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deleted171991
They can. Inpatient with (many) overnight calls.
I know this was tongue in cheek, but I'll answer it anyway.What if he writes '100mg propofol IV once' on an order sheet?
Wow, I don't understand how can he make public statements like this and get away with it. UC Davis anesthesia leadership need to grow some balls.
Sorry to bump this thread but what prevents hospitals/administration from increasing the CRNA to anesthesiologist ratio, especially in states that have already opted out, in order to save money? Wouldn't the recent increase in the past few years of residency training spots also make it harder for graduates to find a job as well in the upcoming years?
Wouldn't the recent increase in the past few years of residency training spots also make it harder for graduates to find a job as well in the upcoming years?
I got a solution. How about some of you old timers (I'm talking 55+) retire? I know y'all are sitting on several million dollars of savings and a few beach houses with a bentley out front. S&P500 is at all time highs so don't tell me you're waiting for a market rebound. Sell now and retire so us young bucks have a shot at a decent job. Also retire because you guys are the reason we have so many CRNAs out there. Us young bucks will fight for the future of the specialty cause we have no other choice.
I'll be able to retire in a few years but I will keep working because I'm healthy and still have a lot of energy. I love my work. It is one of the best things I do.
You have an entitled attitude. If you keep it up you will never be content. We are not the cause of your problem. There are larger forces at work. I'm sorry the timing looks bad you. The anesthesia job market has always had ups and downs.
Ps....no Bentley or beach house, but that's why I could retire.
Us young bucks will fight for the future of the specialty cause we have no other choice.
Multiple market forces are working against anesthesiologists. Perhaps the greatest is Medicare choosing to reimburse crna's 100% in opt out states. This is a movement toward the "pseudo equalization" of anesthesia providers. Imagine if 80+ anesthesiologists graduated annually in one state alone. It would decimate the job market. Now combine the Crna and anesthesiology graduates in TN alone annually. It has to approach 100. AMC's want the cheapest common denominator allowed by law (patient care be damned). Whether or not you consider rural areas desirable, every position filled is one less available. It eventually trickles down.
Damn, Consigliere. You've got your finger on the pulse. How do you pull out this stuff as its happening!What future? Anesthesiology is dead. AMCs will rule the earth:
http://www.bloomberg.com/news/2014-...n-healthcare-in-2-35-billion-transaction.html
While they may be familiar with medico legal risk, hospitals will weigh that risk against improved profit margins. How many "risky" surgeons do we see that butcher patients and keep their priveleges because they generate revenue for the hospital. I fear you are giving these businesses more credit than they deserve.I don't think this is accurate. You are talking about this situation in a vaccuum. Hospitals are familiar with the medicolegal aspects of medicine more than we could ever imagine. They know by employing a higher quantity of CRNA/AA's they are assuming more risk. At major centers with high case complexity (yes, this is monitored), you are absolutely not going to see ratios go much higher, nor will you see the independent practice within higher ASA case stratifications. The real damage is going to be in those elective and low complexity cases -- we can pretty much say "buh-bye" to providing direct care to low complexity cases and can say "hello" to high supervision ratios in this context. This will absolutely be maximized, because the hospital will likely view this as a low-risk population. Just extrapolating what I've seen on rotations and in military medicine with midlevel providers... YMMV, take it for what it's worth.
This will absolutely be maximized, because the hospital will likely view this as a low-risk population. Just extrapolating what I've seen on rotations and in military medicine with midlevel providers...
Hospital administrators care only about saving money and that liability issue is at the very bottom of their list of priorities.I don't think this is accurate. You are talking about this situation in a vaccuum. Hospitals are familiar with the medicolegal aspects of medicine more than we could ever imagine. They know by employing a higher quantity of CRNA/AA's they are assuming more risk. At major centers with high case complexity (yes, this is monitored), you are absolutely not going to see ratios go much higher, nor will you see the independent practice within higher ASA case stratifications. The real damage is going to be in those elective and low complexity cases -- we can pretty much say "buh-bye" to providing direct care to low complexity cases and can say "hello" to high supervision ratios in this context. This will absolutely be maximized, because the hospital will likely view this as a low-risk population. Just extrapolating what I've seen on rotations and in military medicine with midlevel providers... YMMV, take it for what it's worth.
More to the point, are the hospitals even exposed to very much of that liability? I would think that most of that risk is effectively offloaded to the individual's liability insurance carrier.While they may be familiar with medico legal risk, hospitals will weigh that risk against improved profit margins. How many "risky" surgeons do we see that butcher patients and keep their priveleges because they generate revenue for the hospital. I fear you are giving these businesses more credit than they deserve.
What future? Anesthesiology is dead. AMCs will rule the earth:
http://www.bloomberg.com/news/2014-...n-healthcare-in-2-35-billion-transaction.html
Hospital administrators care only about saving money and that liability issue is at the very bottom of their list of priorities.
Say "medicine is dead" if you want to be more accurate.
Damn right. This is a bubble like the Nasdaq in 1999 or real estate/housing in 2006. Now is the time to sell as WallStreet is greedy to buyFWIW Buzz is going into lockdown mode.
I'm saving every penny I can. I'm trying to reposition myself at my new/old job into more a managerial role. I'm going to get my MBA. I'm planning my exit strategy.
When the bean counters finally win, if they win, I'm out. I'm either going to join them or go do something else with my life. But right now we're outnumbered, disorganized, and can't agree what's best for our profession. So plan your exit and make sure you have enough money in your **CK-YOU account to be able to walk away.
That's what all the fatcat grayhairs who are selling out our profession are doing.
What are you talking? You are a perennial anesthesiology basher. Are you this negative in all aspects of your life or only in regards to the future of anesthesiology?
Secondly, if these kinds of transactions are a sign of the death, then it is not only anesthesiology. This is happening across the board to many specialties including radiology and surgery.
I think if you want to make bold statements like "anesthesiology is dead" then you should generalize more to include every other specialty that is going through changes (= every single one). Say "medicine is dead" if you want to be more accurate.
Also, if "anesthesiology is dead" means we won't be making 600k like those who came 10-20 years before us, then no need to post. We already know that. If you are miserable with your job and money is your only motivator then I feel bad for you. Find a new position or go back to residency.
Give me a call when you've got some hair on your nuts, kid.
Multiple market forces are working against anesthesiologists. Perhaps the greatest is Medicare choosing to reimburse crna's 100% in opt out states. This is a movement toward the "pseudo equalization" of anesthesia providers. Imagine if 80+ anesthesiologists graduated annually in one state alone. It would decimate the job market. Now combine the Crna and anesthesiology graduates in TN alone annually. It has to approach 100. AMC's want the cheapest common denominator allowed by law (patient care be damned). Whether or not you consider rural areas desirable, every position filled is one less available. It eventually trickles down.
Give me a call when you've got some hair on your nuts, kid.
What's stopping you from getting an executive MBA and selling out?
Then forget the MBA. What's stopping you from selling out by weaseling your way into administration?Dude......step away from the leaking sevo vaporizer. Since when does an executive MBA grant you the ability to do anything other than waste your time and $35k+?!?
Then forget the MBA. What's stopping you from selling out by weaseling your way into administration?
Why are you so against the guy's opinion?
Why are you so against the guy's opinion? He is only trying to voice his opinion so that medical students will learn about all aspects of practicing Anesthesiology before they sign up for it.
I'd be pretty upset if I happen to train in Anesthesiology and find out when I'm done that it's not as great as it is made out to be.
He wants to make money, there's nothing wrong with that. I want to know why he won't take steps toward becoming a hospital or AMC administrator.
Probably because almost all his posts are extreme doom and gloom.
I guess it's easier to complain about it on the internet than it is to actually do anything about it.The sky has fallen.
Wharton has an executive MBA, is that a waste of time and money as well? Though it runs about $160k.Dude......step away from the leaking sevo vaporizer. Since when does an executive MBA grant you the ability to do anything other than waste your time and $35k+?!?
Yes. No-brainer.Thanks for the responses above. So to summarize, most of you would go to Tufts ortho vs. MGH anesthesia as a new resident?
If you want to do ortho.Thanks for the responses above. So to summarize, most of you would go to Tufts ortho vs. MGH anesthesia as a new resident?
Wharton has an executive MBA, is that a waste of time and money as well? Though it runs about $160k.
If you're going to get an MBA, remember that reputation is FAR more important than in medical school, and the difference between prospects at top 10 programs and your local university are night and day.
Wharton has an executive MBA, is that a waste of time and money as well? Though it runs about $160k.
If you're going to get an MBA, remember that reputation is FAR more important than in medical school, and the difference between prospects at top 10 programs and your local university are night and day.
My observation has been that what opens the administrative doors for physicians is being a revenue generator for the hospital. The relationships are built when the hospital is working closely to keep you there and appease you. Then you slowly transition your role to more administrative duties and less clinical responsibility. This appears to be a pathway that is less available to an anesthesiologist (seen as a liability on a spreadsheet) as opposed to a surgeon or a cardiologist (who is seen as an asset). I am sure that exceptions exist, but it seems this is a more common route. It's not what you know but who you know.Well that's the key to opening the door of corporate medicine to you if you are not interested in practicing medicine anymore.
I'm not sure why you don't see that. Though you wouldn't be starting off as the COO...
You already have the medical background. Now you need to learn about business, that's what business school does.
The advantage of the executive MBA, assuming you don't go to the University of Phoenix, is that you can transition your career while working full time and then leave when you get a business job.
I wasn't referring to internal management jobs.My observation has been that what opens the administrative doors for physicians is being a revenue generator for the hospital. The relationships are built when the hospital is working closely to keep you there and appease you. Then you slowly transition your role to more administrative duties and less clinical responsibility. This appears to be a pathway that is less available to an anesthesiologist (seen as a liability on a spreadsheet) as opposed to a surgeon or a cardiologist (who is seen as an asset). I am sure that exceptions exist, but it seems this is a more common route. It's not what you know but who you know.