Are You Ready For Private Practice?


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Mar 22, 2005
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haha. clout. that's rich. they will shut any practice down who doesn't pucker and suck. clout? i don't even know what that means. the system hired an AMC at one of their affiliates. they are woefully unhappy with them. do you think that stops them from threatening us with dropping our services agreement every time we renegotiate? clout. that's rich.

That's called a negotiation. Be part of the solution to their problems and not the cause of their problems and you have little to worry about.

Man o War

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7+ Year Member
Apr 13, 2015
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i am 54 yrs old. been doing this now for over a decade. i gotta get at least ten more years out of this career.

the situation is worse than i tried to forewarn you about back then. go back and read this thing from the beginning. crnas are still employees for the most part. it doesn't matter where. being the mostly lazy and greedy bastards that we are, we still haven't effectively figured out how to include them and hence control them.

now they are demanding to do regional anesthesia and put in central lines at my current hospital. and the hospital is ****ing freaking out. why? because the hospital currently pays them **** and so they are leaving left and right. what is administrations solution? to increase the locum rate... which has only pissed off the full fte staff crnas even more. next step? they are pressuring our group to change the staff bylaws to allow them to do invasive procedures.

do the surgeons want this? hell no! but guess what? many of the surgical groups are employed by the hospital so administration has them by the short hairs.

dudes, the situation is getting worse. when you get slowly ****ed in the *** over a decade or longer, you learn to deal with the pain incrementally. go back and read this thread from the start. know what you're getting into.

get your chapstick out and pucker up. thats your future.

You mention control.
You have control of this situation. There are tons of hospitals that will not make these demands. No CRNA is going to do a single thing under my license unless I say it is ok. Period. I’ll leave before I take legal risks so they can play doctor. I lasted all of about a few days on a Locums assignment with that BS and I will never EVER do it again.
Why does the hospital care who does the invasive procedures as long as they get done? That’s your call.
You have options, and you are not a victim. I’m also retirement age, I can walk away tomorrow. I assure you, there are plenty of places for you to work where you wont feel like this every day.
We need to start voting with our feet folks or this crap will continue.


Laugh at me, will they?
Volunteer Staff
15+ Year Member
Dec 15, 2005
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Welcome back, VolatileAgent. Been a while. :)

As a reminder to all, please use caution and discretion in referring to other posters by real life names and locations, unless they've posted it first. In general, don't.
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SDN Donor
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Dec 30, 2002
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What a blast from the past! Welcome back, VA!

I take no comfort in the misfortune of others; I've been on the site for over 15 yrs, and have tried to take heed of all the advice, all with varying sized grains of salt.

I am disappointed to hear VA's situation, which chronicles further deterioration in our profession.

Between the (fewer and further between) great clinical posts, and the "real life anesthesia" threads like this one, some very salient advice continues to ring through it all:

1. Endeavor to be the best physician you can be.
2. Almost everyone needs
a) a FU account, so you can bounce from bogus jobs on your terms
b) to pay down debt, which is crippling to many high salary earners
c) to spend wisely until financial independence
d) to save a little
3. You ain't guaranteed ****, and you ain't entitled to ****. Be mindful of this.

I have, at least for the 39 months of my attendinghood, been VERY VERY fortunate in my practice, in which I get to do (almost) everything I want to. I am on guard for the day that it all changes, but am grateful for all I have (personally and professionally) now.

Lastly, there may be, to at least some degree, a choice to be happy. When possible, I choose to be happy, because it can ALWAYS be worse.

Hope things settle out in your favor, VA. I hope those that truly like anesthesiology stick it out - I *still* think it's great.

Happy Thanksgiving to all.
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Sep 30, 2014
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you are an employee. good for you. millenials don't seem to have a problem with this concept. wait a few years until that pay is cut in half and see how you feel. (p.s. i'm currently outpacing your salary by about 25-30% and i don't answer, directly at least, to anyone else but my partners)

this has nothing to do with what i was talking about, jr.

Wrong. Millennials do have a problem with that concept, they just have no choice. Instead we are seeing Millennials taking a different approach by reigning in consumerism and saving aggressively to achieve financial independence. Save 50% of your salary and bow out in 10 years.
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Senior Member
15+ Year Member
May 24, 2006
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Tough choices, I appreciate that. I love CCM myself. I feel as if I must do it just to guarantee my future even if it is at a lower wage!

Q 3 right now in the unit makes you think twice though.

How much can you make locums in CCM, teleCCM?
Thanks for the Necrobump. I am just going to add that PP anesthesiologists in the ICU is still a tough find. However as a hospital employee you can make as much and even more than the OR in some places. Thank Goodness things are changing.


so the question is when any of you guys are going to say enough is enough and fight to take back our profession? or are we as doctors going to continue to let "them" dictate what we do?


Resistance is Futile. (mostly)


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Jan 2, 2009
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Having never been in the military, I agree with PB.
I have been in PP for less than 10 years. Could honestly retire completely in a nother 5-7 years, but won't. Things are different but not THAT different.
I can tell you that I 100% would do it all over again in PP. The job is fun and private practice offers a lot of flexibility depending on your skillset and group/AMC (not all AMCs are built the same way-- Somnia is NOT Mednax or USAP)

Now as for opportunities... there still are plenty.

Join, make partner.
Join make partner and sell.
Join an AMC with no buy in.
Work at an ASC.
Start a ketamine infusion clinic.
If you are really lucky... you work in the mountains with @Noyac
It ain't over folks...

Just last week I was given the opportunity to become a shareholder in an ASC.

In the end there is nothing like a well run PP ship, yet there are still opportunities out there.

You want security? Go into surgery and deal with clinic.

They will still need an anesthesiologist in the OR to do the cases they went to clinic for.

Go to BFE and cash in. :hello:
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