Anesthesiologists unite!

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Well, for this to happen we need
We need Anesthesiologist who are willing to run a business AND who are not willing to sell to corporations for a short-term profit at the end of their career.


Becoming employees of a corporation happened because people don’t want to do the hard job of running a business, and those who did cashed in for their own gain at the end.
 
NICMAN said:
Well, for this to happen we need
We need Anesthesiologist who are willing to run a business AND who are not willing to sell to corporations for a short-term profit at the end of their career.


Becoming employees of a corporation happened because people don’t want to do the hard job of running a business, and those who did cashed in for their own gain at the end.
Click to expand...
Well some of us never were given the chance to run business. Let’s not assume that we all want to be employed. That is a broad generalization.
 
The problems with Anesthesiology is we have or are losing significant control because of the political power of nurses to CRNAsThey are very organized. Rather than fight them politically we need to support and promote AA legislation in every single state and start training them en masse. This is the answer
 
Aheadbyacentury said:
The problems with Anesthesiology is we have or are losing significant control because of the political power of nurses to CRNAsThey are very organized. Rather than fight them politically we need to support and promote AA legislation in every single state and start training them en masse. This is the answer
Click to expand...

Wall street/private equity is much more harmful to the average anesthesiologist than CRNAs. For decades, anesthesiologists did very well employing CRNAs. Then PE came by and bought the franchise in many places. Now they exploit both anesthesiologists and CRNAs.
 
nimbus said:
Wall street/private equity is much more harmful to the average anesthesiologist than CRNAs. For decades, anesthesiologists did very well employing CRNAs. Then PE came by and bought the franchise in many places. Now they exploit both anesthesiologists and CRNAs.
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Private equity will do themselves in, nurses have convinced the politicians that we are not needed. At least not needed for our price point.
 
nimbus said:
Wall street/private equity is much more harmful to the average anesthesiologist than CRNAs. For decades, anesthesiologists did very well employing CRNAs. Then PE came by and bought the franchise in many places. Now they exploit both anesthesiologists and CRNAs.
Click to expand...

PE is the main problem but they can use the crna glut against you. That's basically what's happening in EM.
 
Aheadbyacentury said:
The problems with Anesthesiology is we have or are losing significant control because of the political power of nurses to CRNAsThey are very organized. Rather than fight them politically we need to support and promote AA legislation in every single state and start training them en masse. This is the answer
Click to expand...
If all of the PA legislative gains are any example, then this approach is extremely short-sighted.
 
Are you kidding? I think working for a corporation is a better deal than working for many md groups. Years of low income, worse benefits. They are the often the real leeches. I for one welcome the corporate overlords.
 
Doctors wife said:
We need doctors to take their professions back from Private Equity backed corporate medicine. We need doctors to take back control of their practices and demand the respect they deserve. How can this be done?? Unity..... discussion..... transparency..... education. Doctors are incredibly educated, skilled, loved, and needed. YOU all deserve more! YOU ARE better than this!! Remember..... at the end of the day the administrative suits have no medical skills.....ZERO. At the end of the day.... doctors are still doctors and patients need YOU..... not private equity..... not administrators...... and especially NOT corporate greed.
Click to expand...

while that all sounds noble, a physician has no way to take back a location from an AMC. You cannot just organize like 50 friends and randomly respond to an RFP about how you and your buddies can all start working in 7 weeks and take over from the AMC. The only clawing back from AMC territory that can be done is for large private groups to get awarded those contracts and even that is not terribly easy to do if the current staff are under non competes. There just are not large supplies of talented anesthesiologists that can step in and move to start working somewhere else on short notice so you need a sizeable staffing pool you can pull from on short notice.
 
Mman said:
while that all sounds noble, a physician has no way to take back a location from an AMC. You cannot just organize like 50 friends and randomly respond to an RFP about how you and your buddies can all start working in 7 weeks and take over from the AMC. The only clawing back from AMC territory that can be done is for large private groups to get awarded those contracts and even that is not terribly easy to do if the current staff are under non competes. There just are not large supplies of talented anesthesiologists that can step in and move to start working somewhere else on short notice so you need a sizeable staffing pool you can pull from on short notice.
Click to expand...

Didn’t they do this in Charlotte and Minneapolis?
 
Doctors wife said:
Let’s not pass blame at those who made these bad decisions. AMCs want us to fight among ourselves. Makes us easier to control. It’s important to look at the future and how we can turn this noble profession around for the next generation of doctors. The more we talk about unifying the easier it will be to push back against AMC takeovers. The will be risk but it’s the only way to change things.
Click to expand...
THIS! All providers who care about patients should see that corporate influence is a conflict of interest!
Real change needs to be an organized physician pushback. Physicians for patient protection needs to find a hungry, brilliant lawyer willing to take a case all the way to the supreme court for the publicity alone (they exist). We need to push to unionize (let's call it "Physicians United").
Hospitals have replaced the factories for working class America and the suits are defacto practicing medicine, hence why our sick care system is so stagnant. Lone voices that speak out are labeled disruptive. Organized voices that speak out are labeled change.
 
Well, you know what you’re getting with an AMC.

Private groups can differ based upon business acumen and fair treatment of colleagues.

I’m not defending AMCs, however don’t assume managing physicians/partners will treat each other any better.
 
nimbus said:
Didn’t they do this in Charlotte and Minneapolis?
Click to expand...

I have no idea about Minneapolis.

In Charlotte, the Mednax contract was given to 1 doc (I think out of Maryland) that basically started his own AMC and hired the physicians to be employed by him instead of Mednax. Brought a bunch of locums in initially until he could backfill in with permanent employees over time.
 
gasdoc77 said:
THIS! All providers who care about patients should see that corporate influence is a conflict of interest!
Real change needs to be an organized physician pushback. Physicians for patient protection needs to find a hungry, brilliant lawyer willing to take a case all the way to the supreme court for the publicity alone (they exist). We need to push to unionize (let's call it "Physicians United").
Hospitals have replaced the factories for working class America and the suits are defacto practicing medicine, hence why our sick care system is so stagnant. Lone voices that speak out are labeled disruptive. Organized voices that speak out are labeled change.
Click to expand...

Mid-levels are the fuel that P/E needs to survive. Aside from complete Govt. take-offer of HC, hard to see this trend going away. These battles were lost one by one when private groups decided to sell out.

I wonder if legit push-back by physicians against mid-levels would be viewed by the public as "punching down"?

Also once united, physicians will again turn on each other stating that specialty X makes too much etc.
 
vm26 said:
Mid-levels are the fuel that P/E needs to survive. Aside from complete Govt. take-offer of HC, hard to see this trend going away. These battles were lost one by one when private groups decided to sell out.

I wonder if legit push-back by physicians against mid-levels would be viewed by the public as "punching down"?

Also once united, physicians will again turn on each other stating that specialty X makes too much etc.
Click to expand...
Which is precisely why the push-back has to be against the suits/administrators who are replacing the physicians with the midlevels by means of an organized physician grassroots effort.
If an organization like Physicians for Patient Protection wants anonymous donors to come out of the woodwork, they should strongly consider suing to unionize (or merely for the right amongst physicians).
Every ortho, derm, optho, rad should be made aware of the HCA residencies that are appearing overnight.
As for your last statement, that reads like a beta trying to rationalize.
 
I’m against the proliferation of AMCs and wouldn’t work for one, however these physician owners built a business, if they want to sell it, who am I to say that’s wrong.
With regard to Charlotte, I know someone there and their pay is quite good, so they’re not being run like a typical AMC. I don’t know what the situation was like there, but I would guess the hospital had problems with the previous 2 groups and wanted to continue working with one owner and not employ the physicians or open to a private practice. I’m sure they had offers from both. It’s easier to deal with one entity making promises that are kept vs the will of the majority or a voting board.
 
IlDestriero said:
I’m against the proliferation of AMCs and wouldn’t work for one, however these physician owners built a business, if they want to sell it, who am I to say that’s wrong.
With regard to Charlotte, I know someone there and their pay is quite good, so they’re not being run like a typical AMC. I don’t know what the situation was like there, but I would guess the hospital had problems with the previous 2 groups and wanted to continue working with one owner and not employ the physicians or open to a private practice. I’m sure they had offers from both. It’s easier to deal with one entity making promises that are kept vs the will of the majority or a voting board.
Click to expand...
1 man or person cannot dictate a 90 person operation without significant push-back and internal problems and destabilization. Having said that, from what I understand the charlotte group is basically run like employed physicians without the hospital name signing the paychecks. From what I understand, there is no non-compete. So the hospital can get rid of whoever that 1 guy from maryland is and just employ the physicians. Without a non-compete, the AMC business model crumbles and has no real value.
 
vm26 said:
I wonder if legit push-back by physicians against mid-levels would be viewed by the public as "punching down"?
Click to expand...


I don’t see any pushback. If anything I see midlevels being embraced more and more. Anesthesiologists were ahead of other specialties in using midlevels. Now all the busy surgeons hire their own NP’s and PA’s too. They’re not going anywhere.
 
Mman said:
I have no idea about Minneapolis.

In Charlotte, the Mednax contract was given to 1 doc (I think out of Maryland) that basically started his own AMC and hired the physicians to be employed by him instead of Mednax. Brought a bunch of locums in initially until he could backfill in with permanent employees over time.
Click to expand...

forums.studentdoctor.net

New Partnership Track in Minneapolis-General and Cardiac Positions

Minneapolis Anesthesia Partners is seeking BC/BE anesthesiologists to provide comprehensive anesthesia care at Abbott Northwestern Hospital (ANW) in Minneapolis, MN starting July 2020. We are a newly-formed democratic, egalitarian private practice group replacing a national anesthesia...
forums.studentdoctor.net forums.studentdoctor.net

www.beckersasc.com

Abbott Northwestern to replace anesthesia provider in 2020 - Becker’s ASC

Minneapolis-based Abbott Northwestern Hospital plans to replace its anesthesia provider next year, according to the Star Tribune.
www.beckersasc.com www.beckersasc.com
 
nimbus said:
forums.studentdoctor.net

New Partnership Track in Minneapolis-General and Cardiac Positions

Minneapolis Anesthesia Partners is seeking BC/BE anesthesiologists to provide comprehensive anesthesia care at Abbott Northwestern Hospital (ANW) in Minneapolis, MN starting July 2020. We are a newly-formed democratic, egalitarian private practice group replacing a national anesthesia...
forums.studentdoctor.net forums.studentdoctor.net

www.beckersasc.com

Abbott Northwestern to replace anesthesia provider in 2020 - Becker’s ASC

Minneapolis-based Abbott Northwestern Hospital plans to replace its anesthesia provider next year, according to the Star Tribune.
www.beckersasc.com www.beckersasc.com
Click to expand...

the interesting thing there was they gave the new group 13 months notice. I'm actually surprised Mednax kept the lights on until then. Most contracts I have seen are 90-120 day outs for either party and the changeovers I have seen have all happened within that narrow window from announcement to takeover.
 
Mman said:
In Charlotte, the Mednax contract was given to 1 doc (I think out of Maryland) that basically started his own AMC and hired the physicians to be employed by him instead of Mednax. Brought a bunch of locums in initially until he could backfill in with permanent employees over time.
Click to expand...
He was a puppet installed by the hospital.
 
IlDestriero said:
I don’t know what the situation was like there, but I would guess the hospital had problems with the previous 2 groups and wanted to continue working with one owner and not employ the physicians or open to a private practice.
Click to expand...
Classic pyramid scheme. Long track to partnership. Very few true owners of the practice. Total sellout.

Mednax then ran the place into the ground after a fight with the hospital over money.
 
Hiram Coggin said:
He was a puppet installed by the hospital.
Click to expand...
no, just a guy with a business model the hospital liked. He was not installed by them, they had quite a few bids through their RFP process.
 
gasdoc77 said:
Which is precisely why the push-back has to be against the suits/administrators who are replacing the physicians with the midlevels by means of an organized physician grassroots effort.
If an organization like Physicians for Patient Protection wants anonymous donors to come out of the woodwork, they should strongly consider suing to unionize (or merely for the right amongst physicians).
Every ortho, derm, optho, rad should be made aware of the HCA residencies that are appearing overnight.
As for your last statement, that reads like a beta trying to rationalize.
Click to expand...

Physicians gave their practices over to suits willingly, and now they are going to push back? Too late to turn back, genie is out of the bottle. Labor shortage could potentially hurt P/E but this isn't happening with mid-levels and their organized lobbying efforts. More programs will continue to pump out more mid-levels, and P/E will be getting more physician bodies given recent proposed legislation to increase training spots by congress:

Rep. Terri Sewell, D-Ala., introduced the House bill last month alongside Reps. John Katko, R-N.Y., Tom Suozzi, D-N.Y., and Rodney Davis, R-Ill. Sewell noted that the proposal would support an additional 2,000 positions each year from 2023-2029 for a total of 14,000 positions. Absent any legislation action, the U.S. could face a doc shortage of upward of 121,300 by 2030, experts noted.

Your last statement is simply juvenile, but it does read like projection. Perhaps this is how you feel in the OR when the "alpha" surgeon and "alpha" CEO both view you and a CRNA as interchangeable.
 
vm26 said:
P/E will be getting more physician bodies given recent proposed legislation to increase training spots by congress:
Click to expand...
That is not going to make up for the people leaving the profession in droves way earlier than expected. It is already known that 40 percent of women leave the profession or go part time within 6 years of completing the residency.

This problem will continue until the root of the problem is exposed. Until then it will continue to get worse.....
 
nimbus said:
This is not because of PE backed AMCs. But being a cog in the wheel at at AMC probably makes this easier to do.
Click to expand...
I never suggested a reason for it, it simply is. And you can open up as many residency spots as you wish but if the reason for it is not addressed you will never solve the problem
 
Aheadbyacentury said:
I never suggested a reason for it, it simply is. And you can open up as many residency spots as you wish but if the reason for it is not addressed you will never solve the problem
Click to expand...

The reasons are ages old and they never go away. Child rearing priorities, family obligations, hobbies, illness, high spousal income, etc. Graduating more residents and producing more physicians actually does solve that problem. We actually have a lot of partners who work less than full time in my practice. We just hire more people.
 
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Aheadbyacentury said:
That is not going to make up for the people leaving the profession in droves way earlier than expected. It is already known that 40 percent of women leave the profession or go part time within 6 years of completing the residency.

This problem will continue until the root of the problem is exposed. Until then it will continue to get worse.....
Click to expand...

I'm not sure that this is a major problem. Our women take their fair share of call or give them away to people who want them. Most cases are done during business hours. It's really some of the older partners who don't want to have long days or take call but I get it. There are always people who want the extra cash.
 
GassYous said:
I'm not sure that this is a major problem. Our women take their fair share of call or give them away to people who want them. Most cases are done during business hours. It's really some of the older partners who don't want to have long days or take call but I get it. There are always people who want the extra cash.
Click to expand...

Good points. In my field (rads), there has been this anticipated mass exodus by older baby boomers for about the last 5-10 years. This has not happened to date. Ultimately seems like their retirement goal posts get moved (for various reasons), and they keep on working, maybe some at 0.8FTE. One would have to be incredibly unproductive to get pushed out if they are a long time partner.

Increase in residency spots alone is not a problem (except perhaps for ED as they are projected to have a surplus of 10K ED docs by 2030). Its the combo of increasing scope of practice for mid-levels and increasing the # of their programs.

Who knows, maybe nurse assistants/aids will be bumped up as well.
 
I’ve been a hospital employee and worked for an amc. My amc gig is better. I would love to find a real pp group in someplace that wasn’t freezing.... I just never found a job like what you are describing anywhere. True pp groups seem gone from the market. With the current predatory insurance practices - uhc for example... a small group would be powerless... at least the amc has some resources to fight and not cave. Small pp groups just don’t seem like a viable option in the current climate.
 
nimbus said:
Graduating more residents and producing more physicians actually does solve that problem. We just hire more people.
Click to expand...
Graduating more residents just makes that 40 percent who leave or go part-time within six years larger.
 
Listen, You can do it. I have taken 2 contracts away from national groups. They offer poor services. Most people don't want to spend the ENORMOUS time in creating a group from scratch. People are lazy. Doctors are lazy. Infact there is a current group in Chicago right now. The hospital didn't want to employee the group and wanted a private group to take over. Instead of the existing team there just banding together and starting their own group, they played chicken little. Well now napa is gonna be there...
 
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somedumbDO said:
Listen, You can do it. I have taken 2 contracts away from national groups. They offer poor services. Most people don't want to spend the ENORMOUS time in creating a group from scratch. People are lazy. Doctors are lazy. Infact there is a current group in Chicago right now. The hospital didn't want to employee the group and wanted a private group to take over. Instead of the existing team there just banding together and starting their own group, they played chicken little. Well now napa is gonna be there...
Click to expand...

Can people who work for an AMC at a particular facility get out of the non compete and take the contract back from the AMC? Or does a whole new group have to come in ?
 
Endee said:
Can people who work for an AMC at a particular facility get out of the non compete and take the contract back from the AMC? Or does a whole new group have to come in ?
Click to expand...

non competes are state dependent, and in the ones I am familiar with you would need completely different physicians to come in to take over while the old docs were barred from working there for 12-24 months.

Easy for a 2 or 3 doc surgery center. Difficult for a 25-50 doc hospital.
 
amyl said:
I’ve been a hospital employee and worked for an amc. My amc gig is better. I would love to find a real pp group in someplace that wasn’t freezing.... I just never found a job like what you are describing anywhere. True pp groups seem gone from the market. With the current predatory insurance practices - uhc for example... a small group would be powerless... at least the amc has some resources to fight and not cave. Small pp groups just don’t seem like a viable option in the current climate.
Click to expand...
Sentiments like this were extremely common in the EM forums 5-10 years ago...
 
1619498047486.png

These are your enemies. This is what they are saying.
 
Doctors wife said:
We need doctors to take their professions back from Private Equity backed corporate medicine. We need doctors to take back control of their practices and demand the respect they deserve. How can this be done?? Unity..... discussion..... transparency..... education. Doctors are incredibly educated, skilled, loved, and needed. YOU all deserve more! YOU ARE better than this!! Remember..... at the end of the day the administrative suits have no medical skills.....ZERO. At the end of the day.... doctors are still doctors and patients need YOU..... not private equity..... not administrators...... and especially NOT corporate greed.
Click to expand...
Umm mostly Boomer Sociopaths (the words are practically synonymous) tended to do this.. many others were rather.. stuck.
 
voodoomagic said:
Umm mostly Boomer Sociopaths (the words are practically synonymous) tended to do this.. many others were rather.. stuck.
Click to expand...
Do you realize that the CEOs/CFOs were a significant reason many PP were sold to AMCs? The word was out among the hospital executives to cut anesthesia group stipends to the bone. If the group wouldn't go along then force them to sell out or take them over. HCA did this to many groups in Florida resulting in the collapse of private groups which got no buyout.

Quickly the environment deteriorated to the point that most groups receiving a stipend were scared/terrified that their company was going to become worthless; so, many sold out to AMCs in order to appease their hospital CEOs/CFOs. The AMCS would offer to cut the subsidy and complete the buyout making the hospital management temporarily happy.

Years later HCA realized that the monster they got in bed with was truly sucking large sums of money from them. HCA made a corporate decision to cut ties with that AMC at many locations.

Other hospitals realized the same thing about AMCs. Low quality, poor staffing and large subsidies were recurring issues. The hospitals began to realize "in house" staffing or local groups were a better way to obtain anesthesia services.

The reasons for the rise of the AMC are multifactorial and their downfall will be multifactorial as well.
 
BLADEMDA said:
Do you realize that the CEOs/CFOs were a significant reason many PP were sold to AMCs? The word was out among the hospital executives to cut anesthesia group stipends to the bone. If the group wouldn't go along then force them to sell out or take them over. HCA did this to many groups in Florida resulting in the collapse of private groups which got no buyout.

Quickly the environment deteriorated to the point that most groups receiving a stipend were scared/terrified that their company was going to become worthless; so, many sold out to AMCs in order to appease their hospital CEOs/CFOs. The AMCS would offer to cut the subsidy and complete the buyout making the hospital management temporarily happy.

Years later HCA realized that the monster they got in bed with was truly sucking large sums of money from them. HCA made a corporate decision to cut ties with that AMC at many locations.

Other hospitals realized the same thing about AMCs. Low quality, poor staffing and large subsidies were recurring issues. The hospitals began to realize "in house" staffing or local groups were a better way to obtain anesthesia services.

The reasons for the rise of the AMC are multifactorial and their downfall will be multifactorial as well.
Click to expand...
Hush, boomer. How dare you try and educate!
 
BLADEMDA said:
Do you realize that the CEOs/CFOs were a significant reason many PP were sold to AMCs? The word was out among the hospital executives to cut anesthesia group stipends to the bone. If the group wouldn't go along then force them to sell out or take them over. HCA did this to many groups in Florida resulting in the collapse of private groups which got no buyout.

Quickly the environment deteriorated to the point that most groups receiving a stipend were scared/terrified that their company was going to become worthless; so, many sold out to AMCs in order to appease their hospital CEOs/CFOs. The AMCS would offer to cut the subsidy and complete the buyout making the hospital management temporarily happy.

Years later HCA realized that the monster they got in bed with was truly sucking large sums of money from them. HCA made a corporate decision to cut ties with that AMC at many locations.

Other hospitals realized the same thing about AMCs. Low quality, poor staffing and large subsidies were recurring issues. The hospitals began to realize "in house" staffing or local groups were a better way to obtain anesthesia services.

The reasons for the rise of the AMC are multifactorial and their downfall will be multifactorial as well.
Click to expand...
What he said exactly.
 
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