I guess I was not referring to hospitals so small that they don't have an in house doc 24/7. I would imagine most of those small hospitals are not AMC operated.
Current case volume affect on AMCs
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I guess I was not referring to hospitals so small that they don't have an in house doc 24/7. I would imagine most of those small hospitals are not AMC operated.
No. We are talking full service 300-400 bed community hospitals. Cardiac neurological surgery ortho ob etc.
If they are employing the anesthesiologists as W2. These hospitals are using them as 24/7 airway coverage when the traditionally have icu and Er docs (independent contracts, or Er docs work for management company)
so in this economy with Er visits WAY DOWN. these amc are cutting ER docs hours. And ER docs complain they can’t cover code blues/airways
Icu docs (independent contractors) all of the sudden point to the stupid Asa statement about the “more experienced “ intubator should intubate covid-19 patients.
Guess who is getting dumped with 24/7 airway coverage when they could be home on beeper??
Anesthesiologists employed w2 by the hospital.
I was unaware of any 300-400 bed hospitals that are "full service" that did not have anesthesiologists in house 24/7, at least none near me. I mean how do you even start a stat c-section in less than 20 minutes if the anesthesiologist is sleeping at home?
its not just the w2 hospital employed docs that you are describing, PP groups are having this happen too.. sometimes to keep the contract/stipend, sometimes just to be there and do whats right..
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Do you really think a hospital employing anesthesiologists is going to continue to keep them at home doing nothing with just beeper call and not eventually cut payroll? This is the bullet you have to bite to keep your salary coming in.
It’s needs to be optional to cover out of the scope of your practice. Intubating covid-19 PUI or positive patients. When the normal is not to cover intubations.
I have covered several hospitals md only. solo ob no crna. Acog rules says 30 minutes response time. It’s also in hospital bypass.
Usually it’s unwritten rule they want us back in 15-20 minutes (10 min time to OR) and this was trauma 2 facilities. So we are within the 30 min acog rules.
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deleted162650
Level 2 Trauma now requires in house anesthesia.
It's hard to argue that intubating patients is "out of the scope of your practice" since we kinda do intubate people. It might be a change from normal hospital operating procedure, but when you work for a hospital they can change those rules whenever they want.
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In house? Since when?
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deleted162650
Been a couple years now. We had to amend our contract with the hospital because of this. Maybe a regional thing?
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Senior resident or crna has to be in house. Anesthesiologist has to be 30 min away.
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Well, they can talk with their feet if they feel like they are being treated poorly. And then come back and contract directly with the hospitals like someone else has said.
Have the media on speed dial and
of course a lawyer as well available for all the BS that’s coming.
Not really. My friends Mid East coast area trye PP giving admin a big Fu who is requesting it. Admin trying to leverage usap trying take both the Er and anesthesia contracts (usap Er side division. Us acute care services or whatever they call themselves) Trying to scoop in.
Dare them. Go ahead. The practice takes zero subsidy. They can barley pay daytime MDs 240k to work 5 days a week 50 hours.
so usap can come in take the contract and use “cheaper” crnas who work 4 days a week for 180k.
you see the numbers simple don’t add for usap to take over. Of course they are trying to leverage the ER contract to make up for anesthesia revenue.
They asked for 100 from hospital to cover airway
are you in house call or beeper?
scope of practice for past 30 years of practice has been beeper and no central lines. Er and icu Docs have done them always. Occasionally called for potential difficult airway
That’s what I thought. It’s been a few years since i worked at that one place in California but my friend still works there and hasn’t mentioned any changes in regards to beeper ob/trauma 2 calls. He’s usually in the hospital within 15 minutes to be honest if called.
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USACS is commonly referred to as USUCKS in the EM forum. USAP and USACS are separate companies but both are part of the Welsh Carson portfolio.
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The phrase "scope of practice" refers to things you are legally allowed to do under your licensure/credentials. Intubation is something we do. What you mean to say is that the hospital is changing who they want doing it on some patients but unfortunately that seems in line with what is going on nationally with these patients where they want the most experienced person doing it.
Yes. That’s what i figured and what welsh Carson is trying to do. Take both anesthesia and ER contracts simultaneously.
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you spend too much time online. <3
100k per month?? Did they get it? - I agree that that is reasonable , possibly more
Nothing right now. So anesthesia will still “help out” when needed but won’t be first option. ER docs are still the first option.
it’s all MD private practice. So they aren’t giving the hospital free labor just to sit around. Obviously work is light. So those MD sitting at home not getting paid. But the MD working at truly working on urgent/semi urgent cases solo. So not a free body to roam around 24/7 for the hospital.
