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I did have 2. they wouldn't pay for a 3rd when I said I'd prefer it over transferrin them back and forth. It was a huge complex debacle. Other command had no problems. I had 4 DEAs at one point.
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LOCUMS anesthesia agencies, the good, the bad and the ugly
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Bad. They try to change the contract and gaslight you constantly.
It’s anyone’s guess. A few places have gotten the message that paying permanent staff better is the answer but not enough places. We just interviewed a mid career doc who is a hospital employee. His current position has been having trouble hiring due to location but otherwise sounds like a good job - nice culture and mix of proper ACT/solo. Admins “brilliant” idea is to bring in NAPA, sound or USAP (those are the three they’re talking to.) all three with the playbook of expanding crnas roles and supervision ratios to cover more stuff for less money. So some of the existing docs are walking…. But admin doesn’t care… they need less docs now and free up some capital to recruit more crnas, pay the AMC cut and not have to deal with the headache of anesthesia staffing.
Sounds like this is happening in Grand Rapids, MI and Des Moines as well. Er docs and dentists doing anesthesia too - geez. Huge Locums costs may have killed the goose laying the golden eggs as admins try to invent other ways to run ORs.
Of course slashing admin staff by 80% would be the best idea but they won’t do that. Every hospital I’ve been at has an army of nurse managers or other admins who do nothing but go to meetings. No clue what any of them accomplish ever
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Let this sink in for administrators thinking hiring crnas will solve the issue
And I’ve been around the block. From st pete Tampa to orlando to Daytona to Jacksonville plus middle Florida and everywhere in between. It’s literally a 200 plus sq miles range I cover with 12 hospitals and 5 surgery centers.
Very few hospitals are remotely close to fully staffed w2 crnas. Most places are running at least 30% short to up to 90% 1099 crnas. Crnas have figured it out. I show up at hospital last Tuesday for 1099 call. 10 out of the 13 crnas working there are 1099
you really think Michigan is gonna to get full time w2 crnas for those administrators? Gtfo
It’s gonna to cost the administration $350/hr on the low end up to $450/hr with travel expenses to pay the locums company who in turn will pay the crnas $250-275/hr
And these 1099 crna are sharks. They want to be paid overime after every 8 hr shift if they are 5x8. Or want as many hours as possible plus paid overtime after 40 hrs. There is no cost savings bringing in 1099 crnas. It may cost them even more than a full time w2 doc. Way more.
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In these hourly CRNA practices, who takes responsibility for billing and collecting the actual anesthesia fees from the insurance companies? The hospital? If so, I doubt they know the nuances of anesthesia coding, billing, and collections. They’re likely leaving a lot of money on the table.
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The management company bills for the crna. Or if hospital employed the hospital bills directly.
Management company obviously takes the hospital subsidies. Forces the crnas to use their 100% wholly owned subsidies (often times refusing to let other locums companies contract out). Many crnas have their own fake locums agencies (themselves) and try to “underbid” the wholly owned 1099 management company (envision/envoy). You see envision or similar has zero incentive to let you get into the game as ur own locums company because their wholly own envoy is also pocketing cash with the 1099 30% upgrade.
Let’s say AMC Envison has X hospital contract
Anesthesia provider Joe crna blow has his own company and says he can do it for $250-hr 1099
AMC envision says no. Joe blow agency can’t have the locums contract. Everything has to go through their envoy 1099 division. So the 1099 division may charge the hospital $300/hr for the crna. Envoy pays the crna $200/hr. So envoy is profiting from their own mismanagement keeping the 1099 spread difference for themselves
This is the ingenious nature of the game of anesthesia locums these days these companies play. Two crnas were forced to go with these wholly owned companies.
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If the CRNA is getting paid hourly, does he care how the case is coded? Who enters the CPT codes on the bill? Do they always use the highest value codes? Do they add codes for lines and blocks? Modifiers?
For example, a TEE/cardioversion could be submitted as
93312 (7 base units +time) or
92960 (4 base units +time)
If I was a CRNA or an anesthesiologist getting paid hourly, I wouldn’t care about any of those things.
Correct. Paid hourly. And also correct no one cares as they sit there running up the hours.
Some companies use qz
Some bill medical direction.
I’m sure they extract data from either epic or hca medaxion horrible software. Usap has their own md claim app to extract. I dunno. Those with paper charting send it to the billing company.
I haven't had any luck contracting direct. What route are the "personal locums" companies going to get these contracts--VMS/LM?
who do you contact when you want to do locums directly with a hospital? is it hospital HR?
You can contact a hospital recruiter and they can point you in the right direction, but you likely will hit a brick wall at most places. However PRN opportunities are more flexible in this manner.
Does anyone have experience with Integrity Anesthesia Solutions? Their website makes them seem more like an entry level AMC than a locum company.
If you go back with this thread, someone mentioned that they present your resume everywhere without permission. Also they will not name clear you once they've done that.
does anyone watermark their resume before giving it an agency or anesthesia group/hospital?
Ha! I boldly watermarked a version, printed it, then scanned that physical copy into an image file before sending it to someone I didn’t trust who needed for a reason other than job search.
A friend from a local hospital then told me someone else had tried to use that crappy copy in their batch of locums docs they were trying to present. He called them out and said go away to that startup locums agency.
Trust no-one.
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thanks for the heads up. I've given mine to two pp groups without watermarking thinking they're attendings that work there but from now on I will watermark it regardless who the person i'm giving to is.
I don't understand the benefit of adding a watermark. Can you explain?
It said “Copy for <person’s name> individual use only. No reproduction, distribution, or other uses permitted.”
So, when my friend saw it, it was very clear that it had been lifted and used without my permission. And because of the way I did it, they couldn’t easily remove watermark by editing the file.
Granted I’m not in the locums game, but it justified my concern on that occasion.
If they are a Locumsmart agency, you can complain to Locumsmart directly. They have an agreement not to name clear like that, since it gets in the way of competing agencies that pay into Locumsmart.
Anybody heard of innovative anesthesia solutions for locums?
Looks like a staffing company formed by CRNA’s. That would be a hard pass from me, dawg.
CRNA staffing companies only need MD’s to be their liability sponge or to obtain a hospital contract that requires MD supervision. You will still be subservient to their practice model, which will be an unsafe and uncomfortable working environment. Been there, done that…never again!
Centers for Medicare & Medicaid Services Data
data.cms.gov
Seems like that is the current “model” for a majority of openings these days? Their website says, “physician owned” fwiw.Looks like a staffing company formed by CRNA’s. That would be a hard pass from me, dawg.
CRNA staffing companies only need MD’s to be their liability sponge or to obtain a hospital contract that requires MD supervision. You will still be subservient to their practice model, which will be an unsafe and uncomfortable working environment. Been there, done that…never again!
Centers for Medicare & Medicaid Services Data
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You need to do a google search of every company you deal with. A quick search yielded the CMS registration data which showed everyone on this company's roster is a CRNA. There is no "physician" listed unless these nurses are referring themselves as doctors (of nursing). As someone alluded to in another thread, there are over 300 locums companies. I don't think a majority are CRNA owned, but there are many who try to pass themselves off as something other than that. Anyway based on my experience one time working at a CRNA company, you will be treated as a necessary evil in their operations. They are a CRNA company because they don't want to work with anesthesiologists. They despise you trying to "supervise" them or offer any support unless when things go wrong. When things go wrong, they revert to a we just nurses attitude...Dr. Beach bum told us it was ok and he's the one to blame. YOU'VE BEEN WARNED!!!
A friend of mine who is doing locums at a practice that is wholly staffed by CRNA is getting crapped on royally. They have a CRNA who is the board runner and they treat my friend as persona non grata. Even though he just came off 24 hour call, he gets no breaks, stuck in the longest room....etc. etc. One of the other locums anesthesiologists there requested to leave early to catch a flight home, having finished early for the day, and the CRNA granted him permission. She then proceeded to call the administration and his locums company to tell them he left early without telling her.
Having a CRNA in charge is a red flag for you newcomers here.
Having a CRNA in charge is a red flag for you newcomers here.
Looks like a private equity owned firm based out of Ft. Lauderdale, FL like every other AMC out there. What do you want to know?
Most of these locums agencies put out ads fishing for you to email them your CV. I have contacted some of these mentioned in previous post. These agencies say "reply with CV for immediate consideration" which I do not send them my CV. Once you tell them that you won't send them your CV until you have further details, they ghost you and move on to the next naiive sucker. That's what they do including physician owned, CRNA owned, big agencies, little agencies. Alot of these posts are "ghost postings" with no real job, just wanting you to send them your CV so that they can tell hospital systems, we have 100 docs that work with us
Agreed I don’t send cv without a lot more info! No one should!!
Correct. I do not give them my cv until we have the details worked out, pay, dates, and I know it is a legit opportunity
Some joker here wanted my cv just to get the name of the hospital. No thanks homie.
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My anesthesiologist buddy replied to a locums agency owned by a physician. The physician owner replied via email and quoted rates like $50-75 below what other agencies were quoting and he also told my buddy to reply with his CV. My buddy said that he only emails his CV if he knows specific details and that the locums job is a sure thing. This locums physician owner ghosted my buddy and took down the ad after like 2 weeks. So lame that other physicians would try to scam and claim other physicians. Beware just because the owners are physicians or CRNAs of a locums agency does not mean that they are looking out for you, they want to profit off your sweat too and want to "own you" if you send them your CV.
Has anyone worked with the locums arm of the PE groups like Envoy (Envision), Anesthesia On-call (USAP), Echo (Sound), D&Y (Team Health)? Give some insight. I have communicated with some of these agencies and they seem to give low rates but claim to be exclusive to these sites saying that the hospital prioritizes their locums agency. Also seemed unusual that some of these arm locums agencies are actually charging the locums anesthesiologist an hourly rate deduction for malpractice insurance. When I've worked with non-arm locums agencies they didn't charge me for using their MP. So many schemes to try to get the locums hourly rates lower. They quote an hourly rate but then don't tell you that they will deduct fees for other things. There's a shortage of locums anesthesia people seems like they would try to entice you by giving higher rates and no deductions.
I have that from most places. They're is some local job that has been advertising for well over a year and a half. I've asked for details, Ave they said not without a CV. So I know nothing about it.
I attempted to work with sound at Banner in Phoenix. A bunch of my friends did. The job paid well at the time. They didn't get hey stuff to me quickly, they changed the job terms i negotiated before I started, so i told them I wouldn't continue. I kept getting emails saying I had to complete a bunch of education months after I quit. It took forever to get them to stop emailing me. I also personally don't like their CEO of anesthesia after his previous company took over a job i loved in 2020.
Can always give them a fake cv wirh a fake name
Anyone have experience with any of the following locums companies that can provide feedback on their experience?
Aya
Locumstenens.com
MD Staffers
Lancesoft
Aya
Locumstenens.com
MD Staffers
Lancesoft
I’ve been with D&Y at one specific site for 4 years now. They won’t bump my rate but I have had a decent experience with them for this time period.
Honestly I think they’re all shady but after a recent direct contact with someone who wanted to do an agreement verbally and with loose terms, I appreciate the structure they provide.
seems like many things in anesthesia are shady for some reason. locums agencies wanting your CV to "own" you, PE groups taking over and increasing ratios to 1:6 or even 1:8, pain docs, at least in the past doing shady stuff and getting raided by DEA, list goes on.
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Predatory and corporatized. I’m trying to transition out. I don’t need this bull**** money for what the actual cost is. Toxic, predatory, high stress, liability sponge, work with a group of people who undermine you while lobbying for independence. Surgeons pushing throughput, institutions owning your time, expecting loyalty, etc etc. This job has become just putting your license on the line.
If you want me to do that the pay my 500k student loans + 500k salary and I’ll happily work 40h a week for one year.
Read online that Aya had attempted class action lawsuit from locums nurses (all types of nurse travelers) who claim that they accepted a locums job, told their current jobs they were leaving, rented housing/hotels then got cancelled short notice and had no work for months. Aya said the nurses weren't allowed to do class-action as they signed in their contracts for arbitration. A lot of these companies will force you to sign arbitration clauses. They also seem to post like $50-100/hr less than other sites but at least they post their rates
Some anonymous postings have claimed that Lancesoft is a call center in India and that they will ask for your social security number.
Locumtenens.com is of course huge and heard they pay low attributing it to their corporate overhead expenses. Don't know anything about MD Staffers.
But I wouldn't trust most of these locums companies unless you know someone who has used them. All are out to make a huge profit off your sweat. There are so many fly-by-night locums agencies that have websites which have no specifics on who is running the company, no faces attached to them, and where they really are located (in the US or India or wherever). So you run the risk of sending your sensitive information to someone who could scam you or steal your identity
Even if a Locums company is reputable, there is still a great variance depending on which recruiter you have to deal with. I have an excellent recruiter at Medicus and he has always worked with me to handle any problems. He has represented me well over many years. I referred my friend to Medicus and she got a lying witch (per my friend’s words) who gaslights and ghosts her frequently. It’s a mess of a situation and feel sorry I referred her to this company. I told my recruiter about her situation and he said they are not allowed to poach clients from other recruiters within the company. So now she is stuck with who she has to deal with.
I am breaking in a new Locums agency. I spoke with several of the recruiters there and many sounded like they were reading from a script, didn’t know what they were talking about or were behaving like telemarketers with a hard sell. I found 1 guy there and spoke with him about a job. He was honest with me and said that this place was prioritizing candidates who could start in a month. He didn’t want to present my resume unless I really wanted him to. He didn’t even pressure me to send to him my resume. This is the recruiter I feel comfortable dealing with.
This is actually very similar to my experience with Aya. I never got the signed contract, I was working on my IMLC then the state license, it was all within 30 days, the site was calling me asking me when I could start. As soon as I got my license, they changed what the job was going to be (No supervision to full supervision was the big detail changed as well as days/hours). I had not bought my ticket or housing, but I didn't get reimbursed for the IMLC and state license. They started calling me again last week. The rep I had worked with unexpectedly died a few years ago, and when that happened, I told them to stop contacting me.
Be very careful with Aya Locums. In my experience, when a professional issue arises, they provide essentially zero advocacy for the physician and will prioritize keeping the facility satisfied—even if that means throwing the physician under the bus. They will engage in making up dangerous lies just to avoid breach of contract fees.
I had my worst professional experience working with them. They even had their “Chief of Anesthesia”—who, for the record, was a CRNA—call me and berate me rather than addressing the situation professionally and objectively.
My biggest takeaway: be very cautious about signing with any locums agency that includes a mandatory arbitration clause. Read the contract carefully and understand exactly what protections—and what recourse—you are giving up before signing.
I do. “Present to X hospital only”
which software or tool do you use to apply watermark?
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