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I have included an article from the PRESIDENT of AANA concerning their belief for the future "cost effective" model for Anesthesiologist in the future.
Unfortunately, the model for anesthesiologists in the future very may well be "collaborative" compared to "supervising" CRNAs. If that occurs, expect anesthesiologists to be paid marginally more than CRNAs per hour (5% premium).
The VA independence is the first step towards the decline. Once the VA can "prove" independent CRNAS are equal to "MDAs" in the vast majority of cases (will only take a few years), it will be game over. They will clamor for "collaborative" models in the future hardcore after a few years of VA independence. The can easily use "metrics" to prove that for the vast majority of cases CRNAS are just as "safe" as Anesthesiologists (outside of complex peds or hearts)
Future changes will likely include:
1) Collaboration model with a slight premium for Anesthesiologist who will have to take "liability" for a CRNA that gets into a difficult situation. Salaries will decline for almost all specialists to above 30-50% over PCP but particularly for Anesthesiologists this is an acute issue with VA independence.
2) Decreased reimbursement towards the Medicare payment model (33% of private insurance) as Obamacare premiums skyrocket. This will be made possible with no stipend offered for anesthesiologist practices and increased utilization of CRNAS as more "cost effective" in the future
3) AMC take over of the vast majority of practices (NAPA is the biggest example) due to PE money and Mckinsey consultants
4) Continued pushing for "independence" by healthcare "consultants" while the profits go to PE/Consultants with MBAs taking the profit margins that are left over.
5) Increased liability due to lack of tort reform in the future coupled with increased risk with coverage of "collaborative" CRNAs while not getting paid for it.
This is the opinion of big business/Hillary/militant CRNA PACs for the future who are all collaborating together to make this come to fruition after they can use the VA as "proof":
http://www.beckershospitalreview.co...-quality-anesthesia-care-at-a-lower-cost.html
Notice the article from Becker Spine is supporting strongly by the "Lewin" group that says anesthesiologists are NOT cost effective at all basically in ANY model.
The question occurs for physicians with good net worths (>3-5 million), is it worth it to continue to practice with largely decreasing reimbursement, increased liability, etc?
Would it be better to be a PCP under these systems with a slight decrease in salary but largely less liability? Remember Anesthesiology has HUGE liability risk that is largely uncontrollable in the future due to surgeons/administrators DICTATING providers to do cases or be fired when consolidation occurs, especially with an overabundance of CRNAs.
Any good MBA could tell you about NPV valuations and DCF in the future. According to an NPV analysis, earning after tax income of 300K for 30 years is only equivalent to about 3 million in the bank now at a discount rate of a conservative 6%. This could be marginally better with a 2-3% growth rate in anesthesiologist salaries but the future will likely see a DECLINE rather than increase for the confluence of many factors.
That is why Anesthesiologist have net worth's on average of "2.68" on the medscape survey that is equivalent to between 500-1million and 1-2 million, most in their 60s and 70s. The future will be worse.
Therefore, it might be better to get into the "lower risk" specialities in the future, even if anesthesiologist only makes a slight premium, particularly if you have ASSETS.
Also, don't trust the crap that they won't sue you over "your limits". They will get a forensic account to determine your net worth. If you have millions exposed in stocks, cash, etc, they WILL go after that if they get a big judgement (not that difficult anymore with the huge increases in lawsuits recently).
One of many my friend: http://www.chicagotribune.com/business/ct-u-of-c-malpractice-verdict-0701-biz-20160630-story.html
http://www.chicagotribune.com/busin...ctice-settlement-0223-biz-20160222-story.html
Damn that MBA or even lower risk "lower paid" specialties are looking more and more attractive these days for physicians with any money.
Unfortunately, the model for anesthesiologists in the future very may well be "collaborative" compared to "supervising" CRNAs. If that occurs, expect anesthesiologists to be paid marginally more than CRNAs per hour (5% premium).
The VA independence is the first step towards the decline. Once the VA can "prove" independent CRNAS are equal to "MDAs" in the vast majority of cases (will only take a few years), it will be game over. They will clamor for "collaborative" models in the future hardcore after a few years of VA independence. The can easily use "metrics" to prove that for the vast majority of cases CRNAS are just as "safe" as Anesthesiologists (outside of complex peds or hearts)
Future changes will likely include:
1) Collaboration model with a slight premium for Anesthesiologist who will have to take "liability" for a CRNA that gets into a difficult situation. Salaries will decline for almost all specialists to above 30-50% over PCP but particularly for Anesthesiologists this is an acute issue with VA independence.
2) Decreased reimbursement towards the Medicare payment model (33% of private insurance) as Obamacare premiums skyrocket. This will be made possible with no stipend offered for anesthesiologist practices and increased utilization of CRNAS as more "cost effective" in the future
3) AMC take over of the vast majority of practices (NAPA is the biggest example) due to PE money and Mckinsey consultants
4) Continued pushing for "independence" by healthcare "consultants" while the profits go to PE/Consultants with MBAs taking the profit margins that are left over.
5) Increased liability due to lack of tort reform in the future coupled with increased risk with coverage of "collaborative" CRNAs while not getting paid for it.
This is the opinion of big business/Hillary/militant CRNA PACs for the future who are all collaborating together to make this come to fruition after they can use the VA as "proof":
http://www.beckershospitalreview.co...-quality-anesthesia-care-at-a-lower-cost.html
Notice the article from Becker Spine is supporting strongly by the "Lewin" group that says anesthesiologists are NOT cost effective at all basically in ANY model.
The question occurs for physicians with good net worths (>3-5 million), is it worth it to continue to practice with largely decreasing reimbursement, increased liability, etc?
Would it be better to be a PCP under these systems with a slight decrease in salary but largely less liability? Remember Anesthesiology has HUGE liability risk that is largely uncontrollable in the future due to surgeons/administrators DICTATING providers to do cases or be fired when consolidation occurs, especially with an overabundance of CRNAs.
Any good MBA could tell you about NPV valuations and DCF in the future. According to an NPV analysis, earning after tax income of 300K for 30 years is only equivalent to about 3 million in the bank now at a discount rate of a conservative 6%. This could be marginally better with a 2-3% growth rate in anesthesiologist salaries but the future will likely see a DECLINE rather than increase for the confluence of many factors.
That is why Anesthesiologist have net worth's on average of "2.68" on the medscape survey that is equivalent to between 500-1million and 1-2 million, most in their 60s and 70s. The future will be worse.
Therefore, it might be better to get into the "lower risk" specialities in the future, even if anesthesiologist only makes a slight premium, particularly if you have ASSETS.
Also, don't trust the crap that they won't sue you over "your limits". They will get a forensic account to determine your net worth. If you have millions exposed in stocks, cash, etc, they WILL go after that if they get a big judgement (not that difficult anymore with the huge increases in lawsuits recently).
One of many my friend: http://www.chicagotribune.com/business/ct-u-of-c-malpractice-verdict-0701-biz-20160630-story.html
http://www.chicagotribune.com/busin...ctice-settlement-0223-biz-20160222-story.html
Damn that MBA or even lower risk "lower paid" specialties are looking more and more attractive these days for physicians with any money.
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