Hiring anesthesiologist

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anbuitachi said:
i talked about it friends but seems like its not as easy as it is, since insurance dont cover, and not many depressed patients have the cash to pay 1000$ per treatment.. i think thats why there aren't ketamine clinics everywhere yet. the population who needs and can afford is simply not that high in most areas to make it profitable to start own clinic
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You are correct in that it is cash based, that's why an estimate of 6-8 patients daily is typical. You won't have 40 patients like you would at a pain clinic. It's not just for depressed patients, it's also for pain, etc.
So yes the clinic has to be in an affluent area - can't be in a low income area.
 
Piebaldi said:
Practice and travel costs? not sure what that means. I will hire one of the probably thousands of local anesthesiologists in the area. I have already said that I'll probably guarantee 8 hours either 2-3 days/week. Not sure what "costs" there would be to eat. it's a job like any other - you go in, you get your med mal covered, and you make x amount for x number of hours.
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This in not like any other anesthesiologist job. Your looking for someone that needs money enough to work but not bad enough to work full time in a field with almost 0% unemployment. So yeah you may get lucky and find someone local to do this otherwise you’ll pay more.
 
ryanjmy said:
This in not like any other anesthesiologist job. Your looking for someone that needs money enough to work but not bad enough to work full time in a field with almost 0% unemployment. So yeah you may get lucky and find someone local to do this otherwise you’ll pay more.
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Why would I not look for someone local? That's confusing. I am in the Chicagoland area - there are thousands of anesthesiologists locally and plenty of people willing to work part time. The mommy track type - plenty of people who don't want to work full time.
 
Piebaldi said:
Why would I not look for someone local? That's confusing. I am in the Chicagoland area - there are thousands of anesthesiologists locally and plenty of people willing to work part time. The mommy track type - plenty of people who don't want to work full time.
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Sounds like you’ve got it all figured out. Not sure why you’re seeking advice and arguing with those giving it. Why don’t you ask the thousands of potential applicants what they will work for. I couldn’t care less. Good luck.
 
ryanjmy said:
Sounds like you’ve got it all figured out. Not sure why you’re seeking advice and arguing with those giving it. Why don’t you ask the thousands of potential applicants what they will work for. I couldn’t care less. Good luck.
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My main question was about rates. Thank you.
 
Beach bum said:
For 200/ hr where are you?! Maybe we can work out a deal, u can cover for me!!!!!
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Do you pay med mal? Benefits? What kind of practice? Supervision vs md only?

If you will pay for straight up 24 hour call, as 24 hour call? Hell yeah! I take all your calls for a discounted $4500?!
 
Piebaldi said:
Why would I not look for someone local? That's confusing. I am in the Chicagoland area - there are thousands of anesthesiologists locally and plenty of people willing to work part time. The mommy track type - plenty of people who don't want to work full time.
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I think what he is getting at is there arent these 'fresh resident grads' or 'thousands of anesthesiologists' who will take a PRN job over a full time one. If theyre doing locums, youre expected to pay for their medmal and other expenses (whatever they may be such as travel expenses gas, parking, etc). And theres no reason they would contract with you for $200/hr when they can go through a locums who will pay them $300, and charge you $>300/hr.

Why dont you look for people who will go in with you on these ketamine clinics as partners? that way, youll get more manpower, a shared vested interest, and divide the responsibilities? (I'm sure its because you dont want to share the wealth).
 
Isn’t intranasal ketamine FDA approved now? Any concern that the market isn’t there for IV infusions anymore? Especially since IN ketamine is prob covered by insurance and IV ketamine infusions are mostly cash based?
 
chocomorsel said:
Liar. Aren’t you the one who’s always looking for new partners in GA? Already a partner in the Deep South?
Yeah ok.
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There’s 2 different Gaseous Clays on this board (different avatars and different spellings). Try to keep up.
 
Piebaldi said:
Why would I not look for someone local? That's confusing. I am in the Chicagoland area - there are thousands of anesthesiologists locally and plenty of people willing to work part time. The mommy track type - plenty of people who don't want to work full time.
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The problem is this part-time anesthesiologist will soon lose all the skills.
 
Propofool123 said:
Isn’t intranasal ketamine FDA approved now? Any concern that the market isn’t there for IV infusions anymore? Especially since IN ketamine is prob covered by insurance and IV ketamine infusions are mostly cash based?
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We tried it at our clinic, and it proved ineffective. The patients transitioned over to IV after a couple treatments.
 
anbuitachi said:
i talked about it friends but seems like its not as easy as it is, since insurance dont cover, and not many depressed patients have the cash to pay 1000$ per treatment.. i think thats why there aren't ketamine clinics everywhere yet. the population who needs and can afford is simply not that high in most areas to make it profitable to start own clinic
Click to expand...

the way you make money is by setting up a clinic where you can run 5+ infusions at a time and charge people a far lower rate to do it. Just need to be in an area with the demand for that much service. I mean ketamine is insanely cheap.
 
Mman said:
the way you make money is by setting up a clinic where you can run 5+ infusions at a time and charge people a far lower rate to do it. Just need to be in an area with the demand for that much service. I mean ketamine is insanely cheap.
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You are indeed correct - ketamine costs would be like $10 for infusion or something super cheap like that. And yes you are correct it has to be in an area that has the right demographics that can support something like that. I am placing my clinic in a well to do suburb of the Chicagoland area. And yes the expectation is to have probably 6-8 patients a day, not 40 like a regular pain clinic.
 
Ive seen several Ketamine clinics in my area close their doors recently (not sure of the exact details). I think your best bet is to partner up with a Psychiatrist who can diagnose appropriate patients with refractory depression and recommend Ketamine that you can then infuse. That way insurance companies may cover it...

Not to derail the threat but IV Ketamine for chronic pain is garbage. There are no studies, no actual protocol or dose. In theory it sounds great but in practice it doesnt. Your patients will be coming back for the high and maybe a few weeks of subjective pain relief. Perioperatively its a great adjunct but thats about it.
 
To the op, I would redo your research..... but then hey I am a random dude on the internet. Chicago is NOT saturated market. Yeah there are a lot of residencies but even good groups can’t hire anyone in burbs because people want to either stay in the city or run super f ing fast from Illinois. I won’t even consider waking up for less than 250 an hour w a guarantee 8 hrs plus insurance. Secondly there are already 5 ketamine clinics one in each of the richest burbs (north shore, aurora, south Barrington, Arlington heights... ) Lastly j & j just fda approved intranasal ketamine. Insurance is paying for it. All the psych guys are doing this for insurance payments. Why would anyone go to your place ??? You may capture some pain pts but effects of ketamine are not long lasting and now that weed is legal people won’t bother with this crap. Not to mention the research on this for pain is super sketch, carefull you may be the next dr mercola. Google him if you haven’t heard of him, he ended up owing feds 3-4 million dollars...
 
Piebaldi said:
You are indeed correct - ketamine costs would be like $10 for infusion or something super cheap like that. And yes you are correct it has to be in an area that has the right demographics that can support something like that. I am placing my clinic in a well to do suburb of the Chicagoland area. And yes the expectation is to have probably 6-8 patients a day, not 40 like a regular pain clinic.
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No I mean you'd have a clinic having like 6 patients at a time so maybe 30+ in a day.
 
Mman said:
I assume large metro areas have plenty of rich housewives that are depressed
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you are indeed correct. Or have Fibromyalgia. And there are plenty of rich suburbs in the Chicagoland area - still very few clinics to support numerous millions of people living in Chicagoland/suburbs.
 
Mman said:
I assume large metro areas have plenty of rich housewives that are depressed
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Sure, but keep in mind you aren’t doing this for the Prozac poppin’ I’m kinda sad housewife crowd. You are doing this for the severe refractory suicidal ideation ECT didn’t work for me crowd, and there are far fewer of those running around.
 
SaltyDog said:
Hey what would I know. It’s not like my group runs a successful ketamine clinic or anything 🙄
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Umm if you run a successful ketamine clinic why are you poo pooing the prospects of someone else opening one? All the people I've talked to tell me ketamine IV is not covered by insurance. So I guess this is new. Since when isIV ketamine insurance covered?
 
SaltyDog said:
Sure, but keep in mind you aren’t doing this for the Prozac poppin’ I’m kinda sad housewife crowd. You are doing this for the severe refractory suicidal ideation ECT didn’t work for me crowd, and there are far fewer of those running around.
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For the sake of argument, though, if you’re not seeking insurance payment, wouldn’t the importance of having the strict indication for IV ketamine be less?
 
cchoukal said:
For the sake of argument, though, if you’re not seeking insurance payment, wouldn’t the importance of having the strict indication for IV ketamine be less?
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Sure, obviously you can hang your shingle and run infusions for whatever “indication” you want for whatever rate the local cash pay market will bear. It all just depends on how (un)ethical you want to be.
 
SaltyDog said:
Sure, obviously you can hang your shingle and run infusions for whatever “indication” you want for whatever rate the local cash pay market will bear. It all just depends on how (un)ethical you want to be.
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Is "insurance covers this" the marker for ethical behavior nowadays?
 
Piebaldi said:
Umm if you run a successful ketamine clinic why are you poo pooing the prospects of someone else opening one? All the people I've talked to tell me ketamine IV is not covered by insurance. So I guess this is new. Since when isIV ketamine insurance covered?
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I’m only poo pooing you because you seem utterly clueless as to what goes into making this work.

Our clinic has been up and running for about 3 years, and insurance has been paying for most of that time. Of course it’s carrier/plan dependent.
 
Its covered by most insurances. At our pain fellowship, any patient could get it for refractory neuropathic pain. Hospital did not do charity work and we commonly had to change our treatments plans and prescriptions based on what insurance would or would not cover. Cant recall any ketamine denials.
 
SaltyDog said:
I’m only poo pooing you because you seem utterly clueless as to what goes into making this work.

Our clinic has been up and running for about 3 years, and insurance has been paying for most of that time. Of course it’s carrier/plan dependent.
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I never claimed to be an expert. It takes time obviously. and of all the ketamine clinics that I know of, none accept insurance - at least not in my neck of the woods.
 
TheLoneWolf said:
Its covered by most insurances. At our pain fellowship, any patient could get it for refractory neuropathic pain. Hospital did not do charity work and we commonly had to change our treatments plans and prescriptions based on what insurance would or would not cover. Cant recall any ketamine denials.
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for depression as well? for pain yes.
 
Piebaldi said:
Ok thanks. I won't be ready to hire until a number of months from now, but gathering information to know realistically what I will need in terms of $$$. I'm in the Chicagoland area.
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IMHO, for the Chicago area you should be willing to pay $250 per hour with a 7-8 hour minimum. Since it is a Ketamine clinic with CASH patients the hourly rate should reflect that type of patient.
 
BLADEMDA said:
IMHO, for the Chicago area you should be willing to pay $250 per hour with a 6-7 hour minimum. Since it is a Ketamine clinic with CASH patients the hourly rate should reflect that type of patient.
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Your above colleagues are saying that it's not really cash but insurance based. :| so confused here.
 
Piebaldi said:
Your above colleagues are saying that it's not really cash but insurance based. :| so confused here.
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Most insurance carriers may deny the coverage but Ketamine nasal spray is approved for severe depression so perhaps, you can get insurance to cover it these days.

www.fda.gov

FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic

FDA approved Spravato (esketamine) nasal spray, in conjunction with an oral antidepressant, for the treatment of depression in adults with treatment-resistant depression
www.fda.gov www.fda.gov
 
BLADEMDA said:
Most insurance carriers may deny the coverage but Ketamine nasal spray is approved for severe depression so perhaps, you can get insurance to cover it these days.
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No we are talking IV infusions not nasal spray. Your colleagues are saying I am worng and that IV ketamine is covered which in my neck of the woods all ketamine clinics are cash based and not insurance covered.

You seem to be saying what I am saying too - so confusion persists for me.
 
Piebaldi said:
No we are talking IV infusions not nasal spray. Your colleagues are saying I am worng and that IV ketamine is covered which in my neck of the woods all ketamine clinics are cash based and not insurance covered.

You seem to be saying what I am saying too - so confusion persists for me.
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You misunderstood me. What I am saying is that if NASAL KETAMINE is FDA approved for severe depression it may only be a matter of months until IV Ketamine is also approved by private insurance carriers. As of today, my understanding is that Ketamine IV is only approved by some insurance carriers for Chronic Pain conditions.
 
Some studies have shown that more than 70 percent of those who try IV ketamine feel better; that number is closer to 45 percent for nasal ketamine.

It’s not cheap, either. Ketamine treatments usually cost a few hundred dollars per infusion, but the expense comes not from the generic drug, which is cheap, but from the doctors’ time and the clinic space. In contrast, just the Spravato drug alone can cost almost $900 per session, which would bring a monthly cost — at the recommended two sessions a week — to nearly $7,000, according to Stat News. The good news is that Spravato will be reimbursed at least partly by insurance, which will greatly increase access, says Bryan Clifton, chief medical officer of Kalypso Wellness Centers, another ketamine clinic. But as Calabrese points out, it’s going to be a challenge to figure out how much of the time and labor costs insurance will cover when the treatment alone is more expensive than the alternative, which already has those costs factored in


www.theverge.com

The FDA approved a new ketamine depression drug — here’s what’s next

The newly approved drug, esketamine, is one half of the ketamine compound
www.theverge.com www.theverge.com
 
BLADEMDA said:
You misunderstood me. What I am saying is that if NASAL KETAMINE is FDA approved for severe depression it may only be a matter of months until IV Ketamine is also approved by private insurance carriers. As of today, my understanding is that Ketamine IV is only approved by some insurance carriers for Chronic Pain conditions.
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Correct! That's my understanding also. For pain yes insurance will cover it, for mental health issues - nope. And that's also my undersatnding from the local ketamine clinics in my area.
 
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