Northstar and NAPA in SE Michigan

[ambiturner]

How is this a tough question?

Maybe let me phrase it another way: suppose you were working in this group, own a house, have 2 kids in school with good friends, and a spouse with a good job. There are no better options without moving out of state (this is probably the case in southeast Michigan).

Would you pick up and leave? And if your new job turns to crap in 5 years, would you leave again?

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[nimbus]

Just like ragnorak, giants and gods (both competing PE money guys) are playing games with their pawns (anesthesiologists and CRNAs). The parties with real power are just shuffling the pieces around.

 

[Twiggidy]

Maybe let me phrase it another way: suppose you were working in this group, own a house, have 2 kids in school with good friends, and a spouse with a good job. There are no better options without moving out of state (this is probably the case in southeast Michigan).

Would you pick up and leave? And if your new job turns to crap in 5 years, would you leave again?

That’s the rub. At some point you have to decide when to call the bluff. If the spouse is the true bread winner, then quit and do locums. If you’re the true bread winner then it’s time to have a real discussion because it’s unhealthy (and probably unsafe for patients in the long run) to continue a job you hate.

 

[Zekchar]

Maybe let me phrase it another way: suppose you were working in this group, own a house, have 2 kids in school with good friends, and a spouse with a good job. There are no better options without moving out of state (this is probably the case in southeast Michigan).

Would you pick up and leave? And if your new job turns to crap in 5 years, would you leave again?

I actually understand and agree with the hypothetical situation that you are presenting. There's a lot of board warriors on here who beat their chests and declare in no unconditional terms that they would never ever work in certain circumstances. The truth is that for many others the decision is a lot less straightforward. For the average new grad there are many options for work, but as with any job they each have their own downside. Everybody has to make a personal decision for them and their family.

In the end, the majority of us are cogs in a system. If the job, location, and pay are appropriate, we stay. If something gets too far out of whack, we seek to change the circumstances. I'd argue that in your scenario, 96% of anesthesiologists stay until things get bad. Very few are picking up and leaving until their job directly gets affected.

The goal is to get your FU money and then have the means to dictate the terms of engagement.

 

[GassYous]

Feds are sending doctors and nurses to Michigan as Covid-19 cases rise | CNN

With Michigan's Covid-19 case and hospitalization numbers hovering near all-time highs, the federal government will send doctors, nurses and others to support certain hospitals, the state health department said Wednesday.

edition.cnn.com

Seems like there's not enough doctors and nurses to get the job done. Wonder why?

 

[chessknt]

Feds are sending doctors and nurses to Michigan as Covid-19 cases rise | CNN

With Michigan's Covid-19 case and hospitalization numbers hovering near all-time highs, the federal government will send doctors, nurses and others to support certain hospitals, the state health department said Wednesday.

edition.cnn.com

Seems like there's not enough doctors and nurses to get the job done. Wonder why?

This is happening everywhere regardless of the employment models for physicians. The hospitals pay locums 4-5x what they pay their regular nurses and also keep demanding more work for the same pay or some paltry emergency stipend on top of it. Nurses, rts, lab techs are all quitting en masse and for good reason. At my hospital some of the nurses have quit and been rehired a month later as a locums at 4x their previous pay. The entire thing makes no goddamn sense but that has been par for the course since 2020.

 

[deleted126335]

This is happening everywhere regardless of the employment models for physicians. The hospitals pay locums 4-5x what they pay their regular nurses and also keep demanding more work for the same pay or some paltry emergency stipend on top of it. Nurses, rts, lab techs are all quitting en masse and for good reason. At my hospital some of the nurses have quit and been rehired a month later as a locums at 4x their previous pay. The entire thing makes no goddamn sense but that has been par for the course since 2020.

Our hospital will not hire back previous employees as outside locums via agencies for just this reason. They will pay them a per diem rate at rates kin to what they pay regular employees who work extra shifts.

 

[chessknt]

Our hospital will not hire back previous employees as outside locums via agencies for just this reason. They will pay them a per diem rate at rates kin to what they pay regular employees who work extra shifts.

Just as stupid a move—their competition locally will hire them eagerly I’m sure. If they can’t fill out their staffing they lose money and more people. Why not pay people more to retain them? Locums shouldn’t be getting paid multiples above the people who live in and know the system.

 

[GassYous]

Just as stupid a move—their competition locally will hire them eagerly I’m sure. If they can’t fill out their staffing they lose money and more people. Why not pay people more to retain them? Locums shouldn’t be getting paid multiples above the people who live in and know the system.

Suppy and demand. Workers have the power for the first time in a long time. I don't blame them for doing what they are doing.

 

[chessknt]

Suppy and demand. Workers have the power for the first time in a long time. I don't blame them for doing what they are doing.

Yea but this isn’t the line being slower at Carls junior this is literally people who can’t get medical care as a result. Pressure sores/no vent wean or no elective surgery the entire spectrum is being impacted. I don’t blame the staff I blame the admins who run the enterprise of medicine they created. We should be openly crucifying them in the streets instead hcws are getting hunted down in parking lots by qanon crazies.

 

[dannyboy1]

Our hospital will not hire back previous employees as outside locums via agencies for just this reason. They will pay them a per diem rate at rates kin to what they pay regular employees who work extra shifts.

Is this legal? It’s basically blackballing to try to artificially keep salaries low.

 

[deleted126335]

Is this legal? It’s basically blackballing to try to artificially keep salaries low.

Not my circus. Not my monkeys. But if I were writing the checks, I would make the same call. Assuming it was legal-which I suspect that it is. It is clearly in my interest as a business owner not to cultivate or encourage a local labor pool that costs me far more than it did previously.

 

[GassYous]

Just as stupid a move—their competition locally will hire them eagerly I’m sure. If they can’t fill out their staffing they lose money and more people. Why not pay people more to retain them? Locums shouldn’t be getting paid multiples above the people who live in and know the system.

They probably think that this is a temporary thing and it will soon go back to normal. With the new omicron variant people are already talking about stopping elective surgeries again. No known cases in the US yet but the governor of NY is already talking about a state of emergency.

 

[Blockit]

VERY important words….

 

[Twiggidy]

Is this legal? It’s basically blackballing to try to artificially keep salaries low.

Isn't this basically a non-compete or at least a version of it?

 

[deleted126335]

Isn't this basically a non-compete or at least a version of it?

No. Come on people.

CRNA X who is a solid practitioner and employee of the hospital or the anesthesia group resigns. S/he decides to do locums signs up with an agency or becomes an independent contractor and wants to work at the hospital they just left. Their resume comes across your desk. They now cost twice as much. Who in their right mind would hire them back under those conditions? What message would it send to the other CRNAs/docs? There is almost certainly no noncompete, discrimination question, or other problem in saying “no thank you”.

 

[narcotics999]

No. Come on people.

CRNA X who is a solid practitioner and employee of the hospital or the anesthesia group resigns. S/he decides to do locums signs up with an agency or becomes an independent contractor and wants to work at the hospital they just left. Their resume comes across your desk. They now cost twice as much. Who in their right mind would hire them back under those conditions? What message would it send to the other CRNAs/docs? There is almost certainly no noncompete, discrimination question, or other problem in saying “no thank you”.

Then CRNA x just moves to the hospital in the other side of the town. Now you have few CRNAs and their workloads get worse. Shortly, CRNA y, CRNA z say "enough" and quit too.

The only way to get out of this hellish situation is to increase the full-timers' compensation.

 

[IMGASMD]

Then CRNA x just moves to the hospital in the other side of the town. Now you have few CRNAs and their workloads get worse. Shortly, CRNA y, CRNA z say "enough" and quit too.

The only way to get out of this hellish situation is to increase the full-timers' compensation.

Or you can be NAPA or any AMCs….. we will increase market share first, by hiring lots of locums now. We will deal with fall out when it comes.

 

[ToKingdomCome]

What happens to the Beaumont residency ?

 

[deleted126335]

What happens to the Beaumont residency ?

It may leave skid marks on the bowl.

 

[ERRES2288]

I think the residency is still going strong.

 

[ambiturner]

Absolutely no way North Star turns down resident labor at probably 20-30% of the cost of a CRNA that also comes with a Medicare stipend

 

[nimbus]

Absolutely no way North Star turns down resident labor at probably 20-30% of the cost of a CRNA that also comes with a Medicare stipend

Their Insta makes it seem very resident focused.

Beaumont Anesthesia Residency (@beaumontanesthesia) • Instagram photos and videos

1,116 Followers, 129 Following, 80 Posts - See Instagram photos and videos from Beaumont Anesthesia Residency (@beaumontanesthesia)

instagram.com

 

[deleted126335]

Absolutely no way North Star turns down resident labor at probably 20-30% of the cost of a CRNA that also comes with a Medicare stipend

And just exactly how much effort and resources do you expect Northstar (and their docs who chose non academic careers) to put in to teaching residents?

 

[dannyboy1]

And just exactly how much effort and resources do you expect Northstar (and their docs who chose non academic careers) to put in to teaching residents?

None at all. Your point? The residents will put in their time, learn by doing, and graduate….

 

[deleted126335]

None at all. Your point? The residents will put in their time, learn by doing, and graduate….

It was a response to the above posts about “what happens to the residency” and that Northstar will maintain it for financial reasons. It will be a below average quality training program.

 

[pgg]

It was a response to the above posts about “what happens to the residency” and that Northstar will maintain it for financial reasons. It will be a below average quality training program.

Well, they'll surely get a top-notch education in "never choosing to work within rock-chucking-distance of a facility run by Northstar" ...

 

[nimbus]

FWIW they sent all 18 of their residents to ASA this year. And they seem to get a high volume of blocks (400+). That’s better than many other residencies.


Edit: and apparently no weekend call except liver tx.

Tell Me About This Program: William Beaumont Royal Oak MI

I've used the search and couldn't find any info on this program. It is at a giant hospital with a lot of sub-specialties that must handle a lot of pathology given it's distance to detroit and it's surgical volume. What do people think of this program? Anyone with any experience? Anybody...

forums.studentdoctor.net

 

[Beach bum]

I think the residency is still going strong.

Meh! Define “going strong”!!!

 

[deleted126335]

Meh! Define “going strong”!!!

The residency has a long tradition of existence both to itself and the community at large.

 

[nimbus]

Absolutely no way North Star turns down resident labor at probably 20-30% of the cost of a CRNA that also comes with a Medicare stipend

They only take 6 residents/year, have weekends off, and it appears they are 1:1 with attendings so I don’t think they are used for “labor”. I was actually surprised to see this.

 

[ambiturner]

They only take 6 residents/year, have weekends off, and it appears they are 1:1 with attendings so I don’t think they are used for “labor”. I was actually surprised to see this.

That’s good to hear if so. I would credit the medical school and PD as opposed to North Star for maintaining the integrity of the program, although North Star may also want to make this a success as a bridge to recruit or keep existing programs as they expand. I’d be curious to hear more about how you can get a true residency experience with no weekends, which is when most of the worst situations in my career have presented themselves.

 

[Twiggidy]

That’s good to hear if so. I would credit the medical school and PD as opposed to North Star for maintaining the integrity of the program, although North Star may also want to make this a success as a bridge to recruit or keep existing programs as they expand. I’d be curious to hear more about how you can get a true residency experience with no weekends, which is when most of the worst situations in my career have presented themselves.

I happen to agree with this. I dodged a bullet in my fellowship because it was still in its infancy and none of the fellows took CV call despite takebacks happening enough. Luckily I got enough liver/trauma experience as a resident but the learning curve for me was steep as a young attending because as you say, some of the worse situations happen outside of “bank hours”

And in case any residents start DMing me for info on a cush fellowship, they absolutely changed the call policy and the fellows take call now

 

[Vandalia]

Is this legal? It’s basically blackballing to try to artificially keep salaries low.

Of course it is legal.

This is the United States.

You can decide to hire or fire whoever you want. As long as you don't do it on the basis of race, religion, gender, etc.

The only way this might be close to illegal is if you decided not to rehire someone who was pushing for unionization.