Des moines group change?

Healthcare jobs with pay you can see.
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
1. Why are they doing Epic Go Live in 2025?

2. Sounds like a billing/documentation integration issue. Epic is great once it’s set up but it requires a ton of work/IT investment to get it right at Go Live. Maybe the hospital and the anesthesia group had a disagreement about who would do the work and/or pay for startup costs. The Epic launch at our 5 hospital system was reportedly close to $1bil almost 10 years ago and we had 2 years of workgroup meetings before the launch. Each of our hospital anesthesia departments still has a formal paid “epic liaison” to monitor and provide anesthesia input on updates.

3. Good luck getting 40+ anesthesiologists to move to Des Moines. Likely the existing doctors will transition to hospital employment.
 
Last edited:
Iowa CRNA Opportunity – $300/hr | Quick Credentialing | Weekly Pay

We're seeking experienced CRNAs for an unsupervised role at a Level 2 trauma center in Iowa.

Position Details:

• Start Date: May 12, 2025

• Schedule: 20 shifts/month

◦ Weekdays: 7:00 AM – 5:00 PM

◦ Weeknight Call: 5:00 PM – 7:00 AM

◦ Weekends: 24-hour shifts (7:00 AM – 7:00 AM)

• Duration: Through September with the option to extend if mutually agreed upon

Compensation & Benefits:

• Rate: $300 per hour

• Malpractice Insurance: Provided

• Travel & Lodging: Covered

• Payment: Weekly via Curative

Case Mix & Support:

• 60% Medicare

• 85% Adult/Geriatric, 15% Peds/Adolescent

• General Anesthesia, Blocks, Epidurals, etc.

• Full OR/PACU support

• EMR: Cerner

Requirements:

• Minimum 24 months of experience

• Active Iowa license (no exceptions)

• ACLS & PALS certifications

If you're interested or would like more information, please reach out with your name:

[email protected]
469.658.7038
 
That crna rates for Iowa Folks. $300/hr plus travel.

Trauma Care Facility MercyOne Des Moines Medical Center - Level II. Location Address 1111 6th Avenue Des Moines, IA 50314.
 
Usually 3 Months to get credential as we all know. And magically the hospital system will grant crnas and docs temp privileges in one week. Which shows it’s all a scam this healthcare system

Money talks. And hospital losing money due shutting down of or means shorts cuts can be taken to bring in anesthesiologists and crna
 
aneftp said:
Usually 3 Months to get credential as we all know. And magically the hospital system will grant crnas and docs temp privileges in one week. Which shows it’s all a scam this healthcare system

Money talks. And hospital losing money due shutting down of or means shorts cuts can be taken to bring in anesthesiologists and crna
Click to expand...


How does licensing work for CRNAs? Is it state by state? How long does it take?
 
nimbus said:
How does licensing work for CRNAs? Is it state by state? How long does it take?
Click to expand...
Iowa is a compact state. Can get license extremely quickly. Like one week if pushed through

Temp Credentials can take a week in a big hospital system.

Which tells u agencies and hospitals don’t give a f about docs & quality care.
 
aneftp said:
Iowa is a compact state. Can get license extremely quickly. Like one week if pushed through

Temp Credentials can take a week in a big hospital system.

Which tells u agencies and hospitals don’t give a f about docs & quality care.
Click to expand...
Yeah, credentialinf departments at every hospital in the country. Incredible that these leeches still have jobs in the Information Age where literally all this information is easily public and available.

Like who is able to pull off faking a medical degree at this point?
 
PainInTheAnes said:
Yeah, credentialinf departments at every hospital in the country. Incredible that these leeches still have jobs in the Information Age where literally all this information is easily public and available.

Like who is able to pull off faking a medical degree at this point?
Click to expand...
Read the crna ad I posted closely. They are letting crna get super quick credentials plus work unsupervised (Iowa is opt out state). You don’t need any medical degree is what recruiters or hospitals admin is saying to get a job at that hospital and u can get on staff super quickly.
 
I hope the anesthesia group stays unified and doesn’t join the hospital. 40 anesthetists is a mid sized group, and in a less desirable part of the country, the hospital might hurt without their services.

Yes, I will preface this by saying the requisite “obviously we don’t want patients to suffer”….but I hope that the hospital suffers big time.
 
Last edited:
nimbus said:
1. Why are they doing Epic Go Live in 2025?

2. Sounds like a billing/documentation integration issue. Epic is great once it’s set up but it requires a ton of work/IT investment to get it right at Go Live. Maybe the hospital and the anesthesia group had a disagreement about who would do the work and/or pay for startup costs. The Epic launch at our 5 hospital system was reportedly close to $1bil almost 10 years ago and we had 2 years of workgroup meetings before the launch. Each of our hospital anesthesia departments still has a formal paid “epic liaison” to monitor and provide anesthesia input on updates.

3. Good luck getting 40+ anesthesiologists to move to Des Moines. Likely the existing doctors will transition to hospital employment.
Click to expand...
Still unclear as to the purported reason of severing this relationship- blaming it on epic integration?! Whatever it is, it is obviously a convenient excuse- “we welcome MCA clinicians to continue to provide services through a new relationship” is code for “we want control over you and we want to create our own department and employ you. And we will do this by soliciting your people and helping them violate noncompetes, in clear violation and breach of contract.”

Stay firm and united mca!
 
it’s my understanding that they are not being pushed to be hospital employees they are being forced to sign with an amc.
 
Lecithin5 said:
Still unclear as to the purported reason of severing this relationship- blaming it on epic integration?! Whatever it is, it is obviously a convenient excuse- “we welcome MCA clinicians to continue to provide services through a new relationship” is code for “we want control over you and we want to create our own department and employ you. And we will do this by soliciting your people and helping them violate noncompetes, in clear violation and breach of contract.”

Stay firm and united mca!
Click to expand...
Nah.
1. Hospitals can force non compete out the window “for the benefit of the community” and judges will side with hospitals. Judges have favored community over individual rights over the years.

2. This is about money. This is likely not about epic going live.

3. In the end it will cost the hospital tons of money doing locums. (See Memphis 18-20 months ago)
 
amyl said:
it’s my understanding that they are not being pushed to be hospital employees they are being forced to sign with an amc.
Click to expand...
Abandon the 2 hospitals make 1099 money off the hospitals

Keep the surgery center

That’s why my residency classmate did with her practice 4 years ago. She was the president the last 15 years.

Most members of Group made around 600k (md only) with super busy ob in house , usual busy practice peds, gen,ortho thoracic etc)

AMC comes in
Now my friend. Make 750k 1099. No stress and doubled her vacation from 8 to 16 weeks and doesn’t have to worry about the billing.

That Hospital ceo been let go (as usual , he got another hospital admin job). Lives on same street as my sister.

These docs will make more money not dealing with the hospital in this environment

And of course the crnas stands to gain the most as they will likely double their income with 1099 with the amc
 
aneftp said:
Abandon the 2 hospitals make 1099 money off the hospitals

Keep the surgery center

That’s why my residency classmate did with her practice 4 years ago. She was the president the last 15 years.

Most members of Group made around 600k (md only) with super busy ob in house , usual busy practice peds, gen,ortho thoracic etc)

AMC comes in
Now my friend. Make 750k 1099. No stress and doubled her vacation from 8 to 16 weeks and doesn’t have to worry about the billing.

That Hospital ceo been let go (as usual , he got another hospital admin job). Lives on same street as my sister.

These docs will make more money not dealing with the hospital in this environment

And of course the crnas stands to gain the most as they will likely double their income with 1099 with the amc
Click to expand...
Well, this would be a dream for a group like mca- getting paid 1099 to service a poorly insured, money-sink hospital, but keeping the profitable surgery centers. But a lot of times, hospitals won’t allow this to happen.

Hospitals always say it is about money. But it’s ultimately about control. Because hospitals will pay way more in securing 1099 services thru medicus or whatnot, then they would have paid a PP group in stipends.
 
aneftp said:
Nah.
1. Hospitals can force non compete out the window “for the benefit of the community” and judges will side with hospitals. Judges have favored community over individual rights over the years.

2. This is about money. This is likely not about epic going live.

3. In the end it will cost the hospital tons of money doing locums. (See Memphis 18-20 months ago)
Click to expand...
Agree – “community need” is the most beautiful and convenient excuse that a hospital can use. It’s a load of crock. But hospitals unfortunately usually win out in the end.
 
Hospitals think they have control in this environment but especially with the crnas there is no control if it’s a heavy act model. Paying crnas $300-hr plus like 40% agency markup due to uber surge emergency pricing makes a the crna is costing them close to $500/hr. Or close to 1 million per crna based on 46 weeks at 40 hrs a week and no call and no weekends. The numbers are staggering to try to get this under control quickly.
Lecithin5 said:
Well, this would be a dream for a group like mca- getting paid 1099 to service a poorly insured, money-sink hospital, but keeping the profitable surgery centers. But a lot of times, hospitals won’t allow this to happen.

Hospitals always say it is about money. But it’s ultimately about control. Because hospitals will pay way more in securing 1099 services thru medicus or whatnot, then they would have paid a PP group in stipends.
Click to expand...
 
staple said:
And the hospital wonders why the PP group needed financial support...
Click to expand...
The previously true private practice with some subsidies made 500-550k on good years. Team health stole the contract. Good for them.

Coming back Locums to the same hospital our former president made 900k working less. That’s a win!

Let the hospital take the hit.

I’m about to come back 5.5 years later for a cameo in late August. Easy 40k-45k for the week for me. Beeper call. Crna will cover ob while I get to bill by the hour with epidural running.

That’s how these Iowa docs need to think.
Time to rape the hospital for making poor decisions.

Go in as mercenaries. Provide quality care. Take the cash.
 
They were mostly Md only with few CRNAs I believe? Getting strong armed to sign with Vituity. The new kid on the block. “physician owned” but by a group of physicians who want to be PE and really focus on internal medicine and ED as these are what really makes a hospital work. They are agreeing to staff anesthesia without knowing what they are doing so the hospital gets a one solution vendor. Both smart and dumb by vituity at same time.

Biggest lesson here is that CRNAs will replace MDs, Md only anesthesia is so easy to replace
 
Yup. Either let the crnas roll independently or push you to high ratio firefighter models. Properly done it’s hard to do 4:1 - forget more without cutting serious corners
 
A recruiter just contacted me about locums here -“They are wanting to be around $375-$390 but would consider someone at $400 for 2-4 weeks monthly coverage.”

Close gap between crna and Doc rates…..
 
amyl said:
A recruiter just contacted me about locums here -“They are wanting to be around $375-$390 but would consider someone at $400 for 2-4 weeks monthly coverage.”

Close gap between crna and Doc rates…..
Click to expand...
Supervise or do own ‘collaborative model’ cases?
 
I think it was mostly supervision but I didn’t inquire further - sounds like they either think all their current anesthesiologists will cave and assimilate to the amc or they’ll just run crna only
 
Howard888 said:
They were mostly Md only with few CRNAs I believe? Getting strong armed to sign with Vituity. The new kid on the block. “physician owned” but by a group of physicians who want to be PE and really focus on internal medicine and ED as these are what really makes a hospital work. They are agreeing to staff anesthesia without knowing what they are doing so the hospital gets a one solution vendor. Both smart and dumb by vituity at same time.

Biggest lesson here is that CRNAs will replace MDs, Md only anesthesia is so easy to replace
Click to expand...
Near impossible paying crna only at that Iowa hospital and realize any cost savings.

They don’t understand the crna mentality.

$300/hr daytime and 1.5x after 40 hrs.
Not enough of them to cover a hospital 24/7 as well

Or they know they still need docs to be loosely supervision or doing their own cases at $375/400/hr.

So u narrow the pay gap. Yet u will have a huge staffing gap in terms of coverage

The Vituity model works well in EM and IM since the pay gap is still huge with arnp and docs.

It doesn’t work well in anesthesia with crnas
 
National Locums crna companies get 300 in extreme circumstance. In southeast going W2 rate for CRNAs is just under 200. $200 is for employee 1099. Some local crna companies who can get $250 but most are around the $175-200 mark or around $300k/yr for 40 hour weeks. As you point out the 40 hours is a key point and taking call but many new grad CRNAs are still taking 250k with call.

A lot of these Md only practices in Midwest were doing quite well making 650-750 and 10+ weeks of vacation (CRNAs typically only 6-7 weeks).

CRNA’s are still much cheaper than Md only, but gap is narrowing
 
Howard888 said:
National Locums crna companies get 300 in extreme circumstance. In southeast going W2 rate for CRNAs is just under 200. $200 is for employee 1099. Some local crna companies who can get $250 but most are around the $175-200 mark or around $300k/yr for 40 hour weeks. As you point out the 40 hours is a key point and taking call but many new grad CRNAs are still taking 250k with call.

A lot of these Md only practices in Midwest were doing quite well making 650-750 and 10+ weeks of vacation (CRNAs typically only 6-7 weeks).

CRNA’s are still much cheaper than Md only, but gap is narrowing
Click to expand...
Crna compensation in Florida is $270k w2 with 9 weeks off and 40 hr week. I just saw the contract crna sent me to look over this weekend.

It’s graduated salary scale depending on experience
250k plus annual retention bonus

It’s really 36 hrs and no calls folks. 270k w2/9 weeks.
3 days a week (10% differential for working 7a-7p) day time.
 
aneftp said:
Crna compensation in Florida is $270k w2 with 9 weeks off and 40 hr week. I just saw the contract crna sent me to look over this weekend.

It’s graduated salary scale depending on experience
250k plus annual retention bonus

It’s really 36 hrs and no calls folks. 270k w2/9 weeks.
3 days a week (10% differential for working 7a-7p) day time.
Click to expand...
One contract,,, seriously. Probably an 20 year experienced crna in an high demand area. And…that’s basically what I said other than 2 more weeks vacation just to clarify. These Midwest MDs made 750k with 10 weeks vacation. Do all the adjustments you want but the crna is way cheaper than Md only. Quit trying to frame it otherwise
 
Howard888 said:
One contract,,, seriously. Probably an 20 year experienced crna in an high demand area. And…that’s basically what I said other than 2 more weeks vacation just to clarify. These Midwest MDs made 750k with 10 weeks vacation. Do all the adjustments you want but the crna is way cheaper than Md only. Quit trying to frame it otherwise
Click to expand...
1/3 of crnas in my area are full blown locums. They aren’t cheap.

People crazy thinking crnas will work “independent “ practice for even 300k w2 on a rigid schedule that requires calls nights lates weekends.

Most independent practices make 500k and up. And I say and up. Is it cheaper? Yes. But those are smaller rural practices. The cost escalates are trauma centers like Iowa trauma 2.
 
I think it comes down to MDs not demanding a fixed hourly rate while on call. CRNAs will absolutely do that and have done it for years.

If the MDs are willing to “leave money on the table” then they can be actually cheaper when everything is tallied up.
 
CopaceticOne said:
I think it comes down to MDs not demanding a fixed hourly rate while on call. CRNAs will absolutely do that and have done it for years.

If the MDs are willing to “leave money on the table” then they can be actually cheaper when everything is tallied up.
Click to expand...
Why should the md take less?

At the end of the day. Facilities will figure there is little or no cost savings with true crna independent models in non rural settling s with the way crna want to get paid

Look at state of California. One of the first states for crna Medicare opt out. Yet the vast majority of anesthesia is done by md only in just about all urban and suburban areas of California excluding Kaiser and teaching hospitals. Why?
 
If any of you are cardiac and have weeks of availability now through July, PM me. There may be a decent deal with this Des Moines situation.
 
Any updates on this situation? I heard the anesthesia group was meeting with admin on Friday. I wonder if any deal was made or if any docs from the group are planning to stick around
 
A lot of CRNAs will straight up refuse to start a case if there is uncertainty of whether or not it they’ll be out “on time”. When they say 12 hours, they generally mean they will be in the hospital a maximum of 12 hours, not a minute more. This means either guaranteed relief (extra cost for relief CRNAs on standby) or in practice often 9-10 hour shifts being paid out for 12 hours.

A lot of CRNAs will also demand morning afternoon and lunch breaks. That’s more people you have to pay. MD only generally is eat when you can, leave when cases are done. Only have 6 hours of cases? Then that’s what you get paid etc.

Some CRNAs aren’t comfortable with very sick patients and will refuse to do them. So now you have to figure out/remember which crna is ok with certain cases etc.

For some reason CRNAs seem very prone to falling ill on fridays, mondays, or holidays. Very strange, but such an affliction is generally not present among MDs.

There is probably a gap after all this, but it’s not nearly as big as people think.
 
<(^_^)> said:
For some reason CRNAs seem very prone to falling ill on fridays, mondays, or holidays. Very strange, but such an affliction is generally not present among MDs.
Click to expand...
And AAs. I had one yell at me when the department policy changed, and they started requiring doctor's notes for multiple sick days or a sick day after a holiday. So I reminded this AA to get a doctor's note, and I was yelled at for a few minutes. There were other patterns to the sick calls for this particular AA too. All the attendings could predict when there would be a sick call. The only repercussion for yelling at me was a forced apology.
 
<(^_^)> said:
A lot of CRNAs will straight up refuse to start a case if there is uncertainty of whether or not it they’ll be out “on time”. When they say 12 hours, they generally mean they will be in the hospital a maximum of 12 hours, not a minute more. This means either guaranteed relief (extra cost for relief CRNAs on standby) or in practice often 9-10 hour shifts being paid out for 12 hours.

A lot of CRNAs will also demand morning afternoon and lunch breaks. That’s more people you have to pay. MD only generally is eat when you can, leave when cases are done. Only have 6 hours of cases? Then that’s what you get paid etc.

Some CRNAs aren’t comfortable with very sick patients and will refuse to do them. So now you have to figure out/remember which crna is ok with certain cases etc.

For some reason CRNAs seem very prone to falling ill on fridays, mondays, or holidays. Very strange, but such an affliction is generally not present among MDs.

There is probably a gap after all this, but it’s not nearly as big as people think.
Click to expand...
Why do you fault the CRNAs for this. Other than the sick patients MDs should be doing the exact same. There is a shortage of all providers. Why should an MD stay 13 hours when they said 12? Why should they not get breaks if doing Md only, MDs need to catch up to CRNAs when it comes to this. Work what you have been contracted to do. No more. Don’t go to school for 12 years to be abused. CRNAs are on the money in their shift mentality
 
So was the group 40 docs and 12 crnas?

I’m confused 2 hospitals and 5 surgery centers?
 
We’re physician only. We have 25 people on staff. We get 1-2 sick calls on the night before or morning of in an average year. Our OR on the other hand has 1-3 people (circulators and scrub techs) call in sick every single day. Apparently anesthesiologists have very high immunity 😉
 
Last edited:
nimbus said:
We’re physician only. We have 25 people on staff. We get 1-2 sick calls on the night before or morning of in an average year. Our OR on the other hand has 1-3 people (circulators and scrub techs) call in sick every single day. We anesthesiologists have very high immunity 😉
Click to expand...
My sister MD only group punishes sick call out. More points deducted for Friday first unless hospital note. So u gotta be really sick to call out.

And than punishes Monday calls outs next.

This drastically reduces sick call outs. They go on a point system and time on the seat system.
 
aneftp said:
My sister MD only group punishes sick call out. More points deducted for Friday first unless hospital note. So u gotta be really sick to call out.

And than punishes Monday calls outs next.

This drastically reduces sick call outs. They go on a point system and time on the seat system.
Click to expand...


We’re unit production+stipends. No point system, nothing is deducted. We don’t actively “punish” anyone who calls out. I don’t think that would be right. But if you call out sick, the sick person doesn’t make any money and the person who unexpectedly comes to work to cover for the sick person gets all the money. We always find coverage. We’ve never closed a room because someone calls in sick. The incentive not to call in sick is not screwing our own partners.
 
Last edited:
CubsDynasty said:
We saw during the pandemic 24-48 hour credentialing. That’s what’s really possible without all the red tape.
Click to expand...
i had a colleague of mine get credentialed just by having a drivers license and vetting by saying “no issues”/ “clean profile and already works other places”.

why?

because the surgeon demanded our group…

eventually filled it out and all was ok.

yes it’s all red tape
 
nimbus said:
We’re physician only. We have 25 people on staff. We get 1-2 sick calls on the night before or morning of in an average year. Our OR on the other hand has 1-3 people (circulators and scrub techs) call in sick every single day. Apparently anesthesiologists have very high immunity 😉
Click to expand...
nimbus said:
We’re unit production+stipends. No point system, nothing is deducted. We don’t actively “punish” anyone who calls out. I don’t think that would be right. But if you call out sick, the sick person doesn’t make any money and the person who unexpectedly comes to work to cover for the sick person gets all the money. We always find coverage. We’ve never closed a room because someone calls in sick. The incentive not to call in sick is not screwing our own partners.
Click to expand...
thats a fair system
 
You must log in or register to reply here.

Similar threads

C
Group Health Policies
Replies
9
Views
1K
chessknt
chessknt
S
Dental office based Anesthesia group
Replies
2
Views
398
SuxDrugs&Rocuronium
SuxDrugs&Rocuronium
P
Des
2 3
Replies
130
Views
7K
AKMD_1984
A
N
Tips - Setting up Anesthesia Group?
Replies
20
Views
2K
DesiredMemberName?
DesiredMemberName?
C
Billings group
Replies
13
Views
2K
aneftp
A
Top