"Doctors’ spat with Atrium Health spills into rare public view"

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Man o War said:
They can and do cause issues even as employees if they feel they don't have enough say in big transitions.
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The CRNAs had no say in it and didn't want to make the transition. They are well aware of what happened.
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nimbus said:
6 Ways to Ensure Clinical Quality While Switching Anesthesia Providers

“2. Meet a few weeks before the start date to go over policies and procedures. Dr. Wherry says the center administrator should meet with the new anesthesia group a few weeks in advance to discuss the center's policies and procedures. This particularly applies to pre-op screening processes and post-operative care processes. "If you've had trouble with the old group around pre-op screening processes, this is the opportunity to make changes," Dr. Wherry says. "For example, the old group may have been too stringent on a type of patient or required too much information." He says some surgery center leaders feel that their anesthesia group is not involved enough in the pre-op screening process, so this is a perfect opportunity to lay out expectations for the new providers.”

Guess the preop screening won’t be overly “stringent” now.


Total Anesthesia Solutions

Be wary if Wherry shows up at your hospital as a “consultant”;)

Mednax pays $200mil. Scope gets it for free. Wherry is very smart. This shows how much anesthesia practices are actually worth and how vulnerable we actually are. All hospitals and AMCs are watching this. The upside is that it will have a chilling effect on future AMC buyouts.
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Mednax didn’t lose a dime. Remember mednax is billing for 30-40% more than what the former group was generating due to market forces

Let’s ssys the former practice was generating 100 million a year. Mednax is generating 140 million in increased billing

40 millon each year x 7 years equals 280 million. . They made up their 200 million purchase.

Combined with docs getting less salary each year (350k-400k vs 500-550k)

Mednax is in the clear easily by 100 million over the last 7 years from the purchase.

The partners who sold out are in the clear was well. Selling restricted stock options in 2-3 years and selling around 2014/2015. Easy money in stock options for former partners. Plus the initial cash infusion for each partner.
 
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It's pretty insane how this stuff is allowed in our country. They provide no service at all and only increase cost. They are like a giant parasite that benefits off other peoples work and suffering...
 
anbuitachi said:
It's pretty insane how this stuff is allowed in our country. They provide no service at all and only increase cost. They are like a giant parasite that benefits off other peoples work and suffering...
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That's Crony Capitalism in its purest, unadulterated form. Insurance companies collude with large AMCs to pay them $140 per unit. Hospitals and small groups get $55 per unit. There is no way to compete and the consumer gets screwed with higher rates. Hospitals are forced to fire long standing groups which need a subsidy or end employment of their own staff. AMCs continue the process of bribing the insurance companies to keep the per unit rate higher and higher each year. Meanwhile, the employee on the ground doesn't see a dime of these increases in his/her pay.
 
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BLADEMDA said:
That's Crony Capitalism in its purest, unadulterated form. Insurance companies collude with large AMCs to pay them $140 per unit. Hospitals and small groups get $55 per unit. There is no way to compete and the consumer gets screwed with higher rates. Hospitals are forced to fire long standing groups which need a subsidy or end employment of their own staff. AMCs continue the process of bribing the insurance companies to keep the per unit rate higher and higher each year. Meanwhile, the employee on the ground doesn't see a dime of these increases in his/her pay.
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i bet when this whole scam gets revealed to the public, they'll just blame our profession
 
aneftp said:
Mednax didn’t lose a dime. Remember mednax is billing for 30-40% more than what the former group was generating due to market forces

Let’s ssys the former practice was generating 100 million a year. Mednax is generating 140 million in increased billing

40 millon each year x 7 years equals 280 million. . They made up their 200 million purchase.

Combined with docs getting less salary each year (350k-400k vs 500-550k)

Mednax is in the clear easily by 100 million over the last 7 years from the purchase.

The partners who sold out are in the clear was well. Selling restricted stock options in 2-3 years and selling around 2014/2015. Easy money in stock options for former partners. Plus the initial cash infusion for each partner.
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I agree Mednax did okay on the deal. Wherry could do even better since he swooped in without paying a dime for something Mednax paid $200mil for in 2010. Going forward why would any AMC put up a ton of cash when the same thing can happen elsewhere? The shift in power is favoring the large hospital systems at the expense of private practices and AMCs.
 
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nimbus said:
I agree Mednax did okay on the deal. Wherry could do even better since he swooped in without paying a dime for something Mednax paid $200mil for in 2010. Going forward why would any AMC put up a ton of cash when the same thing can happen elsewhere? The shift in power is favoring the large hospital systems.
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Not sure if they had exclusive contract? Also not sure how, if Atrium is back Wherry’s anesthesia group, knowing that Atrium just lost a recent lawsuit regarding self referral (?), how it’s all going to play out.
I am sure even if there is something fishy about it, it will take another x years to sort out.
 
Does any body have any info as to how things are actually going in Charlotte?
 
nimbus said:
http://businessnc.com/atrium-and-mednax-part-ways-after-months-long-battle/
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Atrium hasn’t disclosed its contract terms with Scope, but Berger says it is similar to its previous Mednax agreement with two key exceptions. First, Scope agreed to so-called physician leasing that gives the hospital more authority to monitor and reduce costs — a key criticism by Mednax, which says the plans are onerous and unfair to doctors. Second, Scope has no noncompete agreements.

What is physician leasing? Is that where you can trade them in for a new model every three years?
 
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IMGASMD said:
How is this very different than employed by hospital? Or hospital going to a locum company?
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I'm not at a point where I am all that versed in business, but I'd imagine it saves the hospital the cost of all the benefits and HR work to directly employ the physicians while also giving them a more stable physician staff at a lower price than they would pay to a locums. Seems like an attractive option at at least my uneducated first glance.
 
caligas said:
Any word from the front lines on how the first couple of months went?
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Our most recent CT fellow was a part of this group. He had left to do fellowship, with his job "secured" for his return. He's obviously now looking for a new job due to the 2 year non-compete.

He told me that the hospitals that his group staffed are now being covered by a combination of locums and the other anesthesia group(s) in town coming in to help.
 
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caligas said:
Any word from the front lines on how the first couple of months went?
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Very rocky.

At least one anesthesiologist was fired.

At least one peripheral site unable to staff adequately.

Some surgeons refusing to work with anesthesiologists because they are so bad.

Presumably low morale because CRNA's are so entitled.

The anesthesiologists who signed on are all making good money but this will change within a couple of years.

MEDNAX losing the few area contracts that they have left.
 
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abolt18 said:
Our most recent CT fellow was a part of this group. He had left to do fellowship, with his job "secured" for his return. He's obviously now looking for a new job due to the 2 year non-compete.

He told me that the hospitals that his group staffed are now being covered by a combination of locums and the other anesthesia group(s) in town coming in to help.
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Pretty much what I’ve been told as well. The new hires are making some big money but they are being run absolutely ragged as they don’t have near enough coverage - 24+ hour shifts the norm.

Charlotte, unfortunately, is a dumpster fire for now. It’ll get better, but slowly. MEDNAX is persona non grata in the area.
 
Hiram Coggin said:
Very rocky.

At least one anesthesiologist was fired.

At least one peripheral site unable to staff adequately.

Some surgeons refusing to work with anesthesiologists because they are so bad.

Presumably low morale because CRNA's are so entitled.

The anesthesiologists who signed on are all making good money but this will change within a couple of years.

MEDNAX losing the few area contracts that they have left.
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Not surprising.
Mednax must’ve really pissed in the wrong person’s Wheaties. What a mess.
Hopefully these docs all negotiated intelligently and are at least hauling in the cash for putting up with this.
 
AdmiralChz said:
Pretty much what I’ve been told as well. The new hires are making some big money but they are being run absolutely ragged as they don’t have near enough coverage - 24+ hour shifts the norm.

Charlotte, unfortunately, is a dumpster fire for now. It’ll get better, but slowly. MEDNAX is persona non grata in the area.
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Wonder what kinda coin these ninja warriors are pulling in for working 24hr shifts.
 
Mman said:
well they used to get an individual anesthesia bill from Mednax at a very high rate. Now they get an anesthesia bill combined with their hospital facility bill so I'm 100% sure the anesthesia bill is less.
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Wasn’t this discussed before that the new anesthesia group was basically the hospitals shill?
 
Mman said:
well they used to get an individual anesthesia bill from Mednax at a very high rate. Now they get an anesthesia bill combined with their hospital facility bill so I'm 100% sure the anesthesia bill is less.
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Wasn't that (supposedly) one of the hospital's primary gripes in the first place? That the AMC was billing ridiculous out-of-network costs to a lot of patients, who got angry, and got their surgeons angry over the practice?
 
Scope is a group of docs that contract w the hospital, same as Mednax. CRNAs did and do work for the hospital. Where’s all the savings? All OON billing issues? And 20 mill of savings?
 
midazzoler said:
Bills for Atrium patients drop after anesthesiology vendor change, hospital CEO says

Any thoughts on claims by the CEO?
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To be clear, this is definitely some spin. Hard to know just how much, of course. Atrium has had some other issues in the past year or so (failed merger with UNC hospital system that caused the UNC president to resign chief among them), so they are pretty desperate for good PR.

That being said, Mednax was definitely billing OON for a large proportion of its cases and refusing to negotiate fair market deals with local insurance carries. Those of us that have been in those negotiations know it can be pretty testy (or total BS), but Mednax didn't help themselves by not at least trying to address it when faced with an expiring contract.

I haven't heard much from Charlotte, I did an acquaintance in that group with significant subspecialty training who was new to join when all this went down... I believe he had to leave the area given their ridiculous noncompete that Atrium agreed to not violate. A lot of surgeons scattered away when Carolinas "rebranded" as Atrium - they were planning expansions (takeovers) in SC and MD, apparently, before the UNC merger behind-the-scenes fell apart last minute.

More on that for those interested:
What Sank Atrium's UNC Health Care Deal?

Questions about control kill merger deal between Atrium Health and UNC Health Care
 
IMGASMD said:
Wasn’t this discussed before that the new anesthesia group was basically the hospitals shill?
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The new "group" basically leases physicians to Atrium and Atrium does all the billing. It's functioning as a staffing company.
 
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Southpaw said:
Scope is a group of docs that contract w the hospital, same as Mednax. CRNAs did and do work for the hospital. Where’s all the savings? All OON billing issues? And 20 mill of savings?
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Patients paying less = no more OON issues.

Atrium "saving" $20 million = the system is skimming anesthesiologists earnings
 
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nimbus said:
Or Scope agreed to work without stipends or reduced stipends.
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I would not be surprised after all this talk, that $20M is just some sort of accounting maneuver now is in top Atrium something-something-O’s pocket. Since it’s not a money going outside of Atrium, it’s a huuuuuge saving..... we will never know.
 
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nimbus said:
Or Scope agreed to work without stipends or reduced stipends.
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you can't have a stipend when you pay the salary. Scope basically employs the physicians and sends Atrium a bill every month to cover their salary/benefits plus whatever amount Weary is taking as an admin fee. I assume Atrium is paying about 110% of the cost of the anesthesiologists.
 
Not hard to read the court documents at the North Carolina Business Court public access( search Mednax)..... latest briefs and reply are an interesting tell on the state of the quality of care being delivered ( of which no one from Atrium ever discusses these days. Most of the older MD’s retired.... younger non partnered MD’s have scattered to real estate, med spas, locums, ketamine clinics,small hospitals in NC ( whose MDs all came to Charlotte.... no one is paying attention to all the small anesthesia departments in NC that lost MDs to Atriums checkbook.) Who knows the patient harm when you decimate existing small group staffing. As far as the noncompete who wants to work next / with the scabs that came in because a big check was being waived in the air.
As to the 20 million in savings... one only has to read Mednax quarterly reports to recognize that the company “lost 20 million/ yr in earnings from the loss of the Charlotte contract”. The change of physicians had no impact on cost savings but removing Mednax did.Atrium has yet to take down the old Southeast MD’s from there website and post who is actually working at the hospital ( including ***deleted by mod*** ) a respected long time MD who was a former partner who hung himself 3 days before the contract ended. Gone are the days where physicians remember the oath they took when they graduated medical school.
E8478427-4808-42A3-AC1F-F3CD38B23F74.png
 
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Notascab said:
Not hard to read the court documents at the North Carolina Business Court public access( search Mednax)..... latest briefs and reply are an interesting tell on the state of the quality of care being delivered ( of which no one from Atrium ever discusses these days. Most of the older MD’s retired.... younger non partnered MD’s have scattered to real estate, med spas, locums, ketamine clinics,small hospitals in NC ( whose MDs all came to Charlotte.... no one is paying attention to all the small anesthesia departments in NC that lost MDs to Atriums checkbook.) Who knows the patient harm when you decimate existing small group staffing. As far as the noncompete who wants to work next / with the scabs that came in because a big check was being waived in the air.
As to the 20 million in savings... one only has to read Mednax quarterly reports to recognize that the company “lost 20 million/ yr in earnings from the loss of the Charlotte contract”. The change of physicians had no impact on cost savings but removing Mednax did.Atrium has yet to take down the old Southeast MD’s from there website and post who is actually working at the hospital ( including ***deleted by mod*** ) a respected long time MD who was a former partner who hung himself 3 days before the contract ended. Gone are the days where physicians remember the oath they took when they graduated medical school.View attachment 262521
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Thank you for the update. If I may ask a few questions.

So Mednax elected to enforce their non-compete, so none of the Mednax former employees can work for Atrium is that my correct read in this?
Is that for only the main hospital or it’s 5-15 (whatever the number is) mile radius?
How many years was the contract and/or noncompete? So after that period, potentially they come go back? Will you/they want to?
So the 20mil saving is just a joke, since it’s just not the money not being paid to Mednax?
Where do YOU stand on Mednax issue?

Lastly, so what now? Everyone who worked for Mednax, like you said, go somewhere else and left whatever they build behind?

So many questions, and feel bad.

Edit: after I read the document.... I see where you’re going.....
 
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Notascab said:
Not hard to read the court documents at the North Carolina Business Court public access( search Mednax)..... latest briefs and reply are an interesting tell on the state of the quality of care being delivered ( of which no one from Atrium ever discusses these days. Most of the older MD’s retired.... younger non partnered MD’s have scattered to real estate, med spas, locums, ketamine clinics,small hospitals in NC ( whose MDs all came to Charlotte.... no one is paying attention to all the small anesthesia departments in NC that lost MDs to Atriums checkbook.) Who knows the patient harm when you decimate existing small group staffing. As far as the noncompete who wants to work next / with the scabs that came in because a big check was being waived in the air.
As to the 20 million in savings... one only has to read Mednax quarterly reports to recognize that the company “lost 20 million/ yr in earnings from the loss of the Charlotte contract”. The change of physicians had no impact on cost savings but removing Mednax did.Atrium has yet to take down the old Southeast MD’s from there website and post who is actually working at the hospital ( including *deleted by mod**( ) a respected long time MD who was a former partner who hung himself 3 days before the contract ended. Gone are the days where physicians remember the oath they took when they graduated medical school.View attachment 262521
Click to expand...

Oh boy. Well, can’t say I’m surprised. You take what you can get when you’re trying to replace that many doctors at one time.
 
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Notascab said:
Not hard to read the court documents at the North Carolina Business Court public access( search Mednax)..... latest briefs and reply are an interesting tell on the state of the quality of care being delivered ( of which no one from Atrium ever discusses these days. Most of the older MD’s retired.... younger non partnered MD’s have scattered to real estate, med spas, locums, ketamine clinics,small hospitals in NC ( whose MDs all came to Charlotte.... no one is paying attention to all the small anesthesia departments in NC that lost MDs to Atriums checkbook.) Who knows the patient harm when you decimate existing small group staffing. As far as the noncompete who wants to work next / with the scabs that came in because a big check was being waived in the air.
As to the 20 million in savings... one only has to read Mednax quarterly reports to recognize that the company “lost 20 million/ yr in earnings from the loss of the Charlotte contract”. The change of physicians had no impact on cost savings but removing Mednax did.Atrium has yet to take down the old Southeast MD’s from there website and post who is actually working at the hospital ( including ***deleted by mod*** ) a respected long time MD who was a former partner who hung himself 3 days before the contract ended. Gone are the days where physicians remember the oath they took when they graduated medical school.View attachment 262521
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What does that really tell us, though? That Scope doesn't want their dirty laundry aired? Which hospital system/physician group/AMC does? Was Southeast/Mednax publishing a list of all their complications?

Kinda meaningless without knowing frequency, severity, etc. I'm not saying the quality of care hasn't changed, I'd have to assume that many things have changed with that kind of transition. Just saying that what you posted isn't exactly proof of anything...
 
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WholeLottaGame7 said:
What does that really tell us, though? That Scope doesn't want their dirty laundry aired? Which hospital system/physician group/AMC does? Was Southeast/Mednax publishing a list of all their complications?

Kinda meaningless without knowing frequency, severity, etc. I'm not saying the quality of care hasn't changed, I'd have to assume that many things have changed with that kind of transition. Just saying that what you posted isn't exactly proof of anything...
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I wouldn't be surprised if what he says is true, but with a username like notascab I'm sure he's not here with an unbiased agenda-free report.
 
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I challenge you to do your own research. The facts are not being denied. The brief was a court document. Read David Salama’s June 30,2018 Facebook post. Go to Atriums web site and see if the only physicians listed are former Southeast and ( Northast medical center MD’s.)Go to find a provider at CHS.gov and search CHS anesthesia. Investigate the real providers at Atrium currently practicing. Read through Gene Woods public comments about transitions take a few years to play out. These are publicly disclosed facts . There are other “ rumors” that I chose not to reveal but have confirmed from multiple independent sources. No one is willling to speak on the record to news outlets because of fear of backlash.
 
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Notascab said:
I challenge you to do your own research. The facts are not being denied. The brief was a court document. Read David Salama’s June 30,2018 Facebook post. Go to Atriums web site and see if the only physicians listed are former Southeast and ( Northast medical center MD’s.)Go to find a provider at CHS.gov and search CHS anesthesia. Investigate the real providers at Atrium currently practicing. Read through Gene Woods public comments about transitions take a few years to play out. These are publicly disclosed facts . There are other “ rumors” that I chose not to reveal but have confirmed from multiple independent sources. No one is willling to speak on the record to news outlets because of fear of backlash.
Click to expand...

I know at least 2 people currently working there and 1 person who helped with the transition. They are hard-working, talented, professional, and were well-regarded at my institution, as I am sure that many of Southeast's former employees were. I am also certain that not everyone there is of that quality, but to act like there aren't people on this board who actually know/knew people both pre- and post-transition is foolish.

The only "facts" you have listed are accusations in a court document, a Facebook post, and some dude's comments. If you would like to present us with data showing us longer PACU LOS, slower turnover time, less OR utilization, decrease case volumes, more intraop MIs, lower patient satisfaction scores, etc, we are all ears.

Like I said earlier, I am quite sure that some of those numbers actually HAVE changed with the transition. But we'll never know about it, because that kind of data isn't public. So don't come on here spouting "facts" when you have none.

I get that you're salty. Any of us would be, in that situation. It's a good lesson for residents and med students out there as to the politics of business, and the importance of watching out for yourself, having backup plans, and to make hay/save while you can, so that you can reach FI as early as possible.

I am sincerely sorry that you're having to learn it the hard way.
 
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DocVapor said:
I'm not at a point where I am all that versed in business, but I'd imagine it saves the hospital the cost of all the benefits and HR work to directly employ the physicians while also giving them a more stable physician staff at a lower price than they would pay to a locums. Seems like an attractive option at at least my uneducated first glance.
Click to expand...
The larger the system the less the cost. For example, HR is already set up. They have hundreds of nursing, IT, dietary, and administrative staff on the books already. So the cost savings are minuscule.
 
WholeLottaGame7 said:
I know at least 2 people currently working there and 1 person who helped with the transition. They are hard-working, talented, professional, and were well-regarded at my institution, as I am sure that many of Southeast's former employees were. I am also certain that not everyone there is of that quality, but to act like there aren't people on this board who actually know/knew people both pre- and post-transition is foolish.

The only "facts" you have listed are accusations in a court document, a Facebook post, and some dude's comments. If you would like to present us with data showing us longer PACU LOS, slower turnover time, less OR utilization, decrease case volumes, more intraop MIs, lower patient satisfaction scores, etc, we are all ears.

Like I said earlier, I am quite sure that some of those numbers actually HAVE changed with the transition. But we'll never know about it, because that kind of data isn't public. So don't come on here spouting "facts" when you have none.

I get that you're salty. Any of us would be, in that situation. It's a good lesson for residents and med students out there as to the politics of business, and the importance of watching out for yourself, having backup plans, and to make hay/save while you can, so that you can reach FI as early as possible.

I am sincerely sorry that you're having to learn it the hard way.
Click to expand...

And what hard lesson is that? That it's ok to have immeasurable patient harm during Corporate warfare? Or that there are no consequences to replacing several dozens of Physicians in one fell swoop?

When the last AMC rolled into town and took our contract we had 15 PDPH and 5 Endo codes in less than two weeks as they sicced their hoards of Mercenary CRNA and Assasin sRNAs during the "Transition".

It's not in the interest of the Hospital or Scope to advertise complications. Those of us that are involved in Staffing know that it takes several years to safely turn over that many Docs. The Lawyers will do the rest now (LOTS of Settlements).
 
WholeLottaGame7 said:
I know at least 2 people currently working there and 1 person who helped with the transition. They are hard-working, talented, professional, and were well-regarded at my institution, as I am sure that many of Southeast's former employees were. I am also certain that not everyone there is of that quality, but to act like there aren't people on this board who actually know/knew people both pre- and post-transition is foolish.

The only "facts" you have listed are accusations in a court document, a Facebook post, and some dude's comments. If you would like to present us with data showing us longer PACU LOS, slower turnover time, less OR utilization, decrease case volumes, more intraop MIs, lower patient satisfaction scores, etc, we are all ears.

Like I said earlier, I am quite sure that some of those numbers actually HAVE changed with the transition. But we'll never know about it, because that kind of data isn't public. So don't come on here spouting "facts" when you have none.

I get that you're salty. Any of us would be, in that situation. It's a good lesson for residents and med students out there as to the politics of business, and the importance of watching out for yourself, having backup plans, and to make hay/save while you can, so that you can reach FI as early as possible.

I am sincerely sorry that you're having to learn it the hard way.
Click to expand...


I am sure your 3 cohorts are fine clinicians...... but I can't consider them professional or physicians. Atrium has a huge marketing budget and does a fine job of touting their successes. Are you trying to tell me that they are holding back how quality, PACU LOS, turnover times, satisfaction has improved? For years, Atrium instructed every staff member to tell patients that they were going " to receive excellent care" so when the patients filled out there satisfaction survey " excellent" came to mind........they make a huge effort to impart that they provide better quality....

Charlotte has a museum for the plane that landed in the Hudson..... I am sure pilots for American are all certified and largely have no issues..... but I am also sure that the passengers on the plane are very happy and satisfied that the captain of that plane had flown that route thousands of times and was a former Navy instructor with countless hours on simulators was at the helm.....not a pilot that happened to be on standby because he/she needed extra cash!

Yes it is an excellent lesson for residents and medical students to see and hear this discussion. There is a big difference in doing locums where there is a "need" vs a replacement. I am sure that there a few clinicians who "needed" to be in Charlotte for personal reasons, but if you review the lists physicians on CMS web site you may find that many are locums..... ... and I suspect are going through a new round of locums in August ( by looking at Gaswork reviewing the locums ads that describe Charlotte but don't actually say Charlotte)


Back up plans and FI are important..... I guess the argument would be to homeschool your kids, don't get involved in your community, don't buy a house, and don't contribute to the local economy wherever you live. In fact hopefully, anesthesiology will go to telemedicine and you can supervise 30 rooms negating the need for half the workforce and you can live wherever you want or just support the AANA in their efforts to practice independently!
 
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Notascab said:
I am sure your 3 cohorts are fine clinicians...... but I can't consider them professional or physicians. Atrium has a huge marketing budget and does a fine job of touting their successes. Are you trying to tell me that they are holding back how quality, PACU LOS, turnover times, satisfaction has improved? For years, Atrium instructed every staff member to tell patients that they were going " to receive excellent care" so when the patients filled out there satisfaction survey " excellent" came to mind........they make a huge effort to impart that they provide better quality....

Charlotte has a museum for the plane that landed in the Hudson..... I am sure pilots for American are all certified and largely have no issues..... but I am also sure that the passengers on the plane are very happy and satisfied that the captain of that plane had flown that route thousands of times and was a former Navy instructor with countless hours on simulators was at the helm.....not a pilot that happened to be on standby because he/she needed extra cash!

Yes it is an excellent lesson for residents and medical students to see and hear this discussion. There is a big difference in doing locums where there is a "need" vs a replacement. I am sure that there a few clinicians who "needed" to be in Charlotte for personal reasons, but if you review the lists physicians on CMS web site you may find that many are locums..... ... and I suspect are going through a new round of locums in August ( by looking at Gaswork reviewing the locums ads that describe Charlotte but don't actually say Charlotte)


Back up plans and FI are important..... I guess the argument would be to homeschool your kids, don't get involved in your community, don't buy a house, and don't contribute to the local economy wherever you live. In fact hopefully, anesthesiology will go to telemedicine and you can supervise 30 rooms negating the need for half the workforce and you can live wherever you want or just support the AANA in their efforts to practice independently!
Click to expand...

Can you address why the group sold to Mednax in the first place? I am always fascinated about these business decisions and their histories.
 
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