Anesthesiologist Offers To Take Pay Cut

[2021Doctor]

At a special meeting of the Northern Inyo Hospital District Board held Friday, March 24, Interim NIHD CEO Lionel “Chad” Chadwick acknowledged that the District has drawn down its reserve account by $28 million over the past two years.

With that as backdrop, the bulk of the meeting was spent debating whether or not the Hospital should replace an independent contractor who costs $450,000/year with an independent contractor who’d cost $220,000/year.

The independent contractor in question is Dr. Kevin Efros, an anesthesiologist, whose contract is expiring, with a CRNA [Nurse Anesthetist] whom Chadwick believes can do the same job.

During his public comment, Efros expressed gratitude at the support from the community. He said he was recruited here and ultimately put together the current team of providers from scratch. Of that team, Efros said he is the most highly qualified and experienced.

He added that he would’ve gladly taken a $25,000 to $50,000 pay cut alongside his peers. “And I stand by this offer.”

NORTHERN (INYO) EXPOSURE

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[aneftp]

I’m not sure how Medicare mid level pass through works with hybrid MD and CRNA model.

I suspect since it’s rural hospital, hospital admin will exploit a loophole saying CRNA is independent on “solo” provider while on call to get the extra 50-75k the hospital gets for each independent mid level via Medicare pass through

 

[DLorNoBalls]

A CRNA being the only anesthesia provider available to a rural hospital sounds like a dangerous game. Who will the CRNA throw under the bus when complications arise?

 

[IMGASMD]

A CRNA being the only anesthesia provider available to a rural hospital sounds like a dangerous game. Who will the CRNA throw under the bus when complications arise?

Easy, surgeons/proceduralists.

 

[kidthor]

Easy, surgeons/proceduralists.

And then the admins will blame the anesthesiologist they unloaded, in absentia.

 

[ambiturner]

I’m curious about the cases, hours etc that are covered for 450k by an anesthesiologist that they can get a CRNA to do for 220

 

[Dr. Rude]

A CRNA being the only anesthesia provider available to a rural hospital sounds like a dangerous game. Who will the CRNA throw under the bus when complications arise?

Rural juries tend to be less plaintiff friendly. Less likely to put a bullet in one of the biggest employers in town (the hospital). Not wanting to antagonize someone who might very well be taking care of them or their family in the future.

 

[aneftp]

A CRNA being the only anesthesia provider available to a rural hospital sounds like a dangerous game. Who will the CRNA throw under the bus when complications arise?

Hospital punt a lot of complicated cases. I covered Md only level 2 trauma center in California 10-15 years ago in Northern California (and no, the Bay Area isn’t really considered real Northern California). More complicated cases got punted to university hospitals 80-100 miles away. But we still did lungs and open heart. So they can cherry pick some cases to divert.

I’m curious about the cases, hours etc that are covered for 450k by an anesthesiologist that they can get a CRNA to do for 220

Rural crna’s make 200k 26 weeks out of the year out west.

 

[BLADEMDA]

Anyone been to Bishop California? It's 100 miles west of Fresno. It seems like a remote location.

 

[BLADEMDA]

The independent contractor in question is Dr. Kevin Efros, an anesthesiologist, whose contract is expiring, with a CRNA [Nurse Anesthetist] whom Chadwick believes can do the same job.

“Both [an Anesthesiologist and a CRNA] can provide unsupervised anesthesia services,” said Chadwick.

Several physicians then got up to defend Dr. Efros – it felt like a Kenny Chesney song.

“You mess with one man you got us all.”

Chief of Orthopedics Dr. Bo Loy urged the NIHD Board to let the existing Anesthesiology group (which consists of Dr. Efros, Dr. Paul Kim, and Drs. Jennifer and Grant Meeker) figure out a plan to save the hospital money without removing one.

Dr. Sierra Bourne said staff is fearful for their own careers and that the proposal is damaging for morale.

Drs. Jeanine Arndal and Marty Kim both questioned whether the Hospital would find a CRNA for that price ($220,000). The idea we’ll get a provider to come in and take calls at fifty cents on the dollar is a stretch, expressed Arndal. And will create conflict within the department.

*The Sheet has since made a public records request regarding the last time NIHD employed CRNA’s for anesthesia services. A source told the newspaper that the former CRNAs were paid approximately $400,000/year.

Dr. Robin Cromer-Tyler said the anesthesiology department has been the best she’s seen it over the past six months. Why mess with a good thing?

Dr. Mark Robinson opined that the hospital shouldn’t punish Efros just because his contract happens to be up. “He has done a good job. Don’t punish that,” said Robinson.

During his public comment, Efros expressed gratitude at the support from the community. He said he was recruited here and ultimately put together the current team of providers from scratch. Of that team, Efros said he is the most highly qualified and experienced.

He added that he would’ve gladly taken a $25,000 to $50,000 pay cut alongside his peers. “And I stand by this offer.”

 

[Dr. Rude]

Something doesn’t compute. Either this is a very low volume lifestyle job or a resort area or some problem CVs in the department or something else wierd.

 

[pgg]

Anyone been to Bishop California? It's 100 miles west of Fresno. It seems like a remote location.

East

It's on the Nevada side of the Sierras. It's remote. About the only thing going for it is that it's about an hour away from the Mammoth ski resort. It's not the sort of place even an outdoors enthusiast would want to live. It's a place to get expensive gas on your way through to drive somewhere else.



All four of those anesthesiologists should quit. Let the place burn.

 

[Fpg1245]

The whole story sounds bizarre. They are aware of a global recruitment problem in anesthesia. It’s nationwide at this point.

Idk why they think they’ll be able to get a crna to go there and I’m not sure why these MDs are so willing to work with the hospital?

 

[Dr. Rude]

The whole story sounds bizarre. They are aware of a global recruitment problem in anesthesia. It’s nationwide at this point.

Idk why they think they’ll be able to get a crna to go there and I’m not sure why these MDs are so willing to work with the hospital?

Maybe they are desperate and are grasping at straws or they think that they can find their Rex who will work very cheaply.

 

[triggermaster]

Hospital punt a lot of complicated cases. I covered Md only level 2 trauma center in California 10-15 years ago in Northern California (and no, the Bay Area isn’t really considered real Northern California). More complicated cases got punted to university hospitals 80-100 miles away. But we still did lungs and open heart. So they can cherry pick some cases to divert.

Rural crna’s make 200k 26 weeks out of the year out west.

Yeah, to make that work it seems like the remaining docs would have to increase their workload to convert the replaced anesthesiologist’s job into one a crna would do for 220.
Like the crna might do 70% of the work for half the pay and the other 3 docs do 110% of their current work for no extra money. I didn’t read this I just don’t think crnas do q4 call for 220.

 

[Fpg1245]

Yeah, to make that work it seems like the remaining docs would have to increase their workload to convert the replaced anesthesiologist’s job into one a crna would do for 220.
Like the crna might do 70% of the work for half the pay and the other 3 docs do 110% of their current work for no extra money. I didn’t read this I just don’t think crnas do q4 call for 220.

My bet is this hospital closes in the next 2 years

 

[GravelRider]

They drew down a reserve account by $28million over two years and the solution they discussed during the bulk of the meeting was a $200k cheaper salary? Someone or everyone in that meeting is not very good at math. That’s like me going to Vegas and blowing $28,000 at the blackjack table and telling my wife I’ll work an extra hour of call to make up for it.

What a bunch of idiots. It sounds like this hospital is doomed. If I were the anesthesiologists there, I would cut my losses and move on.

 

[coffeebythelake]

Seems like the c-suite at this hospital didn't get the memo. cRNa is not cheap. The numbers are way off. Replacing the anesthesiologist with a cRNa will end very poorly for this hospital.

 

[anbuitachi]

its not completely about whether ceo can find a crna to go there for 220k. this is a contract negotiation tactic. and the anesthesiologist lost terribly. its basically ceo gave their offer, and anesthesiologist just said okay. pretty embarassing imo

 

[anbuitachi]

The Sheet followed up this week and asked Mr. Chadwick if the other Anesthesiologists in the group had also offered to take a pay cut. “That’s not an offer on the table,” was his reply.

During Board discussion, the most notable, unguarded comment was made by new board member Melissa Best-Baker, who said, “I wasn’t aware when I came on the board about the financial issues.”

Board member Jody Veenker said to Dr. Efros, in reference to the community support, “I hope this makes you feel good.”

She may as well have said, “Hey, I’m sorry you lost the lottery and are about to be stoned to death.”

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honestly doesnt feel like this hospital will survive even with a pay cut. i would either stand my ground with current salary or just leave and find another job, no need to get big pay cut and still go down w the ship when you are just a passenger

 

[GassYous]

The Sheet followed up this week and asked Mr. Chadwick if the other Anesthesiologists in the group had also offered to take a pay cut. “That’s not an offer on the table,” was his reply.

During Board discussion, the most notable, unguarded comment was made by new board member Melissa Best-Baker, who said, “I wasn’t aware when I came on the board about the financial issues.”

Board member Jody Veenker said to Dr. Efros, in reference to the community support, “I hope this makes you feel good.”

She may as well have said, “Hey, I’m sorry you lost the lottery and are about to be stoned to death.”

-----------------
honestly doesnt feel like this hospital will survive even with a pay cut. i would either stand my ground with current salary or just leave and find another job, no need to get big pay cut and still go down w the ship when you are just a passenger

They should get more money for dealing with the risk of an insolvent hospital

 

[TheLoneWolf]

Seems like the c-suite at this hospital didn't get the memo. cRNa is not cheap. The numbers are way off. Replacing the anesthesiologist with a cRNa will end very poorly for this hospital.

Can we all just pause to admire how well put together the noctor title is.

cRNa.

I am using this from now on.

 

[Burned_Out]

One of the sites I cover is a critical access hospital. It is a solo practice, so only 1 person covers the entire hospital 1 week at a time. This goes for CRNA's who work here too. No back-up. Pretty easy work and we turf anything hard out whenever possible.

My observation having worked here is that small town hospital administrations follows a philosophy of chasing pennies and ignoring the buckets of cash that is lost in revenue-profit. The hospital board tends to be locals with no healthcare experience and they don't have a clue what goes on with the finances. Accountability does not exist. Many of these hospitals do fail, but because many have this quasi-govt. affiliation as a critical access facility, they get bailed out by the taxpayers should they go into insolvency. Healthcare is a right in small places.

That being said, I would never offer to cut my pay to work at this place. The best I could do is cut my hours and/or days of coverage if they offer to pay me less.

 

[Dr. Rude]

One of the sites I cover is a critical access hospital. It is a solo practice, so only 1 person covers the entire hospital 1 week at a time. This goes for CRNA's who work here too. No back-up. Pretty easy work and we turf anything hard out whenever possible.

My observation having worked here is that small town hospital administrations follows a philosophy of chasing pennies and ignoring the buckets of cash that is lost in revenue-profit. The hospital board tends to be locals with no healthcare experience and they don't have a clue what goes on with the finances. Accountability does not exist. Many of these hospitals do fail, but because many have this quasi-govt. affiliation as a critical access facility, they get bailed out by the taxpayers should they go into insolvency. Healthcare is a right in small places.

That being said, I would never offer to cut my pay to work at this place. The best I could do is cut my hours and/or days of coverage if they offer to pay me less.

They have a few places like that not too far from where I live. They close the ORs on the weekend. Couldn’t afford to keep paying call fees that were required.

 

[IMGASMD]

I would not cut my hours nor rates. Especially I have no tie to the community. If it was where my family has to go, sure I’d keep the place running well enough to ensure my family’s well being. If no one has any brain cells trying to cut my pay, while sitting in the c suite not doing jack. No thank you.

 

[DrOwnage]

What a bunch of BS. Get an MBA, become an administrator, and your solution is to cut one positions salary in half which is 1/140th of the yearly deficit. A department that appears to be in great standing with all other departments given the support. The fact he said he would take any pay cut is pretty sad. The docs should not be the expendable asset. The administrators win once you start acting weak/desperate giving them any room to justify their outlandish offers in the first place.

 

[makalu]

wow, this is quite a lot of attention. i’m here as the offended party to answers questions and clear up misconceptions, albeit without getting too far into the details. the events that lead up to my departure are extremely complicated. it’s like a ten episode podcast. at least. maybe a seven part miniseries.

 

[makalu]

but i’ll say that pretty much all of the guesses about what happened are mostly incorrect. overall, the current situation at nih is a loss for the community, a loss for the patients, and a loss for the surgeons and staff that work in the operating rooms and in the l&d suite. i hope they can recover. for those of you that might know me, since my name is posted, i’d like to express my sincerest gratitude to all the surgeons, and all the or and labor and delivery nurses and other staff that stood up on my behalf at multiple board meetings, wrote letters, and expressed their support repeatedly throughout this true debacle. it’s a true shame what happened.

 

[Anesthesia_Guy]

but i’ll say that pretty much all of the guesses about what happened are mostly incorrect. overall, the current situation at nih is a loss for the community, a loss for the patients, and a loss for the surgeons and staff that work in the operating rooms and in the l&d suite. i hope they can recover. for those of you that might know me, since my name is posted, i’d like to express my sincerest gratitude to all the surgeons, and all the or and labor and delivery nurses and other staff that stood up on my behalf at multiple board meetings, wrote letters, and expressed their support repeatedly throughout this true debacle. it’s a true shame what happened.

Grow a pair, dude.

 

[makalu]

and as far as offering to take a pay cut being sad… every move i made at nih was in the interest of the community and patient care first and foremost, and secondly in the interest of the health of our specialty- these two were never at odds. the hospital was never truly interested in saving money by eliminating me… there was never any negotiations. not a single sentence exchanged. the offer was a public statement. anyone who caught a glimpse of the original crna posted on gas work saw they advertised a salary of 140-180k… that whole thing was a sham.

 

[makalu]

Grow a pair, dude.

in what respect? please clarify

 

[makalu]

also these news stories are from march or something. news travels slow i guess.

 

[anonperson]

wow, this is quite a lot of attention. i’m here as the offended party to answers questions and clear up misconceptions, albeit without getting too far into the details. the events that lead up to my departure are extremely complicated. it’s like a ten episode podcast. at least. maybe a seven part miniseries.

Why would you offer to take a pay cut?

That would change nothing for the hospital financials. It's in a deep hole.

It's a bad look and weakens physician negotiations in general. As more physicians move to an employed model in general, the last thing needed is physicians willingly taking paycuts.

 

[2021Doctor]

wow, this is quite a lot of attention. i’m here as the offended party to answers questions and clear up misconceptions, albeit without getting too far into the details. the events that lead up to my departure are extremely complicated. it’s like a ten episode podcast. at least. maybe a seven part miniseries.

Hello Dr. Efros,
Where did you end up?
Did the other anesthesiologists also leave?
Did they hire a CRNA?

 

[coffeebythelake]

but i’ll say that pretty much all of the guesses about what happened are mostly incorrect. overall, the current situation at nih is a loss for the community, a loss for the patients, and a loss for the surgeons and staff that work in the operating rooms and in the l&d suite. i hope they can recover. for those of you that might know me, since my name is posted, i’d like to express my sincerest gratitude to all the surgeons, and all the or and labor and delivery nurses and other staff that stood up on my behalf at multiple board meetings, wrote letters, and expressed their support repeatedly throughout this true debacle. it’s a true shame what happened.

You said you have so much support but someone clearly wants you out. And apparently no actual negotiation? Why even offer to cut your own pay? Is it even a matter of money?

 

[pgg]

wow, this is quite a lot of attention. i’m here as the offended party to answers questions and clear up misconceptions, albeit without getting too far into the details. the events that lead up to my departure are extremely complicated. it’s like a ten episode podcast. at least. maybe a seven part miniseries.

Thanks for posting.

Do you have local ties that make leaving especially difficult? (Spouse with career that isn't mobile or would take a large hit if you moved, local extended family that depend on you, etc.)

Absent exceptionally extenuating circumstances, I can't imagine remaining to work for an organization that treated me that way, especially these days when you can close your eyes and fall off the back of a pickup truck into a locums gig that'll come with a pay raise and a change of scenery. And having spent some time in the Navy, I'm not exactly unfamiliar with organizations that treat me with indifference or disrespect.

I don't get it. Why did you stay?

 

[makalu]

yes, people must have wanted me out, if i had the support of the surgeons and the or staff, but i still got the boot without any negotiations. the other anesthesiologists stayed on to be part of a 3md/1crna group as far as i know, with the crna being an independent practitioner, and all of them sharing the same job responsibilities. i spoke out strongly against this model, as it is inappropriate, and failed at nih in the past, as well as being bad for our specialty. the offer of the paycut was made publicly at a board meeting to show that the hospital wasn’t truly interested in saving money. it was stated that i would gladly take it alongside the other three anesthesiologist, if they had any interest in discussion whatsoever. neither admin nor the other anesthesiologists did. i do have ties to bishop- it’s a wonderful outdoor place, and probably the best place for four season rock climbing in north america. i like it there. but yes, it’s easy to get a great locums gig just by falling off the back of a truck, as previously stated. i definitely did not stay given the level of indifference they showed to me- as an anesthesiologist, as a physician, healthcare provider, and human. but that was never on the table. my only commitment, as previously stated, and i know this seems hard for people to believe, was to better the community and the patients i care for, and to work alongside the surgeons and staff that i interacted with every day. it’s a tiny town with two ORs serving a huge region- it matters. i was committed to the community. i did everything i could to preserve that, while still not violating what i felt was right. my integrity remains intact. i can say that a handful of people made selfish, immature, and vindictive decisions at the expense of a community, and at the expense of their own reputations.

 

[ambiturner]

yes, people must have wanted me out, if i had the support of the surgeons and the or staff, but i still got the boot without any negotiations. the other anesthesiologists stayed on to be part of a 3md/1crna group as far as i know, with the crna being an independent practitioner, and all of them sharing the same job responsibilities. i spoke out strongly against this model, as it is inappropriate, and failed at nih in the past, as well as being bad for our specialty. the offer of the paycut was made publicly at a board meeting to show that the hospital wasn’t truly interested in saving money. it was stated that i would gladly take it alongside the other three anesthesiologist, if they had any interest in discussion whatsoever. neither admin nor the other anesthesiologists did. i do have ties to bishop- it’s a wonderful outdoor place, and probably the best place for four season rock climbing in north america. i like it there. but yes, it’s easy to get a great locums gig just by falling off the back of a truck, as previously stated. i definitely did not stay given the level of indifference they showed to me- as an anesthesiologist, as a physician, healthcare provider, and human. but that was never on the table. my only commitment, as previously stated, and i know this seems hard for people to believe, was to better the community and the patients i care for, and to work alongside the surgeons and staff that i interacted with every day. it’s a tiny town with two ORs serving a huge region- it matters. i was committed to the community. i did everything i could to preserve that, while still not violating what i felt was right. my integrity remains intact. i can say that a handful of people made selfish, immature, and vindictive decisions at the expense of a community, and at the expense of their own reputations.

Sounds like it was personal since they definitely couldn’t have hired a CRNA to work independently and take q4 call for much less than you would have made after the cut. Your offer makes more sense knowing that you knew they wouldn’t take it.

Whatever the full story is, it’s an unfortunate thing to go through but a much better time to be going through it than 5 years ago.

 

[Coffee PRN]

Grow a pair, dude.

It might have been better if you had let him explain his side of things first especially since he was willing to put himself out here instead of personal attacks on his manhood...just saying. After reading his comments I feel like he was very brave for taking a stand and making that point it wasn't about the money.

 

[Anesthesia_Guy]

in what respect? please clarify

Taking a pay cut is a b*tch move.

 

[makalu]

Taking a pay cut is a b*tch move.

i mean, let’s be honest, trolling people anonymously on the internet is a b*tch move. wasting everyone’s time. i’d rather be living my life in peace than trying to inflate my sense of self by putting others down. best of luck though, in every regard.

 

[anbuitachi]

yes, people must have wanted me out, if i had the support of the surgeons and the or staff, but i still got the boot without any negotiations. the other anesthesiologists stayed on to be part of a 3md/1crna group as far as i know, with the crna being an independent practitioner, and all of them sharing the same job responsibilities. i spoke out strongly against this model, as it is inappropriate, and failed at nih in the past, as well as being bad for our specialty. the offer of the paycut was made publicly at a board meeting to show that the hospital wasn’t truly interested in saving money. it was stated that i would gladly take it alongside the other three anesthesiologist, if they had any interest in discussion whatsoever. neither admin nor the other anesthesiologists did. i do have ties to bishop- it’s a wonderful outdoor place, and probably the best place for four season rock climbing in north america. i like it there. but yes, it’s easy to get a great locums gig just by falling off the back of a truck, as previously stated. i definitely did not stay given the level of indifference they showed to me- as an anesthesiologist, as a physician, healthcare provider, and human. but that was never on the table. my only commitment, as previously stated, and i know this seems hard for people to believe, was to better the community and the patients i care for, and to work alongside the surgeons and staff that i interacted with every day. it’s a tiny town with two ORs serving a huge region- it matters. i was committed to the community. i did everything i could to preserve that, while still not violating what i felt was right. my integrity remains intact. i can say that a handful of people made selfish, immature, and vindictive decisions at the expense of a community, and at the expense of their own reputations.

so basically you got fired? for i guess pushing back on using crna?

it sucks that the other 3 MDs stayed. if i were one of the 3, id absolutely pack my bags and leave asap if they fired one of my colleagues for standing up for patients and physicians.

it also sucks that the rest of the OR staff only supported verbally (or so it sounds).

admins can be replaced. if the ceos crap job result in the hospital shutting down the ORs, especially without a wide encatchment area , then ceo should be fired.

 

[makalu]

so basically you got fired? for i guess pushing back on using crna?

it sucks that the other 3 MDs stayed. if i were one of the 3, id absolutely pack my bags and leave asap if they fired one of my colleagues for standing up for patients and physicians.

it also sucks that the rest of the OR staff only supported verbally (or so it sounds).

admins can be replaced. if the ceos crap job result in the hospital shutting down the ORs, especially without a wide encatchment area , then ceo should be fired.

my push back on using the crna happened after the contract non-renewal; it was addressing their sham cost savings plan, which was a convenient cover story to let me go. even though i was the chief and the one with the most work experience, and who had ultimately brought in the other three, my contract was up, and the others had a year left (as far as i knew), so they were able to claim it was just a timing thing.

i felt very supported by the or staff and surgeons. more than just verbally. they truly did everything possible to support me. in the end the whole fiasco had become so disruptive and stressful to the operating rooms that we all just had to move on.

i won’t make any comment on the personnel involved. this isn’t the place for that.

 

[ryanjmy]

This doesn’t make sense. For the most part administration doesn’t know what we do or that we even exist. The 2 things get anesthesiologists on admin’s radar are surgeon complaints and money. You say those were good. There has to be more to the story.

 

[Gaseous Clay]

Taking a pay cut is a b*tch move.

How has this "Dude" not been banned yet?

 

[anbuitachi]

my push back on using the crna happened after the contract non-renewal; it was addressing their sham cost savings plan, which was a convenient cover story to let me go. even though i was the chief and the one with the most work experience, and who had ultimately brought in the other three, my contract was up, and the others had a year left (as far as i knew), so they were able to claim it was just a timing thing.

i felt very supported by the or staff and surgeons. more than just verbally. they truly did everything possible to support me. in the end the whole fiasco had become so disruptive and stressful to the operating rooms that we all just had to move on.

i won’t make any comment on the personnel involved. this isn’t the place for that.

so the others will probably be kicked out too once their contract is up. sucks the way they are treating physicians

 

[tdub878]

Thanks for sharing. Many key board warriors here talk a big game.

 

[anbuitachi]

Thanks for sharing. Many key board warriors here talk a big game.

you have to take pride in what you do. being a warrior is not easy. there are many battles along the way. but i would absolutely quit asap if i were one of the other 3

 

[TheLoneWolf]

so basically you got fired? for i guess pushing back on using crna?

it sucks that the other 3 MDs stayed. if i were one of the 3, id absolutely pack my bags and leave asap if they fired one of my colleagues for standing up for patients and physicians.

it also sucks that the rest of the OR staff only supported verbally (or so it sounds).

admins can be replaced. if the ceos crap job result in the hospital shutting down the ORs, especially without a wide encatchment area , then ceo should be fired.

I could argue that admins take calculated risks. If they can go through HR and find out that you have dependents and have been working for them for at least a few years they can rightly assume uprooting your family will be a hardship that you would avoid over a change in pay for example.

On the other hand, what they did to you in a rural hospital when the market is red hot is shortsighted. All of us are hounded and cold called by recruiters. Hospital near us mishandled their anesthesia situation and now their ORs are closing.

In reading this story, I assume their long term plan is to introduce independent cRNas then slowly non-renew the physician contracts or keep one on staff for posterity. What they don't understand is surgeons who have been working with Anesthesiologists for years see cRNas as a step down. Where I work, especially for stuff like EP labs,vascular, cardiac, OB all want Physician Anesthesiologists. Couldn't place a cRNa in those rooms.

 

[makalu]

This doesn’t make sense. For the most part administration doesn’t know what we do or that we even exist. The 2 things get anesthesiologists on admin’s radar are surgeon complaints and money. You say those were good. There has to be more to the story.

there’s a lot more to the story. sadly, for everyone on here’s education and/or entertainment, the satisfaction of knowing the missing details, and just how willing people are to sacrifice the well being of an entire community (forgetting me for the moment), to service their own immature needs, can’t be elaborated on here. immaturity on the part of physicians. i’ll leave it at that.