cks33

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how do most places handle regional? are you supervising crnas doing blocks?
 
May 28, 2019
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Won't collapse if the docs take a pay cut. ;(

Hoya's practice:
For my practice at 40 rooms we have 10 docs and 40 CRNAs. 10 X 500k (total MD package) + 40 x 250k (total CRNA package) = 15 million

Budget of 15 million could hire 40 docs at $375. Or 30 full time call taking docs with higher salaries and 10 mommy track docs with lower salaries.

Or 25 docs and 22 CRNAS and create a hybrid system with the docs doing all the intense cases, and the supervised CRNAs doing the bread and butter.

The CRNAs should never outnumber the Physicians. Numbers equal power.
you make it sound like you can order 25 docs and they will come.
the ACT practices largely exist because of recruitment and retention issues. They just cant find docs.
And if your docs are making 375. you will be recruiting year round. guranteed
 

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Wiseguy
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Let's clear something up: the entire world has enough anesthesiologists, even critical care-trained, just we don't. Why? Greed.

We have to provide anesthesia for every idiotic procedure (e.g. cataracts); let's not mention all the epidurals, while other countries are just fine with nitrous. The opiate hysteria coupled with regional blocks even for the fly on the wall. We would provide anesthesia even for anesthesia, if anybody paid for it.

The system is designed like that, on purpose, so that the big corporations can siphon billions out of the healthcare system, while whining "we don't have enough doctors, so we should be allowed to let nurses play doctor". How many Americans need to be hurt before somebody realizes that a house with a bad foundation will sink, sooner or later?
 
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SaltyDog

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you make it sound like you can order 25 docs and they will come.
the ACT practices largely exist because of recruitment and retention issues. They just cant find docs.
And if your docs are making 375. you will be recruiting year round. guranteed
Come on man don’t act stupid. Of course you don’t switch models overnight. A CRNA retires or moves - they get replaced by a doc. A CRNA is a problem child - they get replaced by a doc. The model changes over 5-10-15 years.

And pay differential in that example above is waaaaay optimistic. You need more than just 4x the number of docs in nurses ‘cuz I assume they are gonna want to take time off too (and I assume they all want to get paid). And, as mentioned above, you’re not running 4:1 all day every day.
 
May 28, 2019
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Come on man don’t act stupid. Of course you don’t switch models overnight.
You can order docs for 5-10-15 years sometimes it just aint happening. The reason is multi-factorial. That is the problem mon frere!!
 

chocomorsel

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Let's clear something up: the entire world has enough anesthesiologists, even critical care-trained, just we don't. Why? Greed.

We have to provide anesthesia for every idiotic procedure (e.g. cataracts); let's not mention all the epidurals, while other countries are just fine with nitrous. The opiate hysteria coupled with regional blocks even for the fly on the wall. We would provide anesthesia even for anesthesia, if anybody paid for it.

The system is designed like that, on purpose, so that the big corporations can siphon billions out of the healthcare system, while whining "we don't have enough doctors, so we should be allowed to let nurses play doctor". How many Americans need to be hurt before somebody realizes that a house with a bad foundation will sink, sooner or later?
Preach on brother!!!
I doubt Americans in general care though. It’s all about the Benjamins babe!!!
 
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Wiseguy
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Meanwhile, I get this job advertisement email for a position with Envision literally 10 minutes ago. Here's a screenshot of a piece of it. I'm just going to let it speak for itself.

View attachment 268203
It looks like some of the VA jobs (except for the number of sites). I bet the pay is similar, too.
 

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Wiseguy
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we would need to train 5000-7000 residents per year that is 1/4 of all medical graduates gojng into anesthesia for all md. nationwide
Nope. We would need to stop wasting money (as a nation) on cases that either don't need to happen (e.g. elective ortho) or don't need anesthesia (e.g. cataracts, GI), like most other DEVELOPED countries do.

Why do you think healthcare is such a big percentage of our GDP? A lot of that comes from surgical cases, the number one moneymaker. There is simply no interest to give up all those juicy healthcare profits that go to hospital executives and owners.
 
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dannyboy1

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Aug 11, 2008
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Nope. We would need to stop wasting money (as a nation) on cases that either don't need to happen (e.g. elective ortho) or don't need anesthesia (e.g. cataracts, GI), like most other DEVELOPED countries do.

Why do you think healthcare is such a big percentage of our GDP? A lot of that comes from surgical cases, the number one moneymaker. There is simply no interest to give up all those juicy healthcare profits that go to hospital executives and owners.
Umm. Profits go to us as well. Demand for anesthesia drives salaries....
 
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narcotics999

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Feb 18, 2008
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Meanwhile, I get this job advertisement email for a position with Envision literally 10 minutes ago. Here's a screenshot of a piece of it. I'm just going to let it speak for itself.

View attachment 268203
CRNA autonomy is better than ACT. At least you don't need to be responsible for their mistakes or incompetence.

Well, CRNA proponents will argue about patient safety.....
 

IMGASMD

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Jan 24, 2017
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CRNA autonomy is better than ACT. At least you don't need to be responsible for their mistakes or incompetence.

Well, CRNA proponents will argue about patient safety.....
My question always is/will be. What if they ask for a stat “consult” from us? Do you say yes or do you say no?