Job posting I can’t figure out

[PainDrain]

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I recently saw a job posting for an MD “director” position at a small community hospital that has only had CRNAs in the past. It’s in an opt out state with pretty dismal reimbursement. The offer isn’t great but it isn’t horrible. I am trying to figure a couple things out about this ad. First, why would a hospital with no history of having an anesthesiologist start employing one? Second, if it’s an opt out “independent practice environment” why would the CRNAs suddenly want someone as their “director”?

Only thing I can think of is perhaps the hospital and/or surgeons have had enough of the independent practice CRNAs. Perhaps there have been some high profile bad outcomes and the hospital malpractice insurer is mandating this.

Anyone have any other ideas?

 

[abolt18]

I recently saw a job posting for an MD “director” position at a small community hospital that has only had CRNAs in the past. It’s in an opt out state with pretty dismal reimbursement. The offer isn’t great but it isn’t horrible. I am trying to figure a couple things out about this ad. First, why would a hospital with no history of having an anesthesiologist start employing one? Second, if it’s an opt out “independent practice environment” why would the CRNAs suddenly want someone as their “director”?

Only thing I can think of is perhaps the hospital and/or surgeons have had enough of the independent practice CRNAs. Perhaps there have been some high profile bad outcomes and the hospital malpractice insurer is mandating this.

Anyone have any other ideas?

Just shifting liability?

 

[dmk5n]

Liability Sponge. Surgeons don't want it and are complaining they are captain of the ship. Probably 24/7 call too. Ask for 1M

 

[IMGASMD]

Liability Sponge. Surgeons don't want it and are complaining they are captain of the ship. Probably 24/7 call too. Ask for 1M

I thought someone recently posted a job that s/he did. It once a week just to sign CRNA charts.....

 

[PainDrain]

I thought someone recently posted a job that s/he did. It once a week just to sign CRNA charts.....

If he/she is actually doing this it’s fraud and a complete disgrace to our profession.

 

[Man o War]

I recently saw a job posting for an MD “director” position at a small community hospital that has only had CRNAs in the past. It’s in an opt out state with pretty dismal reimbursement. The offer isn’t great but it isn’t horrible. I am trying to figure a couple things out about this ad. First, why would a hospital with no history of having an anesthesiologist start employing one? Second, if it’s an opt out “independent practice environment” why would the CRNAs suddenly want someone as their “director”?

Only thing I can think of is perhaps the hospital and/or surgeons have had enough of the independent practice CRNAs. Perhaps there have been some high profile bad outcomes and the hospital malpractice insurer is mandating this.

Anyone have any other ideas?

This happened twice regionally that I’m aware of. From what we heard through the grapevine, both places the surgeons demanded an anesthesiologist on site because there were some competency concerns with the nurses.
I am not sure how this arrangement would work since I know very few docs who want to basically be on call 24/7. I guess for the right number they could likely find someone- these CRNA only hospitals aren’t generally that busy.
If you think about it, there has to be some type of concern about the CRNAs ability to function independently if they’re bringing in an anesthesiologist. They are either worried about liability or competency, both of which suggest they’re not confident in the nurses’ abilities. Either way, impressive considering how hard it is to carve this extra money out of a likely already tight rural hospital budget.
Basically what we have been saying all along around here.....

 

[leaverus]

Liability Sponge. Surgeons don't want it and are complaining they are captain of the ship. Probably 24/7 call too. Ask for 1M

would you take this for a $1M? I wouldn't. MAYBE $1.5

 

[chocomorsel]

would you take this for a $1M? I wouldn't. MAYBE $1.5

Wouldn’t take it for that. How about wouldn’t take it at all. I turned down a job where CRNAs were working independently but docs were responsible for signing charts. Umm....... no.

 

[PainDrain]

would you take this for a $1M? I wouldn't. MAYBE $1.5

Depends on what was involved. Would I be a chart-signing stooge for a million? No way. But if the CRNAs wanted to play nice and follow my direction then sure. As long as they are competent.

 

[GravelRider]

Come on, no one is going to admit they would sign charts for $1 million? Bunch of liars on here.

I highly doubt that is the arrangement and I highly doubt there is any indiscriminate chart signing in the “directorship” position in question. I bet they just need an MD figurehead for the department and you’ll do your own cases alongside the CRNAs. Maybe you’ll get the more challenging cases and a “director stipend,” but you’ll essentially get paid the same as the CRNAs. That’s my guess without seeing any details of the job ad in question.

 

[chocomorsel]

Come on, no one is going to admit they would sign charts for $1 million? Bunch of liars on here.

I highly doubt that is the arrangement and I highly doubt there is any indiscriminate chart signing in the “directorship” position in question. I bet they just need an MD figurehead for the department and you’ll do your own cases alongside the CRNAs. Maybe you’ll get the more challenging cases and a “director stipend,” but you’ll essentially get paid the same as the CRNAs. That’s my guess without seeing any details of the job ad in question.

Some of us have principles. Hard to believe but we do exist.
And what’s a mil if you get sued and settle on your max policy? Or worse they try to come after your assets? Because of someone else’s mistakes?
No Thank You.
I will take my 400k doing my own cases.

 

[GravelRider]

Some of us have principles. Hard to believe but we do exist.
And what’s a mil if you get sued and settle on your max policy? Or worse they try to come after your assets? Because of someone else’s mistakes?
No Thank You.
I will take my 400k doing my own cases.

Well, you are a rarity...a person with principles. I, for one, would take a million bucks to be a chart bytch, so long as it didn’t require moving to nowheresville, USA or working more than 40 hours a week. I think the malpractice risk is overblown and I have no problem contributing to the continued sellout of the profession. That ship sailed long ago.

Let’s be honest, that’s just a thought experiment, though. The position in the original post likely pays 350k with a 25k director’s stipend and is certainly not worth the aggravation.

 

[narcotics999]

Well, you are a rarity...a person with principles. I, for one, would take a million bucks to be a chart bytch, so long as it didn’t require moving to nowheresville, USA or working more than 40 hours a week. I think the malpractice risk is overblown and I have no problem contributing to the continued sellout of the profession. That ship sailed long ago.

Let’s be honest, that’s just a thought experiment, though. The position in the original post likely pays 350k with a 25k director’s stipend and is certainly not worth the aggravation.

The hospital think we are idiots? Live in a ****ty cornfield/cowfield with rednecks, work with militant nurses and most likely not so stellar surgeons, take a tons of calls for 350k????

 

[Consigliere]

The hospital think we are idiots? Live in a ****ty cornfield/cowfield with rednecks, work with militant nurses and most likely not so stellar surgeons, take a tons of calls for 350k????

Plenty of slobs out there that will do just that. Plenty.

 

[deleted171991]

The hospital think we are idiots? Live in a ****ty cornfield/cowfield with rednecks, work with militant nurses and most likely not so stellar surgeons, take a tons of calls for 350k????

Mmm... YES?

 

[coffeebythelake]

The hospital think we are idiots? Live in a ****ty cornfield/cowfield with rednecks, work with militant nurses and most likely not so stellar surgeons, take a tons of calls for 350k????

They would need to pay me more than a million bucks to work in middle of nowhere with militant crnas.

 

[kmurp]

Years ago a partner of mine took a job just like this in a small town. It ended up morphing into a big money job. The CRNAs were good there and they worked quite well together. He shared call with them and was a hard worker.

 

[chocomorsel]

Years ago a partner of mine took a job just like this in a small town. It ended up morphing into a big money job. The CRNAs were good there and they worked quite well together. He shared call with them and was a hard worker.

Did he/she have to sign their charts? Be liable for any of them? Or just work side by side?
I am ok with that part. How much money was "big money?"

 

[kmurp]

Did he/she have to sign their charts? Be liable for any of them? Or just work side by side?
I am ok with that part. How much money was "big money?"

I think he did medical direction during the day. They all worked independently at night but he was available for backup. A lot of call. The job started at 275k or so in the early 90s but morphed into 750k by the early 00s.