AMCs Post Covid19

[IMGASMD]

Personally I think that is not moral for Doc to take PPP free money. Then the hedge fund, lawyers, etc applied. So whatever...

We are small business too.

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[IMGASMD]

Did someone mention envision took 100M bail out money?!

 

[skypilot]

Did someone mention envision took 100M bail out money?!

They can use it for executive bonuses

 

[dannyboy1]

Think we just saw the first domino to fall. NAPA bought out MEDNAX.

North American Partners in Anesthesia (NAPA) Acquires American Anesthesiology From MEDNAX, Inc., to Create One of the Most Comprehensive Anesthesia, Pain Management, and Perioperative Care Companies in the U.S.

North American Partners in Anesthesia (NAPA) Acquires American Anesthesiology From MEDNAX, Inc.

finance.yahoo.com

 

[kmurp]

They can use it for executive bonuses

Where did you read that? They certainly wouldn’t have qualified for a PPP loan. (Sorry I meant to reply to the post above yours that Envision got a bailout).

 

[IMGASMD]

Where did you read that? They certainly wouldn’t have qualified for a PPP loan. (Sorry I meant to reply to the post above yours that Envision got a bailout).

https://www.axios.com/health-care-...on-361923f7-e5bb-4fb0-9117-1d0a3c759c0d.html

 

[deleted941485]

I haven’t heard anything more about a bankruptcy. Just the pay cuts so far.

 

[Ronin1]

I haven’t heard anything more about a bankruptcy. Just the pay cuts so far.

At least in Florida they are reversing the pay cuts gradually as volume increases. At 85% salary in two weeks

 

[IMGASMD]

At least in Florida they are reversing the pay cuts gradually as volume increases. At 85% salary in two weeks

Just wondering where in contract it says envision is allowed to cut salary? Obviously no job, no income. But isn’t part of being a big corporation, income protection?
I am not trying to argue about anything, merely trying to understand people’s logic.

 

[deleted171991]

Just wondering where in contract it says envision is allowed to cut salary? Obviously no job, no income. But isn’t part of being a big corporation, income protection?
I am not trying to argue about anything, merely trying to understand people’s logic.

That was back when they also gave you a pension, and a cheap health insurance.

A big corporation squeezes you like a lemon, so that the bosses can have their year-end lemonade. The only way to have protection is to be a partner in a fair PP. If your income goes down during a recession (which would happen almost everywhere), it will also skyrocket when it's over.

 

[Arch Guillotti]

If your income goes down during a recession (which would happen almost everywhere), it will also skyrocket when it's over.

I don't think it will skyrocket. Hopefully just go back to normal. Payer mix is probably going to suffer which doesn't help things.

 

[deleted171991]

I don't think it will skyrocket. Hopefully just go back to normal. Payer mix is probably going to suffer which doesn't help things.

Skyrocket compared to mine (or most employees'). Most partners make up to double my hourly rate (about 140-150). Yes, I know that there are CRNAs who come close. I'm making slightly more than in my first academic job, just out of training, about 10 years ago.

 

[Arch Guillotti]

Skyrocket compared to mine (or most employees'). Most partners make up to double my hourly rate (about 140-150). Yes, I know that there are CRNAs who come close. I'm making slightly more than in my first academic job, just out of training, about 10 years ago.

u mad bro?

 

[deleted171991]

u mad bro?

Why?

In my neck of woods one gets paid around 380K/year, for around 2,000 hours of work (200 x 10) plus at least 20 calls (another 500 hours). And that's the "nice" academic version, which comes with good benefits, not the AMC version, with more calls and no real benefits.

 

[anbuitachi]

Skyrocket compared to mine (or most employees'). Most partners make up to double my hourly rate (about 140-150). Yes, I know that there are CRNAs who come close. I'm making slightly more than in my first academic job, just out of training, about 10 years ago.

i dont think their salary will be much higher if at all compared to pre pandemic. i wont be surprised if reimbursements go down after this

 

[deleted171991]

i dont think their salary will be much higher if at all compared to pre pandemic. i wont be surprised if reimbursements go down after this

If their income will go down, so will mine, sooner or later.

The difference between theirs and mine are all the middlemen, who will still want their cut. Also, when many salaries in a market go down, the rest will also go down.

 

[D P356]

Just wondering where in contract it says envision is allowed to cut salary? Obviously no job, no income. But isn’t part of being a big corporation, income protection?
I am not trying to argue about anything, merely trying to understand people’s logic.

In any business, when ownership/leadership pays themselves first during a drought and cuts pay or furloughs all others, that should be a eye opener. You’d wonder if they’re thinking long term.

 

[Arch Guillotti]

Skyrocket compared to mine (or most employees').

So why not say so?

Income is way down. The road back is a long one and things may never return to normal. Lots of people lost their jobs and their insurance. Some people are scared to come into the hospital. Others can't take time off. Now that things are slowly "returning" to normal doesn't mean that we are on easy street once again.

 

[deleted162650]

So why not say so?

Income is way down. The road back is a long one and things may never return to normal. Lots of people lost their jobs and their insurance. Some people are scared to come into the hospital. Others can't take time off. Now that things are slowly "returning" to normal doesn't mean that we are on easy street once again.

Our schedule tomorrow is already back to 90% of pre-COVID levels and we just reinstated electives last week.

 

[Hoya11]

Our schedule tomorrow is already back to 90% of pre-COVID levels and we just reinstated electives last week.

Anywhere outside of NYC area is not on the same page..the place was a war zone. I could absolutely see going back to almost normal being OK in a more rural area far away from NYC or major metropolis

 

[Hoya11]

If their income will go down, so will mine, sooner or later.

The difference between theirs and mine are all the middlemen, who will still want their cut. Also, when many salaries in a market go down, the rest will also go down.

There have been lots of changes in my neck of the woods.

When I first came back to this area looking for a job as a new Grad about 6 years ago I was offered 350 for a call taking position in a busy hospital by EmCare. I didnt think that was so terrible as a new grad with lots of expenses.. but I ended up going somewhere else.

Now NAPA has taken over hospitals in our area and are offering 425k for a call taking position at the very same hospital..

I do get the sense the market for us has gone UP in the past few years.. its definitely not the golden era of decades past, but more in demand as need is growing with the aging population.

 

[GA8314]

Consolidation in an industry almost always means declining margins and a mature business cycle. I think this is telling.

 

[narcotics999]

Our schedule tomorrow is already back to 90% of pre-COVID levels and we just reinstated electives last week.

So what is the % of asymptomatic covid 19 for the whole week?

 

[deleted171991]

There have been lots of changes in my neck of the woods.

When I first came back to this area looking for a job as a new Grad about 6 years ago I was offered 350 for a call taking position in a busy hospital by EmCare. I didnt think that was so terrible as a new grad with lots of expenses.. but I ended up going somewhere else.

Now NAPA has taken over hospitals in our area and are offering 425k for a call taking position at the very same hospital..

I do get the sense the market for us has gone UP in the past few years.. its definitely not the golden era of decades past, but more in demand as need is growing with the aging population.

The question is the work volume for that money. It's a big difference if you're on call with a CRNA or solo in the hospital, for example.

Also, let's not forget the No.1 salary destroyer: inflation. At 3-4%/year, you may not be that impressed by that 425K salary anymore.

Plus the benefits, which tend to disappear in time. People should compare the full packages, not just salaries.

 

[pjl]

So what is the % of asymptomatic covid 19 for the whole week?

Not that poster, but we test every case. We are at ~2% positive rate in asymptotic people. We cancel them.

Our county official rate is 0.8% for comparison.

We are operating at a reduced schedule while enhancing our ability to do testing, procure PPE, and work on the process. Expect to be at full schedule in 2 weeks.

 

[deleted162650]

So what is the % of asymptomatic covid 19 for the whole week?

I haven’t seen updated figures yet. Stay tuned.

 

[Hoya11]

The question is the work volume for that money. It's a big difference if you're on call with a CRNA or solo in the hospital, for example.

Also, let's not forget the No.1 salary destroyer: inflation. At 3-4%/year, you may not be that impressed by that 425K salary anymore.

Plus the benefits, which tend to disappear in time. People should compare the full packages, not just salaries.

That is definitely true. I was very skeptical of the 425 from NAPA and what could entail

 

[skypilot]

Not that poster, but we test every case. We are at ~2% positive rate in asymptotic people. We cancel them.

Our county official rate is 0.8% for comparison.

We are operating at a reduced schedule while enhancing our ability to do testing, procure PPE, and work on the process. Expect to be at full schedule in 2 weeks.

So you have an ample supply of the point of care, immediate tests? Nice. What brand of test?

 

[BLADEMDA]

That is definitely true. I was very skeptical of the 425 from NAPA and what could entail

$425? No salary raises. Poor benefits. Staffing ratios? What happens when an MD quits? Do they get a locums ASAP?

You are a cog in a money making machine. You are expendable and not valued except as a provider. The AMC has no incentive to quickly replace a departing colleague. Who does the extra call shifts? What happens when the coverage becomes 1:6?

 

[skypilot]

$425? No salary raises. Poor benefits. Staffing ratios? What happens when an MD quits? Do they get a locums ASAP?

You are a cog in a money making machine. You are expendable and not valued except as a provider. The AMC has no incentive to quickly replace a departing colleague. Who does the extra call shifts? What happens when the coverage becomes 1:6?

. Look at the ratio of Anesthesiologists to CRNAs for the whole group. That will tell you a lot.

 

[pjl]

So you have an ample supply of the point of care, immediate tests? Nice. What brand of test?

Cepheid PCR for rapid, otherwise we do all the others as a send out 24-72 hours ahead.

 

[deleted162650]

So what is the % of asymptomatic covid 19 for the whole week?

I didn’t see the actual numbers, but I’m told it came out about 1/20 so 5% positives.

 

[nimbus]

Wuhan China is planning to test all 11 million residents over next 10 days. It’ll be pretty impressive if they can actually pull it off.

Coronavirus: Wuhan draws up plans to test all 11 million residents

Wuhan has proposed an ambitious battle plan to test its entire population in just 10 days.

www.bbc.com

 

[narcotics999]

I didn’t see the actual numbers, but I’m told it came out about 1/20 so 5% positives.

Good to know. Considering 20-30% false negative rate and if ORs do 50 elective cases per day, there will probably be one positive case every 2 days.

I am wondering how asymptomatic the positives really are.

 

[linkin06]

Hard to generalize because prevalence is so different from town to town

 

[amyl]

Then it will change again when they get their first multimillion dollar-lawsuit.

agreed - they should be careful what they wish for.... in the past two weeks alone I've had to bail my crnas out of killing someone at least half a dozen times.

 

[deleted126335]

agreed - they should be careful what they wish for.... in the past two weeks alone I've had to bail my crnas out of killing someone at least half a dozen times.

Nope. They will be supervised 1:6-8. So the doc will be atleast partially on the hook. "We had an anesthesiologist supervising..."

 

[chocomorsel]

Nope. They will be supervised 1:6-8. So the doc will be atleast partially on the hook. "We had an anesthesiologist supervising..."

Give me the 250k job doing my own cases any day. Beats this crap.
Better yet, let me stick to the unit. Only would have one mid level, if any to deal with.

 

[aneftp]

Give me the 250k job doing my own cases any day. Beats this crap.
Better yet, let me stick to the unit. Only would have one mid level, if any to deal with.

Hospitalist now make 250k easy 26 weeks a year mainly 7am-7pm. Very rare to be called for admission after 7pm with resident or NP at night in hospital.

know you worth. And 250k solo cases 40 hours a week is not ur worth. 6 weeks vacation.

 

[Arch Guillotti]

agreed - they should be careful what they wish for.... in the past two weeks alone I've had to bail my crnas out of killing someone at least half a dozen times.

Your CRNA’s are terrible. I work in a very busy place and this type of crap is rare.

 

[Ronin1]

Give me the 250k job doing my own cases any day. Beats this crap.
Better yet, let me stick to the unit. Only would have one mid level, if any to deal with.

You all need to find a new spot to work if you are getting 250k.

 

[deleted171991]

You all need to find a new spot to work if you are getting 250k.

 

[chocomorsel]

You all need to find a new spot to work if you are getting 250k.

I am talking about the future dude.
You know when the sky falls and there are too many anesthesia “providers” for not enough jobs since CRNAs will be independent.

 

[aneftp]

I am talking about the future dude.
You know why the sky falls and there are too many anesthesia “providers” for not enough jobs since CRNAs will be independent.

And independent cRna makes more than 250k with little or zero nights and weekends.
Most true independent crnas I know make 350k and up easy. The ones in hospital base make 400-450k.

 

[chocomorsel]

And independent cRna makes more than 250k with little or zero nights and weekends.
Most true independent crnas I know make 350k and up easy. The ones in hospital base make 400-450k.

I know that. But if we end up with too many “providers” you think those numbers will still be that high?
Quite frankly, I don’t believe the sky is falling in the next five years, but if it does...

 

[chocomorsel]

And independent cRna makes more than 250k with little or zero nights and weekends.
Most true independent crnas I know make 350k and up easy. The ones in hospital base make 400-450k.

But what about all this bologna about being the “cheaper provider”?
You mean they are lying to the public?

 

[narcotics999]

agreed - they should be careful what they wish for.... in the past two weeks alone I've had to bail my crnas out of killing someone at least half a dozen times.

This is awful.

 

[kmurp]

You all need to find a new spot to work if you are getting 250k.

I might be close to that this year. We just missed out on almost 25% of the year in Billings due to the shut down.

 

[kmurp]

I didn’t see the actual numbers, but I’m told it came out about 1/20 so 5% positives.

I’m surprised it’s that high.

 

[deleted162650]

I’m surprised it’s that high.

So were we. Especially given how few hospitalizations we have.