people to anesthetize patients for surgery, but not at current expected income levels. Sorry. If I was a suit, I wouldn't pay an anesthetist much more than a primary care doc...maybe less.
 
  • Like
Reactions: 1 user
I'm here. I presented. Lots of perioperative home stuff but some cool gadgets to sample too. I think it will mean more to me after fellowship year, or maybe I'll stick to my specialty conference if I'm not presenting (i.e. If I have to pay for it). But I'm having fun in the city!
 
Pinkegg said:
Any thoughts on the conference. There is a huge push on value, perioperative home, expanding role of the anesthesiologist,etc. The stuff that outrages the large majority of what I read online and yet in person I don't see the same outrage. Is this a case of a vocal minority online or a case of anesthesiologists being the stereotypical spineless anesthesiologist in person? I'll admit I'm the latter.
Click to expand...
My partners are leaving the conference early because they think it sucks so badly this year.
 
I like the ASA conference and try to attend every 2 or 3 years. I hate Chicago as a location, however. Now don't get me wrong, I love visiting the city and have several friends and relatives that are there. What I mean is it is a terrible place for a convention. The convention center isn't near anything. It has what, 1 hotel on location and everything else is a 10-20 minute bus ride? You know what that means? Waiting at the bus stop for 10 minutes when you want to go and another 10 minutes when you want to leave. At a conference where I like to come and go throughout the day that makes it extremely inefficient.

San Francisco is a much better location where you have at least 10 or 15 hotels with a couple block walk and loads of stuff to do nearby. You can walk over to the convention center and attend a lecture or two and then head out to meet somebody for lunch before coming back for something else in the afternoon.

Chicago tends to be take the bus to the convention center and then don't leave until you are done for the day. Throw in what is usually kinda crappy weather in Chicago in October and it's the least favorite ASA location I've attended.
 
  • Like
Reactions: 1 user
Consigliere said:
My partners are leaving the conference early because they think it sucks so badly this year.
Click to expand...
It sucked last year, too. Huge disappointment. I didn't see one really good presentation, except for a couple which were both by foreigners. A lot of presenters were inexperienced youngish faculty there just to add another line to the CV (instead of rock stars); not worth the expenses by far. I swore not to go for another 10 years, except for the alumni night if it's nearby. Plus they did the same idiotic thing of holding the meeting in an expensive town, with only a couple hotels nearby.

No offense, but that conference is interesting mostly for those who have been too lazy to read any anesthesia literature for years. It should be 10 times smaller with 10x better speakers, and watchable 100% online.
 
Last edited by a moderator:
  • Like
Reactions: 3 users
Mman said:
it is a terrible place for a convention. The convention center isn't near anything. It has what, 1 hotel on location and everything else is a 10-20 minute bus ride? You know what that means? Waiting at the bus stop for 10 minutes when you want to go and another 10 minutes when you want to leave. At a conference where I like to come and go throughout the day that makes it extremely inefficient.
Click to expand...

Heard this from many people. I went to ASA in New Orleans a couple years ago, was so easy to walk to and from as needed.
 
AdmiralChz said:
Heard this from many people. I went to ASA in New Orleans a couple years ago, was so easy to walk to and from as needed.
Click to expand...

Like I said, I like Chicago. I will happily spend a weekend there in the summer. But October is very iffy on the weather and the convention center location almost forces you to spend the entire day there. San Fran, New Orleans, Orlando, and DC are all much better locations I've been to for it IMHO. Last time it was in Chicago it was 45 and raining and windy and that doesn't make standing outside waiting for a bus any better.
 
Consigliere said:
Hell no! Hanging out with a bunch of hard on anesthesiologists (>98% of ASA attendees) is certainly not my idea of a good time.
Click to expand...
i'm with you. I went once when it was local and was reminded how much i didn't like my attendings and they didn't like me. Plus the one I wanted to see didn't even go.
 
Mman said:
I like the ASA conference and try to attend every 2 or 3 years. I hate Chicago as a location, however. Now don't get me wrong, I love visiting the city and have several friends and relatives that are there. What I mean is it is a terrible place for a convention. The convention center isn't near anything. It has what, 1 hotel on location and everything else is a 10-20 minute bus ride? You know what that means? Waiting at the bus stop for 10 minutes when you want to go and another 10 minutes when you want to leave. At a conference where I like to come and go throughout the day that makes it extremely inefficient.

San Francisco is a much better location where you have at least 10 or 15 hotels with a couple block walk and loads of stuff to do nearby. You can walk over to the convention center and attend a lecture or two and then head out to meet somebody for lunch before coming back for something else in the afternoon.

Chicago tends to be take the bus to the convention center and then don't leave until you are done for the day. Throw in what is usually kinda crappy weather in Chicago in October and it's the least favorite ASA location I've attended.
Click to expand...
Agree - best setup was San Diego last year - literally walked across the street to the convention center. I was lucky this year - my only required meeting wasn't anywhere near McCormick Place, and the steak was superb!
 
You must log in or register to reply here.
Next unread thread

Similar threads

G
MOCA without ASA?
Replies
7
Views
906
Leinie
L
linkin06
Sugammadex now recommended per ASA
2 3
Replies
107
Views
5K
narcusprince
narcusprince
nimbus
2022 ASA Commercial Rate survey
Replies
4
Views
795
BLADEMDA
BLADEMDA
O
ASA is opening up membership to nurses
Replies
17
Views
2K
OptionOffense
O
R
ASA’s House of Delegates Event 2023
Replies
0
Views
445
realtalk15
R
Top