Even ortho

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nimbus

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Very sad to see. We are losing/selling control of our own destiny.


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Anesthesia has its troubles, but at least they’re already baked into the package. When I picked this field it already had CRNAs and national/local group consolidations. While the problem is worse now, other fields have caught up much more quickly, in particular derm EM and primary care.

Surgical fields might not see the mid level infiltration as bad, but who knows? Circumcisions are done by an NP at one of our local hospitals, and it doesn’t take a rocket scientist to put in ear tubes or take out tonsils. What’s stopping a surgeon from employing some NPs and supervising double the number of cases? They already do that with residents in academics.

Where surgery is much more vulnerable though is when a big system takes over the referral base - this happened at a place near my residency, surgical group refused hospital takeover so the system got their own surgeons and made the primary care docs refer to them instead. Established surgeons with a good local reputation can avoid this new grads might not have a choice.
 
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Where surgery is much more vulnerable though is when a big system takes over the referral base - this happened at a place near my residency, surgical group refused hospital takeover so the system got their own surgeons and made the primary care docs refer to them instead. Established surgeons with a good local reputation can avoid this new grads might not have a choice.

The article is describes a 20 year established surgeon likely getting canned.
 
The article is describes a 20 year established surgeon likely getting canned.

Sure, but I assume if they’re not hiring him in there are no applicable non-competes and he could practice elsewhere in town? My point was more that if he is well-known he can still work as long as he can still get referrals whereas a new surgeon wouldn’t have that network to rely on. Might be tough in this case since this is a small town without other facilities.
 
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