Charlotte, NC job market

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james775

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Anyone with insight into the market in charlotte? I see postings on gaswork about NAAPA. Also see a providence anesthesia group. Just curious what the market is like and if there are any other jobs. Thanks
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I was unable to find a PP job there 10 years ago, the offer I got from the big group /AMC covering CMC was horrible. interested to see responses to see if/how things have changed.
 
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james775 said:
Anyone with insight into the market in charlotte? I see postings on gaswork about NAAPA. Also see a providence anesthesia group. Just curious what the market is like and if there are any other jobs. Thanks
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It's terrible. Look up Scope Anesthesia. Big debacle a couple years ago where the hospital gave the contract to this scam artist which led to 100+ anesthesiologists being kicked out and turned over. Have heard they use medical supervision (ie covering >4 CRNAs at a time) and there have been many disasters the hospital has tried to keep out of the public eye since the switch happened. I would steer clear.

Thread of interest to you
 
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One only has to google Scope anesthesia and H1B and ask ... why would you need a waiver for a visa in a city like Charlotte? but if you need a waiver maybe Scope is the place for you! Last advertised H1B was 4/2021 but you can "find a physician" in Medicare.gov and search CHS anesthesia if you want to really find out who is working there......
 
Part time Physcian. Say it loud and say it proud!! Physician not Provider.
You gotta be over 40 if you are talking about retirement presumably. When did you incorporate “provider” into your vocabulary?
This I thought was something that young people did. You and @BLADEMDA need to stop with this.
LineAndBerry said:
We will be looking for a part time provider as my partner and I scale back in 2022. FT potential when one of us retires. Good pay and very nice place to work outside Charlotte.
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chocomorsel said:
Part time Physcian. Say it loud and say it proud!! Physician not Provider.
You gotta be over 40 if you are talking about retirement presumably. When did you incorporate “provider” into your vocabulary?
This I thought was something that young people did. You and @BLADEMDA need to stop with this.
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Yikes, I really did not intend any offense here. I am 66.
 
We can't just go along with corporate and midlevel speak that tries to put us all on the same level and muddy the waters. If we do this, we are adding to the problem. Go to another country outside of America and tell people you are a "provider" and see if they know what that means.
It's not about offending me, it's just we in this profession need to have a united front and realize that our careers, education are undervalued and getting eroded slowly every day with this kind of vocabulary.
I tell anyone who dares call me a provider, I tell them that I am not a provider. I am a physician. We all need to get on board.
LineAndBerry said:
Yikes, I really did not intend any offense here. I am 66.
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chocomorsel said:
We can't just go along with corporate and midlevel speak that tries to put us all on the same level and muddy the waters. If we do this, we are adding to the problem. Go to another country outside of America and tell people you are a "provider" and see if they know what that means.
It's not about offending me, it's just we in this profession need to have a united front and realize that our careers, education are undervalued and getting eroded slowly every day with this kind of vocabulary.
I tell anyone who dares call me a provider that I am not a provider. I am a physician. We all need to get on board.
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Yes, I do agree with these sentiments and oddly I never use the term. TBH, I wrote that note on the run, probably coming from some meeting with a head full of admin speak.
Anyway, I agree with your points and am the first to defend our profession given the opportunity.
 
Do you still feel thesame way about scope anesthesia today. Trying to set up an interview with them in the coming months
 
apparently scope is more stable. Still some turnover and it’s really run by Atrium (telling Tom Wherry what to do). It’s not a true private practice but pay is good and hours fine apparently.

What I’m hearing is no one knows how the new Atrium/wake forest relationship will work, particularly as they build a new medical school.

Academics and what Wake Forest pays is very different than scope.

Nothing definitive…just lots of questions.
 
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Same stable. Good pay. Big questions still remain as the med school is built though and likely residency to come and how Atrium deals with the big differences in Scope vs Wake Forest academics. Scope also doesn’t staff all of Atrium even in Charlotte area. Another group called Northeast staffs concord/university/Cornelius area. Point being it’s a good job but Atrium could pivot at any point and lots of options for them to do so
 
I’ve have seen the atrium scopes contract (2024 contract) seems reasonable. Average 45 hrs a week mid 550s range with match etc
10 weekends a month but more shift work.
Plus retirement match
It’s on gaswork but they will give u the details

As always. Negotiate a sign on bonus

Personally. I’d do 1 plus 1 sign on deals

LeBron James and KD 1 plus 1 contracts with the bonus.
Meaning 2 guaranteed years but u have option of bailing at end of year 1. Or option of taking second year bonus or renegotiate for higher pay.
 
amyl said:
10 weekends a year you mean?
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Yes. 10 weekends a year. So every 5 weeks. There are no 24 hr calls. Just shift work. Some night shift work. This doc turned it down early but they have a second big time income source so didnt need the job.
 
aneftp said:
I’ve have seen the atrium scopes contract (2024 contract) seems reasonable. Average 45 hrs a week mid 550s range with match etc
10 weekends a month but more shift work.
Plus retirement match
It’s on gaswork but they will give u the details

As always. Negotiate a sign on bonus

Personally. I’d do 1 plus 1 sign on deals

LeBron James and KD 1 plus 1 contracts with the bonus.
Meaning 2 guaranteed years but u have option of bailing at end of year 1. Or option of taking second year bonus or renegotiate for higher pay.
Click to expand...

yeah but its all medical direction/supervision. need atleast 650k base for that risk and running around like a preop monkey and a firefighter dealing with CRNA disasters
 
Howard888 said:
Same stable. Good pay. Big questions still remain as the med school is built though and likely residency to come and how Atrium deals with the big differences in Scope vs Wake Forest academics. Scope also doesn’t staff all of Atrium even in Charlotte area. Another group called Northeast staffs concord/university/Cornelius area. Point being it’s a good job but Atrium could pivot at any point and lots of options for them to do so
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Which med school is being built and what university will it be associated with
 
Status Sciaticus said:
yeah but its all medical direction/supervision. need atleast 650k base for that risk and running around like a preop monkey and a firefighter dealing with CRNA disasters
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I've been everywhere. I really don't know about people's perception of supervising/medical direction. I don't waste much time preoping or prepping patients lines/blocks. 1:4 doesn't bother me. 1:7 was kinda of tough but I handled it for a couple of years.

What type of work do you think is hard work? I know workload because I'm all about workload. Many people are highly inefficient with their times. Yes, one complication will and can ruin the flow of any ACT model.

4 high acuity rooms to start is tough. So what exactly is running around? Seeing 28 GI preop and couple of ortho blocks is not high acuity in my opinion.
 
Wake Forest is the med school in Charlotte. Been in news for a while. Opens in next 12-16 months. I love folks saying direction/supervision is difficult crazy. It’s not. Act model is the correct model. 1:1-1:6 depending on the acuity/extra lines procedures/, timing etc. neonatal peds 1:1 to an eye center 1:6. Quit fooling yourselves thinking Md only is superior and it’s definitely not cost effective nor superior. But you folks keep sitting those healthy knee scopes and lap choles and pat yourself on the back thinking you have better care, whatever it takes to make you feel better
 
Howard888 said:
Wake Forest is the med school in Charlotte. Been in news for a while. Opens in next 12-16 months. I love folks saying direction/supervision is difficult crazy. It’s not. Act model is the correct model. 1:1-1:6 depending on the acuity/extra lines procedures/, timing etc. neonatal peds 1:1 to an eye center 1:6. Quit fooling yourselves thinking Md only is superior and it’s definitely not cost effective nor superior. But you folks keep sitting those healthy knee scopes and lap choles and pat yourself on the back thinking you have better care, whatever it takes to make you feel better
Click to expand...
You do 1:1 supervision for neonates? Not very cost effective.
 
caligas said:
You do 1:1 supervision for neonates? Not very cost effective.
Click to expand...
Do you leave neonates unattended in pacu post op as you rush to start the next case?

Any free anesthesia docs immediately available?

1:1 supervision of neonates is usually in true academics
 
ToKingdomCome said:
lol supervision warrants 650K a year ?
Click to expand...
1 liability in solo MD vs. 4 liabilities in supervision. If my likelihood of relative adverse outcomes increases 400%, then I think its fair for my compensation to increase 15%.

Im not about to let the hospital keep that extra physician salary profit in ACT vs solo all to themselves.
aneftp said:
I've been everywhere. I really don't know about people's perception of supervising/medical direction. I don't waste much time preoping or prepping patients lines/blocks. 1:4 doesn't bother me. 1:7 was kinda of tough but I handled it for a couple of years.

What type of work do you think is hard work? I know workload because I'm all about workload. Many people are highly inefficient with their times. Yes, one complication will and can ruin the flow of any ACT model.

4 high acuity rooms to start is tough. So what exactly is running around? Seeing 28 GI preop and couple of ortho blocks is not high acuity in my opinion.
Click to expand...

Its not that I think pre-op or supervision is hard work. I think its actually the opposite. It breeds laziness in anesthesiologists sitting in the lounge. We've all seen it. I also don't like dealing with inferiority complexes from CRNAs, which can and sometimes do lead to patients having bad outcomes.

My dislike for it simply is the risk of supervision vs solo, and the fact that I did not go to medical school to be an intra-op nurse manager.
 
Status Sciaticus said:
1 liability in solo MD vs. 4 liabilities in supervision. If my likelihood of relative adverse outcomes increases 400%, then I think its fair for my compensation to increase 15%.

Im not about to let the hospital keep that extra physician salary profit in ACT vs solo all to themselves.


Its not that I think pre-op or supervision is hard work. I think its actually the opposite. It breeds laziness in anesthesiologists sitting in the lounge. We've all seen it. I also don't like dealing with inferiority complexes from CRNAs, which can and sometimes do lead to patients having bad outcomes.

My dislike for it simply is the risk of supervision vs solo, and the fact that I did not go to medical school to be an intra-op nurse manager.
Click to expand...
Do you have any stats on whether malpractice lawsuits are more common in ACT model versus physician solo? I've been searching for this for awhile. Having extra hands that are capable is a great way to prevent adverse outcomes in my experience.
 
PainInTheAnes said:
Do you have any stats on whether malpractice lawsuits are more common in ACT model versus physician solo? I've been searching for this for awhile. Having extra hands that are capable is a great way to prevent adverse outcomes in my experience.
Click to expand...
I’d guess that four to one supervision results in at least four times as many lawsuits for the anesthesiologist.

In regards to the extra set of hands, my experience is that 90% of the time it’s my set of hands fixing the problem that the CRNA hands caused.
 
caligas said:
I’d guess that four to one supervision results in at least four times as many lawsuits for the anesthesiologist.

In regards to the extra set of hands, my experience is that 90% of the time it’s my set of hands fixing the problem that the CRNA hands caused.
Click to expand...
I’d potentially guess that too, but I want someone to prove it to me. Until then it’s a dubious claim imo. We don’t even have data from independent crna practice on settlement frequency and that would also help this debate.

The frequency of anesthesia complications has likely plummeted in the last 25 years despite care teams being the most common practice model now. We haven’t made anesthesia fool proof quite yet but we’re pretty close.

Picking out stochastic events like lawsuits is difficult as always.

All MD practices I’ve seen have a lot more people with tunnel vision and antiquated practice in my experience. Too comfortable and sure of themselves all too commonly.
 
PainInTheAnes said:
I’d potentially guess that too, but I want someone to prove it to me. Until then it’s a dubious claim imo. We don’t even have data from independent crna practice on settlement frequency and that would also help this debate.

The frequency of anesthesia complications has likely plummeted in the last 25 years despite care teams being the most common practice model now. We haven’t made anesthesia fool proof quite yet but we’re pretty close.

Picking out stochastic events like lawsuits is difficult as always.

All MD practices I’ve seen have a lot more people with tunnel vision and antiquated practice in my experience. Too comfortable and sure of themselves all too commonly.
Click to expand...
Agree with this completely. Arrogance. Having talked to med mail companies they tell me no difference in claims. However I haven’t seen it written down either so if anyone has data please provide
 
Status Sciaticus said:
1 liability in solo MD vs. 4 liabilities in supervision. If my likelihood of relative adverse outcomes increases 400%, then I think its fair for my compensation to increase 15%.

Im not about to let the hospital keep that extra physician salary profit in ACT vs solo all to themselves.


Its not that I think pre-op or supervision is hard work. I think its actually the opposite. It breeds laziness in anesthesiologists sitting in the lounge. We've all seen it. I also don't like dealing with inferiority complexes from CRNAs, which can and sometimes do lead to patients having bad outcomes.

My dislike for it simply is the risk of supervision vs solo, and the fact that I did not go to medical school to be an intra-op nurse manager.
Click to expand...
I DO think it's hard work, if you want to actually play a significant role in the care of your patients. Mind-numbing doing 15+ pre-ops in a day. Near impossible for me to keep them all straight by the end of the day (especially when they're all complex and/or having big surgeries). I also find it much more demanding to run around from room to room, anticipating or correcting issues. Much worse when I worked with crnas who wouldn't call for help, wouldn't call for induction/emergence, and wouldn't follow directions (which I gave very few), as I literally had to be on my toes all the time to be where I needed to be. At least I have great AAs now who are excellent communicators and are easy to work with.

Most days I'm doing my own cases and I find it FAR more relaxing and enjoyable, even when it's a sick patient or very demanding case.
 
aneftp said:
Do you leave neonates unattended in pacu post op as you rush to start the next case?

Any free anesthesia docs immediately available?

1:1 supervision of neonates is usually in true academics
Click to expand...

Same liability with neonate vs adult. No one gets more malpractice insurance because they do neonates. Yes, I will do solo cases all day.
 
centdoc said:
Same liability with neonate vs adult. No one gets more malpractice insurance because they do neonates. Yes, I will do solo cases all day.
Click to expand...
So no one mans the pacu? That’s the question

There was one place in California i worked mean eons ago had a peds airway issue…no one in pacu cause MD only

Hospital agreed to pay for free available MD 7-3p stipend (that was before stipends were common)

But only after the fact.
 
aneftp said:
So no one mans the pacu? That’s the question

There was one place in California i worked mean eons ago had a peds airway issue…no one in pacu cause MD only

Hospital agreed to pay for free available MD 7-3p stipend (that was before stipends were common)

But only after the fact.
Click to expand...
In ACT model? All mds man the PACU as they aren’t in the room. So 20 room place 5 mds available to help in PACU.
 
Howard888 said:
In ACT model? All mds man the PACU as they aren’t in the room. So 20 room place 5 mds available to help in PACU.
Click to expand...
I’m talking MD only places. Very few places leave an unattended less than 1 year old
Post anesthesia alone
 
Oh yes I don’t know how they do that unless they wait until phase 2
 
PainInTheAnes said:
I’d potentially guess that too, but I want someone to prove it to me. Until then it’s a dubious claim imo. We don’t even have data from independent crna practice on settlement frequency and that would also help this debate.

The frequency of anesthesia complications has likely plummeted in the last 25 years despite care teams being the most common practice model now. We haven’t made anesthesia fool proof quite yet but we’re pretty close.

Picking out stochastic events like lawsuits is difficult as always.

All MD practices I’ve seen have a lot more people with tunnel vision and antiquated practice in my experience. Too comfortable and sure of themselves all too commonly.
Click to expand...
I'd like that as well, but I don't believe that every point has a study associated with it. I am going purely on deductive reasoning and logic.
I did mention the relative risk of anesthesia complications, not the absolute risk. It doesn't matter how safe anesthesia gets.
If you are liable for 4 rooms instead of 1, your risk of adverse events is going to be much higher than if running a solo room.

I cant speak for every MD practice or every ACT practice, but from my anecdotal experience, I have seen better quality of care delivered at MD only practices.
 
Status Sciaticus said:
I'd like that as well, but I don't believe that every point has a study associated with it. I am going purely on deductive reasoning and logic.
I did mention the relative risk of anesthesia complications, not the absolute risk. It doesn't matter how safe anesthesia gets.
If you are liable for 4 rooms instead of 1, your risk of adverse events is going to be much higher than if running a solo room.

I cant speak for every MD practice or every ACT practice, but from my anecdotal experience, I have seen better quality of care delivered at MD only practices.
Click to expand...
Deductive reasoning would also show that malpractice premiums are larger for care team anesthesiologists than for solo ones. To my knowledge, this is not the case.

We may not know the risk but insurance companies definitely do. They act on those risks but I haven’t heard much about different premiums depending on the care model or that being a determining factor in tail coverage either.

Anyone with insight on that?
 
PainInTheAnes said:
Deductive reasoning would also show that malpractice premiums are larger for care team anesthesiologists than for solo ones. To my knowledge, this is not the case.

We may not know the risk but insurance companies definitely do. They act on those risks but I haven’t heard much about different premiums depending on the care model or that being a determining factor in tail coverage either.

Anyone with insight on that?
Click to expand...
Again most large hospital systems and AMC are self insured these days.
 
aneftp said:
Again most large hospital systems and AMC are self insured these days.
Click to expand...
Good point. To me, the flexibility and financial benefit of supervising outweighs the potential increase of malpractice. Much of malpractice is related to not following algorithms in emergencies, nerve block injuries, PACU complications, and positioning injuries. Most of it is preventable with minimal oversight in my experience and other malpractice comes from patients or places you'd never expect.
 
aneftp said:
Again most large hospital systems and AMC are self insured these days.
Click to expand...
exactly, and the true outcomes are likely muddled because of this.
PainInTheAnes said:
Good point. To me, the flexibility and financial benefit of supervising outweighs the potential increase of malpractice. Much of malpractice is related to not following algorithms in emergencies, nerve block injuries, PACU complications, and positioning injuries. Most of it is preventable with minimal oversight in my experience and other malpractice comes from patients or places you'd never expect.
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This is where we disagree. To me, the financial benefit doesnt outweigh the potential risk and harm to my patients.
 
Status Sciaticus said:
exactly, and the true outcomes are likely muddled because of this.

This is where we disagree. To me, the financial benefit doesnt outweigh the potential risk and harm to my patients.
Click to expand...
You have no proof to that there is more harm per patient with ACT. I’d grant that because you take care of more patients there’s more exposure to risk. But the benefit is that more people are taken care of under current rules and hospital structures.
 
PainInTheAnes said:
You have no proof to that there is more harm per patient with ACT. I’d grant that because you take care of more patients there’s more exposure to risk. But the benefit is that more people are taken care of under current rules and hospital structures.
Click to expand...
Can you prove there isnt more harm?

jamanetwork.com

Anesthesiologist Staffing Ratio and Surgical Patient Morbidity and Mortality

This cohort study uses data from the Multicenter Perioperative Outcomes Group database to examine the association between intraoperative anesthesiologist staffing ratio and surgical patient morbidity and mortality across 23 hospitals in 18 states.
jamanetwork.com jamanetwork.com

A recent study that says morbidity increases as you increase staffing ratios.
 
Howard888 said:
Wake Forest is the med school in Charlotte. Been in news for a while. Opens in next 12-16 months. I love folks saying direction/supervision is difficult crazy. It’s not. Act model is the correct model. 1:1-1:6 depending on the acuity/extra lines procedures/, timing etc. neonatal peds 1:1 to an eye center 1:6. Quit fooling yourselves thinking Md only is superior and it’s definitely not cost effective nor superior. But you folks keep sitting those healthy knee scopes and lap choles and pat yourself on the back thinking you have better care, whatever it takes to make you feel better
Click to expand...

Ohhh boy… 😂
 

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Howard888 said:
Wake Forest is the med school in Charlotte. Been in news for a while. Opens in next 12-16 months. I love folks saying direction/supervision is difficult crazy. It’s not. Act model is the correct model. 1:1-1:6 depending on the acuity/extra lines procedures/, timing etc. neonatal peds 1:1 to an eye center 1:6. Quit fooling yourselves thinking Md only is superior and it’s definitely not cost effective nor superior. But you folks keep sitting those healthy knee scopes and lap choles and pat yourself on the back thinking you have better care, whatever it takes to make you feel better
Click to expand...

You are the one sounding superior.
As soon as you realize we are all on the same side, you might realize that which you don’t underatand.

You can say this or that, but you are working with your professions literal nemesis who claims you are no better than the CRNA you supervise… and you ARE better.

Chill bro. You are arguing with the wrong side.
 
sevoflurane said:
You are the one sounding superior.
As soon as you realize we are all on the same side, you might realize that which you don’t underatand.

You can say this or that, but you are working with your professions literal nemesis who claims you are no better than the CRNA you supervise… and you ARE better.

Chill bro. You are arguing with the wrong side.
Click to expand...
Must be a guy who supervises/directs and doesnt sit his own stool who got his feelings hurt that others dont share his opinion.
 
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