Anesthesiologist shortage

[dizzy21]

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Not much new but some nice anecdotes of hospital administrators finding out what happens when you don’t have a functioning anesthesia department.

https://www.sciencedirect.com/science/article/pii/S2949916X2400001X

 

[IMGASMD]

Are they on this board too? [emoji1787]
A lot of cases that we were all talking about.

Loved that Barnabas tidbit……. Wonder how that will play out….

 

[IlDestriero]

Our problem is that the hospital system has gone headlong into a decade long dramatic expansion in the high reimbursement and high profit cost centers. Expanding surgical and other procedural hiring with no regard to our ability to staff any of it and apparently forgetting that all these people need ORs and procedure rooms to make all that facility fee loot. In the middle of our own little staffing crisis, 1/2 way in, they added 2 anesthetizing locations every day. Surprise dinguses, we can’t conjure up an experienced anesthesiologist or 10 with a linked in ad. And doing more cases on nights and weekends is making people leave, so expect it to get worse not better.

 

[deleted1130227]

You should say:

 

[IlDestriero]

That’s been the current reply. 😆

 

[bocciball]

This is an excellent synopsis and should be forwarded to decision makers at area hospitals as part of an educational curriculum..

 

[Iso4ane]

You want to pay me $200/hr?! How about $2,000/hr? I’m willing work, if you’re willing to pay.

 

[Hoya11]

Our problem is that the hospital system has gone headlong into a decade long dramatic expansion in the high reimbursement and high profit cost centers. Expanding surgical and other procedural hiring with no regard to our ability to staff any of it and apparently forgetting that all these people need ORs and procedure rooms to make all that facility fee loot. In the middle of our own little staffing crisis, 1/2 way in, they added 2 anesthetizing locations every day. Surprise dinguses, we can’t conjure up an experienced anesthesiologist or 10 with a linked in ad. And doing more cases on nights and weekends is making people leave, so expect it to get worse not better.

Right. The inefficiency is growing. How much is truly a shortage ( surely some) vs how much is just the perception of a shortage because we are all on call at different hospitals waiting for the same appy to come in? If hospitals were organized individually and collectively into some kind of system where they werent all competing for the same surgeon/cases the shortage would be a lot more manageable

 

[coffeebythelake]

Right. The inefficiency is growing. How much is truly a shortage ( surely some) vs how much is just the perception of a shortage because we are all on call at different hospitals waiting for the same appy to come in? If hospitals were organized individually and collectively into some kind of system where they werent all competing for the same surgeon/cases the shortage would be a lot more manageable

Don't give people ideas. These mega hospital mergers allow hospital admin to do just that. Shunt every case to the mothership so bare bones coverage can be had at the satellites.

 

[Shimmy8]

Hospitals and c-suites continue to assume that because they’re making money, that we’re making money. Not sure if it’s incompetence or ignorance, but they’ll learn one way or another…

 

[aneftp]

Hospitals and c-suites continue to assume that because they’re making money, that we’re making money. Not sure if it’s incompetence or ignorance, but they’ll learn one way or another…

Once surgeons even the employed hospitals ones demand compensation for answering phone calls at night. It’s game over for the hospital.

If you think anesthesia isn’t making money not working but being available (if private practice and billing per case) Try being on call as a surgeon. It’s even worst.

So there is a ton of uncompensated work docs do from many specialists

Not sure what the end game is. The good old days of being able to come who with creative ways to bill (like running down to the er for every bs trauma even minor fender benders). Having patients open their mouth for $200 airway exam each patient was easy money. Those were the good ole days (even before my time) in the 1970s and early 1980s.

 

[anbuitachi]

healthcare has its own market. can we really say we are so short in anesthesiologists when the average anesthesiologists makes much less than an avg surgeon? practically all subspecialties make significantly more than we do, ortho, neuro, thoracic, plastics, pediatrics, ent, vascular, etc. Really the only surgeons our salaries are close to are general surgeons.

If we are so short, the market will simply increase pay, so that enough anesthesiologists are willing to work extra to satisfy that gap. i'll do an extra shift for 400+ a hr. maybe its just my region, but my work is still fully staffed. no one quit recently, we created a spot due to more cases, and it filled pretty easily.

 

[anbuitachi]

Once surgeons even the employed hospitals ones demand compensation for answering phone calls at night. It’s game over for the hospital.

If you think anesthesia isn’t making money not working but being available (if private practice and billing per case) Try being on call as a surgeon. It’s even worst.

So there is a ton of uncompensated work docs do from many specialists

Not sure what the end game is. The good old days of being able to come who with creative ways to bill (like running down to the er for every bs trauma even minor fender benders). Having patients open their mouth for $200 airway exam each patient was easy money. Those were the good ole days (even before my time) in the 1970s and early 1980s.

not sure about other places. here the surgeons are employed and are paid a set amount for home call (answering phone calls), and if they need to come in, at hourly rate...

 

[deleted1183938]

healthcare has its own market. can we really say we are so short in anesthesiologists when the average anesthesiologists makes much less than an avg surgeon? practically all subspecialties make significantly more than we do, ortho, neuro, thoracic, plastics, pediatrics, ent, vascular, etc. Really the only surgeons our salaries are close to are general surgeons.

If we are so short, the market will simply increase pay, so that enough anesthesiologists are willing to work extra to satisfy that gap. i'll do an extra shift for 400+ a hr. maybe its just my region, but my work is still fully staffed. no one quit recently, we created a spot due to more cases, and it filled pretty easily.

We are short. Maybe not in the big cities but for sure in smaller cities and towns. Huge exodus with Covid and increased demand for outside main OR services as someone stated above.

 

[deleted1183938]

Right. The inefficiency is growing. How much is truly a shortage ( surely some) vs how much is just the perception of a shortage because we are all on call at different hospitals waiting for the same appy to come in? If hospitals were organized individually and collectively into some kind of system where they werent all competing for the same surgeon/cases the shortage would be a lot more manageable

This is a terrible idea. This has only led to increased cost for patients and poorer quality care. It’s been happening for decades. And then they Jack the prices up for everyone because they are the main player of one of the main players in town. They self refer from all their little hospitals and clinics and hire a bunch of midlevels and screw everyone and everything up squeezing money from every patients’ orifice.

 

[Hoya11]

This is a terrible idea. This has only led to increased cost for patients and poorer quality care. It’s been happening for decades. And then they Jack the prices up for everyone because they are the main player of one of the main players in town. They self refer from all their little hospitals and clinics and hire a bunch of midlevels and screw everyone and everything up squeezing money from every patients’ orifice.

So you are in support of several different competing healthcare systems each with an anesthesiologist on call competing for the same cases? Yet hospital working together in an organized fashion “drives up cost” . It seems like it would make it way more efficient for OR staffing and EMS.

Competing hospitals in the same town building multiple MRI machines, multiple EP suites, multiple docs on call waiting for any scraps to come in, but the suggestion of somehow organizing and streamlining those off hours cases will drive cost UP? Not following .. hard disagree, competing hospital systems create redundancy and inefficiency to the patients , community, payers, not sure how your thinking this inefficient redundant expansion is a good idea to meet the needs of the expanding community

The reason it doesn’t happen is because the hospitals won’t work together and want to hold onto these late night cases and admissions for their own financial gains .

Designating one hospital in a town/region as the “call” hospital would allow that hospital to be prepared for the action , as opposed to a bare bones crew at a community hospital holding onto a pediatric appy for the money

 

[deleted1183938]

So you are in support of several different competing healthcare systems each with an anesthesiologist on call competing for the same cases? Yet hospital working together in an organized fashion “drives up cost” . It seems like it would make it way more efficient for OR staffing and EMS.

Competing hospitals in the same town building multiple MRI machines, multiple EP suites, multiple docs on call waiting for any scraps to come in, but the suggestion of somehow organizing and streamlining those off hours cases will drive cost UP? Not following .. hard disagree, competing hospital systems create redundancy and inefficiency to the patients , community, payers, not sure how your thinking this inefficient redundant expansion is a good idea to meet the needs of the expanding community

The reason it doesn’t happen is because the hospitals won’t work together and want to hold onto these late night cases and admissions for their own financial gains .

Designating one hospital in a town/region as the “call” hospital would allow that hospital to be prepared for the action , as opposed to a bare bones crew at a community hospital holding onto a pediatric appy for the money

Because I have actually read about topics like these. They interest me. And when you actually do the same, you will open your eyes. What you “think” makes a better option actually doesn’t. It creates a freer market that keeps costs down for patients.
And what do you mean scraps? Patients? We aren’t talking about little towns here. We are talking major cities and bigger towns where there are plenty of patients.

 

[anbuitachi]

we hear and see all the time these papers mentioning boomers getting to that old age needing surgeries so we are predicting massive shortages. the solution is partially to increase residency spots. no one talks about what happens after this period ends. is the plan to reduce residency spots later? where are these extra physicians going to go?

 

[Hoya11]

Because I have actually read about topics like these. They interest me. And when you actually do the same, you will open your eyes. What you “think” makes a better option actually doesn’t. It creates a freer market that keeps costs down for patients.
And what do you mean scraps? Patients? We aren’t talking about little towns here. We are talking major cities and bigger towns where there are plenty of patients.

Lol ok your right man you read the books ... And I’m actually not talking about big major cities. I’m talking about multiple hospital systems competing within the same medium to small market that could be more efficiently served by one larger hospital or by a system that makes the hospitals work together instead of competing

 

[crash2500]

Lol ok your right man you read the books ... And I’m actually not talking about big major cities. I’m talking about multiple hospital systems competing within the same medium to small market that could be more efficiently served by one larger hospital or by a system that makes the hospitals work together instead of competing

You mean like United healthcare? How they have consolidated insurance, clinics, surgery centers, hospitals and physical groups? You think they have lowered costs?

 

[coffeebythelake]

You mean like United healthcare? How they have consolidated insurance, clinics, surgery centers, hospitals and physical groups? You think they have lowered costs?

They upped profit margins and their fat bonuses that's for sure

 

[narcotics999]

They upped profit margins and their fat bonuses that's for sure

Doj is investigating UnitedHealth.

 

[aneftp]

Doj is investigating UnitedHealth.

lol that’s why I mention United Healthcare is the one blasting usap for their lobbying tactics. United healthcare is the worst of the major insurers cause they always have issues negotiating with big hospitals systems throughout the country as well.

It’s all dirty.

 

[deleted1130227]

It’s all dirty.

It’s just capitalism. It is not dirty if you are the one cashing the check. [emoji6]

 

[amyl]

Anesthesiologist demand outstripping supply

"Discover the alarming shortage of anesthesiologists in the healthcare market, with 5 key statistics from a 2023 whitepaper by Medicus Healthcare Solutions."

www.beckersasc.com

 

[Status Sciaticus]

Right. The inefficiency is growing. How much is truly a shortage ( surely some) vs how much is just the perception of a shortage because we are all on call at different hospitals waiting for the same appy to come in? If hospitals were organized individually and collectively into some kind of system where they werent all competing for the same surgeon/cases the shortage would be a lot more manageable

Don't give people ideas. These mega hospital mergers allow hospital admin to do just that. Shunt every case to the mothership so bare bones coverage can be had at the satellites.

This will never happen as long as EMTALA is the law.

 

[deleted1130227]

This will never happen as long as EMTALA is the law.

We do lots of transfers in from outlying hospitals part of our system. EMTALA is not an issue if part of the same system and The service is not available.

E.g. no general surgery ER coverage on weekends, no GI coverage available and patient will need a scope as part of their care.

 

[Status Sciaticus]

We do lots of transfers in from outlying hospitals part of our system. EMTALA is not an issue if part of the same system and The service is not available.

E.g. no general surgery ER coverage on weekends, no GI coverage available and patient will need a scope as part of their care.

I am aware of escalation of care transfers. What I am saying is that anesthesiology is considered an essential part of any hospital staffing to the point that to not have one in a hospital or on call immediately available would be very unusual.

GI is never there on the weekends anyways.

 

[aneftp]

I am aware of escalation of care transfers. What I am saying is that anesthesiology is considered an essential part of any hospital staffing to the point that to not have one in a hospital or on call immediately available would be very unusual.

GI is never there on the weekends anyways.

My gi doc friend covers a small hospital locums on the side on weekends. He’s far cheaper ($4000 beeper plus $200 a scope) per 24 hours than transferring patients outside.

Keeps my locums gig going also lol cause we cover the same hospital.

 

[lotsapain]

healthcare has its own market. can we really say we are so short in anesthesiologists when the average anesthesiologists makes much less than an avg surgeon? practically all subspecialties make significantly more than we do, ortho, neuro, thoracic, plastics, pediatrics, ent, vascular, etc. Really the only surgeons our salaries are close to are general surgeons.

If we are so short, the market will simply increase pay, so that enough anesthesiologists are willing to work extra to satisfy that gap. i'll do an extra shift for 400+ a hr. maybe its just my region, but my work is still fully staffed. no one quit recently, we created a spot due to more cases, and it filled pretty easily.

You fail to see that as a specialty we do not bring any patients directly. A large number of surgeries are still elective, where as emergency surgery comprises anywhere between 10-20% of surgical volume.

That being said in an ideal world as someone else has pointed if surgeons are employed perhaps there is a a way to build a truly collaborative system. Though, I doubt this will ever happen. I have seen multiple hospitals exhibit same patterns as are described in this very insightful article - surgeons DEMANDING longer operating hours without consideration for their colleagues. In an ideal world there would be no 24, 16 or maybe even 12 hour shifts, you would have a fresh crew every 8-10 hours. I fail to understand why some of these acute care / trauma / ortho trauma specialties just love doing cases at night where it has been proven that outcomes are worse.

The rhetoric will always be the same - we do not bring cases we do not command higher pay ....... some people on here continue with this "pay me $500/hr nonsense or else" while the truth is may will take less money in a friendly, collaborative environment.

Administrators are both blind, short-sighted and for some reason for supposedly intelligent people are just well.... dumb.... most (if not all) do NOT understand OR operations...... because they have never set foot in the OR....

Someone mentioned mega hospitals and that is a bad idea - actually that will be the only solution. Supporting many brick and mortar building requiring double triple etc of the same support staff is not viable. Why have 3 hospitals and x3 of all the staff (ie janitors, accountants, HR, nurse managers, physicians) when you can have a well streamlined mega hospital that has all the specialties all the time and not having to transfer patients from country hospitals that can't even do a basic appy at night because there is no surgeon on call....

No clue what the future holds it can go either way - ie salaries will become so high they will be unsustainable or they will ALL drop because we will be unaffordable otherwise.

In reference to RWJ.. there is much more to that story.... that being they are now offering really high salaries to ensure nipping this in the butt once and for all..... NJ landscape is oh so very interesting.

 

[deleted1183938]

I am aware of escalation of care transfers. What I am saying is that anesthesiology is considered an essential part of any hospital staffing to the point that to not have one in a hospital or on call immediately available would be very unusual.

GI is never there on the weekends anyways.

Some doctors cover moultiple hospitals at once over night. Even anesthesiologists

 

[aneftp]

You fail to see that as a specialty we do not bring any patients directly. A large number of surgeries are still elective, where as emergency surgery comprises anywhere between 10-20% of surgical volume.

That being said in an ideal world as someone else has pointed if surgeons are employed perhaps there is a a way to build a truly collaborative system. Though, I doubt this will ever happen. I have seen multiple hospitals exhibit same patterns as are described in this very insightful article - surgeons DEMANDING longer operating hours without consideration for their colleagues. In an ideal world there would be no 24, 16 or maybe even 12 hour shifts, you would have a fresh crew every 8-10 hours. I fail to understand why some of these acute care / trauma / ortho trauma specialties just love doing cases at night where it has been proven that outcomes are worse.

The rhetoric will always be the same - we do not bring cases we do not command higher pay ....... some people on here continue with this "pay me $500/hr nonsense or else" while the truth is may will take less money in a friendly, collaborative environment.

Administrators are both blind, short-sighted and for some reason for supposedly intelligent people are just well.... dumb.... most (if not all) do NOT understand OR operations...... because they have never set foot in the OR....

Someone mentioned mega hospitals and that is a bad idea - actually that will be the only solution. Supporting many brick and mortar building requiring double triple etc of the same support staff is not viable. Why have 3 hospitals and x3 of all the staff (ie janitors, accountants, HR, nurse managers, physicians) when you can have a well streamlined mega hospital that has all the specialties all the time and not having to transfer patients from country hospitals that can't even do a basic appy at night because there is no surgeon on call....

No clue what the future holds it can go either way - ie salaries will become so high they will be unsustainable or they will ALL drop because we will be unaffordable otherwise.

In reference to RWJ.. there is much more to that story.... that being they are now offering really high salaries to ensure nipping this in the butt once and for all..... NJ landscape is oh so very interesting.

Crnas are moving towards 2-3 day work weeks (16/24 hr shifts)

Plus if they you don’t give them that schedule want as w2. They will bolt to another place. The may take a 0.6 position w2 (2 days a week) and bolt to another location. This creates an artificial shortage

Anesthesia docs are the dumb ones working 5 days a week providing coverage for calls etc. oh yeah. We get to leave “early 10/11” pre call, post late the previous days. But the damage is done the minute u show up at the door. Showing up is 80% of the efforts.

The crnas or even Or staff “think” anesthesiologist has it easy leaving at 11am yet the crna rots away to 8-9pm. But they are the ones off more days and they GET TO CHOOSE if they want to pickup extra work elsewhere or internally.

The coverage is the issue. Even in all MD practices. It becomes a pain showing up 5 days a weeks. That’s why surgery center running 630am-5pm consistently (maybe a 2 days end at 3pm but 3 days ends 5/6pm). That’s a 46-48 hr work week which on paper sounds nice. But it’s not nice in 2024.

You can’t get anyone willing to work 5 days a week with no calls at surgery centers anymore with those hours.

Those surgery centers need to be done at 2pm to get a full time doc to work 5 days a week at 500k and 10 weeks off.

But they offer 450-500k with 8 weeks off and 48 hrs. Ain’t no one gonna to do it. I see them advertise all the time and no takers.

 

[lotsapain]

Crnas are moving towards 2-3 day work weeks (16/24 hr shifts)

Plus if they you don’t give them that schedule want as w2. They will bolt to another place. The may take a 0.6 position w2 (2 days a week) and bolt to another location. This creates an artificial shortage

Anesthesia docs are the dumb ones working 5 days a week providing coverage for calls etc. oh yeah. We get to leave “early 10/11” pre call, post late the previous days. But the damage is done the minute u show up at the door. Showing up is 80% of the efforts.

The crnas or even Or staff “think” anesthesiologist has it easy leaving at 11am yet the crna rots away to 8-9pm. But they are the ones off more days and they GET TO CHOOSE if they want to pickup extra work elsewhere or internally.

The coverage is the issue. Even in all MD practices. It becomes a pain showing up 5 days a weeks. That’s why surgery center running 630am-5pm consistently (maybe a 2 days end at 3pm but 3 days ends 5/6pm). That’s a 46-48 hr work week which on paper sounds nice. But it’s not nice in 2024.

You can’t get anyone willing to work 5 days a week with no calls at surgery centers anymore with those hours.

Those surgery centers need to be done at 2pm to get a full time doc to work 5 days a week at 500k and 10 weeks off.

But they offer 450-500k with 8 weeks off and 48 hrs. Ain’t no one gonna to do it. I see them advertise all the time and no takers.

I am not sure what this has to do with the prior post..

 

[aneftp]

I am not sure what this has to do with the prior post..

In relation to the original post. The author of the linked article has no day to day clue what goes on. This is an example of someone who writes articles and extrapolates data from what they are spoon fed why there is an anesthesia shortage.

Read the article. They mention there are complex issues why there is a shortage. Yet no one mentions one of the most important issues.

The anesthesia working conditions. Anesthesiologist especially private practice ones used to work 55-60 hours routinely. Covered more days. Available more weeks. Took less weeks off (4-5 weeks was standard paid (or unpaid time off). Now it’s routinely 8-10 weeks off). That’s double the routine time off. That creates a shortage.

Crnas also would work 5 days a week 8 hours at a time then get relieved by docs (if in act model). Crna are available less days now and increased time off as well 7-9 weeks paid time off is standard now. That’s just the standard Time off. Now with their shift to 7-8 work days a month total. They have a lot more time off

This is what happens when the author has no clue what goes on day to day on the ground like I do.

 

[T-burglar]

It’s true the working conditions in anesthesia are bull**** and I’m happy to see things move from catering to surgeons to something more reasonable for us.

5 days a week in the hospital before 630 am ? plus call? So I can miss my sons activities AND never see him off to school in the morning? Go **** yourselves, I like my child and want to see him.

 

[deleted1183938]

Crnas are moving towards 2-3 day work weeks (16/24 hr shifts)

Plus if they you don’t give them that schedule want as w2. They will bolt to another place. The may take a 0.6 position w2 (2 days a week) and bolt to another location. This creates an artificial shortage

Anesthesia docs are the dumb ones working 5 days a week providing coverage for calls etc. oh yeah. We get to leave “early 10/11” pre call, post late the previous days. But the damage is done the minute u show up at the door. Showing up is 80% of the efforts.

The crnas or even Or staff “think” anesthesiologist has it easy leaving at 11am yet the crna rots away to 8-9pm. But they are the ones off more days and they GET TO CHOOSE if they want to pickup extra work elsewhere or internally.

The coverage is the issue. Even in all MD practices. It becomes a pain showing up 5 days a weeks. That’s why surgery center running 630am-5pm consistently (maybe a 2 days end at 3pm but 3 days ends 5/6pm). That’s a 46-48 hr work week which on paper sounds nice. But it’s not nice in 2024.

You can’t get anyone willing to work 5 days a week with no calls at surgery centers anymore with those hours.

Those surgery centers need to be done at 2pm to get a full time doc to work 5 days a week at 500k and 10 weeks off.

But they offer 450-500k with 8 weeks off and 48 hrs. Ain’t no one gonna to do it. I see them advertise all the time and no takers.

Clearly someone is doing it. Otherwise they wouldn’t function. But maybe not that many are doing it.

 

[lotsapain]

It’s true the working conditions in anesthesia are bull**** and I’m happy to see things move from catering to surgeons to something more reasonable for us.

5 days a week in the hospital before 630 am ? plus call? So I can miss my sons activities AND never see him off to school in the morning? Go **** yourselves, I like my child and want to see him.

You did know that this profession implies early morning starts right? Perhaps you are in the wrong field?! Pathology and ophthalmology are short too. Perhaps find a plastics surgery office twice a week if you can make it work ..... I understand your frustration but I am tired of hearing this consistent song of "I don't like this.... I don't like that" and pay me 600-700k to come in two days a week.... come on people I am very well aware of certain practices pushing crazy hours but you cannot expect to not work and get paid ...... this millenial approach to life will go so far.... I am all about safe workplace practices limiting call to 12-16 hours but rolling into a hospital when you feel like it.... then you are surprised why the profession is treated like it is.... bunch of snowflakes who want to get paid and do nothing... there is a middle ground..

 

[lotsapain]

In relation to the original post. The author of the linked article has no day to day clue what goes on. This is an example of someone who writes articles and extrapolates data from what they are spoon fed why there is an anesthesia shortage.

Read the article. They mention there are complex issues why there is a shortage. Yet no one mentions one of the most important issues.

The anesthesia working conditions. Anesthesiologist especially private practice ones used to work 55-60 hours routinely. Covered more days. Available more weeks. Took less weeks off (4-5 weeks was standard paid (or unpaid time off). Now it’s routinely 8-10 weeks off). That’s double the routine time off. That creates a shortage.

Crnas also would work 5 days a week 8 hours at a time then get relieved by docs (if in act model). Crna are available less days now and increased time off as well 7-9 weeks paid time off is standard now. That’s just the standard Time off. Now with their shift to 7-8 work days a month total. They have a lot more time off

This is what happens when the author has no clue what goes on day to day on the ground like I do.

This is a MACRO level article it is not meant to dissect the minutia

 

[T-burglar]

You did know that this profession implies early morning starts right? Perhaps you are in the wrong field?! Pathology and ophthalmology are short too. Perhaps find a plastics surgery office twice a week if you can make it work ..... I understand your frustration but I am tired of hearing this consistent song of "I don't like this.... I don't like that" and pay me 600-700k to come in two days a week.... come on people I am very well aware of certain practices pushing crazy hours but you cannot expect to not work and get paid ...... this millenial approach to life will go so far.... I am all about safe workplace practices limiting call to 12-16 hours but rolling into a hospital when you feel like it.... then you are surprised why the profession is treated like it is.... bunch of snowflakes who want to get paid and do nothing... there is a middle ground..

you’re gonna be on your deathbed some day, you know. Thinking about your life.

 

[deleted1183938]

You did know that this profession implies early morning starts right? Perhaps you are in the wrong field?! Pathology and ophthalmology are short too. Perhaps find a plastics surgery office twice a week if you can make it work ..... I understand your frustration but I am tired of hearing this consistent song of "I don't like this.... I don't like that" and pay me 600-700k to come in two days a week.... come on people I am very well aware of certain practices pushing crazy hours but you cannot expect to not work and get paid ...... this millenial approach to life will go so far.... I am all about safe workplace practices limiting call to 12-16 hours but rolling into a hospital when you feel like it.... then you are surprised why the profession is treated like it is.... bunch of snowflakes who want to get paid and do nothing... there is a middle ground..

Come on. No one is asking for 600k to work 2 days a week. There is nothing wrong with wanting to work less and make less. People who want their weekends off and mommy track/surgicenter positions are happy to take 350-400k in this market.

 

[deleted641888]

You did know that this profession implies early morning starts right? Perhaps you are in the wrong field?! Pathology and ophthalmology are short too. Perhaps find a plastics surgery office twice a week if you can make it work ..... I understand your frustration but I am tired of hearing this consistent song of "I don't like this.... I don't like that" and pay me 600-700k to come in two days a week.... come on people I am very well aware of certain practices pushing crazy hours but you cannot expect to not work and get paid ...... this millenial approach to life will go so far.... I am all about safe workplace practices limiting call to 12-16 hours but rolling into a hospital when you feel like it.... then you are surprised why the profession is treated like it is.... bunch of snowflakes who want to get paid and do nothing... there is a middle ground..

I’ve run into plenty of boomers and senior partners who want the same thing. If anything, maybe more so than the younger folks.

 

[aneftp]

This is a MACRO level article it is not meant to dissect the minutia

The article seems to attack private equity more than hospital mergers and greed themselves.
Everyone in leadership wants to “grow” and in healthcare it means doing “more”

The two easiest ways to “grow” and stil maintain profitability is
1. Market share rape private insurance payors for more money. Hospital mergers especially during the last 15 years with Obamacare have only increased costs to the system. The little hospital system can’t compete.

2. The smaller private doc practice eventually sell out to hospitals (cardiology rad onc, peds, internal medicine, gi ). If they can’t find buyers than private equity or bigger public traded companies like pediatrix medical group “MD stock ticket l (American anesthesiology parent company) which also owns icu practices and peds practices

Come on. No one is asking for 600k to work 2 days a week. There is nothing wrong with wanting to work less and make less. People who want their weekends off and mommy track/surgicenter positions are happy to take 350-400k in this market.

there are no mommy track jobs that pay moms 3 days a week for 400k

Moms want to have extreme flexibility and not stuck to 5pm 5 days a week at surgery center

No moms anesthesia docs I know even work 5 days week these days. Unless they are at the VA. And even those I know work 3-4 days a week at the VA.

 

[deleted1183938]

The article seems to attack private equity more than hospital mergers and greed themselves.
Everyone in leadership wants to “grow” and in healthcare it means doing “more”

The two easiest ways to “grow” and stil maintain profitability is
1. Market share rape private insurance payors for more money. Hospital mergers especially during the last 15 years with Obamacare have only increased costs to the system. The little hospital system can’t compete.

2. The smaller private doc practice eventually sell out to hospitals (cardiology rad onc, peds, internal medicine, gi ). If they can’t find buyers than private equity or bigger public traded companies like pediatrix medical group “MD stock ticket l (American anesthesiology parent company) which also owns icu practices and peds practices

there are no mommy track jobs that pay moms 3 days a week for 400k

Moms want to have extreme flexibility and not stuck to 5pm 5 days a week at surgery center

No moms anesthesia docs I know even work 5 days week these days. Unless they are at the VA. And even those I know work 3-4 days a week at the VA.

Who said three days a week??. I thought it’s undershoot that mommy track/surgicenter positions are five day workweeks and no weekends or call which is what I stated.

 

[aneftp]

Who said three days a week??. I thought it’s undershoot that mommy track/surgicenter positions are five day workweeks and no weekends or call which is what I stated.

Man. Ain’t no one working 5 days a week at surgery center these days unless it’s done by 2pm which is rare.

Surgery centers are not what they used to be in the old days. They run to 5-6pm about. Ain’t no one gonna to work 45-50 hours 5 days a week

Not even moms.

That’s why a lot of surgery centers can’t hire

Even retirement track docs won’t take those jobs either.

1. Pace of surgery center doing 10-12 blocks at busy ortho center? That’s a lot of work 1:4 coverage? Lots of factors
2. Days worked per week
3. Time surgery center (last patient expected to leave). So if last patient finish at 430p. U are likely stuck there to 515pm at the earliest.

 

[deleted1183938]

Man. Ain’t no one working 5 days a week at surgery center these days unless it’s done by 2pm which is rare.

Surgery centers are not what they used to be in the old days. They run to 5-6pm about. Ain’t no one gonna to work 45-50 hours 5 days a week

Not even moms.

That’s why a lot of surgery centers can’t hire

Even retirement track docs won’t take those jobs either.

1. Pace of surgery center doing 10-12 blocks at busy ortho center? That’s a lot of work 1:4 coverage? Lots of factors
2. Days worked per week
3. Time surgery center (last patient expected to leave). So if last patient finish at 430p. U are likely stuck there to 515pm at the earliest.

So who is providing anesthesia at these places? Only half the states allow independent CRNAs. So you mean to tell me the other half of the states don’t have surgery centers? Some gas docs are working there.

 

[aneftp]

So who is providing anesthesia at these places? Only half the states allow independent CRNAs. So you mean to tell me the other half of the states don’t have surgery centers? Some gas docs are working there.

I don’t know how long you have been out in practice. It’s the wild Wild West now.

I’ve been doing it over 2 decades plus.

We are in unchartered territory

You have random anesthesiologist (recycled) who cover places intermittent

Only the cushiest places (7-1/2pm) have full time docs with 1:2 or 1:3 coverage can retain anesthesia docs full time these days.

My friend has surgery center contract in prime downtown location in a bit top 15 metro area The long time doc he was paying 420k /8 weeks for th last 15 years is retiring. Doc is old school willing to work to 6pm some days there. He just works. He’s ok

But the new people want more. And balk when it’s 6pm (2 days a week) so he can’t get anyone for 450k/9 weeks now. It’s been 4 months. So his private group has been cross covering the surgery center and it’s annoying them also!

 

[Meyer-Overton]

I want 600k with no more than 32 hrs per week. No call, no nights, no weekends ever. At least 10 weeks off.

 

[lotsapain]

I want 600k with no more than 32 hrs per week. No call, no nights, no weekends ever. At least 10 weeks off.

When you find that gig I will cover the other 32 hrs....

 

[lotsapain]

you’re gonna be on your deathbed some day, you know. Thinking about your life.

There are other colors than black and white..... think on that ....

 

[lotsapain]

So who is providing anesthesia at these places? Only half the states allow independent CRNAs. So you mean to tell me the other half of the states don’t have surgery centers? Some gas docs are working there.

Its complicated now... I tried running a surgery center... 1:4 5 days a week days varied in length..... docs who did call at the hospital covered on their pre-call days etc etc....... when you are on vacation..... ASCs are not what they use to be .... that job is prolly worth more $$$ then a hospital gig depending on the site...