How will you handle possible stop to elective surgery?

[deleted500612]

Hospitals are getting a lot of FEDERAL assistance money.

Hospitals bid for $100 billion in next coronavirus package

Hospitals want $100 billion in the next relief package along with targeted changes to tax laws.

www.politico.com

The $100 billion ask from the American Hospital Association — joined by the American Medical Association and American Nurses Association — is built around the argument that it's better to get federal assistance before the full force of the pandemic hits, to fortify a health system that lacks the beds, necessary equipment and the workforce to deal with a pandemic. Hospital lobbyists want a massive infusion of cash for specialized gear to protect workers, child care for doctors and nurses and to offset revenue lost from the suspension of elective surgeries and other new costs.

If we're going to give any industry a massive COVID bailout this makes the most sense as that money directly helps manage the outbreak and minimize morbidity and mortality by buying equipment and funding overtime demand for front-line health workers, in contrast to other industries requesting huge bailouts just to buffer financial losses of having to close their doors for a while.

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[GravelRider]

It would be pretty bold for society to ask doctors and nurses to work for free on the front lines while they sign multi-billion dollar bailout bills for tourism and hospitality industries. Perhaps equally as bold for the hospital to ask people to work for free when they are operating at a loss... because I absolutely guarantee you that when normalcy returns and they are once again making steady profits off our work in the OR they are not going to retroactively volunteer to compensate you for your volunteered time using those profits but instead will continue funneling those restored profits into executive bonuses and that swanky new lobby renovation as previously earmarked; your extraordinary efforts and selfless charity forgotten in the blink of an eye. Your worth to the hospital quickly summed up as a tool from which they can extract profits when times are good and a tool which they can shunt financial losses onto by exploiting free labor when times are bad. Healthcare workers are expected to be altruistic by nature, which is reasonable. Unfortunately savvy healthcare MBAs will absolutely take advantage of that societal expectation quite readily and without remorse.

Our large tertiary center is already encouraging employees to donate PTO to fellow colleagues who need more due to quarantine restrictions... meanwhile the hospital itself (part of a large health systems in no danger of bankruptcy) is not offering any additional PTO for those who are on mandatory leave due to a disease they contracted at work... but asking their employees to donate their PTO to colleagues and take a loss so that the hospital doesn't have to. I'd be more disgusted if it wasn't all so predictable.

Funny you mention that. We’ve started getting emails asking physicians to volunteer.

 

[CardioDad]

Gov: Shut down all but essential services. Please stop elective surgeries.
UPMC: Meh. Let's continue elective surgeries anyway.

My ID sister in Pitt is no longer practicing, thank heaven, but still works in this building (now working from home x 1 week). She can't believe these idiots. PGH just had its first death and confirmed community spread. "Italy. Italy. Italy."

OT: Bless all of you on the front lines. Seriously. So many heartfelt thanks and continued prayers, oms and good juju that you stay healthy.

Despite governor's request, UPMC continues to do elective surgeries

 

[kmurp]

If we're going to give any industry a massive COVID bailout this makes the most sense as that money directly helps manage the outbreak and minimize morbidity and mortality by buying equipment and funding overtime demand for front-line health workers, in contrast to other industries requesting huge bailouts just to buffer financial losses of having to close their doors for a while.

This, I think, is one of the reasons for the Democrats holding up the bill. 500 billion carte Blanche to one man (Munchin) that may be used to bail out cruise companies. They want $ for hospitals, and more oversight.

 

[chocomorsel]

Gov: Shut down all but essential services. Please stop elective surgeries.
UPMC: Meh. Let's continue elective surgeries anyway.

My ID sister in Pitt is no longer practicing, thank heaven, but still works in this building (now working from home x 1 week). She can't believe these idiots. PGH just had its first death and confirmed community spread. "Italy. Italy. Italy."

OT: Bless all of you on the front lines. Seriously. So many heartfelt thanks and continued prayers, oms and good juju that you stay healthy.

Despite governor's request, UPMC continues to do elective surgeries

The anesthesia department needs to grow a pair like someone already pointed out.
I presume there is a department chair there? And other anesthesiologists who aren’t getting a gun put to their heads?

 

[Shimmy8]

Any AMC employees getting salaries cut yet? We've got a big meeting next week where I assume this will be brought up.

 

[Justice4all]

Hiring freeze too

 

[deleted126335]

Any AMC employees getting salaries cut yet? We've got a big meeting next week where I assume this will be brought up.

Rumor has it that the nearest northstar group just slashed salaries.


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[narcotics999]

Rumor has it that the nearest northstar group just slashed salaries.


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Is it against contract?

 

[deleted126335]

Is it against contract?

Don't know.

 

[Man o War]

I feel bad for the CA4s who likely have jobs lined up at this point. Any residents/fellows being told their future employer no longer needs them?
My friend’s son had a job lined up with an ortho group, they have suspended his job offer since they’re all hurting for RVUs at this point.

 

[Shimmy8]

I mean if they cut salaries what are we gonna do even if it is against contract? Sue? Quit? I don’t have the cash for that, and no one else is hiring.

Just have to hope it’s done fairly across the board for everyone until volume is back up. At my small-ish shop we have a lot more inpatient volume, trauma, strokes, neuro,vascular, etc so we’re not as down as our big shops with 90%+ elective outpatient stuff.

 

[narcotics999]

I mean if they cut salaries what are we gonna do even if it is against contract? Sue? Quit? I don’t have the cash for that, and no one else is hiring.

Just have to hope it’s done fairly across the board for everyone until volume is back up. At my small-ish shop we have a lot more inpatient volume, trauma, strokes, neuro,vascular, etc so we’re not as down as our big shops with 90%+ elective outpatient stuff.

The cases are still there, just delayed. In the future when cases pile up and anesthesiologists work day and night, will the amc increase salary?


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[dabears505]

Are they all there? If this drags on a few months, will people really want to go to a hospital and get something purely elective done?

 

[dannyboy1]

Any AMC employees getting salaries cut yet? We've got a big meeting next week where I assume this will be brought up.

We were just told to either take unpaid leave or use PTO....

 

[Shimmy8]

We were just told to either take unpaid leave or use PTO....

That was offered to us already, and some have taken it. Guess not enough, though.

 

[San Marzano]

Are they all there? If this drags on a few months, will people really want to go to a hospital and get something purely elective done?

I feel doubtful that this huge influx of elective cases is really going to pan out how people are hoping. We are in uncharted territory right now and nobody has any answers about what's going to happen. Hospitals and healthcare networks are going to be taking a massive hit over the next few months. Recovery may be slow and painful.

 

[leaverus]

Are they all there? If this drags on a few months, will people really want to go to a hospital and get something purely elective done?

why not, once the dust settles? nothing is "purely" elective; everyone has a subjective reason for wanting (or even needing) surgery that is important to them.

 

[dannyboy1]

I feel doubtful that this huge influx of elective cases is really going to pan out how people are hoping. We are in uncharted territory right now and nobody has any answers about what's going to happen. Hospitals and healthcare networks are going to be taking a massive hit over the next few months. Recovery may be slow and painful.

Agreed. You facility can only do so many cases/day. Also. When people finally get back to work they may not be so eager to take off again for the hernia or knee replacement. Many patients will have lost insurance and some may be dead from corona....

 

[chocomorsel]

why not, once the dust settles? nothing is "purely" elective; everyone has a subjective reason for wanting (or even needing) surgery that is important to them.

Many will lose coverage.
Many will end up homeless.
Many more will be barely making ends meet and will be pinching too many pennies to even meet deductibles.

This is America. We like consumerism and live paycheck to paycheck.

There’s no way this will go back to normal immediately.

 

[dannyboy1]

Many will lose coverage.
Many will end up homeless.
Many more will be barely making ends meet and will be pinching too many pennies to even meet deductibles.

This is America. We like consumerism and live paycheck to paycheck.

There’s no way this will go back to normal immediately.

Amazing how quickly perspective can change. That 4:1 coverage 350k job with the AMC doesn’t seem quite so bad now...

 

[Shimmy8]

That job won’t exist for that pay for the next few months, though.

 

[deleted697127]

Agreed. You facility can only do so many cases/day. Also. When people finally get back to work they may not be so eager to take off again for the hernia or knee replacement. Many patients will have lost insurance and some may be dead from corona....

If I’ve learned anything from covid it’s that we had really gone overboard with PPE, sterility, and the number of patients we thought we could vent per ventilator....3:1 MD only in my room going forward, baby cha Ching $$$$$$

 

[dhb]

If I’ve learned anything from covid it’s that we had really gone overboard with PPE, sterility, and the number of patients we thought we could vent per ventilator....3:1 MD only in my room going forward, baby cha Ching $$$$$$

I don't understand what you mean...

 

[CubsDynasty]

I don't understand what you mean...

With how creative we are becoming with our vent utilization he/she is saying they will practice MD-only however be able to take care of 3 patients in the same OR with the same vent. Imagine the RVUs they will be raking in

 

[chocomorsel]

If I’ve learned anything from covid it’s that we had really gone overboard with PPE, sterility, and the number of patients we thought we could vent per ventilator....3:1 MD only in my room going forward, baby cha Ching $$$$$$

How have we gone overboard with PPE?
You guys aren't actually splitting vents are you?

 

[DrOwnage]

I feel bad for the CA4s who likely have jobs lined up at this point. Any residents/fellows being told their future employer no longer needs them?
My friend’s son had a job lined up with an ortho group, they have suspended his job offer since they’re all hurting for RVUs at this point.

Yep, had a job in the bag and they retracted. Really unfortunate timing. Really stressed now lol.

 

[Shimmy8]

Employee. Asked to take 50% pay cut indefinitely. My hours will be down only 20-25% because high call volume in my call pool. Other shops hours will be likely down 60-75%.

Hoping they make it right with either more money or bring guys from other shops to mine to help cover. Good luck out there everyone.

Let this be a lesson to any med students or residents that no job is 100% safe and it’s always prudent to have liquid emergency fund, which I do thankfully.

 

[sunshinefl]

Employee. Asked to take 50% pay cut indefinitely. My hours will be down only 20-25% because high call volume in my call pool. Other shops hours will be likely down 60-75%.

Hoping they make it right with either more money or bring guys from other shops to mine to help cover. Good luck out there everyone.

Let this be a lesson to any med students or residents that no job is 100% safe and it’s always prudent to have liquid emergency fund, which I do thankfully.

Med student taking the lesson. Also hope they make it right either way for you, that would irk me too.

 

[deleted875186]

Employee. Asked to take 50% pay cut indefinitely. My hours will be down only 20-25% because high call volume in my call pool. Other shops hours will be likely down 60-75%.

Hoping they make it right with either more money or bring guys from other shops to mine to help cover. Good luck out there everyone.

Let this be a lesson to any med students or residents that no job is 100% safe and it’s always prudent to have liquid emergency fund, which I do thankfully.

How does this work? Either take a 50% pay cut or you’re laid off? Do they make yoj sign a new contract?

 

[vector2]

Med student taking the lesson. Also hope they make it right either way for you, that would irk me too.

The better lesson is that the people whose primary day job is taking care of actual sick people will always have safer jobs. Think trauma/acute care surgery, critical care, EM, stroke neuro, IC/heart failure cards etc.

 

[Shimmy8]

How does this work? Either take a 50% pay cut or you’re laid off? Do they make yoj sign a new contract?

Presumably. No new contract sent out as of yet.

The better lesson is that the people whose primary day job is taking care of actual sick people will always have safer jobs. Think trauma/acute care surgery, critical care, EM, stroke neuro, IC/heart failure cards etc.

This is correct. But I'm at a busy level 2 trauma center and our volume is still down about 30-40%. Elective surgery pays the bills for everyone across the board.

 

[vector2]

This is correct. But I'm at a busy level 2 trauma center and our volume is still down about 30-40%. Elective surgery pays the bills for everyone across the board.

No doubt, elective surgery is the lifeblood. However, it doesnt matter what the stipend is for the high acuity/emergency specialities....the hospital will pay it for those services until about the minute the hospital is about to go insolvent.

 

[deleted697535]

The better lesson is that the people whose primary day job is taking care of actual sick people will always have safer jobs. Think trauma/acute care surgery, critical care, EM, stroke neuro, IC/heart failure cards etc.

I dont necessarily agree with that.
ICU is not profitable in a pure business model.
I know of plenty of icu docs in various countries that had to travel far to get a sh1t job for years. Who knows how the future is going to go? Probably a few lean years where each hospital has huge redundant icus awaiting the next pandemic which probably wont come on time, then we go back to something like what we had for the last few decades

 

[nimbus]

The better lesson is that the people whose primary day job is taking care of actual sick people will always have safer jobs. Think trauma/acute care surgery, critical care, EM, stroke neuro, IC/heart failure cards etc.

Add OB and onc to the list. Babies and cancer dont care about COVID. Same with pus, whether it’s in a butt, a valve, or a foot. The pus business is always reliable.

 

[GravelRider]

Add OB and onc to the list. Babies and cancer dont care about COVID.

I suspect I’ll be placing A LOT of epidurals in about 9 months.

 

[dannyboy1]

The better lesson is that the people whose primary day job is taking care of actual sick people will always have safer jobs. Think trauma/acute care surgery, critical care, EM, stroke neuro, IC/heart failure cards etc.

Nobody could have foreseen this coming. Elective surgery has always been the hospitals lifeblood and will continue to be. The demand will be there in the second half of the year. Don’t make a career choice because of this once in a lifetime pandemic. This too shall pass....

 

[vector2]

I dont necessarily agree with that.
ICU is not profitable in a pure business model.
I know of plenty of icu docs in various countries that had to travel far to get a sh1t job for years. Who knows how the future is going to go? Probably a few lean years where each hospital has huge redundant icus awaiting the next pandemic which probably wont come on time, then we go back to something like what we had for the last few decades

I don't know what it's like in foreign countries, but here critical care billing is relatively lucrative depending on the payer mix. We have a pretty busy 20 bed SICU and most surgical intensivists bring in much more revenue staffing a week in the unit as opposed to a week of acute care surgery.

 

[vector2]

Nobody could have foreseen this coming. Elective surgery has always been the hospitals lifeblood and will continue to be. The demand will be there in the second half of the year. Don’t make a career choice because of this once in a lifetime pandemic. This too shall pass....

I just acknowledged that it was the lifeblood of the hospital....while also pointing out that stipends for acute and emergent services never dry up. I also would never tell anyone to select a specialty unless they have some degree of passion for it. I did CCM fellowship because I really enjoy CCM. The fact that it adds some extra job diversification and security is just gravy

 

[deleted162650]

I suspect I’ll be placing A LOT of epidurals in about 9 months.

Maybe not as many as you think according to this graph:

 

[ambiturner]

Add OB and onc to the list. Babies and cancer dont care about COVID. Same with pus, whether it’s in a butt, a valve, or a foot. The pus business is always reliable.

Have a friend in PP onc group, they are very much in the red. All new patients that can wait are on hold and many follow-ups, didn’t know there were that many onc patients that could wait but I guess there are...

 

[drmwvr]

If any PP surgeon is "in the red" over all of this...he/she is a *****....living hand to mouth as a surgeon in the US? I'm just a dumb anesthesiologist and I have at least a year with no income if need be...won't be pretty, but I can do it....

 

[Realgassy]

Yep, had a job in the bag and they retracted. Really unfortunate timing. Really stressed now lol.

I’m so sorry and can only imagine your stress! I’m also a soon to be graduating CA3 and I’m very worried that this will happen to me too

 

[anbuitachi]

Yep, had a job in the bag and they retracted. Really unfortunate timing. Really stressed now lol.

what specialty?

 

[deleted697127]

How have we gone overboard with PPE?
You guys aren't actually splitting vents are you?

Sarcasm. It’s very clear we need more and better PPE.

 

[anbuitachi]

there needs to be a physician union that is just like the nurse union. its insane how easily doctors are to abuse. their reason is always the same. they took an oath. so it doesnt matter if the work endangers them, or their families, or if we cut their pay by 50%, they need to work, and definitely not complain

 

[abolt18]

Maybe not as many as you think according to this graph:

View attachment 300369

It seems that after the sex dries up, the arguing increases, which then leads to hiding toilet paper. Key things to watch out for. Intervene early!

 

[CubsDynasty]

It seems that after the sex dries up, the arguing increases, which then leads to bring toilet paper. Key things to watch out for. Intervene early!

Set up a Coitus Early Warning System

 

[DrOwnage]

what specialty?

General Anesthesia

 

[deleted171991]

Yep, had a job in the bag and they retracted. Really unfortunate timing. Really stressed now lol.

Get a critical care fellowship. Will give you a salary and make you into a real doctor. Then practice kick-ass anesthesia for the rest of your life.