ASA conference Thread

[ThinkFast007]

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Who in here's going? We should have an afterparty for med students/residents ..... ok fine, UT, military, and Jet too 😉

But seriously, who's down? I'm 90% sure I'll be there....New Orleans, I've never been...should be fun, from what I've heard

 

[Justin4563]

the asa is whats wrong with anesthesia today.. so I dont join.. and I get the audio tapes of the asa conferences that im interested in.

 

[jwk]

the asa is whats wrong with anesthesia today.. so I dont join.. and I get the audio tapes of the asa conferences that im interested in.

Now that brings up a whole other interesting topic...Who is going to speak for anesthesiologists if not the ASA? Do you even understand what it is they do, not just at the professional level, but at a political level as well? The ASA-PAC is 2nd only to the AMA's among all medical PAC's. I attended the ASA Legislative Conference in DC in May. It was very eye-opening.

BTW, I'll be in New Orleans.

 

[cubs3canes]

You know what sucks about this. I am a med student in New Orleans, but I will be away that month at another Southern school. I can't believe I am going to miss the conference in my own city.

 

[Justin4563]

Now that brings up a whole other interesting topic...Who is going to speak for anesthesiologists if not the ASA? Do you even understand what it is they do, not just at the professional level, but at a political level as well? The ASA-PAC is 2nd only to the AMA's among all medical PAC's. I attended the ASA Legislative Conference in DC in May. It was very eye-opening.

BTW, I'll be in New Orleans.

why was it eye opening? enlighten me..

 

[jwk]

why was it eye opening? enlighten me..

It's a side of medicine I personally don't get to see much of - the political side.

I didn't know that anesthesia is paid through Medicare at only about 40% of what the average private insurance payment would be, whereas other specialties like surgery are closer to 80%. I now understand not only what the Sustainable Growth Rate formula is (besides an oxymoron since it always decreases) but why it is senseless and why it is important to get rid of it. The ASA is working very hard at dealing with these issues.

Are you aware that rural hospitals using CRNA's can pass through the costs of those CRNA's under Medicare Part A so they can pay them more, but that the same system will not pay for anesthesiologists? The CRNA's of course like to boast how they serve in rural areas where anesthesiologists don't (actually, they say won't). There is a financial disincentive for MD's to serve in those areas because they're actually paid less than CRNA's.

I now understand the lobbying system a little better, and why it's important to have good people lobbying for you. The ASA has some really good lobbyists who are very well known in congressional offices. Every congressman and senator that addressed the conference knew who Manny Bonilla is, and so did every congressional staffer we talked with that week.

Even mundane things like locked anesthesia carts - did you know this is actually a federal issue? So are reimbursement methodologies and how they affect the payment to academic practices and residents. So is the CRNA opt-out issue.

Besides listening to several congressional speeches, we also met personally with our state's congressmen. In addition to my own congressman, I met three others, and we had a few minutes to discuss some of the more important items. As one of them put it, everyone they meet is here with their hand out, and essentially he's right. They want to know why we're any different. We did our best to explain it to them.

As many of you toss in here from time to time, I'm "just an AA". But this AA is a member of the ASA, and I have some of the same concerns that you do, especially that little thing about getting paid for the work I do. I got a first-hand look at what the ASA does at the national level. It was pretty impressive. So is the work that state component societies are doing (and I'm a member of that too) in helping elect medicine-friendly legislators at both the state and federal levels.

The figures I've seen show that better than 90% of CRNA's belong to the AANA. I can't figure out why an anesthesiologist would not be a member of the ASA.

 

[Justin4563]

because the asa are a bunch of dinguses.. they have consistently shown me that they dont respond to the needs of the trainees..

For example,

my program did not pay for the intraining exam.. we had to shell out 80 bucks every may to take the intraining exam in july. when i was a ca2 I was at away rotation so i did not get the money to the secretary by the due date so she sent away the applications without my money on the due date may 1st.. I was informed that i would not be eligible to sit for the intraining exam because i did not pay the 80 bucks.. I called the ASA and stated my case saying that I was at an away rotation and how important the written exam is to me I would like to send my money now even wire transfer if necessary.. They said, SORRY you should have thought about that in the first place.. So I did not take the exam.. This just illustrates the mentality of the ASA. So I will keep my 4or 500 dollars in my pocket this year and maybe for the next 10 years. Maybe buy myself some golf clubs or something

2) in this day and age of cost cutting and hospital closing and most of the system struggling except for the big ceos I find it unconscionable to be charging close to 3000 dollars for the ABA board exam.. Moreover, the board exam (orals) is given consistently at the most expensive cities in the USA. This does not help the candidates who invariably have hundreds or thousands of dollars of student loan debt, credit card debt etc. Not to mention the cost of preparing for the exam. 2000 dollar review course..etc..

Give the exam every year at the same place.... a medium sized city like wichita, kansas or topeka kansas.. somewhere in the middle so its equidistant to everyone.. Lease out an entire hotel for a week twice a year.. and youll be ab le to negotiate hotel deals and airline deals.. Have the board examiniers pay their own way to wichita, or topeka and have them pay for their own stay.. WOuld cost them 1000 tops.. Hey if you want the privelege to be a board examiner. i think 1000 dollars a year is nothing.. DOnt make the poor residents foot the bill..

Thats why I dont join.. I DONT SEE THE BENEFIT>. and until I DO I WILL BE A PROUD NON MEMBER OF THE ASA....

 

[UTSouthwestern]

You have had an unfortunate experience, but I would be more upset with your program than with the ASA. Many programs foot the bill of the in training exams as well as the boards and as you said, why make the residents pay the bill during training.

The cost of the board exam is high but not prohibitive when you look at other specialties board exam costs (Orals only: Ophthalmology - $1500, Plastics - $1800 plus more than a dozen associated fees). The boards are not held in one location in Timbuktu because of the number of people that would have to be housed at one time. Consider two examiners for each person taking the oral boards, plus ancillary staff and you are talking well over 10,000 people. I doubt Wichita could handle that volume at one time. Even if they could, what if the back asswards farmer's daughters' association decided to hold their hog calling contest on the same week as the oral boards and took all of the lodging?

If you feel the need to take a Niels Jensen review course (only one person in my class did that and then only because she wanted some time away from her family to concentrate on studying), then your department has failed you in the didactic arena.

Finally, if the examinations are what you are most upset with, then by all means rail against the ABA, but keep the ASA separate from that issue. While the ABA reports to the ASA, it is a fully independent entity from a decision making perspective. As a member of the ASA, you could in fact lobby to change or even eliminate the ABA or some aspect of the ABA.

I fully agree with you on the issue of the cost of the exams but I disagree that being a conscientious objector does any more than deprive our organization of a valuable member and voice in the legislative arena. As jwk stated, we are only shooting ourselves in the foot by not giving our backing and resources to the one organization that continues to push our goals on all fronts. To boot, our organization's leadership is very approachable and I had a two hour conversation with Roger Detweiler in Seattle at the SAMBA meeting last year in which I voiced every resident's concerns about private practice directly to him. He gave me an outline of the organization's initiatives, encouraged me to stay active, and gave me his card with his work, pager, and home phone number and told me to call him any time I wanted to talk.

So fight the system if you feel you have to, but don't do it from the sidelines.

 

[coccygodynia]

... The figures I've seen show that better than 90% of CRNA's belong to the AANA. I can't figure out why an anesthesiologist would not be a member of the ASA.

This is pretty interesting ... do you happen to know the % of anesthesiologists that ARE members of the ASA?

 

[jetproppilot]

It's a side of medicine I personally don't get to see much of - the political side.

I didn't know that anesthesia is paid through Medicare at only about 40% of what the average private insurance payment would be, whereas other specialties like surgery are closer to 80%. I now understand not only what the Sustainable Growth Rate formula is (besides an oxymoron since it always decreases) but why it is senseless and why it is important to get rid of it. The ASA is working very hard at dealing with these issues.

Are you aware that rural hospitals using CRNA's can pass through the costs of those CRNA's under Medicare Part A so they can pay them more, but that the same system will not pay for anesthesiologists? The CRNA's of course like to boast how they serve in rural areas where anesthesiologists don't (actually, they say won't). There is a financial disincentive for MD's to serve in those areas because they're actually paid less than CRNA's.

I now understand the lobbying system a little better, and why it's important to have good people lobbying for you. The ASA has some really good lobbyists who are very well known in congressional offices. Every congressman and senator that addressed the conference knew who Manny Bonilla is, and so did every congressional staffer we talked with that week.

Even mundane things like locked anesthesia carts - did you know this is actually a federal issue? So are reimbursement methodologies and how they affect the payment to academic practices and residents. So is the CRNA opt-out issue.

Besides listening to several congressional speeches, we also met personally with our state's congressmen. In addition to my own congressman, I met three others, and we had a few minutes to discuss some of the more important items. As one of them put it, everyone they meet is here with their hand out, and essentially he's right. They want to know why we're any different. We did our best to explain it to them.

As many of you toss in here from time to time, I'm "just an AA". But this AA is a member of the ASA, and I have some of the same concerns that you do, especially that little thing about getting paid for the work I do. I got a first-hand look at what the ASA does at the national level. It was pretty impressive. So is the work that state component societies are doing (and I'm a member of that too) in helping elect medicine-friendly legislators at both the state and federal levels.

The figures I've seen show that better than 90% of CRNA's belong to the AANA. I can't figure out why an anesthesiologist would not be a member of the ASA.

Thank God for jwk and his/her clones. I just don't have the emotional capacity to delve into the political side of anesthesia. Gimme a critical patient and I will stabilize them as good as any other critical care Joe Schmoe, but gimme an esoteric political problem and I'm looking for my condo and my boat and my family.
Funny that when my buddy who works for Louisiana Power & Light gets called after hours he gets double-time (triple-time on holidays) but when I go out at 3 am for a non-insured trauma patient I'm working for free.
JWK, please tell the medicare-dingus-administrator-nonmedical-paperpushing jerks that I should make more for a medicare CABG than my buddy who fixes electrical wires after a storm.

 

[ThinkFast007]

any one know what the topic of the original thread was

 

[jetproppilot]

any one know what the topic of the original thread was

Good point, Think. Sorry for my interupted, useless two-cents.

 

[ThinkFast007]

Good point, Think. Sorry for my interupted, useless two-cents.

nothing but love to ya Jet....ur posts rock.

but seriously, who the heck in here is down for ASA ? come Oct 2005, i need to find some guys/gals to be drinking buddies w/ over in Orleans 😉

 

[UTSouthwestern]

Thank God for jwk and his/her clones. I just don't have the emotional capacity to delve into the political side of anesthesia. Gimme a critical patient and I will stabilize them as good as any other critical care Joe Schmoe, but gimme an esoteric political problem and I'm looking for my condo and my boat and my family.

So just give money to the ASA and let them haggle with the politicians.

 

[usnavdoc]

Ill be there. I used to live in the city and still have a few friends there in fellowships. Some really great bars and of course there is the quarter. Im looking forward to it. We should definitely get some people together.

 

[Sugar72]

I'm just an MS4 but I'll be there. I used to be a craps dealer at the Harrah's downtown...maybe I can hit my old coworkers up for a free late night buffet. New Orleans is responsible for my missing years between college and medical school - good times.

 

[jetproppilot]

nothing but love to ya Jet....ur posts rock.

but seriously, who the heck in here is down for ASA ? come Oct 2005, i need to find some guys/gals to be drinking buddies w/ over in Orleans 😉

UH, Think, I'm sorry Dude, but I can now drink you under the table. Being a New Orleans resident, my hepatic P450-cytochrome-reductase system is now Christopher Reeves-like. Before I moved here, Hermit The Frog could've out-drank me. Now, being the R-OH acclimated New Orleanian, I challenge you to a nite of the ethanol of your choice, and I'll hang. Name the bar of your choice (Cats Meow, Bull Dog, Santa Fe, Galletoires, etc) and I'll be there, ready for great conversation and partying gallore...BRING YOURSELF HERE AND WE'LL PARTY, DUDE.....

 

[Justin4563]

So just give money to the ASA and let them haggle with the politicians.

or give money to the asa and let them line their pockets...


Approachable, my ass. Its like talking to city hall about getting your expired meter ticket ousted because the meter was actually "broken".

 

[zippy2u]

Used to live in new orleans and went to Tulane undergrad. 3 for 1 night at Que Sera on St. Charles Ave ---Those were the days. Used to party at The Christmas Bar -- a hole in the wall around Oak and Burdette, uptown. Lot of drunkin nights to say the least. ---Zippy

 

[Justin4563]

You have had an unfortunate experience, but I would be more upset with your program than with the ASA. Many programs foot the bill of the in training exams as well as the boards and as you said, why make the residents pay the bill during training.

The cost of the board exam is high but not prohibitive when you look at other specialties board exam costs (Orals only: Ophthalmology - $1500, Plastics - $1800 plus more than a dozen associated fees). The boards are not held in one location in Timbuktu because of the number of people that would have to be housed at one time. Consider two examiners for each person taking the oral boards, plus ancillary staff and you are talking well over 10,000 people. I doubt Wichita could handle that volume at one time. Even if they could, what if the back asswards farmer's daughters' association decided to hold their hog calling contest on the same week as the oral boards and took all of the lodging?

If you feel the need to take a Niels Jensen review course (only one person in my class did that and then only because she wanted some time away from her family to concentrate on studying), then your department has failed you in the didactic arena.

Finally, if the examinations are what you are most upset with, then by all means rail against the ABA, but keep the ASA separate from that issue. While the ABA reports to the ASA, it is a fully independent entity from a decision making perspective. As a member of the ASA, you could in fact lobby to change or even eliminate the ABA or some aspect of the ABA.

I fully agree with you on the issue of the cost of the exams but I disagree that being a conscientious objector does any more than deprive our organization of a valuable member and voice in the legislative arena. As jwk stated, we are only shooting ourselves in the foot by not giving our backing and resources to the one organization that continues to push our goals on all fronts. To boot, our organization's leadership is very approachable and I had a two hour conversation with Roger Detweiler in Seattle at the SAMBA meeting last year in which I voiced every resident's concerns about private practice directly to him. He gave me an outline of the organization's initiatives, encouraged me to stay active, and gave me his card with his work, pager, and home phone number and told me to call him any time I wanted to talk.

So fight the system if you feel you have to, but don't do it from the sidelines.

YOu still did not address.. why cant the oral board examiners foot their own bill for a week. It would reduce the price of the board exam. If it gets to be too expensive.. it needs to be eliminated. Cheap price to pay to say you are an oral board examiner. it would cost them about 2000 dollars. thats nothing for someone who has been working as an anesthesiologist for 20 years, and has about 5 anesthesiologist and 10 crnas working for him/ her. and never does anesthesia. But for the resident coming out with massive loans. I think its unreasonable to have them pay so much for the exam process.. It really is. ANd the asa is just turning their backs and heads at it because the people in charge arent feeling it.. so why should they worry about it.. ANd you dont need an act of congress to change it..

 

[zippy2u]

The way I worked the ASA was that I joined them as a resident and paid the dues money and then when I became boarded, dropped them like a hot potato. Haven't heard from them since, how are they doin'? ---Zippy

 

[jetproppilot]

YOu still did not address.. why cant the oral board examiners foot their own bill for a week. It would reduce the price of the board exam. If it gets to be too expensive.. it needs to be eliminated. Cheap price to pay to say you are an oral board examiner. it would cost them about 2000 dollars. thats nothing for someone who has been working as an anesthesiologist for 20 years, and has about 5 anesthesiologist and 10 crnas working for him/ her. and never does anesthesia. But for the resident coming out with massive loans. I think its unreasonable to have them pay so much for the exam process.. It really is. ANd the asa is just turning their backs and heads at it because the people in charge arent feeling it.. so why should they worry about it.. ANd you dont need an act of congress to change it..

Justin,

Let me give you some unsolicited advice. You are obviously an intellect and an over achiever. But you are ruining your life with your angry, pissed off, "my microcosm world is ***ked up" attitude.

Hey, you can tell me to go f*ck my self and I'd understand. But listen up for a minute...

1)Unless you are a Paul Tinker/Michael Roizen/Alan Kaye (the last dude is my buddy who just got a chair so I gotta give him a plug 👍 ) analogue, you are an anesthesiologist, just like all of us. We all have frustrations at work, we are frustrated with the politics of the job/ the fact that we get paid more for a cuppla tonsils than a medicare CABG/group dynamics/etc etc

2) You have your health, your condo/house/dog/wife/computer, and you make more money every year than 90% of the population in this country.

3)If you are unhappy with your current anesthesia gig, our job market is wide open, there are jobs in every state, and you can move somewhere new, be a partner in 1 year, and be in a better place than you are now.
Bottom line? Because of the blood, sweat and tears you sacrificed to attain your current position, you are in an enviable position. Yes, you are frustrated, but because of your crudentials, you can make your situation even better.

4) Anesthesia/Surgery/Whatever Your Specialty Is is a mean to an end, unless you are a prolific, published academician/philanthropist. I don't know about you, but I do what I do because I'm a working stiff just like everyone else. Don't get me wrong, I really like my job and I don't loathe going to work, but I go to work because I am not "jet plane rich". Know what "jet plane rich" is? Thats when you can afford your own Gulfstream V and travel all over the world at a moments notice, like Benny Hann the criminal-I-take-your-grandma's-money televangelist, John I'm-a-super-stud-who-owns-a-Boeing 707- Travolta, Bill Gates, etc.
That being said, we make a very respectable salary. The top 10% of all specialties. Think about it...our CRNAs make more than most pediatricians, the primary care MD dudes who's pagers go off every 35 seconds with another mother concerned about the suspicious color of her 18 month old's bugar.
5) Are you really thinking your life sucks? Lemme remind you how small of a piece of the puzzle you/me/everyone else is in the big picture.
Remember 9/11? Remember how devastated everyone in this country felt about the needless loss of thousands of american people? Remember feeling the grievance/loss/anger/revenge?
Thats the past now. Yes, we remember, but life goes on, and every american now pretty much goes on with their lives with no sequelae.
So do you think your gripes are really significant? Or are you having a pity party for a young/professional/educated dude who makes great cash compared to everyone else?

Dude, you have an education better than anyone's, you work in an air-conditioned room, and you make more than most physicians. Yes, you could be in a better situation, but that doesnt justify your incessant complaining.

Here's my advice:

1) Take a cuppla days off and have a few margaritas
2) Take a look at the anesthesiologist job market, go to church, and thank God for your good fortune
3) Consider relocating
4) Stop feeling sorry for yourself, step up to the mike with Micatin, and land one of the hundreds of great anesthesiologist jobs out there.

Nuff said.

 

[UTSouthwestern]

YOu still did not address.. why cant the oral board examiners foot their own bill for a week. It would reduce the price of the board exam. If it gets to be too expensive.. it needs to be eliminated. Cheap price to pay to say you are an oral board examiner. it would cost them about 2000 dollars. thats nothing for someone who has been working as an anesthesiologist for 20 years, and has about 5 anesthesiologist and 10 crnas working for him/ her. and never does anesthesia. But for the resident coming out with massive loans. I think its unreasonable to have them pay so much for the exam process.. It really is. ANd the asa is just turning their backs and heads at it because the people in charge arent feeling it.. so why should they worry about it.. ANd you dont need an act of congress to change it..

Why should the examiners foot the bill? They don't just step forward and become designated as oral board examiners. They have to go through extensive training, create and submit questions/scenarios yearly, AND attend multiple meetings each year on their own coin to first become an oral board examiner, then to maintain their status as oral board examiners. It takes at least two years to even get considered for a junior examiner's position. Many of them became examiners and are becoming examiners to ensure that the process is fair and that the content accurately reflects what is being taught today and not ten years ago. The turnover among the examiners is fairly high because of the extensive time and effort commitment each examiner makes. I don't see why they should also be asked to fork over money as well.

The pressure on the residents to pay the combined cost of the exams is why myself and the other residents in the resident component of the ASA governing board pushed to have the fee split between the written and oral board years. I don't know if you had to pay for both at the same time, but that is no longer the case and you are thus paying only $950 for the written exam at the end of your CA-3 year. I can make that with two weekdays of moonlighting or a weekend day of moonlighting during residency. The oral board fee of $1725 is no longer due at that time and you should be able to foot the bill for that by March of your first year in practice or fellowship year.

Someone has to pay for the cost of creating, writing, and administering these exams. Do we need these exams? Hell yes. These tests are difficult and should be difficult to ensure that residents not only read, but read thoroughly and extensively to provide a thorough, fundamental, AND advanced understanding of EVERY aspect and concept of anesthesiology. It should provide a vehicle for which physician providers can separate themselves from other providers.

If we could get at least 70-80% membership in the ASA, then I would be all for footing the cost, but the reality is that too many people skimp on giving to the ASA and that would make the idea completely unfeasable and inequitable for those who do join the ASA and do give consistently to the organization.

In lieu of that, many residency programs ARE paying for the exams. My program requires that you get a 30 by the end of your CA-2 year, which should be easily achieved, before they pony up, but they pay for both the written and oral exams. Many other programs likewise tie the payment to some type of incentive standard.

I and others in the ASA are already putting together a proposal to make the test available at Sylvan testing centers, but that is preliminary and the fees that Sylvan charges to administer a written test of this length could be more expensive than the current format.

So again, if you want to complain about something, get involved and propose a solution that all sides would feel comfortable with, or at least all sides would feel the same about.

 

[UTSouthwestern]

The way I worked the ASA was that I joined them as a resident and paid the dues money and then when I became boarded, dropped them like a hot potato. Haven't heard from them since, how are they doin'? ---Zippy

They could be doing a lot better if you would join and lend your name and some money if not your voice to our advocators.

 

[Justin4563]

Justin,

Let me give you some unsolicited advice. You are obviously an intellect and an over achiever. But you are ruining your life with your angry, pissed off, "my microcosm world is ***ked up" attitude.

Hey, you can tell me to go f*ck my self and I'd understand. But listen up for a minute...

1)Unless you are a Paul Tinker/Michael Roizen/Alan Kaye (the last dude is my buddy who just got a chair so I gotta give him a plug 👍 ) analogue, you are an anesthesiologist, just like all of us. We all have frustrations at work, we are frustrated with the politics of the job/ the fact that we get paid more for a cuppla tonsils than a medicare CABG/group dynamics/etc etc

2) You have your health, your condo/house/dog/wife/computer, and you make more money every year than 90% of the population in this country.

3)If you are unhappy with your current anesthesia gig, our job market is wide open, there are jobs in every state, and you can move somewhere new, be a partner in 1 year, and be in a better place than you are now.
Bottom line? Because of the blood, sweat and tears you sacrificed to attain your current position, you are in an enviable position. Yes, you are frustrated, but because of your crudentials, you can make your situation even better.

4) Anesthesia/Surgery/Whatever Your Specialty Is is a mean to an end, unless you are a prolific, published academician/philanthropist. I don't know about you, but I do what I do because I'm a working stiff just like everyone else. Don't get me wrong, I really like my job and I don't loathe going to work, but I go to work because I am not "jet plane rich". Know what "jet plane rich" is? Thats when you can afford your own Gulfstream V and travel all over the world at a moments notice, like Benny Hann the criminal-I-take-your-grandma's-money televangelist, John I'm-a-super-stud-who-owns-a-Boeing 707- Travolta, Bill Gates, etc.
That being said, we make a very respectable salary. The top 10% of all specialties. Think about it...our CRNAs make more than most pediatricians, the primary care MD dudes who's pagers go off every 35 seconds with another mother concerned about the suspicious color of her 18 month old's bugar.
5) Are you really thinking your life sucks? Lemme remind you how small of a piece of the puzzle you/me/everyone else is in the big picture.
Remember 9/11? Remember how devastated everyone in this country felt about the needless loss of thousands of american people? Remember feeling the grievance/loss/anger/revenge?
Thats the past now. Yes, we remember, but life goes on, and every american now pretty much goes on with their lives with no sequelae.
So do you think your gripes are really significant? Or are you having a pity party for a young/professional/educated dude who makes great cash compared to everyone else?

Dude, you have an education better than anyone's, you work in an air-conditioned room, and you make more than most physicians. Yes, you could be in a better situation, but that doesnt justify your incessant complaining.

Here's my advice:

1) Take a cuppla days off and have a few margaritas
2) Take a look at the anesthesiologist job market, go to church, and thank God for your good fortune
3) Consider relocating
4) Stop feeling sorry for yourself, step up to the mike with Micatin, and land one of the hundreds of great anesthesiologist jobs out there.

Nuff said.

great post.. great post.. margaritas are not my thing.. more like white russians..

Let me ask you something jet to see if we are on the same page.. You are probably 5-8 years ahead of me as an attending.. If I do a tonsil and you do a tonsil.. who do you think should be reimbursed more?


ITs about calling a spade a spade.. I call bull**** when i see it. and thats how i see it.. I take good care of my patients.. I like what i do. I dont give a **** about the greedy asa who want to line their pockets.. I understand it is an imperfect sysem and will never be perfect but at least can we make it less imperfect..

 

[Justin4563]

The way I worked the ASA was that I joined them as a resident and paid the dues money and then when I became boarded, dropped them like a hot potato. Haven't heard from them since, how are they doin'? ---Zippy

good for you zippy.. whats your reason for not paying your dues for asa membership..

 

[UTSouthwestern]

Justin,

Let me give you some unsolicited advice. You are obviously an intellect and an over achiever. But you are ruining your life with your angry, pissed off, "my microcosm world is ***ked up" attitude.

Hey, you can tell me to go f*ck my self and I'd understand. But listen up for a minute...

1)Unless you are a Paul Tinker/Michael Roizen/Alan Kaye (the last dude is my buddy who just got a chair so I gotta give him a plug 👍 ) analogue, you are an anesthesiologist, just like all of us. We all have frustrations at work, we are frustrated with the politics of the job/ the fact that we get paid more for a cuppla tonsils than a medicare CABG/group dynamics/etc etc

2) You have your health, your condo/house/dog/wife/computer, and you make more money every year than 90% of the population in this country.

3)If you are unhappy with your current anesthesia gig, our job market is wide open, there are jobs in every state, and you can move somewhere new, be a partner in 1 year, and be in a better place than you are now.
Bottom line? Because of the blood, sweat and tears you sacrificed to attain your current position, you are in an enviable position. Yes, you are frustrated, but because of your crudentials, you can make your situation even better.

4) Anesthesia/Surgery/Whatever Your Specialty Is is a mean to an end, unless you are a prolific, published academician/philanthropist. I don't know about you, but I do what I do because I'm a working stiff just like everyone else. Don't get me wrong, I really like my job and I don't loathe going to work, but I go to work because I am not "jet plane rich". Know what "jet plane rich" is? Thats when you can afford your own Gulfstream V and travel all over the world at a moments notice, like Benny Hann the criminal-I-take-your-grandma's-money televangelist, John I'm-a-super-stud-who-owns-a-Boeing 707- Travolta, Bill Gates, etc.
That being said, we make a very respectable salary. The top 10% of all specialties. Think about it...our CRNAs make more than most pediatricians, the primary care MD dudes who's pagers go off every 35 seconds with another mother concerned about the suspicious color of her 18 month old's bugar.
5) Are you really thinking your life sucks? Lemme remind you how small of a piece of the puzzle you/me/everyone else is in the big picture.
Remember 9/11? Remember how devastated everyone in this country felt about the needless loss of thousands of american people? Remember feeling the grievance/loss/anger/revenge?
Thats the past now. Yes, we remember, but life goes on, and every american now pretty much goes on with their lives with no sequelae.
So do you think your gripes are really significant? Or are you having a pity party for a young/professional/educated dude who makes great cash compared to everyone else?

Dude, you have an education better than anyone's, you work in an air-conditioned room, and you make more than most physicians. Yes, you could be in a better situation, but that doesnt justify your incessant complaining.

Here's my advice:

1) Take a cuppla days off and have a few margaritas
2) Take a look at the anesthesiologist job market, go to church, and thank God for your good fortune
3) Consider relocating
4) Stop feeling sorry for yourself, step up to the mike with Micatin, and land one of the hundreds of great anesthesiologist jobs out there.

Nuff said.

Hey Jet, how is AD Kaye doing in Baton Rouge? Why did he leave Texas Tech and that goldmine of a pain program?

 

[jetproppilot]

Hey Jet, how is AD Kaye doing in Baton Rouge? Why did he leave Texas Tech and that goldmine of a pain program?

Actually he's not in Baton Rouge, UT, he's back here in New Orleans. Texas Tech apparently has a new Dean who is not liked, and Alan was not happy with the political turnaround. Top that off with the fact that Alan's boss (wife) is from New Orleans, and you see the evolution. Combine that with the fact that he was given a small fortune to come here, and its a done deal. Dudes smart as a whip, relates well to residents/faculty. As you are aware LSU lost its anesthesia residency so they were looking for a young dude with crudentials (ALAN has so many degrees I call him thermometer) to come in and turn the place around. The Chair business is kinda like being an NFL head coach- get in the game, have some success, and wait for the offers to come your way. He was ready to leave Texas Tech, got an offer where his boss would be in her utopia, now everyone is happy.

 

[jetproppilot]

great post.. great post.. margaritas are not my thing.. more like white russians..

Let me ask you something jet to see if we are on the same page.. You are probably 5-8 years ahead of me as an attending.. If I do a tonsil and you do a tonsil.. who do you think should be reimbursed more?


ITs about calling a spade a spade.. I call bull**** when i see it. and thats how i see it.. I take good care of my patients.. I like what i do. I dont give a **** about the greedy asa who want to line their pockets.. I understand it is an imperfect sysem and will never be perfect but at least can we make it less imperfect..

We should get the same $. Whether you're 28 or 48, if you're an anesthesiologist and you do the case, you get the same $. I'm content with that.

Learn how to pick your battles, Dude, and you'll be a happier person. Geez, if I went off on everything I see wrong with the system I'd be a lunatic.

Forgive me for making a generalization, Norm and Chi, but it seems that oriental people are born/bred/taught some kind of inner peace...I've seen this on many oriental patients and most recently, a 53 y/o woman with breast cancer having a port placed for CTX...I went in to pre-op her and she was in her Day Surgery room reading the paper, sitting with her husband like they were at a coffee shop or something...we did a MAC, and the CRNA remarked how easy it was to sedate her...she exuded this confidence, even though she was faced with a grim diagnosis....anyway my point is, this lady was about the 10th oriental I've seen with this inner peace thing going on, and I'm learning from her and the other patients similar to her. Am I crazy? Made me realize how insignificant all my complaints/concerns are.

Taught me that this every day bull**** we complain about isnt really significant in the global scheme of things. Think about that lady, Justin, and find that inner peace that'll enable you to live a happy life.
Geez, now I sound like Dr. Phil, and I havent even had a margarita yet...

 

[militarymd]

I have it....just not all the time. 🙂, but definitely after a few.

 

[UTSouthwestern]

Look Jet, don't spread this around, but we are trained from birth to use very special relaxation techniques to focus out thoughts and actions. It is something that makes us calm and peaceful on the outside yet strong and determined on the inside. The keepers of the peace in the old country were famous for using and teaching these principles and techniques.

Yes Jet, we are Jedi. Let's just get that out right now. Chi has the green lightsaber, I have the purple one, and I strongly suspect my brother has a red one, but that's another story.

So there you have it. Not only are we cool, peaceful dudes, we can choke the life out of you with just a thought through the internet. 😱

 

[jetproppilot]

Look Jet, don't spread this around, but we are trained from birth to use very special relaxation techniques to focus out thoughts and actions. It is something that makes us calm and peaceful on the outside yet strong and determined on the inside. The keepers of the peace in the old country were famous for using and teaching these principles and techniques.

Yes Jet, we are Jedi. Let's just get that out right now. Chi has the green lightsaber, I have the purple one, and I strongly suspect my brother has a red one, but that's another story.

So there you have it. Not only are we cool, peaceful dudes, we can choke the life out of you with just a thought through the internet. 😱

Gotcha. I deserved that. 👍

 

[UTSouthwestern]

Hey if I can't pick on you, who can I pick on?

 

[jetproppilot]

Hey if I can't pick on you, who can I pick on?

HAHAHAHAHAHAHAHAHAHAHAHAHHAHAHAHAHAH. Alright, anesthesia stud. Just keep that saber thing outside somewhere.

 

[UTSouthwestern]

Jet, just saw the part about LSU losing their residency. Ouch. I also heard about the misgivings at Tech this past year, plus the fact that a large number of their pain faculty are/have bolted with Leland Lou and Miles Day now in charge of our pain program. One of the guys that we took this year through the match from Tech was really disappointed that Kaye left so the next time you see him, tell him he is sorely missed there.

Justin, just out of curiosity, did I answer your question about the ASA?

 

[Justin4563]

We should get the same $. Whether you're 28 or 48, if you're an anesthesiologist and you do the case, you get the same $. I'm content with that.

Learn how to pick your battles, Dude, and you'll be a happier person. Geez, if I went off on everything I see wrong with the system I'd be a lunatic.

Forgive me for making a generalization, Norm and Chi, but it seems that oriental people are born/bred/taught some kind of inner peace...I've seen this on many oriental patients and most recently, a 53 y/o woman with breast cancer having a port placed for CTX...I went in to pre-op her and she was in her Day Surgery room reading the paper, sitting with her husband like they were at a coffee shop or something...we did a MAC, and the CRNA remarked how easy it was to sedate her...she exuded this confidence, even though she was faced with a grim diagnosis....anyway my point is, this lady was about the 10th oriental I've seen with this inner peace thing going on, and I'm learning from her and the other patients similar to her. Am I crazy? Made me realize how insignificant all my complaints/concerns are.

Taught me that this every day bull**** we complain about isnt really significant in the global scheme of things. Think about that lady, Justin, and find that inner peace that'll enable you to live a happy life.
Geez, now I sound like Dr. Phil, and I havent even had a margarita yet...

I think she may have zen... and I think "oriental" is a derogatory term// asian american i think is politically correct..

Hey jet,, you have great great points.. and i think you probably are a conscientious attending and a good doctor.. I am a easy going guy in the or.. I never get pissed off at anything.. I kid around with everybody.. If anyone gets in my way. i make it seem like Hey its great to see you.. I am a total "ILL work with anything" type of guy. If the tech cant get me a mac 3. Ill do it with a mac 4.. Im not picky.. as long as the tube is in.. i can hack myway through any disaster.. but it burns my ass some of the bull**** that is tolerated.

 

[VentdependenT]

UH, Think, I'm sorry Dude, but I can now drink you under the table. Being a New Orleans resident, my hepatic P450-cytochrome-reductase system is now Christopher Reeves-like. Before I moved here, Hermit The Frog could've out-drank me. Now, being the R-OH acclimated New Orleanian, I challenge you to a nite of the ethanol of your choice, and I'll hang. Name the bar of your choice (Cats Meow, Bull Dog, Santa Fe, Galletoires, etc) and I'll be there, ready for great conversation and partying gallore...BRING YOURSELF HERE AND WE'LL PARTY, DUDE.....

You would not stand a chance my friend. My liver is so hard core that its grown its own organ system and is now seeking employment as a high end bar tender. The rest of myself is to be auctioned off as parts....so says the liver.

 

[militarymd]

Yes Jet, we are Jedi. Let's just get that out right now. Chi has the green lightsaber, I have the purple one, and I strongly suspect my brother has a red one, but that's another story.

Funny that you used the term "Jedi". My chief and I have been talking about building our group around a strong core of Jedi's (his words) who will "protect and serve" our hospital.

Last couple of days have been rough....so I think I choose the red saber.....and the dark side.

 

[jetproppilot]

I think she may have zen... and I think "oriental" is a derogatory term// asian american i think is politically correct..

Hey jet,, you have great great points.. and i think you probably are a conscientious attending and a good doctor.. I am a easy going guy in the or.. I never get pissed off at anything.. I kid around with everybody.. If anyone gets in my way. i make it seem like Hey its great to see you.. I am a total "ILL work with anything" type of guy. If the tech cant get me a mac 3. Ill do it with a mac 4.. Im not picky.. as long as the tube is in.. i can hack myway through any disaster.. but it burns my ass some of the bull**** that is tolerated.

Yeah, youre right. I really wasnt trying to be derogatory. Quite the contrary. Thanks for the correction.

 

[jetproppilot]

Jet, just saw the part about LSU losing their residency. Ouch. I also heard about the misgivings at Tech this past year, plus the fact that a large number of their pain faculty are/have bolted with Leland Lou and Miles Day now in charge of our pain program. One of the guys that we took this year through the match from Tech was really disappointed that Kaye left so the next time you see him, tell him he is sorely missed there.

Justin, just out of curiosity, did I answer your question about the ASA?

I'll pass that on. Your opinion is corraborated by the quasi exodus from there.

 

[jetproppilot]

You would not stand a chance my friend. My liver is so hard core that its grown its own organ system and is now seeking employment as a high end bar tender. The rest of myself is to be auctioned off as parts....so says the liver.

lmao, Dude!

 

[militarymd]

Yeah, youre right. I really wasnt trying to be derogatory. Quite the contrary. Thanks for the correction.

HEY, since when is "oriental" derogatory??....I prefer "ornamental"

 

[jetproppilot]

HEY, since when is "oriental" derogatory??....I prefer "ornamental"

Always knew you'd have my back, Doctor. 👍

 

[ThinkFast007]

Jet and Vent...

well you guys do have the upper hand on me cuz you're out of med school and done with freakin MSIII yr (the yr that blows), so perhaps you guys have a few extra enzymes able to process EtoH better....

HOWEVER, never underestimate the capabilities of a frat boy 😀

 

[Justin4563]

Why should the examiners foot the bill? They don't just step forward and become designated as oral board examiners. They have to go through extensive training, create and submit questions/scenarios yearly, AND attend multiple meetings each year on their own coin to first become an oral board examiner, then to maintain their status as oral board examiners. It takes at least two years to even get considered for a junior examiner's position. Many of them became examiners and are becoming examiners to ensure that the process is fair and that the content accurately reflects what is being taught today and not ten years ago. The turnover among the examiners is fairly high because of the extensive time and effort commitment each examiner makes. I don't see why they should also be asked to fork over money as well.

The pressure on the residents to pay the combined cost of the exams is why myself and the other residents in the resident component of the ASA governing board pushed to have the fee split between the written and oral board years. I don't know if you had to pay for both at the same time, but that is no longer the case and you are thus paying only $950 for the written exam at the end of your CA-3 year. I can make that with two weekdays of moonlighting or a weekend day of moonlighting during residency. The oral board fee of $1725 is no longer due at that time and you should be able to foot the bill for that by March of your first year in practice or fellowship year.

Someone has to pay for the cost of creating, writing, and administering these exams. Do we need these exams? Hell yes. These tests are difficult and should be difficult to ensure that residents not only read, but read thoroughly and extensively to provide a thorough, fundamental, AND advanced understanding of EVERY aspect and concept of anesthesiology. It should provide a vehicle for which physician providers can separate themselves from other providers.

If we could get at least 70-80% membership in the ASA, then I would be all for footing the cost, but the reality is that too many people skimp on giving to the ASA and that would make the idea completely unfeasable and inequitable for those who do join the ASA and do give consistently to the organization.

In lieu of that, many residency programs ARE paying for the exams. My program requires that you get a 30 by the end of your CA-2 year, which should be easily achieved, before they pony up, but they pay for both the written and oral exams. Many other programs likewise tie the payment to some type of incentive standard.

I and others in the ASA are already putting together a proposal to make the test available at Sylvan testing centers, but that is preliminary and the fees that Sylvan charges to administer a written test of this length could be more expensive than the current format.

So again, if you want to complain about something, get involved and propose a solution that all sides would feel comfortable with, or at least all sides would feel the same about.

That is an acceptable explanation and kudos to you for at least splitting the fees for oral and written exam. BUt the cost is still too high. and i cant believe you dont see that. The fact that you mentioned that I should make the oral board fee during my first year in practice tells me you will be the asa president at some point in your career.. Let me just say something. IT DOESNT MATTER HOW MUCH I MAKE PLUS ITS NOBODIES BUSINESS. Price the exam in a fair manner.. And 3000 dollars to be board certified is laughable in these times of escalating malpractices, hospital closings, physicians leaving practice etc.. You are not examining people off the street. You are examining, physicians who completed a eight years of training. and i disagree with you.. if you wanna have the honor of being a board examiner foot your own bill. dont put it on the newbies to foot your bill. and you can easily test the oral concepts in a written format at a sylvan center where you enter your responses in free text and someone reads it.. This would decrease the cost of the exam which is ****ing ridiculous.. and they fail people just to make more money.. If i were the asa I would first publish the books of the ABA.. its a money making scheme.. and this whole maintenance of certification is another way of making more money on physicians.. I am all for high standards in medicine. but we have to take a step back and look at what we are doing. why do you think internal medicine doesnt have oral boards. and t hats a specialty that lends itself to that in that they love to talk and rationalize..

 

[UTSouthwestern]

That is an acceptable explanation and kudos to you for at least splitting the fees for oral and written exam. BUt the cost is still too high. and i cant believe you dont see that. The fact that you mentioned that I should make the oral board fee during my first year in practice tells me you will be the asa president at some point in your career.. Let me just say something. IT DOESNT MATTER HOW MUCH I MAKE PLUS ITS NOBODIES BUSINESS. Price the exam in a fair manner.. And 3000 dollars to be board certified is laughable in these times of escalating malpractices, hospital closings, physicians leaving practice etc.. You are not examining people off the street. You are examining, physicians who completed a eight years of training. and i disagree with you.. if you wanna have the honor of being a board examiner foot your own bill. dont put it on the newbies to foot your bill. and you can easily test the oral concepts in a written format at a sylvan center where you enter your responses in free text and someone reads it.. This would decrease the cost of the exam which is ****ing ridiculous.. and they fail people just to make more money.. If i were the asa I would first publish the books of the ABA.. its a money making scheme.. and this whole maintenance of certification is another way of making more money on physicians.. I am all for high standards in medicine. but we have to take a step back and look at what we are doing. why do you think internal medicine doesnt have oral boards. and t hats a specialty that lends itself to that in that they love to talk and rationalize..

We'll have to agree to disagree because you and I seem to disagree on whether or not these tests are even necessary. Again, looking at other specialties' exam costs, ours are in line on the lower end of the spectrum. Internal medicine does not have oral boards primarily because the number of people that would have to be examined would be at least 10 times the number that anesthesiologists and other subspecialty fields usually examine each year.

Again, the honor of being an oral board examiner does NOT come with a bounty of money as you are implying. I have spoken with our oral board examiners and any compensation they receive goes toward housing costs to travel to and stay at the city that they are asked to be present in for examinations.

So what is a fair price for these examinations? I agree that it would be great to lower the price of these examinations, but I haven't explored all of the costs in making the examinations. If you were a member of the ASA, you could spearhead an effort to reduce the costs of the tests instead of just commenting from the sidelines. If the membership of the ASA was higher, perhaps there wouldn't have to be a money making scheme to fund the legal and political efforts of the organizations, not to mention the research organizations that the ASA provides yearly funding to including the ones recently cited for excellence in medicine by the Wall Street Journal a couple of weeks ago.

To take that a step further, look at the AANA and its 90% membership rate. With the financial clout they pack, it should be more than obvious to anyone looking at the disparity between our two organizations that membership and the ability to present thousands of names to back their agendas, makes our lack of support of our main organizations look down right silly. How can we stave off attacks on our profession when we don't even support its primary legal and political entity?

If you want to hold back your support, you are more than entitled to do so, but at least present another reason other than "My test was too expensive" so the ASA/ABA is a scheme. Try going to the legislative meetings at least ONE time before you pass judgement. I was actually of the same mindset as you two years ago, but I decided to get involved and after meeting our advocators and the people who donate a significant amount of time to be our voices, I understand that the kind of statements you make to try to dissuade people from participating or supporting the ASA ONLY BENEFITS THE COMPETITION.

As for doing the oral boards by computer at SLC's, that would defeat the whole purpose of the oral boards which is to test your ability to react to an ever changing clinical situation. How can you do that with a question on a computer that the person taking the test only answers in that one scenario with an essay? I was recently examined by one of our oral board examiners and his ability to change the clinical scenario pushed my knowledge base to its limits and made me realize that I still have a lot to learn in order to provide the BEST patient care I can possibly provide. That is what the oral board is designed to test: First your knowledge base, your ability to apply that knowledge base in an organized and COMPREHENSIBLE and comprehensive manner, and your ability to adapt to sudden changes. If you tell the examiner that you would now like to defeat the rigidity of MH with a neuromuscular blocking agent instead of stopping the triggering agents and treating with Dantrolene, bicarb, etc., you deserve to fail because you have just killed your patient.

 

[EW1779]

Well, if we haven't completely departed from the reason this thread was started....

If you're a med student interested in anesthesiology, the ASA is becoming a great resource, all the polititcal mumbo jumbo in this thread aside.

I'm the current chair of the ASA Medical Student Delegation, and on behalf of our organization I'd like to invite all med students to come take part in the meeting in New Orleans. The MSD was started relatively recently, and we now have about 200 members, 5 of which are official ASA Board of Delegate members. We will be voting at the annual BoD meeting for the first time ever this October.

If you're interested, or want further information, please visit

http://www.asahq.org/Newsletters/2004/08_04/resReview08_04.html
http://www.asahq.org/Newsletters/2005/03-05/whatsNew03_05.html

You can email me directly at [email protected] for more information. Hope to see you all there!

E

 

[Justin4563]

We'll have to agree to disagree because you and I seem to disagree on whether or not these tests are even necessary. Again, looking at other specialties' exam costs, ours are in line on the lower end of the spectrum. Internal medicine does not have oral boards primarily because the number of people that would have to be examined would be at least 10 times the number that anesthesiologists and other subspecialty fields usually examine each year.

Again, the honor of being an oral board examiner does NOT come with a bounty of money as you are implying. I have spoken with our oral board examiners and any compensation they receive goes toward housing costs to travel to and stay at the city that they are asked to be present in for examinations.

So what is a fair price for these examinations? I agree that it would be great to lower the price of these examinations, but I haven't explored all of the costs in making the examinations. If you were a member of the ASA, you could spearhead an effort to reduce the costs of the tests instead of just commenting from the sidelines. If the membership of the ASA was higher, perhaps there wouldn't have to be a money making scheme to fund the legal and political efforts of the organizations, not to mention the research organizations that the ASA provides yearly funding to including the ones recently cited for excellence in medicine by the Wall Street Journal a couple of weeks ago.

To take that a step further, look at the AANA and its 90% membership rate. With the financial clout they pack, it should be more than obvious to anyone looking at the disparity between our two organizations that membership and the ability to present thousands of names to back their agendas, makes our lack of support of our main organizations look down right silly. How can we stave off attacks on our profession when we don't even support its primary legal and political entity?

If you want to hold back your support, you are more than entitled to do so, but at least present another reason other than "My test was too expensive" so the ASA/ABA is a scheme. Try going to the legislative meetings at least ONE time before you pass judgement. I was actually of the same mindset as you two years ago, but I decided to get involved and after meeting our advocators and the people who donate a significant amount of time to be our voices, I understand that the kind of statements you make to try to dissuade people from participating or supporting the ASA ONLY BENEFITS THE COMPETITION.

As for doing the oral boards by computer at SLC's, that would defeat the whole purpose of the oral boards which is to test your ability to react to an ever changing clinical situation. How can you do that with a question on a computer that the person taking the test only answers in that one scenario with an essay? I was recently examined by one of our oral board examiners and his ability to change the clinical scenario pushed my knowledge base to its limits and made me realize that I still have a lot to learn in order to provide the BEST patient care I can possibly provide. That is what the oral board is designed to test: First your knowledge base, your ability to apply that knowledge base in an organized and COMPREHENSIBLE and comprehensive manner, and your ability to adapt to sudden changes. If you tell the examiner that you would now like to defeat the rigidity of MH with a neuromuscular blocking agent instead of stopping the triggering agents and treating with Dantrolene, bicarb, etc., you deserve to fail because you have just killed your patient.

I tooke the oral boards last year and all the questions they asked me i felt i could answer on computer. If you feel the only way to test oral concepts is through an oral board format halfway across the world you should be the asa president.. Think outside the box. And if you feel oral board examinations are the only way of being competent physicians yet you say medicine dont require it because of the sheer numbers. That should not detract the board of internal medicine. They should make the board exam 12, 000 dollars and they would be able to examine every last medicine resident in an oral format.
The oral board examination process is still about hazing. Think about it. 2 so called experts quiz you make you feel nervous, My guy was yelling at me when i defended one of my statements.

The asa does not have higher membership rates because physicians are out to screw one another. thats just the way we are and will always be. Its about competition from the get go. The mentality is why should i help out a fellow physician, when he is in direct competition with me. However, the nurse anesthetist help each other out. They teach each other stuff in a non threatening manner. They stick together, cover for each other etc. Its their culture. Where we could give 2 ****s about each other, truly. IF i had to do it you have to do it mentality. (UT SOUTHWESTERN MENtality). we yell at residents at rounds, make them look stupid just to make us fell better about ourselves. Purposefully make things difficult. SO its not difficult to understand why not everyone is an asa or ama member. WHy should I support an organization that still supports archaic mentalities.. and you know what .. i dont give a **** if the nurse anesthetists take over . serves the anesthesiologists right for being so damn greedy for so many years. ao its more than my test was too expensive.. I mean if paid every dues to every society and medical licensure. I would be paying like 10,000 dollars a year.. and thats no small potatoes if you are making 110 a year as a pediatrician.
and if you need an oral board format to know not to treat malignant hyperthermia with atracurium.. then residency has failed us. LOL

 

[jetproppilot]

I tooke the oral boards last year and all the questions they asked me i felt i could answer on computer. If you feel the only way to test oral concepts is through an oral board format halfway across the world you should be the asa president.. Think outside the box. And if you feel oral board examinations are the only way of being competent physicians yet you say medicine dont require it because of the sheer numbers. That should not detract the board of internal medicine. They should make the board exam 12, 000 dollars and they would be able to examine every last medicine resident in an oral format.
The oral board examination process is still about hazing. Think about it. 2 so called experts quiz you make you feel nervous, My guy was yelling at me when i defended one of my statements.

The asa does not have higher membership rates because physicians are out to screw one another. thats just the way we are and will always be. Its about competition from the get go. The mentality is why should i help out a fellow physician, when he is in direct competition with me. However, the nurse anesthetist help each other out. They teach each other stuff in a non threatening manner. They stick together, cover for each other etc. Its their culture. Where we could give 2 ****s about each other, truly. IF i had to do it you have to do it mentality. (UT SOUTHWESTERN MENtality). we yell at residents at rounds, make them look stupid just to make us fell better about ourselves. Purposefully make things difficult. SO its not difficult to understand why not everyone is an asa or ama member. WHy should I support an organization that still supports archaic mentalities.. and you know what .. i dont give a **** if the nurse anesthetists take over . serves the anesthesiologists right for being so damn greedy for so many years. ao its more than my test was too expensive.. I mean if paid every dues to every society and medical licensure. I would be paying like 10,000 dollars a year.. and thats no small potatoes if you are making 110 a year as a pediatrician.
and if you need an oral board format to know not to treat malignant hyperthermia with atracurium.. then residency has failed us. LOL

Its sad that you are so digruntled.
You are presenting a "grass is always greener" philosophy in your post. 2 parts of it bothered me:

1)Half of my problems as chief of our department involve troubleshooting CRNA issues with each other. I can assure you they are no different than any other group of people. They in-fight over the schedule, not cleaning up after themselves, etc.

2)Doctors are not out to "screw" each other. I'm sure there are times/individuals that this happens, but your depiction is very skewed. My partners and I cover for each other, etc. We strive for a friendly workplace. We are not disgruntled.

 

[militarymd]

JD,

Are you saying we don't need to have a board certification process?

I have worked with and gotten to know close to 100 anesthesiologists in the various places that I have practiced.....and let me tell you, there IS a difference between those who were invited to join the club and those who have been rejected.

I think I said that before.