Northstar work

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
A

anbuitachi

Full Member
Verified Member
Physician
15+ Year Member
Joined
Oct 26, 2008
Messages
7,495
Reaction score
4,185
Nursestar Anesthesia- “Now hiring chart completion experts, er..., MDA’s, er..., Physician Anesthetists, ummm... Physician Anesthesiologists. Come herd cats, sit on hospital committes, accept blame from other medical specialties, and absorb malpractice suits for us!!”

The best part is gonna be when the “Doctorate of Nursing” folks start waving their degrees in front of the MBA’s and the MHA’s, until they feel the need to start offering a “DBA” and “DHA”, for the suits running the group and the hospitals.
 
Last edited:
Zoom in on the name plate on his desk in the background
 

Attachments

  • IMG_0100.jpeg
    IMG_0100.jpeg
    164 KB · Views: 327
DirtDocMD said:
Nursestar Anesthesia- “Now hiring chart completion experts, er..., MDA’s, er..., Physician Anesthetists, ummm... Physician Anesthesiologists. Come herd cats, sit on hospital committes, accept blame from other medical specialties, and absorb malpractice suits for us!!”

The best part is gonna be when the “Doctorate of Nursing” folks start waving their degrees in front of the MBA’s and the MHA’s, until they feel the need to start offering a “DBA” and “DHA”, for the suits running the group and the hospitals.
Click to expand...
Not only will you be asked to train your replacements. You will be asked to train your future bosses.
 
yossarian22 said:
They will be promoting independent CRNAs very soon in states that allow it, as it is all about the bottom line. North Star anesthesiologists need to be prepared.
Click to expand...
What is an “independent CRNA” and what states don’t allow it? 😉
 
NorthStar was infamously started by an anesthesiologist and a nurse anesthetist who made bank when selling the group to a private equity firm.
 
Northstar ran the anesthesia at the surgicenter where I quit after 4 shifts.

The final straw was when I was asked to clear a patient with a LifeVest defibrillator for some general anesthetic head case. I said no, and they did the case anyway. Or maybe the final straw was the obnoxious ophthalmologist who kept bitching because I wounldn't do his retrobulbar blocks for him, but the other locums docs and CRNAs were willing.

What a ****show. Never again.
 
pgg said:
Northstar ran the anesthesia at the surgicenter where I quit after 4 shifts.

The final straw was when I was asked to clear a patient with a LifeVest defibrillator for some general anesthetic head case. I said no, and they did the case anyway. Or maybe the final straw was the obnoxious ophthalmologist who kept bitching because I wounldn't do his retrobulbar blocks for him, but the other locums docs and CRNAs were willing.

What a ****show. Never again.
Click to expand...

When corporate Healthcare allies itself with nursing midlevels to try to extract as much money as possible, it's only inevitable that dangerous **** like this happens. Profits over safety. They are called Deathstar for a reason
 
Last edited:
nimbus said:
Zone coverage? Is that a thing?

apennedpoint.com

Anesthesia practices in peril when hospitals lose money

Forget the pandemic, say hospital executives. What have you done for us lately? There was a time, at the peak of the pandemic, when many of us believed that anesthesiologists finally would get the …
apennedpoint.com
Click to expand...

Seems like thr worst firefighter role for anesthesiologist ever. When CRNAs are unleashed burning everything down.
 
DrOwnage said:
That's my residency mentor right there baby, Dr. Sibert is awesome
Click to expand...

Yeah it’s interesting that she’s the ONLY one writing about the enormous elephant in the room. Not a blip from the rest of organized anesthesia. I’m still waiting for the ASA official position statement on PE buyouts and predatory takeovers.
 
Last edited:
nimbus said:
Yeah it’s interesting that she’s the ONLY one writing about the enormous elephant in the room. Not a blip from the rest of the rest of organized anesthesia. I’m still waiting for the ASA official position statement on PE buyouts and predatory takeovers.
Click to expand...
I let my ASA membership lapse about 5 years ago and quit donating to ASAPAC about the same time. Maybe I'm being shortsighted but it's like they're not even trying.
 
nimbus said:
Yeah it’s interesting that she’s the ONLY one writing about the enormous elephant in the room. Not a blip from the rest of organized anesthesia. I’m still waiting for the ASA official position statement on PE buyouts and predatory takeovers.
Click to expand...
Bingo.

The “takeover” of anesthesia, by AMC’s, private equity, et al, has done as much or more harm than the AANA. They have “forced” the “care team” model on many facilities that were previously Doc only, and are now forcing “independent practice CRNA” models on facilities, in a quest for even MORE money to stick in their own pockets.

Where’s the ASA???
 
Outrigger said:
NorthStar was infamously started by an anesthesiologist and a nurse anesthetist who made bank when selling the group to a private equity firm.
Click to expand...

Yep, and that Doc is now “head” of the “Anesthesia Division” of “Sound Physicians”, trying to do it all over again, and make Anesthesiologists as interchangeable as EM and Hospitalists.
 
No personal experience, but told by a colleague: The problem with these companies (in addition to the fact that they are the worst in putting profits over safety), is that they also attract some of the worst anesthesiologists and weak arrogant CRNAs. Those who know better see quickly the **** show for what it is and don't stay.
 
DirtDocMD said:
Yep, and that Doc is now “head” of the “Anesthesia Division” of “Sound Physicians”, trying to do it all over again, and make Anesthesiologists as interchangeable as EM and Hospitalists.
Click to expand...
What a f in sellout. So glad I am not doing Anesthesia much anymore.
 
nimbus said:
Yeah it’s interesting that she’s the ONLY one writing about the enormous elephant in the room. Not a blip from the rest of organized anesthesia. I’m still waiting for the ASA official position statement on PE buyouts and predatory takeovers.
Click to expand...
Who is to say that the ASA is not in the bag with PE, death-star, anesthesia management cos. and even the AANA ? You assume they will align themselves with their membership, but that is not necessarily true. Politics make strange bedfellows. I, too, wonder why on earth is there not more rhetoric from the ASA against all of this. We can solve the mid-level issue by advocating for AAs everywhere, in every state. Start TODAY. BUt radio silence from the ASA. I wonder why!

I would be ok with zone coverage, but not if the liability stays the same. I will not be held liable for a plan gone awry when I did not invent said bad plan nor execute it.. I'm just here cleaning the mess up.. The lawsuit is not going to stipulate how your employer billed for your services, nor will it stipulate how many ****ing anesthetizing locations you were responsible for at the time.. There needs to be relief from liability for the MDs on the ground for zone coverage to be even a starting conversation. And this needs to be spelled out for EVERYONE to be aware of least of which being the patient(s).
 
pgg said:
I let my ASA membership lapse about 5 years ago and quit donating to ASAPAC about the same time. Maybe I'm being shortsighted but it's like they're not even trying.
Click to expand...
I dont think you are being short-sighted at all.
I dumped the ASA even before I started back in residency. I seethis beast for what it is . I am convinced they are in the bag with many of our enemies for the sake of $$$$.
It is like they are not even trying, because they arent.
 
DirtDocMD said:
Bingo.

The “takeover” of anesthesia, by AMC’s, private equity, et al, has done as much or more harm than the AANA. They have “forced” the “care team” model on many facilities that were previously Doc only, and are now forcing “independent practice CRNA” models on facilities, in a quest for even MORE money to stick in their own pockets.

Where’s the ASA???
Click to expand...
Dont forget the affordable care act didnt help at all... The nursing organizations were up Obama's dingus to get their agenda in there.
 
Aheadbyacentury said:
Who is to say that the ASA is not in the bag with PE, death-star, anesthesia management cos. and even the AANA ? You assume they will align themselves with their membership, but that is not necessarily true. Politics make strange bedfellows. I, too, wonder why on earth is there not more rhetoric from the ASA against all of this. We can solve the mid-level issue by advocating for AAs everywhere, in every state. Start TODAY. BUt radio silence from the ASA. I wonder why!

I would be ok with zone coverage, but not if the liability stays the same. I will not be held liable for a plan gone awry when I did not invent said bad plan nor execute it.. I'm just here cleaning the mess up.. The lawsuit is not going to stipulate how your employer billed for your services, nor will it stipulate how many ****ing anesthetizing locations you were responsible for at the time.. There needs to be relief from liability for the MDs on the ground for zone coverage to be even a starting conversation. And this needs to be spelled out for EVERYONE to be aware of least of which being the patient(s).
Click to expand...
Based on my experience the only thing people seem to care about in a job are $$ and hours. If those are acceptable people will take the job. Last I checked there were no hard and fast liability rules. Liability is whatever a jury decides it to be. Don’t expect to be shown any sympathy because you were 1:8 instead of 1:4. If you are somewhere on the case you are fair game….
 
dannyboy1 said:
Based on my experience the only thing people seem to care about in a job are $$ and hours. If those are acceptable people will take the job. Last I checked there were no hard and fast liability rules. Liability is whatever a jury decides it to be. Don’t expect to be shown any sympathy because you were 1:8 instead of 1:4. If you are somewhere on the case you are fair game….
Click to expand...

Agree. It is the level of insurance coverage that make physicians the medicolegal target regardless of how much involvement and blame should be rightfully assigned
 
Aheadbyacentury said:
I dont think you are being short-sighted at all.
I dumped the ASA even before I started back in residency. I seethis beast for what it is . I am convinced they are in the bag with many of our enemies for the sake of $$$$.
It is like they are not even trying, because they arent.
Click to expand...
I would argue that being in bed with PE, management companies, and the AANA is precisely in the interest of a significant portion of anesthesiologists.

A majority of anesthesiologists supervise, making more money than they would doing their own cases, therefore their interest is in continuing the ACT. If the ASA pisses off the CRNAs by getting aggressive with AA legislation or going to war with the AANA and risks the staffing and profitability of ACT practices then, well, they're not representing the majority of their donors. I don't think it's fair to always blame the ASA leadership for doing what they do since this model has evolved over many years for reasons out of their control and PE, consolidation, and CRNA leverage have made many anesthesiologists very, very rich. Obviously this doesn't help young anesthesiologists like you or I but a lot of the membership just want to maintain the status quo and make hay while the sun shines.

Nothing would make me happier than never supervising again and doing all my own cases, but there aren't enough anesthesiologists in the US to do that unless CRNAs are to practice independently. I doubt the ASA will embrace that.

Disclosures: I am an ASA member, though not politically active, and supervise about 50% of my cases (although I wish I didn't).
 
coffeebythelake said:
Agree. It is the level of insurance coverage that make physicians the medicolegal target regardless of how much involvement and blame should be rightfully assigned
Click to expand...
At least by us the CRNA’s have the exact same liability coverage. They can and do get sued. There is a strange idea floating around SDN that mid levels are not named in lawsuits and when they are the blame the physician and are dropped from the suit. This is simply untrue. All malpractice policies have a limit on how much they will pay per incident. The limit is typically the state required minimum coverage. The name of the game in a lawsuit is to get as many providers as possible involved, increasing the policies and therefore the payout….
 
dannyboy1 said:
At least by us the CRNA’s have the exact same liability coverage. They can and do get sued. There is a strange idea floating around SDN that mid levels are not named in lawsuits and when they are the blame the physician and are dropped from the suit. This is simply untrue. All malpractice policies have a limit on how much they will pay per incident. The limit is typically the state required minimum coverage. The name of the game in a lawsuit is to get as many providers as possible involved, increasing the policies and therefore the payout….
Click to expand...
In medmal litigation, you have to have a legal theory though, by saying it's everyone's fault and everyone should pay is not believable. Badness happened, and someone has to be blamed.. You put your chips on where the money is. CRNAs ARE sued for sure, but only when the theory does not support the Anesthesiologist to be blamed
 
Aheadbyacentury said:
In medmal litigation, you have to have a legal theory though, by saying it's everyone's fault and everyone should pay is not believable. Badness happened, and someone has to be blamed.. You put your chips on where the money is. CRNAs ARE sued for sure, but only when the theory does not support the Anesthesiologist to be blamed
Click to expand...
Yes. Anesthesia complications will exclude surgeon and nurse. Probably will not exclude CRNA in the setting of anoxic injury, vascular access injury ect.
 
Aheadbyacentury said:
In medmal litigation, you have to have a legal theory though, by saying it's everyone's fault and everyone should pay is not believable. Badness happened, and someone has to be blamed.. You put your chips on where the money is. CRNAs ARE sued for sure, but only when the theory does not support the Anesthesiologist to be blamed
Click to expand...
This. CRNAs absolutely are sued and do lose if found to be negligent. They also have to carry malpractice insurance. The idea that the anesthesiologist is always responsible, irrespective of circumstances if their name is on a chart is nonsense. The nurses putting "MDA aware" also doesn't absolve them of liability, no matter how much their CRNA instructors teach them that.

This in fact will be the great equalizer. Have enough bad outcomes and enough lawsuits up to and above malpractice policy limits and suddenly the $50-$100k you save by using incompetent CRNAs pales in comparison to hiring physicians to do the cases and or appropriately medically direct in a safe ratio ACT model. 1 lawsuit with a payout of just 1Mil combined with the negative press is enough to make the independent CRNA model not worth it for a hospital system. At the end of the day, the physician oversight is the state board of medicine. The CRNA oversight is the board of nursing. Never let them forget that.
 
CRNAs can be named in suits, but uniformly - essentially 100% of the time - if the suit can be rolled up to whoever has the highest malpractice premium, i.e. the surgeon and anesthesiologist, it historically has been and will be.

I linked this in another thread, but the state of California has explicit laws which say that midlevels can be sued, but yet the California Society of Anesthesiologists was unable to find a single case where a CRNA was the ultimate party held liable:

csahq.org

Resources - California Society of Anesthesiologists

By Christopher G. Tirce, MD, FASA In my last article, I discussed a case of nurse anesthetist non-liability in North Carolina1 that asks us to consider several […]
csahq.org csahq.org
 
You must log in or register to reply here.

Similar threads

D
Watches at work
2
Replies
78
Views
4K
sevo00
S
G
Can you ask to work involuntarily?
Replies
32
Views
3K
deleted1130227
D
S
SSTB status for 1099 work
Replies
4
Views
775
stephenpatrickd
S
G
How does partnership work?
2
Replies
55
Views
7K
agammaglobulin
agammaglobulin
C
SALT work around
Replies
10
Views
2K
nimbus
nimbus
Top