Manpower?

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GassYous said:
Meanwhile I can't even get blood for a scheduled case before the case is over. The shenanigans are endless "has to be drawn twenty minutes apart, you didn't date and sign and initial, patient sticker needs to be perpendicular not parallel and you should deliver it with a courier born in the 70s not the 80s"
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Glad to know the blood bank ridiculousness at my hospital is apparently universal now.
 
vector2 said:
Glad to know the blood bank ridiculousness at my hospital is apparently universal now.
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One of the hospital that I worked at… the blood bank doesn’t even “belong” to the hospital. It was a “county” entity. You think dealing with hospital *****s is problematic…. Try to get govt employees to do anything while they’re on their breaks.

Edit: M0r0ns is a no no word?
 
aneftp said:
There was so much Covid money the last 24 months. It’s drying up. The smart ones left 20 months ago to make the cash.

I know locums docs making 1 million plus Crnas locums making 400k

Pay up. People know their worth.
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How much are these million dolla docs working? How much are they earning per hour?
 
chocomorsel said:
How much are these million dolla docs working? How much are they earning per hour?
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$300/hr usually. Up to $500/hr.

Working 60 plus hours a week. Sometimes 70-80. A lot. But a lot of beeper calls with epidural running in house and not required to be in hospital. So the clock is running
 
IlDestriero said:
I’ve gotten a few “what do you think? Looks ok for the ASC” emails from med directors only to look at the notes and see recommendations for additional testing, follow up, etc that was never done or delayed. I generally say no. As I get older I am more confident I can get them through whatever happens, but I don’t want to be dealing with that stool at the ASC. So they can go to the big house, or reschedule after all the testing they blew off.
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Agreed.

I think it comes down to what you’d want for your family members - and that’s to never cut corners. But sadly too many in the machine of medicine are happy with just good enough.
 
aneftp said:
a lot of beeper calls with epidural running in house and not required to be in hospital. So the clock is running
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Interesting

So I do some hourly / flat rate moonlighting at a place where once the epidural is in, the anesthesiologist leaves. I asked how they bill that, and they said it's just the time to place the epidural, because billing for time when you're not in the hospital is fraud.

You seem to know a lot of people who are rather aggressive with billing, taxes etc.
 
pgg said:
Interesting

So I do some hourly / flat rate moonlighting at a place where once the epidural is in, the anesthesiologist leaves. I asked how they bill that, and they said it's just the time to place the epidural, because billing for time when you're not in the hospital is fraud.

You seem to know a lot of people who are rather aggressive with billing, taxes etc.
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I never got a definitive answer here or anywhere regarding labor epidural billings. The last two practices, (perhaps has something to do with record keeping), just charge a set fee. And according to the higher ups, that’s how we get 1500+ per epidural. But the records keeps on running. One is on paper, one has a dedicated Anesthesia record.
Where I am now…. We literally just close the record after epidural placement, and don’t keep tract of any vitals. And when I told the partners how much my old practices were getting per epidurals, everyone’s jaw just drops.
All these practices are in different states, I wonder if that’s what’s different about all this…..

 
pgg said:
Interesting

So I do some hourly / flat rate moonlighting at a place where once the epidural is in, the anesthesiologist leaves. I asked how they bill that, and they said it's just the time to place the epidural, because billing for time when you're not in the hospital is fraud.

You seem to know a lot of people who are rather aggressive with billing, taxes etc.
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Crna in house. Epidural running. Your name is still on the chart. 15 min response time for any stat c/s. Totally legal.
 
aneftp said:
$300/hr usually. Up to $500/hr.

Working 60 plus hours a week. Sometimes 70-80. A lot. But a lot of beeper calls with epidural running in house and not required to be in hospital. So the clock is running
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$500 per hour? That’s crazy. I keep getting pushback for $350 an hour. Being told the highest rates are at $300. Are these people going thru an agency?
Yeah at 70-80 hours I would want a million too. No thank you.
 
aneftp said:
Crna in house. Epidural running. Your name is still on the chart. 15 min response time for any stat c/s. Totally legal.
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Exactly this. I believe the universal term is "immediately available" but many people have different definitions of that term. I would still be a bit nervous being 15 min away for a true stat general, but it seems the CRNA is there to be a buffer.
 
chocomorsel said:
$500 per hour? That’s crazy. I keep getting pushback for $350 an hour. Being told the highest rates are at $300. Are these people going thru an agency?
Yeah at 70-80 hours I would want a million too. No thank you.
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I know of several systems in different parts of the country paying $350-400 per hour to agencies to get prn CRNAs. Unless it’s a very in-demand location they’re lying through their teeth.

But it does seem like there’s a ceiling. At some point the hospital will be losing money for every surgery they do (even when you factor in the facility fees, inpatient revenue, imaging, half-dozen consults from the NP to every IM service, etc)
 
The Duck Knows said:
I know of several systems in different parts of the country paying $350-400 per hour to agencies to get prn CRNAs. Unless it’s a very in-demand location they’re lying through their teeth.

But it does seem like there’s a ceiling. At some point the hospital will be losing money for every surgery they do (even when you factor in the facility fees, inpatient revenue, imaging, half-dozen consults from the NP to every IM service, etc)
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To the agencies or what the CRNAs are actually making? That’s a big difference.
 
pgg said:
Interesting

So I do some hourly / flat rate moonlighting at a place where once the epidural is in, the anesthesiologist leaves. I asked how they bill that, and they said it's just the time to place the epidural, because billing for time when you're not in the hospital is fraud.

You seem to know a lot of people who are rather aggressive with billing, taxes etc.
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I’ve moonlighted at a hospital where they would set me up in a hotel close to the hospital and paid me my hourly rate as long as an epidural was running, they didn’t care if I was at the hospital or hotel. Locums work pay/schedules/call requirements are all over the place. I usually just stayed at the hospital due to my own discomfort with leaving.
 
IMGASMD said:
I never got a definitive answer here or anywhere regarding labor epidural billings. The last two practices, (perhaps has something to do with record keeping), just charge a set fee. And according to the higher ups, that’s how we get 1500+ per epidural. But the records keeps on running. One is on paper, one has a dedicated Anesthesia record.
Where I am now…. We literally just close the record after epidural placement, and don’t keep tract of any vitals. And when I told the partners how much my old practices were getting per epidurals, everyone’s jaw just drops.
All these practices are in different states, I wonder if that’s what’s different about all this…..

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How much were you getting at your old practices?
 
chocomorsel said:
To the agencies or what the CRNAs are actually making? That’s a big difference.
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Paying to the agencies, but I assumed that if you’re negotiating directly with a hospital who is telling you they can’t pay more then this is evidence that they obviously can and do
 
The Duck Knows said:
Paying to the agencies, but I assumed that if you’re negotiating directly with a hospital who is telling you they can’t pay more then this is evidence that they obviously can and do
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I am taking of the agency negotiations. I can never seem to find a hospital that wants to work w me directly. Boggles my mind.
 
GassYous said:
Meanwhile I can't even get blood for a scheduled case before the case is over. The shenanigans are endless "has to be drawn twenty minutes apart, you didn't date and sign and initial, patient sticker needs to be perpendicular not parallel and you should deliver it with a courier born in the 70s not the 80s"
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as i understand it, this is meant to reduce clerical errors from the blood bank side?
so.. why can't they get their **** together instead of making us do more work??
 
nimbus said:
Any anesthesia groups pulling out of less desirable surgicenters and hospitals due to manpower issues?
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Not pulling out, but unable to expand as aggressively as my group would like. The ASCs we've pulled out from have been due to other shenanigans like a lower unit value than was originally advertised or some surgeon with ownership playing games with how we're paid for anesthesia time.
 
thinkorswim said:
Not pulling out, but unable to expand as aggressively as my group would like. The ASCs we've pulled out from have been due to other shenanigans like a lower unit value than was originally advertised or some surgeon with ownership playing games with how we're paid for anesthesia time.
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So what happens after your group pulls out? Find some other suckers, pay up, use crna?
 
narcotics999 said:
So what happens after your group pulls out? Find some other suckers, pay up, use crna?
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Not our problem anymore. The ASC is responsible for finding anesthesia services at their own facility. There's plenty of other anesthesia groups and contractors willing to do the work for less.

My group tends to have a better reputation around town, so some ASCs will seek us out and we work with them to become more compliant, safe, and efficient. It's still never a good look for us to drop a contract though.
 
aneftp said:
$300/hr usually. Up to $500/hr.

Working 60 plus hours a week. Sometimes 70-80. A lot. But a lot of beeper calls with epidural running in house and not required to be in hospital. So the clock is running
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No anesthesiologist is getting $500/hr. Might pay Locums company close to that amount and anesthesiologist gets part of that. At $300/hr, you would have to average a 64-65 hr work week working 52 weeks of the year. Math and/or lifestyle not adding up. Even if not house call, not worth it being on the hook so often
 
Lashler9054 said:
No anesthesiologist is getting $500/hr. Might pay Locums company close to that amount and anesthesiologist gets part of that. At $300/hr, you would have to average a 64-65 hr work week working 52 weeks of the year. Math and/or lifestyle not adding up. Even if not house call, not worth it being on the hook so often
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Where were you when another poster trying to sell 1 week on/1 week off, “lifestyle”, easy cases for the low low price of 350? (1099?)
 
Hoya11 said:
I’ve never seen a surgicenter like that.

Around me the hospital is the hot potato

Recently left the hospital doing only asc work with a huge income increase
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Yea we left an ASC like that a few years ago. Volume dwindled because the didn't want to pay the experienced staff so surgeons got pissed.

The surgery center became desperate and wanted to run 2-3 rooms on days with some rooms only having 1 case. They didn't want to lose the few cases they were getting.

So we didn't renew the contract.
 
UscGhost said:
Yea we left an ASC like that a few years ago. Volume dwindled because the didn't want to pay the experienced staff so surgeons got pissed.

The surgery center became desperate and wanted to run 2-3 rooms on days with some rooms only having 1 case. They didn't want to lose the few cases they were getting.

So we didn't renew the contract.
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Some work is not worth having.
 
Lashler9054 said:
No anesthesiologist is getting $500/hr. Might pay Locums company close to that amount and anesthesiologist gets part of that. At $300/hr, you would have to average a 64-65 hr work week working 52 weeks of the year. Math and/or lifestyle not adding up. Even if not house call, not worth it being on the hook so often
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U just don’t how contracts work. Everything is negotiable.

I’ve seen his spread sheet and pay. Known the dude for 15 years.
 
Lashler9054 said:
No anesthesiologist is getting $500/hr. Might pay Locums company close to that amount and anesthesiologist gets part of that. At $300/hr, you would have to average a 64-65 hr work week working 52 weeks of the year. Math and/or lifestyle not adding up. Even if not house call, not worth it being on the hook so often
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If you’re medically directing 3-4 rooms and getting paid on productivity, then $500/hr should be doable. Or MD only on a busy labor deck.
 
Lashler9054 said:
No anesthesiologist is getting $500/hr. Might pay Locums company close to that amount and anesthesiologist gets part of that. At $300/hr, you would have to average a 64-65 hr work week working 52 weeks of the year. Math and/or lifestyle not adding up. Even if not house call, not worth it being on the hook so often
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nimbus said:
If you’re medically directing 3-4 rooms and getting paid on productivity, then $500/hr should be doable. Or MD only on a busy labor deck.
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Definitely seen 400/hr in decent areas. 500 not too far off in this market.
 
aneftp said:
U just don’t how contracts work. Everything is negotiable.

I’ve seen his spread sheet and pay. Known the dude for 15 years.
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I love how people are always, “I have never heard of this, so if must not exist or is absolutely untrue.”
I mean I got called a liar 5 years ago for stating I was getting $243 an hour. Lol
Does your friend got some contacts for us travel docs?
PM me. I believe it and I want some!! 😂
 

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chocomorsel said:
I love how people are always, “I have never heard of this, so if must not exist or is absolutely untrue.”
I mean I got called a liar 5 years ago for stating I was getting $243 an hour. Lol
Does your friend got some contacts for us travel docs?
PM me. I believe it and I want some!! 😂
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Let us know what you find out, if you contact them.
 
We work at a surgeon owned surgery center with a piss poor payer mix and is also extremely inefficient. Surgeons like to use it as their playground and schedule things at 6am and then again in the early afternoon. It still makes us enough money to not walk away. If Medicare stops paying for BS anesthesia for cataracts and pain blocks, we would be done.
 
The gulf between what the middle man takes and what the doc was actually making is crazy. The locums company told us they were seeing rates as high as $500/hr for their doc placements. Turns out my friend was making $225/hr and wanted a bump to $275/hr. For that bump, the locums company wanted to charge our hospital $437/hr. So strange that most hospitals won't negotiate with individual practitioners but would rather pay more than the doc would ask to a locums agency.
The bubble seems to be bursting a bit as the higher rates are likely unsustainable, at least from the perspective of the C-suite (especially the CRNA salaries that have been bananas post-pandemic). It is encouraging to read that the most recently released MGMA survey showed an increase in doc compensation across the board with some normalization as we emerge from Pandemia.
 
pmichaelmd said:
The gulf between what the middle man takes and what the doc was actually making is crazy. The locums company told us they were seeing rates as high as $500/hr for their doc placements. Turns out my friend was making $225/hr and wanted a bump to $275/hr. For that bump, the locums company wanted to charge our hospital $437/hr. So strange that most hospitals won't negotiate with individual practitioners but would rather pay more than the doc would ask to a locums agency.
The bubble seems to be bursting a bit as the higher rates are likely unsustainable, at least from the perspective of the C-suite (especially the CRNA salaries that have been bananas post-pandemic). It is encouraging to read that the most recently released MGMA survey showed an increase in doc compensation across the board with some normalization as we emerge from Pandemia.
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Have you asked your admin why they would rather waste money with a locums instead of negotiating directly with the doc? It makes no sense to me and I used to do full time locums.
 
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