Exactly this. From what I see across the drapes, HCA very happy selecting "untouchables" for their surgery and cardiology residents, bc they know their only option will be to stay within HCA after graduation. These are HCA apprenticeships, because even mediocre results are billable and add up to major profit if done in high volume.
news4sanantonio.com
There is a Gi center near here that has RNs pushing propofol ….with the GI doc supervising.
“Delegation”
I wonder who intubates if something goes south? I’m guessing the RN will attempt it.
This is the cycle of anesthesia. Report comes out that we have too many. Applicants plummet. Economy tanks, prolongs retirements, positions plummet. Covid happens, old people retire in droves, theres a shortage. Anesthetist traveling spurs locums spending spree. Salaries skyrocket. Interest increased, spots increase. 10 yrs from now, there will be too many.
Well I agree with you, in previous cycles the number of spots didn't necessarily increase/decrease, they just went unfilled in down years. That won't happen in the future with the growth of DO graduates + IMGs willing to fill any and all residency positions left over in the SOAP. HCA and for-profit hospital residencies are willing to staff their residencies with bottom of the barrel applicants to save on costs.
Of course that’s concerning, but I and many others would have assumed this dystopian future would already be here and yet somehow it isn’t. Demand for anesthesia is likely up about 16% in that same timeframe. There’s never been more crnas than today and somehow demand is as high as ever to hire them. And who would want to work at HCA anyway? Good jobs will be available for good people, the money might not be as crazy but I don’t think anyone predicted it would get to where it is now either.
You can only delegate what you are credentialed to personally do when it comes to a regular rn. So in the bylaws someone gave credentials to gi guys to do mod/deep sedation apparently
Yeah
Hoya11 is the closest. GravelRider's first paragraph is sort of the point.... they didn't force anybody. Nuvance Health is a regional health system that was created when Western Connecticut Health Network and Health-Quest combined several years ago. Their goal seems to be focused on becoming a regional academic system. This anesthesia residency is associated with, contracted with, and serve as employees of Nuvance Health -- an important distinction. NAPA isn't hiring residents. Yes, NAPA staffs the attendings in the ORs, but whether it's them or a different group in the future, supporting the Nuvance residency is part of their contract with the hospital. Is it going to be someone's top rank or competing with Mayo Clinic? Likely not... but this is utter nonsense about only cataracts, SRNAs (there's only 1), and preoping for CRNAs. The training is solid.
I worry about exceeding 1:4 becoming the norm.
You think MD only is some incredible expense, but these days it is not. Increased CRNA wages have made the savings of the medical direction model evaporate. There are about 50:50 ratios of CRNAs and MDs in the US today. If all the MDs are 1:4 or 1:8 and there is no MD only anesthesia, what do all the other MDs do? Just become unemployed? Clearly not. Mathematically it makes 0 sense that all the MDs would become liability sponges with very high ratios, and then 80% of the rest would just quit medicine.
If I’m ever required or expected to do 1:4 I’d quit anesthesiology or half retire and do locums (MD only). More than 1:4 is an absolutely nonstarter because 1:4 is absolute hell to begin with.
Maybe from an anesthesia payroll standpoint only. Your analysis fails to take in things like productivity, efficiency, utilization, cost of complications, malpractice, intangibles, etc. that come from being better educated and trained and if you will forgive me brighter on average.
No way 10 years..probably less than two in desirable areas IMO. Two confounding factors would be complete CRNA independence (would solve the shortage TODAY) and if stock market returns are historically low int he next few years (anesthesiologists tend not to retire.)
In 3-5 years the market will turn so those doing locums will have a harder time finding work and the pay will level off. This includes anesthesiologists and CRNAs because they are truly making a killing right now doing locums. So, the next 3 years is the time to make lots of hay. Of course, eventually the tide turns and the market tightens up.
So your assessment is that there’ll be shortages and decent pay/hours for both CRNAs and MDs, but we’ll either be doing high ratio supervision or working in a collaborative model?
I didn’t say shortage. Rather, the exorbitant locums gigs in popular spots will dry up to some extent. The remote locations will still need help. There won’t be a surplus supply in 5 years but rather a return to a more normal employment situation in terms of jobs. This is a good thing as the shortages today are on the extreme side in many locations. As for Anesthesiology becoming EM that may still occur at some point but it’s at least 10+ years away.
I just wanted to say I have been reading your posts for probably 10 years now (before I signed up) and this is probably the most optimistic I’ve seen you haha.
For peds people there’s a new Texas Children’s hospital opening up which sounds like a nice academic option in Austin actually - they’re actively recruiting with an expected open date within the year. It still has some of the Austin downsides mentioned, but also people do seem to love the place too.
Cost of living does suck here.
Average doc in our group makes more than than
Y'all ever need any prn docs? I may or not be moving to Ft Hood (this is all hypothetical to any Russians reading this) and will have ample time to play substitute doc. Feel free to pm me.
So what is the starting salary?
People like this on here drive me nuts. Either you let private equity pimp you or you let old boomers in a private practice pimp you on a partnership track. Make your decision.
540k for 12 months off seems amazing. Where is this ?
It's 12 weeks man haha. It's in the southeast. Don't wanna give my location away.
