Michigan CRNA's set up Go Fund Me page to raise money for lawyers!

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Mjolner said:
I'm getting my name changed to Jedi Knight Doctor.
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I'd drop a little extra cash for my kids to be seen by a doc dressed like a jedi.

But seriously, I'm not using app in real life.
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Aralc said:
:)

But in case anyone really doesn't know:

Advanced practice providers. Just learned that is the preferred terminology over MLP - midlevel provider.

Whatever, in my opinion, not a big deal, but if you all get upset by MDA, I suppose they can get all huffy over MLP.
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I have never heard of "advanced practice provider" which sounds ridiculous. You don't become advanced just because you call yourself advanced. There's a reason why north Korea has democratic and republic in its name while America doesn't. And why waste your breath with mda when doctor is just fine
 
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Aralc said:
Just to spell this out- the likely end result of pushing for independent practice while at the same time succeeding in alienating MDs will be independent CRNAs taking the crappy jobs that the MDs don't want in hospitals that can't afford MDs.
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That's not true. You forget that Medicare/caid legislation is actually written in favor of employing CRNAs in rural areas. I love the country but my options are limited because of that. Most of those hospitals can afford MDs.
 
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I have no problem calling them advanced practice providers (which wants to be a generic term for APRN/PA/CNS), as long as the administration and everybody else calls us (and only us) doctors, and the patient knows who supervises whom.
 
Random Resident said:
That's not true. You forget that Medicare/caid legislation is actually written in favor of employing CRNAs in rural areas. I love the country but my options are limited because of that. Most of those hospitals can afford MDs.
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quit whining about this. if you look hard enough, and are possibly willing to make some compromises, you will be able to find a job in the country. Go talk to choc - she seems to have found some pretty nice gigs.
 
hsc said:
quit whining about this. if you look hard enough, and are possibly willing to make some compromises, you will be able to find a job in the country. Go talk to choc - she seems to have found some pretty nice gigs.
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^^^^definitely a CRNA. We will quit whining when the playing field is leveled. Truth is, none of you want it level because you will lose every time and you know it. Hell, you're losing even with pass through money. Just heard of another CRNA only group booted out of a rural hospital in favor of an AMC with more docs/doc supervision.
 
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FFP said:
No second chances? ;)
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:) To give you a serious answer ...

We don't scrutinize and channel our inner Scooby Doo on every single new username that pops up here, but we do look twice at newish registrations that make a beeline for threads like this. Those who draw the eye of the moderator staff within minutes of arrival don't get the benefit of the doubt.

If someone who has been banned for uncouth misbehavior wants that second chance, the answer is to be polite, stay off the radar, make at least occasional positive contributions, not poke any sticks, and sometimes ... sometimes ... by the time we connect the dots and notice an old friend is back, we're so gratified to see a born-again good citizen that we just let it slide. Such things happen occasionally, and we (unofficially) welcome them back with a clean slate.
 
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hsc said:
quit whining about this. if you look hard enough, and are possibly willing to make some compromises, you will be able to find a job in the country. Go talk to choc - she seems to have found some pretty nice gigs.
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I'm not terribly worried about it right now. But it eliminates my hometown for sure. If everyone wants equal footing, then let there be equal footing, that's all.
 
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Random Resident said:
I'm not terribly worried about it right now. But it eliminates my hometown for sure. If everyone wants equal footing, then let there be equal footing, that's all.
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Amen to that. But CRNA's have no interest in competing on a level playing field because they simply can't. That would destroy their "we do all the rural areas because YOU don't want to" arguments. It's the same with competing with AA's on a level playing field - they can't/won't because all the lies they've been telling about AA's for years would be totally exposed as the falsehoods they are.
 
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This is the lie they tell congress to oppose including anesthesiologists in the rural pass through legislation in case you are interested.
--

Oppose Unnecessarily Increasing Anesthesia Costs in Rural Settings

Legislation pending in the U.S. House (HR 1044, Jenkins, R-KS) would expand the Medicare Part A rural hospital reasonable cost passthrough program to also cover the services of anesthesiologists. Because the labor cost of an anesthesiologist is about three times that of a nurse anesthetist, enactment of such legislation could triple Medicare rural anesthesia costs in a hospital without expanding patient access to care or improving quality.
 
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IlDestriero said:
This is the lie they tell congress to oppose including anesthesiologists in the rural pass through legislation in case you are interested.
--

Oppose Unnecessarily Increasing Anesthesia Costs in Rural Settings

Legislation pending in the U.S. House (HR 1044, Jenkins, R-KS) would expand the Medicare Part A rural hospital reasonable cost passthrough program to also cover the services of anesthesiologists. Because the labor cost of an anesthesiologist is about three times that of a nurse anesthetist, enactment of such legislation could triple Medicare rural anesthesia costs in a hospital without expanding patient access to care or improving quality.
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Wow. Didn't know that. Just wow.
Because unless they are hired by the hospital at CRNA wages, they are billing insurance and making money just like we are. How the hell is that cheaper?
 
To be honest, I'm not really sure changing this would lead to many physicians moving out to rural tiny hospitals. Even with a significant per unit boost, and I haven't taken the time to look at how much the increase is with this legislation, these places are by definition small low volume shops. I don't think it would have much impact. The hospital would likely still have to pay a significant subsidy or the anesthesiologist would have to accept below market income.
Maybe someone here has some idea of the numbers and the volume of these rural hospitals?
 
IlDestriero said:
This is the lie they tell congress to oppose including anesthesiologists in the rural pass through legislation in case you are interested.
--

Oppose Unnecessarily Increasing Anesthesia Costs in Rural Settings

Legislation pending in the U.S. House (HR 1044, Jenkins, R-KS) would expand the Medicare Part A rural hospital reasonable cost passthrough program to also cover the services of anesthesiologists. Because the labor cost of an anesthesiologist is about three times that of a nurse anesthetist, enactment of such legislation could triple Medicare rural anesthesia costs in a hospital without expanding patient access to care or improving quality.
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How can they sleep at night when they tell these bald faced lies
 
IlDestriero said:
This is the lie they tell congress to oppose including anesthesiologists in the rural pass through legislation in case you are interested.
--

Oppose Unnecessarily Increasing Anesthesia Costs in Rural Settings

Because the labor cost of an anesthesiologist is about three times that of a nurse anesthetist, enactment of such legislation could triple Medicare rural anesthesia costs in a hospital without expanding patient access to care or improving quality.
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That's just disrespectful, how dare they. Fire the missiles.
 
IlDestriero said:
To be honest, I'm not really sure changing this would lead to many physicians moving out to rural tiny hospitals. Even with a significant per unit boost, and I haven't taken the time to look at how much the increase is with this legislation, these places are by definition small low volume shops. I don't think it would have much impact. The hospital would likely still have to pay a significant subsidy or the anesthesiologist would have to accept below market income.
Maybe someone here has some idea of the numbers and the volume of these rural hospitals?
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The one I was talking to did about 1100 cases per year. 40 bed hospital but only had a census of 10 to 12 or so daily inpatients.
I don't know what below market value is but they were offering above 325 in the south. Plus bennies.
For the amount of work, I thought it was pretty fair.
 
siednarb said:
They updated the go fund me page (it is their version of events) and yet another article in CRAINS.


Likely to indue groans and eye rolls "Since then, the hospitals have continued to host surgeries, largely via a combination of anesthesiologist doctors performing CRNA duties"
http://www.crainsdetroit.com/articl...vidence-crna-dispute-28-to-return-as-contract
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LOL LOL. Anesthesiologist Doctors - redundant much? Also love the idea that we perform CRNA duties, does that include pushing 30mg of Roc when the patient bucks as the dermabond is drying?
 
So many questions,

So how many of the 68 went back to PSJ?, Did they accept what they were offered? Wouldn't them going back to work with the hospital and anesthesiologist they trashed be super awkward? And as far as "market value" for CRNAs shouldn't the degree mills they are apart of be saturating their market by now, making them easily replaceable and driving salaries down.
 
psychMDhopefully said:
So many questions,

So how many of the 68 went back to PSJ?, Did they accept what they were offered? Wouldn't them going back to work with the hospital and anesthesiologist they trashed be super awkward? And as far as "market value" for CRNAs shouldn't the degree mills they are apart of be saturating their market by now, making them easily replaceable and driving salaries down.
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Most CRNA's are so focused on the disparity of income opportunities between themselves and anesthesiologists, irregardless of not considering the differences in responsibilities and, importantly, hours worked, as well as generally having a victim mentality, that they fail to realize that SOMEBODY is GOING to employ them.

The simplistic naiveté of their focus is now being uncovered like never before, and perhaps as consolidation (and AMC's) hits the stage, versus the old model where it was either the hospital or anesthesiology group employing them. But, SOMEBODY will employ them. The anesthesia services company who EMPLOYS them can be run by a hospital administrator, an MBA/Wall Street, or those pesky anesthesiologists...... It's ridiculous how simple some of them can be.

They expect to be treated as "professionals" yet they also argue for "overtime pay" and pay for 8 hours when they only may have worked 2 hours, and other benefits more akin to that of an hourly worker. Those things DO exist. Where do they exist?? They exist amongst the ranks of a blue collar, hourly worker. That's where. In other words they want their cake and eat it too.
 
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psychMDhopefully said:
So how many of the 68 went back to PSJ?, Did they accept what they were offered? Wouldn't them going back to work with the hospital and anesthesiologist they trashed be super awkward
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Well ...

In all, four of the 66 employees who lost their jobs starting Dec. 31 at St. John Providence Hospital and Medical Center in Southfield or St. John Providence Park Hospital in Novi are returning to work full time as PSJ contract employees, while 24 more will be contingent employees paid an hourly wage without benefits, with an option to sign on full time later.
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So the answer is four (4).

It's funny to see their attorney try to put a shine on what can only be objectively viewed as a complete loss:

”I think this is a really healthy decision. This was a fair and market-value contract that was negotiated unfortunately after the fact, but the group as a whole thought it was fair," Shea said.
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Among the newest concessions CRNAs won at the meeting earlier this month with PSJ management were: each side would forgo potential litigation against the other, the CRNAs would participate in profit-sharing in lieu of having an equity stake in PSJ, and a performance enhancement committee of CRNAs and PSJ owners would convene to set policies and procedures, Shea said.
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Aah, big concessions there. Sounds like 4 of the 68 agreed to the contract originally offered, 24 are going to do some hourly work with the option to maybe later sign the contract originally offered. They get to sit on a committee. Profit sharing could mean anything.

A Gofundme account online dedicated to covering legal and other expenses for the Michigan 68 holdouts during contract negotiations has raised more than $63,000 in donations since late November.
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And it still just kills me that sixty-eight (68!!!!) CRNAs had to resort to begging on the internet to come up with less than $1000 apiece to pay for their attorney. If that isn't straight off the kids' table, I don't know what is.

I wonder how much of that $63K went to this Shea character.


psychMDhopefully said:
And as far as "market value" for CRNAs shouldn't the degree mills they are apart of be saturating their market by now, making them easily replaceable and driving salaries down.
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I think the answer is yes.
 
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Bottom line - the CRNAs FAILED.
 
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"And, most importantly, have shown the selfless ability to forgive - exemplifying the compassion and professionalism inherent throughout the entire nurse and advanced nurse practice field. The members of the #MI68 who have chosen not to return have found other employment and are choosing to move on, also with their heads held high and with no regrets."

They weren't fired, just chose to find other employment with compassion, forgiveness and professionalism
 
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Psai said:
"And, most importantly, have shown the selfless ability to forgive - exemplifying the compassion and professionalism inherent throughout the entire nurse and advanced nurse practice field. The members of the #MI68 who have chosen not to return have found other employment and are choosing to move on, also with their heads held high and with no regrets."

They weren't fired, just chose to find other employment with compassion, forgiveness and professionalism
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Hard to file a wrongful termination suit without being fired.
 
I don't think the ones that left had problems finding jobs. So many adds on Gaswork " No experience needed" " New grads welcome to apply" " work 7-3 make 200k" must be plenty of work for CRNAs
 
psychMDhopefully said:
I don't think the ones that left had problems finding jobs. So many adds on Gaswork " No experience needed" " New grads welcome to apply" " work 7-3 make 200k" must be plenty of work for CRNAs
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But they still had to leave or accept working for PSJ which wasnt the CRNAs goal for the holdout. To be honest without knowing any details I thought if 68 CRNAs held out that the hospital would cave and be forced to bring them back on board...tells me that was a greatly overstuffed Anesthesia group.
 
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Siednarb? Where for art thou?
 
I'm here - things are good. Sorry for not checking in as much. Yes, some of them have come back and for the most part it has been without incident. Some came back contigent and some came back signing on as a full employee. Many surgeons have asked to try and find a way to maintain a mixed model where we still do our own cases as they have really enjoyed us being in the room doing our own cases. There were many silver linings in all of this and our group has stayed strong and united. I feel fortunate to be a part of a great group of Anesthesiologists.
 
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Great to hear it, Godspeed.
 
Excellent seidnarb! Thanks for taking the time to update us. I wish you many years of continued success.
 
siednarb said:
I'm here - things are good. Sorry for not checking in as much. Yes, some of them have come back and for the most part it has been without incident. Some came back contigent and some came back signing on as a full employee. Many surgeons have asked to try and find a way to maintain a mixed model where we still do our own cases as they have really enjoyed us being in the room doing our own cases. There were many silver linings in all of this and our group has stayed strong and united. I feel fortunate to be a part of a great group of Anesthesiologists.
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How is it in the coffee lounge? I can't imagine everyone acting like nothing happened. Are the crnas that returned walking around with their tails between their legs? Or is everyone just acting cordial and not really talking about it.
 
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IlDestriero said:
This is the lie they tell congress to oppose including anesthesiologists in the rural pass through legislation in case you are interested.
--

Oppose Unnecessarily Increasing Anesthesia Costs in Rural Settings

Legislation pending in the U.S. House (HR 1044, Jenkins, R-KS) would expand the Medicare Part A rural hospital reasonable cost passthrough program to also cover the services of anesthesiologists. Because the labor cost of an anesthesiologist is about three times that of a nurse anesthetist, enactment of such legislation could triple Medicare rural anesthesia costs in a hospital without expanding patient access to care or improving quality.
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To me what the AANA is saying "without expanding patient access to care " is completely contradictory when it wants to block another healthcare provider from providing care.

Why doesn't the ASA call the AANA out on this hypocritical statement.

By blocking patient access to anesthesiologist. The AANA is in fact trying to limit access!!!

Pretty simple. Make a big poster board. Highlight what the AANA statement in bright bold print. Cause this is the AANA agenda. Aka trying to convince the public they need more access to care.


First AANA tries to block AA practice saying while it provides more access but they claim AA adds unnecessary provider since they need supervision of anesthesiologist.

So now what's the AANA gonna to say? By limiting access to Anesthesilogist they are in fact limiting access.

And "triple cost to Medicare". Last we checked. Medicare payments are the same to MD
or Crna.
 
Could someone explain rural pass through?
 
I know of 2 large private practice groups who are currently only expanding with AAs and are done hiring CRNAs. They are only hurting themselves with this adversarial nonsense.
 
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Man o War said:
I know of 2 large private practice groups who are currently only expanding with AAs and are done hiring CRNAs. They are only hurting themselves with this adversarial nonsense.
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I am sure they have their reasons. I don't think they are necessarily hurting themselves. How so?
 
chocomorsel said:
I am sure they have their reasons. I don't think they are necessarily hurting themselves. How so?
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The CRNA organization, the AANA, is hurting themselves with their extreme stance that doesn't represent the majority of their members. That's been going on for years and years. That and things like this higher profile blunder bring more attention to their radical position. Many states allow AAs and they will gain ground, though heavily contested, in other states. I don't care who I work with as long as they are competent, attentive and want to be part of the team. AAs have their limitations, but more and more groups will at least explore the option of expanding to AAs if they can.
We are fortunate to have good CRNAs that we hand picked because we are in a desirable location and practice. Applicants are a dime a dozen. We are clear about the practice structure. Militant minded people, those wanting pseudo independent practice, etc. don't survive an interview. They won't like it here, and we will never change.
 
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I misunderstood then. I thought he meant the group that was expanding with only AAs was hurting itself with adversarial crap.

Also, what do you mean IIDestriero that you handpicked your CRNAs? Do most groups not pick their CRNAs?
 
chocomorsel said:
I misunderstood then. I thought he meant the group that was expanding with only AAs was hurting itself with adversarial crap.

Also, what do you mean IIDestriero that you handpicked your CRNAs? Do most groups not pick their CRNAs?
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That depends on the practice. If the anesthetists are hospital employees, the hospital hires them, not the docs. With a private group there is much more selectivity.
 
Celestia said:
Could someone explain rural pass through?
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Physician services, including anesthesiology, are generally paid for out of Medicare Part B. You provide the service, bill Med B, and get paid whatever CMS says they'll pay you. Due to the low reimbursement rate (about $75/hr or so in our area) certain hospitals and critical access hospitals are allowed to use Medicare Part A to supplement - pass through - payments to their anesthesia providers, the idea being that those extra payments are necessary to attract anesthesia providers to BFE. Nice concept - except it doesn't apply to anesthesiologists. Only CRNA's (and interestingly, AA's, which is generally pointless since they have to work with an anesthesiologist) are eligible for this pass-through funding. The ASA has tried for years to level the playing field. I talked to congressmen about this 10 years ago at my first ASA Legislative Conference. But as usual, CRNA's continue with their lies about how much less expensive they are than an anesthesiologist, and of course "you know an anesthesiologist would never come here anyway".

Similar to their opposing AA legislation, CRNA's are scared to death of open market competition. They get red-faced and wet their pants when it's' brought up. They fight tooth and nail to preserve the rural pass-through for CRNA's only, and repeat the "we're cheaper" and "anesthesiologists cost three times as much as us" lies, over and over again. The lies they tell must be ingrained in them from the moment they start CRNA school. Maybe the DNAP programs add "Anesthesia Propaganda 701 - Lying to Get Your Way in the Anesthesia Marketplace" - as a graduate level BS class. I mean really, they don't get more clinical time, so it has to be filled up with some sort of pablum.
 
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jwk said:
Physician services, including anesthesiology, are generally paid for out of Medicare Part B. You provide the service, bill Med B, and get paid whatever CMS says they'll pay you. Due to the low reimbursement rate (about $75/hr or so in our area) certain hospitals and critical access hospitals are allowed to use Medicare Part A to supplement - pass through - payments to their anesthesia providers, the idea being that those extra payments are necessary to attract anesthesia providers to BFE. Nice concept - except it doesn't apply to anesthesiologists. Only CRNA's (and interestingly, AA's, which is generally pointless since they have to work with an anesthesiologist) are eligible for this pass-through funding. The ASA has tried for years to level the playing field. I talked to congressmen about this 10 years ago at my first ASA Legislative Conference. But as usual, CRNA's continue with their lies about how much less expensive they are than an anesthesiologist, and of course "you know an anesthesiologist would never come here anyway".

Similar to their opposing AA legislation, CRNA's are scared to death of open market competition. They get red-faced and wet their pants when it's' brought up. They fight tooth and nail to preserve the rural pass-through for CRNA's only, and repeat the "we're cheaper" and "anesthesiologists cost three times as much as us" lies, over and over again. The lies they tell must be ingrained in them from the moment they start CRNA school. Maybe the DNAP programs add "Anesthesia Propaganda 701 - Lying to Get Your Way in the Anesthesia Marketplace" - as a graduate level BS class. I mean really, they don't get more clinical time, so it has to be filled up with some sort of pablum.
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Thanks for responding. What are the rules regarding pass through? Is this too off topic? if so, is there a better place for this discussion?

If we are trying to stay on topic, looks like the nurses updated their gofundme, Facebook, and are tweeting again (#MI68).

(I can't get the gofundme link to work)

https://m.facebook.com/Michigan-68-1254552734561504/?tsid=0.6526804624591023&source=typeahead

https://mobile.twitter.com/gmanboz
 
We hire our own CRNAs, usually experienced ones that worked in our PICU, NICU, or CCU. No accelerated nursing degree, one year low acuity unit time, CRNA mill applicants need apply. We also have the advantage of being in a good location where people don't mind living. So we get lots of applicants for few openings. We've also cut dead weight in the past, so if you're not up to the task, you're not going to survive the probationary year. However we established a training program for our hires to bring them up to speed and mentor them. I think that helps. We've been fortunate to get good people. We're not the highest paying group, but we have a nice practice. Many CRNAs appreciate that. They can also moonlight to their hearts content as there are many hospitals in the area.
 
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