Genuine surgeon support?

[Lecithin5]

Just curious if you guys have examples of this:

We all know that often times when a reputable and beloved (usually private) anesthesia group gets threatened by a hospital system, surgeons often speak up. The usual sequence is this: hospital decides to get rid of a group—-> there is outrage amongst surgeons—-> surgeons speak up on behalf of the anesthesiologists—> hospital dgaf—-> a new normal is established with the new group—-> life goes on for the surgeon, with a new, and oftentimes inferior, anesthesia provider.

By the way, no judgment against the surgeons. At the end of the day, they have their own interests.

But has anyone come across a powerful surgeon who has genuinely threatened to leave if a new Anesthesia group was brought in? Or in fact did leave the system because a new Anesthesia group was brought in? I’m just very curious.

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[Arch Guillotti]

Probably not

 

[BlueRug]

Uhhhh this has happened multiple times I know of personally. Not a single surgeon but a group of surgeons.

This is very common

 

[pgg]

It's a more plausible threat in big cities where surgeons are already operating at multiple facilities in different systems. Surgeons can shift caseload around based on how they perceive the working conditions. Whether that influences administration at all is another question.

Out here in the sticks where one hospital has a monopoly, no one has any illusions that any surgeon might leave because the hospital ruined the anesthesia group, or moved their block time, or turned physician parking into a food court, etc.

 

[FatKid]

Unfortunately, with many small community hospitals being taken over & bought-up by the big Hospital Systems over the past 20 years, the negotiating power physicians once had is long gone.

 

[Maverikk]

I’ve seen this, it’s usually only surgeons who do cardiac, ortho or very complex cases. Their outcomes are affected by anesthesia and something they care about. As mentioned it only happens in urban areas where surgeons can move their cases. It was simultaneously getting rid of the PP anesthesia group by toxic admin who were also eroding the trust of other departments so I can’t say it was just anesthesia getting the boot but more the whole system going from a great place to work to subpar, this was all reflected in the staff as well (nurses, techs etc). The one place I knew that was a larger community hospital that kicked out the group I belonged in and self-employed, the anesthesiologists are now actively looking to start/join a union last I heard bc admin is trying to decrease their salaries and increase call.

 

[dmk5n]

A point of negotiaton could be this.

Suppose the group of anesthesiologists gets replaced with an all CRNA group. Guess who becomes captain of the ship and the liability sponge? they do.

 

[zizzer]

Happened in my group a couple of years ago with our transplant, vascular, and neurosurgeons. The neurosurgeons were hospital employed, but the others were private practice.

 

[Maverikk]

A point of negotiaton could be this.

Suppose the group of anesthesiologists gets replaced with an all CRNA group. Guess who becomes captain of the ship and the liability sponge? they do.

It depends, if it's an opt-out state the CRNAs bill QZ, no medical direction; this is how it will be sold.

Does it practically matter? No, one endo center my previous group staffed went to CRNA only in an opt-out state billing QZ, within a year they had a death, everyone involved was sued, didn't matter about the supervision aspect. They previously had no issues for over a decade. Asked the group to come back in 6 months.

 

[turnupthegas]

There is a group in Los Gatos, CA that was replaced by a national corp. Surgeons/staff hates the new group and the hospital went back to the old group.

 

[GassYous]

There is a group in Los Gatos, CA that was replaced by a national corp. Surgeons/staff hates the new group and the hospital went back to the old group.

G2?

 

[TheLoneWolf]

We covered an ortho and GI ASC. ACT model with physicians doing the blocks and spinals, ordering premeds etc. No eligibility criteria was ever followed. BMI>50, severe CAD, Oxygen dependent end stage COPD, recent strokes etc.

Now it's CRNAs doing everything with one attending hanging out doing just preops and pacu issues.

Spoke to the orthos and they said they hadn't noticed any difference.

I can't imagine the orthos stepping up and saying positive things to admin. Even when we stay late or take in disasters that had no business stepping foot in an ASC.

I remember one orthobro even taking photos of the room clock as you push the patient in and would send those to admin if you were even a minute late.

Glad I'm outta there.

 

[FatKid]

We covered an ortho and GI ASC. ACT model with physicians doing the blocks and spinals, ordering premeds etc. No eligibility criteria was ever followed. BMI>50, severe CAD, Oxygen dependent end stage COPD, recent strokes etc.

Now it's CRNAs doing everything with one attending hanging out doing just preops and pacu issues.

Spoke to the orthos and they said they hadn't noticed any difference.

I can't imagine the orthos stepping up and saying positive things to admin. Even when we stay late or take in disasters that had no business stepping foot in an ASC.

I remember one orthobro even taking photos of the room clock as you push the patient in and would send those to admin if you were even a minute late.

Glad I'm outta there.

Let’s be real … Surgeons only care about 3 things with regards to Anesthesia

1. “Don’t cancel my cases!”
2. “The patient is moving!”
3. “Why does it take so long to put the patient to sleep?”

The vast majority of Surgeons couldn’t care less about the Anesthesia Department contract disputes with Administration as long as their cases are not cancelled, the patients don’t move and you don’t “delay” them even though no one ever says anything when they take 2 hours to do a case that should take 30 minutes

 

[NicholasPavona]

Let’s be real … Surgeons only care about 3 things with regards to Anesthesia

1. “Don’t cancel my cases!”
2. “The patient is moving!”
3. “Why does it take so long to put the patient to sleep?”

The vast majority of Surgeons couldn’t care less about the Anesthesia Department contract disputes with Administration as long as their cases are not cancelled, the patients don’t move and you don’t “delay” them even though no one ever says anything when they take 2 hours to do a case that should take 30 minutes

Now this cat's experienced!

 

[Lecithin5]

Let’s be real … Surgeons only care about 3 things with regards to Anesthesia

1. “Don’t cancel my cases!”
2. “The patient is moving!”
3. “Why does it take so long to put the patient to sleep?”

The vast majority of Surgeons couldn’t care less about the Anesthesia Department contract disputes with Administration as long as their cases are not cancelled, the patients don’t move and you don’t “delay” them even though no one ever says anything when they take 2 hours to do a case that should take 30 minutes

Of course- totally agree
Which is why I posed the question- it would be intriguing and I’d imagine quite rare for a surgeon to (threaten to) sacrifice their job because they believe in the value of quality anesthesia wholeheartedly (btw, it wouldn’t be my expectation that they would).

 

[FatKid]

Of course- totally agree
Which is why I posed the question- it would be intriguing and I’d imagine quite rare for a surgeon to (threaten to) sacrifice their job because they believe in the value of quality anesthesia wholeheartedly (btw, it wouldn’t be my expectation that they would).

Not quite rare …. more like never

 

[NicholasPavona]

Not quite rare …. more like never

Once again, the fat ass is right.

 

[nimbus]

OTOH we had an excellent neurosurgery group cover trauma at our hospital for many years. We had very good working relationship with them and several of us were friends outside of work. They were replace by another competing group last year and not a single anesthesiologist quit because of it.