EM docs in Michigan justifying replacing their anesthesiologist colleagues

[zero2460]

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What? They hired full time replacements for the entire group they just ousted? Already? Maybe there isn't a shortage of anesthesiologists nationwide if something like this could happen? Or maybe these people are defectors from other groups. But if this is true, it's shocking.

They did hire a few new full time people, but the overstaffing is due to over hiring locums.

They probably credentialed more locums than any other site in the country this past year. They likely caught up to demand, and are now figuring out where equilibrium lies.

 

[aneftp]

They did hire a few new full time people, but the overstaffing is due to over hiring locums.

They probably credentialed more locums than any other site in the country this past year. They likely caught up to demand, and are now figuring out where equilibrium lies.

This is good hospital management. I applaud them. Can’t nickel and dime. Probably costing them 750k in locums fees for 3 months ago. Just the cost of doing business.

Better to get the ship fully stocked and not it slowly sink.

 

[cockblockandrun]

They did hire a few new full time people, but the overstaffing is due to over hiring locums.

They probably credentialed more locums than any other site in the country this past year. They likely caught up to demand, and are now figuring out where equilibrium lies.

The same thing happened in Midland. Credentialed something like 40 anesthesiologists for 8 spots per day.
The Grand Rapids job is a more ideal location so easier to recruit- but shocking thing is how quickly after people started they were getting notices. Plus with the size of the old group there was a strong chance to sign some of the older docs back.

 

[aneftp]

The same thing happened in Midland. Credentialed something like 40 anesthesiologists for 8 spots per day.
The Grand Rapids job is a more ideal location so easier to recruit- but shocking thing is how quickly after people started they were getting notices. Plus with the size of the old group there was a strong chance to sign some of the older docs back.

The old docs are slowing coming back at contracts based on 40 hrs. Even administration is reading my post or talking to other administration who have figured out how to pay anesthesia docs.

The 40 hrs pay model is the the fairest compensation because it will factor in calls etc

What’s to be determined is the second call coverage. Currently no crnas do overnight there it’s all docs at night.

I’ve always stated beeper call is the trickiest payment to figure out. Especially with the high acuity there

A night float system 6pm-7a 7 days a week should be equivalent to two weeks of work

That’s 91 hrs of work on beeper. And nights are more valuable in terms of pay structure.

 

[CubsDynasty]

The same thing happened in Midland. Credentialed something like 40 anesthesiologists for 8 spots per day.
The Grand Rapids job is a more ideal location so easier to recruit- but shocking thing is how quickly after people started they were getting notices. Plus with the size of the old group there was a strong chance to sign some of the older docs back.

This is the play book. When the hospital opens up the checkbook you hire anyone you can to make sure you cover everything. Those early days are the absolute best when you’re overstaffed and getting paid to do little. Then as you figure out who plays well with others (some refuse supervision, some refuse solo, some refuse certain cases) you get rid of them and you cut out the more expensive ones or the locums staffing agency.

 

[cockblockandrun]

This is the play book. When the hospital opens up the checkbook you hire anyone you can to make sure you cover everything. Those early days are the absolute best when you’re overstaffed and getting paid to do little. Then as you figure out who plays well with others (some refuse supervision, some refuse solo, some refuse certain cases) you get rid of them and you cut out the more expensive ones or the locums staffing agency.

Yup. I told some of my friends who went there that they were overstaffed- now they are scrambling last minute to find other gigs.

Got to have a rotation of places, multiple agencies, direct contracts, etc so when you are canceled you don't scramble.

 

[amyl]

So what was the package for 40h that filled the place… that’s lots of full time spots filled quickly….

 

[godfather091]

Do we really think 40 hrs/week is the new “full time” anesthesiologist benchmark? What other specialties work 40 hours a week? Should this be averaged out over a year with PTO? If not 40, and you had to say a number, what should it be?

 

[aneftp]

Do we really think 40 hrs/week is the new “full time” anesthesiologist benchmark? What other specialties work 40 hours a week? Should this be averaged out over a year with PTO? If not 40, and you had to say a number, what should it be?

I have been posting about this for the last 12-15 months.

700k/40 hrs /10 weeks. That is the new standard admin needs acknowledge.

40 hrs is inclusive of calls (including beeper call hours)

or give them 20-26 weeks off plus still do the 40 hrs a week for 500k ish.

If u are an admin and want to stick to the old anesthesia model. You are blockbuster. You will lose customers (and employees) for failing to change.

Be Netflix and change. And keep evolving with staffing and compensation and time off.

The old style of working 55-60 hrs a week with 5 weeks off doesn’t work anymore. That was the standard when I came out. 55 hrs was the average. 2 plus decades ago. And many anesthesiologists routinely worked 65 hrs. 7-5 (5 days a week) was mommy track.

 

[SRYSPAC]

I have been posting about this for the last 12-15 months.

700k/40 hrs /10 weeks. That is the new standard admin needs acknowledge.

40 hrs is inclusive of calls (including beeper call hours)

or give them 20-26 weeks off plus still do the 40 hrs a week for 500k ish.

If u are an admin and want to stick to the old anesthesia model. You are blockbuster. You will lose customers (and employees) for failing to change.

Be Netflix and change. And keep evolving with staffing and compensation and time off.

The old style of working 55-60 hrs a week with 5 weeks off doesn’t work anymore. That was the standard when I came out. 55 hrs was the average. 2 plus decades ago. And many anesthesiologists routinely worked 65 hrs. 7-5 (5 days a week) was mommy track.

That or continue to pay locums agencies $600+/hour thinking the shortage is temporary; good luck! 😆

 

[aneftp]

That or continue to pay locums agencies $600+/hour thinking the shortage is temporary; good luck! 😆

It worked out to $2750/hr for my friend Friday night.

Hint. Make them guranteee ur beeper hours.

 

[Dantrolene FC]

I have been posting about this for the last 12-15 months.

700k/40 hrs /10 weeks. That is the new standard admin needs acknowledge.

40 hrs is inclusive of calls (including beeper call hours)

or give them 20-26 weeks off plus still do the 40 hrs a week for 500k ish.

If u are an admin and want to stick to the old anesthesia model. You are blockbuster. You will lose customers (and employees) for failing to change.

Be Netflix and change. And keep evolving with staffing and compensation and time off.

The old style of working 55-60 hrs a week with 5 weeks off doesn’t work anymore. That was the standard when I came out. 55 hrs was the average. 2 plus decades ago. And many anesthesiologists routinely worked 65 hrs. 7-5 (5 days a week) was mommy track.

This is what I have except I make about $600k. But it’s like working at a VA where’s really slow, call is super slow, and I leave early often.

Otherwise I totally agree with you. 40 hours is the new norm with call counting toward the 40 hours. When I work the weekend (12 hour call fri-sun) I get the entire next week off.

 

[ucladoc2b]

That or continue to pay locums agencies $600+/hour thinking the shortage is temporary; good luck! 😆

That’s the true current market value for anesthesia. $400/hr (average) for 40 hours a week is not unreasonable for a FT W2.

 

[RedandBlack7]

That’s the true current market value for anesthesia. $400/hr (average) for 40 hours a week is not unreasonable for a FT W2.

What do you guys recommend if you live in an area where Envision dominates the market and rates are 250/hr w2 with them. People seem to consistently cover shifts for this type of compensation because they are tied to the area and there is nowhere else to work really.

 

[SRYSPAC]

What do you guys recommend if you live in an area where Envision dominates the market and rates are 250/hr w2 with them. People seem to consistently cover shifts for this type of compensation because they are tied to the area and there is nowhere else to work really.

Work the minimum that will get you benefits, then locums elsewhere; don't cover extra for CRNA rates.

There will always be those in every group that will take those shifts, because they're easy to slide into and don't require any additional work like credentialing, and I can't speak to their personal/family/financial situations, so no knock on them, it is what it is.

At the same time, don't complain about the **** PRN rates and keep taking them 😆

 

[aneftp]

Work the minimum that will get you benefits, then locums elsewhere; don't cover extra for CRNA rates.

Unfortunately some people are hard up for money.
$250/hr w2 extra pay (70-% likely doing solo cases in place of a crna. Docs shouldn’t do this.

Envision knows the 1099 crnas plus agency fee markup is $300-350/hr. So the doc w2 at $250/hr is cheaper.

But this is the reason I avoid south Florida proper.


But south Florida is way more populated. One of the south Florida (Miami-dade) docs I know is driving all the way to the Florida panhandle to do 1099 work and leaving his wife and kids for 2 weeks. That’s what more docs need to do. Leave their family to do more 1099 work to collapse the system down there if they need the money.

Or else. Envison can keep paying this $250/hr.

 

[cockblockandrun]

Unfortunately some people are hard up for money.
$250/hr w2 extra pay (70-% likely doing solo cases in place of a crna. Docs shouldn’t do this.

Envision knows the 1099 crnas plus agency fee markup is $300-350/hr. So the doc w2 at $250/hr is cheaper.

But this is the reason I avoid south Florida proper.


But south Florida is way more populated. One of the south Florida (Miami-dade) docs I know is driving all the way to the Florida panhandle to do 1099 work and leaving his wife and kids for 2 weeks. That’s what more docs need to do. Leave their family to do more 1099 work to collapse the system down there if they need the money.

Or else. Envison can keep paying this $250/hr.

NAPA is paying $225/hr W2- it is so insulting but someone will sign up for that. Envision has all these no Florida resident rules for the locum/PRN jobs to control the rates- it is self defeating because they are paying up the ass to get out of state people. And there is one south Florida job every locum company has been hitting me up for since the spring- obviously they are still having a hard time filling it up.

 

[aneftp]

NAPA is paying $225/hr W2- it is so insulting but someone will sign up for that. Envision has all these no Florida resident rules for the locum/PRN jobs to control the rates- it is self defeating because they are paying up the ass to get out of state people. And there is one south Florida job every locum company has been hitting me up for since the spring- obviously they are still having a hard time filling it up.

$225-hr w2 is like $146/hr post tax for an anesthesiologist in the 35% tax bracket.

Let that sink in.

 

[Coffee PRN]

They did hire a few new full time people, but the overstaffing is due to over hiring locums.

They probably credentialed more locums than any other site in the country this past year. They likely caught up to demand, and are now figuring out where equilibrium lies.

Yup, they overhired locums. Some people were getting notice for full or partial cancellation of their weeks even before starting.

Most of the hires to their new hospital group are from the old group who were sitting around at home without work and had few other options if they wanted to stay in the area.

 

[centdoc]

NAPA is paying $225/hr W2- it is so insulting but someone will sign up for that. Envision has all these no Florida resident rules for the locum/PRN jobs to control the rates- it is self defeating because they are paying up the ass to get out of state people. And there is one south Florida job every locum company has been hitting me up for since the spring- obviously they are still having a hard time filling it up.

Self defeating is great for locums… no need to teach them

 

[NPJR]

Most of the hires to their new hospital group are from the old group who were sitting around at home without work and had few other options if they wanted to stay in the area.

Wasn't there a non-compete? and why on earth would you go back to work at a place that didnt value you. People create their own problems.

 

[aneftp]

Wasn't there a non-compete? and why on earth would you go back to work at a place that didnt value you. People create their own problems.

Scope anesthesia in charlotte tried to be sneaky when atrium healthcare really funded the charlotte North Carolina and that brought about lawsuits and non compete with mednax. I think mednax just gave up on the end (2018)

So when entities fight each other it’s just blowing smoke with non competes.

What does the dissolving anesthesia group gain from a lawsuit at a cost of probably 100k a min to 500k. I doubt each partner wants to use 10-50k of their own funds to fight a battle

Corewell is taking anesthesia in house w2. As a hospital. They can always claim for the greater good of society and judges generally have sided with public services over private physican practice

It’s just a losing battle to sue.

I value 95% of all USA anesthesia practices at zero these days. They are all contractors and very few have a stake in facilities they contract out.

 

[NPJR]

What does the dissolving anesthesia group gain from a lawsuit at a cost of probably 100k a min to 500k. I doubt each partner wants to use 10-50k of their own funds to fight a battle

i get what you're saying, but it doesn't cost that much to put together a lawsuit of this nature. It's simple stuff, very little discovery, or deposition time. All you need is a lawyer to send out a letter saying they are in violation of the contracts. Very little interms of discovery, depositions which is where the money adds up