BloodySurgeon

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I started an anesthesia position with a potential to transition to 50/50 pain/anesthesia however there has been some hurdles in the transition and I was wondering what other peoples experiences were.

I am a hospital employee with a standard salary. Plan was to keep referrals in house and replace private practice physicians in the area. Initially the anesthesia director and hospital agreed to give me dedicated pain time twice a week and the rest of the time ill be doing anesthesia including calls.

Unfortunately they are now putting a halt in the transition for outpatient pain and keeping me in the dark in many of the administrative meetings and conversations. Apparently they are concern that they will be losing money if i am doing pain as i am paid a set salary oppose to a baseline + wRVU.

Normally I would agree that there is a risk with a return in investment for a starting pain physician but this is a unique situation. My hospital covers a large area and the closest pain office is 45mins away. I advertised myself as the only hospital in-network pain physician and already received a line up of referrals from internist and surgeons in the area. I am also only 1 of 3 pain physicians with privileges doing procedures at the hospital. The other 2 doctors commute and only here part time for only spine procedures. At the moment they use the fluoro suite twice a week and empty the rest of the week. There was a pain practice here before me but after my hire they lost privileges and had to move shop 45 minutes away.

Am I wrong in saying they will receive probably equal or more investment with me doing part time pain? In my opinion they shouldnt look at my salary as a potential lost. They should think of how to make the most revenue after already paying me.

Any thoughts?
 
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willabeast

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I started an anesthesia position with a potential to transition to 50/50 pain/anesthesia however there has been some hurdles in the transition and I was wondering what other peoples experiences were.

I am a hospital employee with a standard salary. Plan was to keep referrals in house and replace private practice physicians in the area. Initially the anesthesia director and hospital agreed to give me dedicated pain time twice a week and the rest of the time ill be doing anesthesia including calls.

Unfortunately they are now putting a halt in the transition for outpatient pain and keeping me in the dark in many of the administrative meetings and conversations. Apparently they are concern that they will be losing money if i am doing pain as i am paid a set salary oppose to a baseline + wRVU.

Normally I would agree that there is a risk with a return in investment for a starting pain physician but this is a unique situation. My hospital covers a large area and the closest pain office is 45mins away. I advertised myself as the only hospital in-network pain physician and already received a line up of referrals from internist and surgeons in the area. I am also only 1 of 3 pain physicians with privileges doing procedures at the hospital. The other 2 doctors commute and only here part time for only spine procedures. At the moment they use the fluoro suite twice a week and empty the rest of the week. There was a pain practice here before me but after my hire they lost privileges and had to move shop 45 minutes away.

Am I wrong in saying they will receive probably equal or more investment with me doing part time pain? In my opinion they shouldnt look at my salary as a potential lost. They should think of how to make the most revenue after already paying me.

Any thoughts?
They probably correctly figured out that a non anesthesia pain guy is cheaper. For example, a PMR pain doctor. That is just a guess...
 
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BobBarker

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Or they are dumb. They can make a fortune on the facility fees and imaging you will order. Last month I ordered 28% of the total MRI’s for my facility. My NP ordered more on top of that. Both orthos were 9% each.
 
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drusso

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I started an anesthesia position with a potential to transition to 50/50 pain/anesthesia however there has been some hurdles in the transition and I was wondering what other peoples experiences were.

I am a hospital employee with a standard salary. Plan was to keep referrals in house and replace private practice physicians in the area. Initially the anesthesia director and hospital agreed to give me dedicated pain time twice a week and the rest of the time ill be doing anesthesia including calls.

Unfortunately they are now putting a halt in the transition for outpatient pain and keeping me in the dark in many of the administrative meetings and conversations. Apparently they are concern that they will be losing money if i am doing pain as i am paid a set salary oppose to a baseline + wRVU.

Normally I would agree that there is a risk with a return in investment for a starting pain physician but this is a unique situation. My hospital covers a large area and the closest pain office is 45mins away. I advertised myself as the only hospital in-network pain physician and already received a line up of referrals from internist and surgeons in the area. I am also only 1 of 3 pain physicians with privileges doing procedures at the hospital. The other 2 doctors commute and only here part time for only spine procedures. At the moment they use the fluoro suite twice a week and empty the rest of the week. There was a pain practice here before me but after my hire they lost privileges and had to move shop 45 minutes away.

Am I wrong in saying they will receive probably equal or more investment with me doing part time pain? In my opinion they shouldnt look at my salary as a potential lost. They should think of how to make the most revenue after already paying me.

Any thoughts?

Why on earth would you want to replace the private guys??? That sounds evil. Private practice is the heart and soul of American Medicine. You wouldn't go to the post-office for a prostate exam???
 
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drusso

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Or they are dumb. They can make a fortune on the facility fees and imaging you will order. Last month I ordered 28% of the total MRI’s for my facility. My NP ordered more on top of that. Both orthos were 9% each.


"Researchers found that hospital-employed physicians caused 27% higher costs for the Medicare program and 21% higher costs for patients. The study reported that hospital-employed physicians “deliver a higher volume of services in the more costly hospital outpatient setting than independent physicians.”
 

drusso

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Wouldn’t go to you to post a letter either. Or for a prostate exam, for that matter.


"A seminal 2016 paper in the Annals of Family Medicine showed that “small, physician-owned practices while providing a greater level of personalization and responsiveness to patient needs, have a lower average cost per patient, fewer preventable hospital admissions, and lower readmission rates” than larger or hospital-owned practices. Independent physician practice represents an invaluable thread in the fabric of American healthcare delivery that should be preserved."
 
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"A seminal 2016 paper in the Annals of Family Medicine showed that “small, physician-owned practices while providing a greater level of personalization and responsiveness to patient needs, have a lower average cost per patient, fewer preventable hospital admissions, and lower readmission rates” than larger or hospital-owned practices. Independent physician practice represents an invaluable thread in the fabric of American healthcare delivery that should be preserved."
I’m in private practice myself, and agree financially it’s better for doctors and better for the community. I just couldn’t resist being sarcastic.
 
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SommeRiver

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Your hospital admin are dumb. Having said that, in my outpt private practice set up I am far quicker and cheaper than you.
 
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Ducttape

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hospital based offices do see sicker patients.

in addition, hospital based practices do not weed out Medicaid patients, unlike most private practices.


just saying. there is a need for both. I can guarantee you that the typical Medicaid patient that I see are not seeing private practice doctors.
 
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