Future anesthesia job market ?

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Do you recommend going into Anesthesia (projected residency graduation in 2019)

  • Yes

    Votes: 93 38.8%
  • No

    Votes: 59 24.6%
  • not sure, too hard to predict

    Votes: 90 37.5%

  • Total voters
    240
If their 'practice' had intrinsic value, then they could cancel their exclusive contract and noncompete clauses and still sell out. Without those things it has almost NO VALUE.
If it were a real business there would be value other than access to other people's work. I can't think of any other business where the kitchen schedulers offer so little added value beyond the work of all the independently practicing employees.

Most business models in the service industry are like this. How much value add does the partner in a law firm provide? How about a partner at McKinsey? Not much besides bring in the business. The difference is that at an anesthesiology group, the partners only have one sale to make every few years (though they have to aggressively negotiate terms). You can argue that their role is smaller, but the principle remains the same.
Also, you signed your contract and your non-compete clause. No one put a gun to your head. You can also go to a different area to compete. Morality has nothing to do with this discussion.

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Most business models in the service industry are like this. How much value add does the partner in a law firm provide? How about a partner at McKinsey? Not much besides bring in the business. The difference is that at an anesthesiology group, the partners only have one sale to make every few years (though they have to aggressively negotiate terms). You can argue that their role is smaller, but the principle remains the same.
Also, you signed your contract and your non-compete clause. No one put a gun to your head. You can also go to a different area to compete. Morality has nothing to do with this discussion.
We disagree. That's ok.
 
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Lol, ok. Love how people want to reap all the benefits but take none of the initiative or risk.
There's no risk.
Reap what benefits? The proceeds of our own labor? How unreasonable!

Note- I'm not arguing I should be cut in on the sell out. I'm saying there should be no sale because my labor (and everyone else's) isn't theirs to sell.
 
There's no risk.
Reap what benefits? The proceeds of our own labor? How unreasonable!
Leave the area of your non-compete clause and go undercut the incumbent group, while maximizing quality of services provided.
 
Lol, ok. Love how people want to reap all the benefits but take none of the initiative or risk.

What is the risk of a person trying to start a "practice" in Anesthesiology from scratch? How does one even do it? What's the overhead consist of?
 
Then you've got your head in the sand, man. "The greatest trick the Devil ever pulled was convincing the world he didn't exist"

Who doesn't like to dance with the devil every now and then. I have a good 25-30yrs left practicing anesthesiology….not going to worry about some short sighted groups selling out to AMC just to make a quick dollar near the end of their careers. AMC are not spending millions of dollars buying groups because they think anesthesiology is going down the tubes. In my opinion, anesthesiology is in a very unique position to be very powerful players in hospitals moving forward. To quote Francis Underwood:

"Money is the Mc-mansion in Sarasota that starts falling apart after 10 years. Power is the old stone building that stands for centuries. I cannot respect someone who doesn't see the difference."
 
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Who doesn't like to dance with the devil every now and then. I have a good 25-30yrs left practicing anesthesiology….not going to worry about some short sighted groups selling out to AMC just to make a quick dollar near the end of their careers. AMC are not spending millions of dollars buying groups because they think anesthesiology is going down the tubes. In my opinion, anesthesiology is in a very unique position to be very powerful players in hospitals moving forward. To quote Francis Underwood:

"Money is the Mc-mansion in Sarasota that starts falling apart after 10 years. Power is the old stone building that stands for centuries. I cannot respect someone who doesn't see the difference."
+1 for a House of Cards reference and cheery outlook
 
Who doesn't like to dance with the devil every now and then. I have a good 25-30yrs left practicing anesthesiology….not going to worry about some short sighted groups selling out to AMC just to make a quick dollar near the end of their careers. AMC are not spending millions of dollars buying groups because they think anesthesiology is going down the tubes. In my opinion, anesthesiology is in a very unique position to be very powerful players in hospitals moving forward. To quote Francis Underwood:

"Money is the Mc-mansion in Sarasota that starts falling apart after 10 years. Power is the old stone building that stands for centuries. I cannot respect someone who doesn't see the difference."


Just because anesthesia services are necessary does not meant that we are important.
 
Who doesn't like to dance with the devil every now and then. I have a good 25-30yrs left practicing anesthesiology….not going to worry about some short sighted groups selling out to AMC just to make a quick dollar near the end of their careers. AMC are not spending millions of dollars buying groups because they think anesthesiology is going down the tubes. In my opinion, anesthesiology is in a very unique position to be very powerful players in hospitals moving forward. To quote Francis Underwood:

"Money is the Mc-mansion in Sarasota that starts falling apart after 10 years. Power is the old stone building that stands for centuries. I cannot respect someone who doesn't see the difference."

Just because anesthesia services are necessary does not meant that we are important.

Lowly M1 opining:

If AMCs solely exist to make money, as is so ubiquitously touted here, then it must stand that these profit-driven entities are projecting that anesthesiologists are necessary in the future. Otherwise, like Stank said, why would they buy up all these practices?

I know that in the near future, graduates will be meeting with fewer opportunities than in the past, but I don't know that things will stay grim in the long run. I feel like AMC's are investing for the long run. They're buying up practices right now b/c they believe that practices are presently selling at a price below true value based on long term projected future earnings b/c retiring anesthesiologists can't afford the potential dip in earnings in the near future. They want a "sure thing" for their twilight years.

Also, AMC's clearly expect premium future revenue from physician anesthesiology. Otherwise, if I were them, I would just hold out until "all states go opt-out" and purely contract with hospitals using CRNA labor. So essentially, AMC's are not expecting anesthesiologists to become obsolete, because if they do, who are they going to sell these newly purchased practices to? Other anesthesiology groups? Young budding ones? No, because by then, hospitals will just staff their OR's with CRNA's and there will be no contracts available for Anesthesiologists. I don't see that as an insubstantial financial loss on the part of AMC's.

So right now, even though the near future is uncertain, I feel like the fact that AMC's are buying up practices at such a rate means that anesthesiology as a specialty is here to stay. And in the future, who knows? Maybe once all the dust clears from the ACA implementation, physician run-PP groups may be able to be competitive again based on value of services provided, since AMC culture doesn't exactly provide incentives for quality and loyalty.

Am I completely off target? Blade? PGG?
 
Completely off target. Using the rationale that AMCs buying anesthesia practices = brilliant future for anesthesiology is flawed logic. Here's an example of how AMCs make money AND displace physicians from jobs....
WeDaBest Anesthesiologists has been practicing at St. Elsewhere for 25 years. They are a group of 10 anesthesiologists making $500k each or $5 million dollars a year. In comes Sheridan, underbids the contract, fires all the anesthesiologists but offers them contracts for $250k each if they'd like to stay. Three desperate slobs do and 10 CRNAs are hired at $150k each. Now we have $2.25 million dollars to pay the "providers" in salary and $2.75 million to the AMC. Seven anesthesiologists have lost their jobs and the AMC has just made millions in profits. Repeat hundreds of times across the USA. Where are these anesthesiologists going for jobs? There are only a finite number, and now you have a growing pool vying for these jobs which is not being offset by the septugenarians who should have retired but won't. How is this good for the future of the speciality?
 
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Completely off target. Using the rationale that AMCs buying anesthesia practices = brilliant future for anesthesiology is flawed logic. Here's an example of how AMCs make money AND displace physicians from jobs....
WeDaBest Anesthesiologists has been practicing at St. Elsewhere for 25 years. They are a group of 10 anesthesiologists making $500k each or $5 million dollars a year. In comes Sheridan, underbids the contract, fires all the anesthesiologists but offers them contracts for $250k each if they'd like to stay. Three desperate slobs do and 10 CRNAs are hired at $150k each. Now we have $2.25 million dollars to pay the "providers" in salary and $2.75 million to the AMC. Seven anesthesiologists have lost their jobs and the AMC has just made millions in profits. Repeat hundreds of times across the USA. Where are these anesthesiologists going for jobs? There are only a finite number, and now you have a growing pool vying for these jobs which is not being offset by the septugenarians who should have retired but won't. How is this good for the future of the speciality?
Why, then, can't three anesthesiologists underbid the AMC, hire 10 CRNAs at $150k apiece, pocket $500k each, and still save the hospital $2 mil?
 
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The OR is the financial life blood of hospitals
This is a specialty where people can die in minutes
Nobody is going to give the contract to an unknown entity

It will take a million dollars + to get the ball rolling in terms of insurance, HR, legal fees, billing resources, office support, making payroll, negotiating payor contracts before the A/Rs start rolling in.
Not a lot of start up docs willing to take on that level of risk.
 
Why, then, can't three anesthesiologists underbid the AMC, hire 10 CRNAs at $150k apiece, pocket $500k each, and still save the hospital $2 mil?

This is exactly how many AMCs started. A group of anesthesiologists underbid an existing group and discovered that they could replicate that model and scale up nationwide. Anesthesiologists were instrumental in the formation of most AMCs. They got out of the anesthesia business and went into the business of anesthesia. Smart move IMO.

AMCs are in the skimming business and no matter how low reimbursements go, they will always be able to skim a portion of practice revenues because they are now the owners.
 
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This is exactly how many AMCs started. A group of anesthesiologists underbid an existing group and discovered that they could replicate that model and scale up nationwide. Anesthesiologists were instrumental in the formation of most AMCs. They got out of the anesthesia business and went into the business of anesthesia. Smart move IMO.

AMCs are in the skimming business and no matter how low reimbursements go, they will always be able to skim a portion of practice revenues because they are now the owners.
It's bad enough when CRNAs try to scam Anesthesiology, but when actual anesthesiologists do it, it's very sad. Really sad to see Anesthesiology going through such a gauntlet, as the field is very difficult and stressful as it is.
 
There's no risk.
Reap what benefits? The proceeds of our own labor? How unreasonable!

Note- I'm not arguing I should be cut in on the sell out. I'm saying there should be no sale because my labor (and everyone else's) isn't theirs to sell.

It will take a million dollars + to get the ball rolling in terms of insurance, HR, legal fees, billing resources, office support, making payroll, negotiating payor contracts before the A/Rs start rolling in.
Not a lot of start up docs willing to take on that level of risk.

Dr Doze for the win!!!

ianmcgalt,
Of course, it is the partners' contract to sell. It's not yours if you're not a partner. As much as it stinks, if you're a new hire, you weren't there to compete for the initial contract. You don't have to work there, and you can leave if you'd like. But until you're the boss/owner, you're an employee and you're kept out of the mix . This is not an anomaly confined to medicine/anesthesiology. This crap happens in every facet of business.

@bronx43 you make too much sense; I appreciate your posts.
 
t
Lowly M1 opining:

If AMCs solely exist to make money, as is so ubiquitously touted here, then it must stand that these profit-driven entities are projecting that anesthesiologists are necessary in the future. Otherwise, like Stank said, why would they buy up all these practices?

I know that in the near future, graduates will be meeting with fewer opportunities than in the past, but I don't know that things will stay grim in the long run. I feel like AMC's are investing for the long run. They're buying up practices right now b/c they believe that practices are presently selling at a price below true value based on long term projected future earnings b/c retiring anesthesiologists can't afford the potential dip in earnings in the near future. They want a "sure thing" for their twilight years.

Also, AMC's clearly expect premium future revenue from physician anesthesiology. Otherwise, if I were them, I would just hold out until "all states go opt-out" and purely contract with hospitals using CRNA labor. So essentially, AMC's are not expecting anesthesiologists to become obsolete, because if they do, who are they going to sell these newly purchased practices to? Other anesthesiology groups? Young budding ones? No, because by then, hospitals will just staff their OR's with CRNA's and there will be no contracts available for Anesthesiologists. I don't see that as an insubstantial financial loss on the part of AMC's.

So right now, even though the near future is uncertain, I feel like the fact that AMC's are buying up practices at such a rate means that anesthesiology as a specialty is here to stay. And in the future, who knows? Maybe once all the dust clears from the ACA implementation, physician run-PP groups may be able to be competitive again based on value of services provided, since AMC culture doesn't exactly provide incentives for quality and loyalty.

Am I completely off target? Blade? PGG?


Wall Street is really good at taking risk/making bets with other people's money. Here are some examples:

1. Subprime Debt in 2007- Hundreds of Billions were bet by smart Wall Street Bankers on these CDOs

2. Enron- We all know how that one ended but some big Wall Street Firms lost millions

3. Silver- Silver peaked at $48 per ounce a few years ago. Look at it now.

4. WorldCom- Another belly up company with a crook for a CEO


What does this have to do with Anesthesiology? Everything. The explosion of AMCs involves Wall Street money and bets by financial gurus that Anesthesiology is viable for the longer term as a fee for service model. Are they right? Is the Group in Charlotte, Nashville, Orlando, Houston, etc. the next NETFLIX or the next Enron? Do you want to bet your life savings on this decision or mitigate the risk by cashing in NOW to an AMC at a good price?

Most of the senior partners have seen the market risks over the past 14 years including the real estate crash. We don't want to risk our long term financial goals by NOT selling our practice while the sun is shining. Think of selling a practice like selling a home. Would you have wanted to sell in '06 or '09? In addition, that "home" can be taken away by the government at any time leaving you with nothing.

Future Anesthesiologists will be renters not owners of a practice. Salaries will be lower because the new owners run the practice and have an abundant supply of relatively cheap labor to tap in order to staff the practice.
 
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t


Wall Street is really good at taking risk/making bets with other people's money. Here are some examples:

1. Subprime Debt in 2007- Hundreds of Billions were bet by smart Wall Street Bankers on these CDOs

2. Enron- We all know how that one ended but some big Wall Street Firms lost millions

3. Silver- Silver peaked at $48 per ounce a few years ago. Look at it now.

4. WorldCom- Another belly up company with a crook for a CEO


What does this have to do with Anesthesiology? Everything. The explosion of AMCs involves Wall Street money and bets by financial gurus that Anesthesiology is viable for the longer term as a fee for service model. Are they right? Is the Group in Charlotte, Nashville, Orlando, Houston, etc. the next NETFLIX or the next Enron? Do you want to bet your life savings on this decision or mitigate the risk by cashing in NOW to an AMC at a good price?

Most of the senior partners have seen the market risks over the past 14 years including the real estate crash. We don't want to risk our long term financial goals by NOT selling our practice while the sun is shining. Think of selling a practice like selling a home. Would you have wanted to sell in '06 or '09? In addition, that "home" can be taken away by the government at any time leaving you with nothing.

Future Anesthesiologists will be renters not owners of a practice. Salaries will be lower because the new owners run the practice and have an abundant supply of relatively cheap labor to tap in order to staff the practice.

I am not sure about Wall Street 2007 subprime bet.

Wall Street was done. Wachovia was going down because of its ill fated purchase of golden west.

BOA thought they got a bargain countrywide.

Merrill Lynch was done
Bears Stern was done
Lehman was done

All was left was Morgan Stanley and Goldman and Morgan Stanley had to have huge cash infusions from the Japs.

Goldman would have survived barely and a shell of its shelf.

Wall Street is betting big on healthcare but don't be surprised if they pull out in 2015.
 
I'm serious, why don't you guys start your own AMC?
 
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Completely off target. Using the rationale that AMCs buying anesthesia practices = brilliant future for anesthesiology is flawed logic. Here's an example of how AMCs make money AND displace physicians from jobs....
WeDaBest Anesthesiologists has been practicing at St. Elsewhere for 25 years. They are a group of 10 anesthesiologists making $500k each or $5 million dollars a year. In comes Sheridan, underbids the contract, fires all the anesthesiologists but offers them contracts for $250k each if they'd like to stay. Three desperate slobs do and 10 CRNAs are hired at $150k each. Now we have $2.25 million dollars to pay the "providers" in salary and $2.75 million to the AMC. Seven anesthesiologists have lost their jobs and the AMC has just made millions in profits. Repeat hundreds of times across the USA. Where are these anesthesiologists going for jobs? There are only a finite number, and now you have a growing pool vying for these jobs which is not being offset by the septugenarians who should have retired but won't. How is this good for the future of the speciality?
I like how you ignore the forces against the AMC e.g. the measurable decrease in quality of care that comes with hiring a bottom of the barrel anesthesiologist for half of the fair market rate and the similar decrease in quality of care when replacing anesthesiologists with CRNAs.
 
I like how you ignore the forces against the AMC e.g. the measurable decrease in quality of care that comes with hiring a bottom of the barrel anesthesiologist for half of the fair market rate and the similar decrease in quality of care when replacing anesthesiologists with CRNAs.

I like how you think that makes one iota of difference.
 
I like how you ignore the forces against the AMC e.g. the measurable decrease in quality of care that comes with hiring a bottom of the barrel anesthesiologist for half of the fair market rate and the similar decrease in quality of care when replacing anesthesiologists with CRNAs.

And where is this data showing the "measurable decrease in quality of care that comes with hiring a bottom of the barrel anesthesiologist" hmmmmm? I bet Blade couldn't even find it. Oh that's right......it's because it doesn't exist.
 
And where is this data showing the "measurable decrease in quality of care that comes with hiring a bottom of the barrel anesthesiologist" hmmmmm? I bet Blade couldn't even find it. Oh that's right......it's because it doesn't exist.
You described them as "desperate slobs." Who do you envision getting a job at an AMC at a below market salary: a US-trained physician at the top of his or her game, or the clock-puncher/desperate IMG/barely-board-certified crowd?

Or are you saying that safely and effectively providing anesthesia isn't difficult, and that there really is no reason to pay you guys $400k or $500k a year? :confused:
 
You described them as "desperate slobs." Who do you envision getting a job at an AMC at a below market salary: a US-trained physician at the top of his or her game, or the clock-puncher/desperate IMG/barely-board-certified crowd?

Or are you saying that safely and effectively providing anesthesia isn't difficult, and that there really is no reason to pay you guys $400k or $500k a year? :confused:


Market Forces? Median wage? Those are NOT static variables and in fact, are in play right now LOWERING wages for new graduates. AMCS will simply the pay the wage necessary to fill the positions. If they can pay less because of a relative surplus of new labor (1600 new graduates per year) they will do so. There is no such thing as "barely board certified" as one is or is not Board Certified in his/her specialty.

As for the IMG the AMCs will soon be able to hire top notch fellowship trained (AMG) Anesthesiologists for $300K. The IMG may be delegated to the $250K AMC jobs.
Once the AMCs control 80% of the market they ARE the market. Right now they are in an acquisition phase and in about 36-48 months should control 40-50% of non academic anesthesia.
 
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Market Forces? Median wage? Those are NOT static variables and in fact, are in play right now LOWERING wages for new graduates. AMCS will simply the pay the wage necessary to fill the positions. If they can pay less because of a relative surplus of new labor (1600 new graduates per year) they will do so. There is no such thing as "barely board certified" as one is or is not Board Certified in his/her specialty.

As for the IMG the AMCs will soon be able to hire top notch fellowship trained (AMG) Anesthesiologists for $300K. The IMG may be delegated to the $250K AMC jobs.
Once the AMCs control 80% of the market they ARE the market. Right now they are in an acquisition phase and in about 36-48 months should control 40-50% of non academic anesthesia.
I meant more along the lines of idiots who bounce from **** job to **** job because they're slow, stupid, or barely able to safely practice anesthesia -- the ones who somehow made it through the cracks.

Anyway, back to my original point: why doesn't anyone start their own AMC? If the start-up estimates in this thread are accurate, obtaining a $1 million line of credit shouldn't be too hard for a small group of anesthesiologists.
 
I meant more along the lines of idiots who bounce from **** job to **** job because they're slow, stupid, or barely able to safely practice anesthesia -- the ones who somehow made it through the cracks.

Anyway, back to my original point: why doesn't anyone start their own AMC? If the start-up estimates in this thread are accurate, obtaining a $1 million line of credit shouldn't be too hard for a small group of anesthesiologists.


The same reason why buying homes on SPEC in 2007 was a really bad idea especially in Florida, Arizona, Nevada, etc. At some point the market becomes saturated and only the STRONG survive.

Recent AMC start-ups have been backed by tens of millions of dollars from Wall Street firms.
 
You described them as "desperate slobs." Who do you envision getting a job at an AMC at a below market salary: a US-trained physician at the top of his or her game, or the clock-puncher/desperate IMG/barely-board-certified crowd?

Or are you saying that safely and effectively providing anesthesia isn't difficult, and that there really is no reason to pay you guys $400k or $500k a year? :confused:

Once the AMCs fully take the market share, anesthesiologists won't have a choice. If 95% of the jobs are for $250k then guess what? It doesn't matter if you're the best anesthesiologist on the planet or an incompetent loser. That's what you'll be getting paid or you will be UNEMPLOYED.
 
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Market Forces? Median wage? Those are NOT static variables and in fact, are in play right now LOWERING wages for new graduates. AMCS will simply the pay the wage necessary to fill the positions. If they can pay less because of a relative surplus of new labor (1600 new graduates per year) they will do so. There is no such thing as "barely board certified" as one is or is not Board Certified in his/her specialty.

As for the IMG the AMCs will soon be able to hire top notch fellowship trained (AMG) Anesthesiologists for $300K. The IMG may be delegated to the $250K AMC jobs.
Once the AMCs control 80% of the market they ARE the market. Right now they are in an acquisition phase and in about 36-48 months should control 40-50% of non academic anesthesia.

What about competition between AMC's, both for hospital contracts and labor (anesthesiologists)? Wouldn't that have a net benefit effect for anesthesiologists (given that there's more demand than supply, which, granted, does not seem favorable in the near future)? Maybe in the long run?

Also, you often speak of how market forces will dictate how future anesthesiologists will be paid once AMC's take over. But... that kind of implies that PP models were insulated from those forces. Was that really the case? I mean, if so, then why the all the "bears" in the market selling their practices? Economic pressures of supply/demand/reimbursement/expenses are still in flux, AMC or PP. It seems like sometimes PP just provides the illusion of security.

Again, just trying to learn.
 
I have to remember to revisit this thread in 36-48months....I bet AMC wont even be a large part of the discussions anymore. All this talk about young physicians not willing to take the risk to start their own groups to undercut the AMCs or any other group is silly...I am confident young physicians are willing to take the risk...just not enough pressure currently in the market to make the risk worth it...at least in my neck of the woods.
 
I have to remember to revisit this thread in 36-48months....I bet AMC wont even be a large part of the discussions anymore. All this talk about young physicians not willing to take the risk to start their own groups to undercut the AMCs or any other group is silly...I am confident young physicians are willing to take the risk...just not enough pressure currently in the market to make the risk worth it...at least in my neck of the woods.

Hahahahahahahahahaha! Ok. Should be interesting for you then.
 
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Another thing, if AMC's are backed by Wall St. money, then wouldn't that mean that Wall St., THE Lobbyist, has skin in the game in terms of not wanting universal, decommodified healthcare? I mean, Wall St. is Wall St., but if there's one thing they're good at, it's influencing policy.
 
I have to remember to revisit this thread in 36-48months....I bet AMC wont even be a large part of the discussions anymore. All this talk about young physicians not willing to take the risk to start their own groups to undercut the AMCs or any other group is silly...I am confident young physicians are willing to take the risk...just not enough pressure currently in the market to make the risk worth it...at least in my neck of the woods.
Young doctors don't know how to deal with hospital administrators... that's the problem!
By the time you understand the game and figure out that nothing you learned in medical school or residency is relevant to this game you are usually no longer young and no longer adventurous.
Hospital administrators are interested in low cost service, they don't want to give you money and they want you to guarantee that you will always provide the service and you will handle all the headaches that come with staffing an anesthesia department. A young doctor in the eyes of an administrator is fresh meat that only qualifies to be another faceless nameless anesthesia provider.
 
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You described them as "desperate slobs." Who do you envision getting a job at an AMC at a below market salary: a US-trained physician at the top of his or her game, or the clock-puncher/desperate IMG/barely-board-certified crowd?

Or are you saying that safely and effectively providing anesthesia isn't difficult, and that there really is no reason to pay you guys $400k or $500k a year? :confused:


I didn't know an IMG can practice anesthesia without a US-trained residency?
 
Young doctors don't know how to deal with hospital administrators... that's the problem!
By the time you understand the game and figure out that nothing you learned in medical school or residency is relevant to this game you are usually no longer young and no longer adventurous.
Hospital administrators are interested in low cost service, they don't want to give you money and they want you to guarantee that you will always provide the service and you will handle all the headaches that come with staffing an anesthesia department. A young doctor in the eyes of an administrator is fresh meet that only qualifies to be another faceless nameless anesthesia provider.

I agree young docs are inexperienced with hospital administration and likely will get taken advantage of in the process. My point was that if the markets gets as bad as some on this forum like to predict then the young docs are already being taken advantage of by their partners or employers…so then the risk will be worth the potential benefit of breaking away from the safety of an established group in attempts to better your situation.
 
They Can't!
But this is one of these stupid things that people keep repeating and it makes them feel good about themselves:
"the foreigners took my job"
Not true any longer. The ABA has a pathway for non US trained Anesthesiologists to become Board Eligible. This involves an academic program sponsor and service to the residency program as a junior attending.
 
A young doctor in the eyes of an administrator is fresh meat that only qualifies to be another faceless nameless anesthesia provider.
+10.

"New graduates welcome" = don't expect high salaries.
 
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They Can't!
But this is one of these stupid things that people keep repeating and it makes them feel good about themselves:
"the foreigners took my job"
I was thinking more along the lines of an FMG taking a low paying or otherwise undesirable job at an AMC because it's still better than the jobs in their home country.
 
I'm serious, why don't you guys start your own AMC?

This is basically the point I made before. If others can do it, so can you. It's called competition, and physicians need to embrace it. An enterprising group of Anesthesiologists can definitely do it, and I'm sure some will.
 
This is basically the point I made before. If others can do it, so can you. It's called competition, and physicians need to embrace it. An enterprising group of Anesthesiologists can definitely do it, and I'm sure some will.
Recent AMC start-ups are more of a partnership with WallStreet backing. This means the Anesthesiologist are still shareholders in the new mega group turned AMC.

The groups in Orlando and Houston for example merged into one large AMC with WallStreet funding. The new owners are now Anesthesiologists and corporate guys. The group in Nashville did the same thing.

This means the newly hired Anesthesiologists will just be employees paid a lower wage under the AMC banner.

The AMC is a cut throat business these days and I wouldn't recommend pursuing a new venture without at least 30 million in capital.
 
U.S. Anesthesia Partners adds two groups with more than 700 providers

By Andis Robeznieks
Posted: January 7, 2014 - 2:00 pm ET
Tags: Acquisitions, Deals, McKesson Corp., Mergers,Oncology, Physicians, Systems
Two large anesthesia groups with more than 700 providers have joined U.S. Anesthesia Partners, a Fort Lauderdale, Fla.-based anesthesiology practice-management services company.

Dallas-based Pinnacle Anesthesia, with more than 500 anesthesia providers, and Orlando, Fla.-based JLR Medical Group, with more than 200 anesthesia providers, announced Jan. 6 that they will join U.S. Anesthesia as founding clinical partners.

U.S. Anesthesia already includes Greater Houston Anesthesiology, a 400-anesthesia provider group, which entered into a partnership agreement with the company and its sponsors, the Welsh, Carson, Anderson & Stowe private equity firm, in December 2012.

The groups will continue to operate under their current name in their local markets, Kristen Bratberg, USAP president and CEO, told Modern Healthcare. The groups will also continue to be led by their existing physicians and local management teams, and their physician partners will gain equity ownership in USAP upon the closing of the transactions.

“Under healthcare reform, hospital systems are looking for more sophisticated services from their anesthesia providers,” Bratberg said in a news release. “By bringing together the nation's top-tier anesthesia practices, supporting them with capital and other resources and allowing them to share best practices, investments in IT and other infrastructure, we position them to provide a higher level of service to their facilities, surgeons and patients.”

As part of the deal with Pinnacle, USAP has entered into an agreement with that group's former practice-management services provider, Dallas-based EmCare, to acquire assets used in support of Pinnacle, according to a news release. In its 2012 agreement with Greater Houston, USAP acquired that group's assets used for practice-management support.

Pinnacle's provider workforce includes 325 physicians, 233 certified registered nurse anesthetists and eight nurse practitioners. JLR has more than 80 doctors (including eight board certified in both anesthesiology and pain medicine) and 135 CRNAs.

“All anesthesia (service) is either personally performed by a physician or provided in the anesthesia care team model in which an anesthesiologist medically directs nurse anesthetists,” Carl Michael, CEO of physician-owned JLR, told Modern Healthcare.

In a news release, Michael said that the arrangement was part of JLR's “aggressive and forward-thinking approach in adapting to healthcare reform.”

“Our hospital partners are growing, and we will be ready to meet their increasing needs,” he added.

Welsh, Carson, Anderson & Stowe is a New York-based private equity firm that has partnerships with some 35 companies and total capital of $20 billion. Partners include Ardent Health Services, CareSpot Express Healthcare, and United Surgical Partners International. It previously owned U.S. Oncology, which was acquired by McKesson Corp. at the end of 2010 for about $2.2 billion.

Follow Andis Robeznieks on Twitter: @MHARobeznieks
 
Recent AMC start-ups are more of a partnership with WallStreet backing. This means the Anesthesiologist are still shareholders in the new mega group turned AMC.

The groups in Orlando and Houston for example merged into one large AMC with WallStreet funding. The new owners are now Anesthesiologists and corporate guys. The group in Nashville did the same thing.

This means the newly hired Anesthesiologists will just be employees paid a lower wage under the AMC banner.

The AMC is a cut throat business these days and I wouldn't recommend pursuing a new venture without at least 30 million in capital.

$30 million in capital? We're talking about starting a management group from scratch and slowly building it with new employees or small acquisitions, not building a massive AMC or ASC and subsequent staff from the ground up.
 
U.S. Anesthesia Partners adds two groups with more than 700 providers

By Andis Robeznieks
Posted: January 7, 2014 - 2:00 pm ET
Tags: Acquisitions, Deals, McKesson Corp., Mergers,Oncology, Physicians, Systems
Two large anesthesia groups with more than 700 providers have joined U.S. Anesthesia Partners, a Fort Lauderdale, Fla.-based anesthesiology practice-management services company.

Dallas-based Pinnacle Anesthesia, with more than 500 anesthesia providers, and Orlando, Fla.-based JLR Medical Group, with more than 200 anesthesia providers, announced Jan. 6 that they will join U.S. Anesthesia as founding clinical partners.

U.S. Anesthesia already includes Greater Houston Anesthesiology, a 400-anesthesia provider group, which entered into a partnership agreement with the company and its sponsors, the Welsh, Carson, Anderson & Stowe private equity firm, in December 2012.

The groups will continue to operate under their current name in their local markets, Kristen Bratberg, USAP president and CEO, told Modern Healthcare. The groups will also continue to be led by their existing physicians and local management teams, and their physician partners will gain equity ownership in USAP upon the closing of the transactions.

“Under healthcare reform, hospital systems are looking for more sophisticated services from their anesthesia providers,” Bratberg said in a news release. “By bringing together the nation's top-tier anesthesia practices, supporting them with capital and other resources and allowing them to share best practices, investments in IT and other infrastructure, we position them to provide a higher level of service to their facilities, surgeons and patients.”

As part of the deal with Pinnacle, USAP has entered into an agreement with that group's former practice-management services provider, Dallas-based EmCare, to acquire assets used in support of Pinnacle, according to a news release. In its 2012 agreement with Greater Houston, USAP acquired that group's assets used for practice-management support.

Pinnacle's provider workforce includes 325 physicians, 233 certified registered nurse anesthetists and eight nurse practitioners. JLR has more than 80 doctors (including eight board certified in both anesthesiology and pain medicine) and 135 CRNAs.

“All anesthesia (service) is either personally performed by a physician or provided in the anesthesia care team model in which an anesthesiologist medically directs nurse anesthetists,” Carl Michael, CEO of physician-owned JLR, told Modern Healthcare.

In a news release, Michael said that the arrangement was part of JLR's “aggressive and forward-thinking approach in adapting to healthcare reform.”

“Our hospital partners are growing, and we will be ready to meet their increasing needs,” he added.

Welsh, Carson, Anderson & Stowe is a New York-based private equity firm that has partnerships with some 35 companies and total capital of $20 billion. Partners include Ardent Health Services, CareSpot Express Healthcare, and United Surgical Partners International. It previously owned U.S. Oncology, which was acquired by McKesson Corp. at the end of 2010 for about $2.2 billion.

Follow Andis Robeznieks on Twitter: @MHARobeznieks
2.6 million per partner. $600k has to be held back as part of the buyout for a few years

The private equity group immediately flipped the investment over to a private pension firm off loading most of the hot potatoes and raking in millions in fees.

The private pension firm is holding most of the anesthesia hot potato now.

This is how Wall Street plays with funny money. They aren't risking much at all.
 
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