Seattle Hospital Fires all its Anesthesiologists

[militarymd]

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Stronger to what end?

ok......

OR efficiency....for what?

wake patients up faster with less PONV....to what end?

Prevent MI's in 95 year old gomes with a broken hip....what for?

taking care of a growing population of retirees who generate no income but feed off social security and medicare.......why do that?

and on and on and on.....as our society progresses and the demographics and work environment changes.........why bother with this sh it?

Just live off Hiliary and Obama's government......that'll be good....while the strong work and pay the taxes.




I think it's time for me to hit the booze and play with my children....or is tonight the night I beat them.....ahhh hell, I'll play with my .357 magnum tonight...screw the kids....

 

[nedflanders]

that's right ....it sucks...compensation has been steadily dropping over the last 30 years while work hours have been going up...and the trend will continue....

This will force our specialty to have only strong (mentally and/or likely physically), harder working folks....many will disagree, but I think that makes our specialty stronger....

Really? You think that's what will happen? What I think will happen is smart med students will decide anesthesia ain't worth it, and you'll get dumber (on a relative basis) people going into anesthesia. Compounding this will be CRNA's taking over more practice sites. I think that will make our specialty weaker.

Military you keep reinforcing the part where you're part of the problem. What our specialty needs is strong groups with strong leadership securing our position as a physician specialty with appropriate compensation. It's amazing to me hw physicians sell themselves short. We give away the best years of our lives (24-33) to go to medical school/residency. We save zero during this time period while accumulating debt. We tend to be on the smarter side of society. Yet we're stupid when it comes to compensation. Military, by assuming this role of underbidding, you're helping lead our specialty in a downward spiral, yet you keep arguing that your position is right when you're part of the problem.

 

[militarymd]

Really? You think that's what will happen? What I think will happen is smart med students will decide anesthesia ain't worth it, and you'll get dumber (on a relative basis) people going into anesthesia. Compounding this will be CRNA's taking over more practice sites. I think that will make our specialty weaker.

Military you keep reinforcing the part where you're part of the problem. What our specialty needs is strong groups with strong leadership securing our position as a physician specialty with appropriate compensation. It's amazing to me hw physicians sell themselves short. We give away the best years of our lives (24-33) to go to medical school/residency. We save zero during this time period while accumulating debt. We tend to be on the smarter side of society. Yet we're stupid when it comes to compensation. Military, by assuming this role of underbidding, you're helping lead our specialty in a downward spiral, yet you keep arguing that your position is right when you're part of the problem.

ok....good luck to you....I plan on retiring soon.

 

[militarymd]

Really? You think that's what will happen? What I think will happen is smart med students will decide anesthesia ain't worth it, and you'll get dumber (on a relative basis) people going into anesthesia. Compounding this will be CRNA's taking over more practice sites. I think that will make our specialty weaker.

Military you keep reinforcing the part where you're part of the problem. What our specialty needs is strong groups with strong leadership securing our position as a physician specialty with appropriate compensation. It's amazing to me hw physicians sell themselves short. We give away the best years of our lives (24-33) to go to medical school/residency. We save zero during this time period while accumulating debt. We tend to be on the smarter side of society. Yet we're stupid when it comes to compensation. Military, by assuming this role of underbidding, you're helping lead our specialty in a downward spiral, yet you keep arguing that your position is right when you're part of the problem.

Oh....and BTW...I'm still waiting on your answer to my question....

What do we do with the people who want work and can't find it?

the ones who are WILLING to work for less than what you think is "fair" compensation.....The ones who are going to be graduating in the next few years.

 

[g3pro]

Militarymd, you really ought to be ashamed of yourself. I bet you truly think that what you're doing is good. But let me assure you that it is bad practice and bad precedent for physicians. You are currently in the business of screwing your colleagues to satisfy your prideful attitude that "lower salaries, weaker position of MDAs in healthcare, and less incentives for going into anesthesiology" are good for anesthesiologists. What you are doing is exactly part of the problem, and you are making your colleagues less well off in the process.

This is a profession. You are part of a larger system, which includes people other than yourself and your mentor. Try to act like it.

 

[militarymd]

Militarymd, you really ought to be ashamed of yourself. I bet you truly think that what you're doing is good. But let me assure you that it is bad practice and bad precedent for physicians. You are currently in the business of screwing your colleagues to satisfy your prideful attitude that "lower salaries, weaker position of MDAs in healthcare, and less incentives for going into anesthesiology" are good for anesthesiologists. What you are doing is exactly part of the problem, and you are making your colleagues less well off in the process.

This is a profession. You are part of a larger system, which includes people other than yourself and your mentor. Try to act like it.

It's the system. I didn't make it. I just work in it...

AND ONE MORE TIME:

What should we do with the people who are HAPPY AND WILLING TO WORK FOR WAGES THAT YOU THINK IS TOOO LOW????

 

[jetproppilot]

It's the system. I didn't make it. I just work in it...

AND ONE MORE TIME:

What should we do with the people who are HAPPY AND WILLING TO WORK FOR WAGES THAT YOU THINK IS TOOO LOW????

Okay, I've read this entire f u kking thread.

I'm at a loss to the alarm by all parties.

This is not uncommon.

Medicine is a business.

Groups get fired.

Groups fire hospitals.

Anesthesia groups "fire" surgeons. (PIPE IN, UT!)

Too much melodrama by too many people who are unfamiliar with the ins and outs of private practice medicine.....not just private practice anesthesia, mind you.....private practice medicine.

S hi t happens.

Relationships between administration and MDs sometimes goes awry.

Sometimes its in our favor, sometimes it is not.

Lets not get our panties in a wad over this one incident thats published for all to see on SDN.

And overblow the sequelae.

For our budding pre-med/med student/resident colleagues:

This is normal business. The signing and "un-signing" of contracts.

In all specialties.

As in all media, SDN has the ability to deliver a contorted message.....with an undeserved alarming tone....

Lose the melodrama.

EXPECT to gain some contracts.

And to lose some.

 

[militarymd]

finally...the JET weighs in👍

 

[jetproppilot]

finally...the JET weighs in👍

We all wanna think rosy thoughts about our current positions....I'm happy to report that my group's Chief has one primary goal at all times.....wanna know what it is?....contract renewal.......every move the dude makes is toward
that primary goal...and we are in the first year of a (second) five year contract.

But fact of the matter is things dont always work out.

Four years from now I may have to look for another job.

But I enjoyed an eight year run at a bum-fuk-egypt job that allowed me to accrue alotta fuk you money.

I encourage all my colleagues out there to do the same.

Initiate a fuk you account....in other words, accrue a large amount of money so if your contract ends tomorrow you'll be OK for a year or two. Even if you sit on a beach and drink Patron margaritas all day.

It allowed me to eventually leave the bum-fuk-egypt job.

I sacrificed desirable locality for the first eight years of my career.

But now I have fuk you money in case all goes awry.

Contributes largely to restful sleep.

 

[MossPoh]

From the outsiders perspective this seems like each side isn't getting much of the story. I think that hospital CEO, IF he/she is a fairly moral person, has a pretty rough job. No matter what happens, you're the bad guy. I get the sense they leave a lot of valuable information out to make it seem like the anesthesiologists were getting uppity, so they fired them and replaced them with happy wholesome people on a whim. I suspect this could have been handled more tactfully and both sides could've gotten a chunk of what they wanted. If they were giving unsatisfactory results, then from the business perspective that MUST be corrected. The ones who give the satisfactory results get the raise. I know this makes the hospital essentially become the labyrinth of cubicles that most of us wanted to avoid, but at this point it seems inevitable to happen to some degree. Just goes to show you, sometimes you have to play ball to get what you want. Doctors, teachers, business people....none of us can overvalue our skills and abilities. There is always someone in line behind us willing to do it for just a little less. Whether that takes a hit on the quality is another debate.

 

[jwk]

Even if you sit on a beach and drink Patron margaritas all day.

There are worse things

I'll be doing that in about two months in the Mayan Riviera - albeit only for a week.

 

[coprolalia]

But now I have fuk you money in case all goes awry.

Great advice, Jet. First rule of personal finances: pay yourself first.

-copro

 

[drccw]

Just an update:
As of Feb 1 the hospital has a contract with Seattle Anesthesia... which comprise a grand total of 3 anesthesiologists (to replace 20). For February 1st there is a grand total of one case booked... one.. the surgical volume at NW isnt very high but you can best that all of the surgeons with priveleges elsewhere are taking their surgical patients.. you got it.. elsewhere until this thing smoothes over. So yeah, there will not be a disruption in services because there will be nobody needing services. At least 2 of the 4 (maybe 5) anesthesia techs have quit. The displaced anesthesiologists are finding job offers (one signed on at Overlake already) so they for the most part arent terribly concerned... Who will lose? NW hospital I bet. Surgical volume will go down (does that mean that the nurses and scrub techs will lose their jobs too-> I bet they can find work easily as well)....

Just what I know..

 

[militarymd]

Please keep us updated...this is interesting.

 

[coprolalia]

Just an update:
As of Feb 1 the hospital has a contract with Seattle Anesthesia... which comprise a grand total of 3 anesthesiologists (to replace 20). For February 1st there is a grand total of one case booked... one.. the surgical volume at NW isnt very high but you can best that all of the surgeons with priveleges elsewhere are taking their surgical patients.. you got it.. elsewhere until this thing smoothes over. So yeah, there will not be a disruption in services because there will be nobody needing services. At least 2 of the 4 (maybe 5) anesthesia techs have quit. The displaced anesthesiologists are finding job offers (one signed on at Overlake already) so they for the most part arent terribly concerned... Who will lose? NW hospital I bet. Surgical volume will go down (does that mean that the nurses and scrub techs will lose their jobs too-> I bet they can find work easily as well)....

Just what I know..

The Board of Directors is going to have that CEO's head on a platter, I'd be willing to bet pounds to pence.

-copro

 

[nociceptor]

Just an update:
As of Feb 1 the hospital has a contract with Seattle Anesthesia... which comprise a grand total of 3 anesthesiologists (to replace 20). For February 1st there is a grand total of one case booked... one.. the surgical volume at NW isnt very high but you can best that all of the surgeons with priveleges elsewhere are taking their surgical patients.. you got it.. elsewhere until this thing smoothes over. So yeah, there will not be a disruption in services because there will be nobody needing services. At least 2 of the 4 (maybe 5) anesthesia techs have quit. The displaced anesthesiologists are finding job offers (one signed on at Overlake already) so they for the most part arent terribly concerned... Who will lose? NW hospital I bet. Surgical volume will go down (does that mean that the nurses and scrub techs will lose their jobs too-> I bet they can find work easily as well)....

Just what I know..

I love the updates. I thought it would be bad but not anywhere near that bad.

Now the question I have is how long will it take NW to recover?

 

[VentdependenT]

I love the updates. I thought it would be bad but not anywhere near that bad.

Now the question I have is how long will it take NW to recover?

Just build another couple of interventional cards Suite out of some OR's. Start some B.S. marketing campaign about being the best for hearts in Seattle area. Radio, billboard, T.V.

Let em roll on in.

Once the cards guy lances a LCA, blow's an RCA, causes large pulsating aortic takoff aneurysm, puts the guy in acute heart failure, or causes worse occlusion and slaps a ballon pump in, then you can have the standby "cardiac ambulance" bring the crumping patient to UW.

Maybe that's where I'll be.🙂

 

[drccw]

Just build another couple of interventional cards Suite out of some OR's. Start some B.S. marketing campaign about being the best for hearts in Seattle area. Radio, billboard, T.V.

Let em roll on in.

Once the cards guy lances a LCA, blow's an RCA, causes large pulsating aortic takoff aneurysm, puts the guy in acute heart failure, or causes worse occlusion and slaps a ballon pump in, then you can have the standby "cardiac ambulance" bring the crumping patient to UW.

Maybe that's where I'll be.🙂

Actually the only anestehsia coverage that NW has is cardiac anesthesia- the NW group didnt provide the coverage there; the university group comes over when there are cases (the surgeons are also from the U.) So yeah maybe they will pump up the cardiac volume to take advantage of the contract with the U (and the emty rooms)

 

[militarymd]

It's the system. I didn't make it. I just work in it...

AND ONE MORE TIME:

What should we do with the people who are HAPPY AND WILLING TO WORK FOR WAGES THAT YOU THINK IS TOOO LOW????

anyone??? Bueller? Bueller??

 

[militarymd]

competition benefits the consumer.... it doesn't benefit anesthesia as a field (unless it is competition in research) and it doesn't benefit anesthesia business models...

you still haven't explained how it would benefit anesthesia the field or anesthesia as a business...

the only way to compete is to provide more service for cheaper costs --- and if everybody keeps on competing you will end up with cheap service - and when it is a plastic toy no big deal - but when it is medical care you may be compromising on what our accepted standards of care.

The "consumer" in our case is the "patient".....isn't that why we're all here....for the "patient"?

 

[Tenesma]

no the consumer is the employer/government who purchases the health insurance

 

[cchoukal]

I agree; we're not saving the patient any money. I'm not even sure if the savings will get passed down to corporate purchasors; I suspect the hospital administrators and HMO/insurance companies will eat up most of it.

Of course, in states like MN where such companies have to be non-profit, this couldn't actually be true, right? Except they (successfully) petition the state gov't every year to let them keep their profits... But that's a whole 'nother thread.

 

[militarymd]

So insurance premiums that I have to pay for my coverage doesn't count?

So taxes that I have to pay to cover CMS doesn't count?

Gee...I don't know about you, but I would like my Blue Cross premiums to be lower.

Gee...I would sure like to pay uncle same a LOT less.

One way or another, the "patient" pays for their healthcare.

Whether or not the savings gets passed onto the "patient"...that's another story and a longer thread.


Now back to: BUELLER... BUELLER???? ANYONE??

 

[cchoukal]

So insurance premiums that I have to pay for my coverage doesn't count?

So taxes that I have to pay to cover CMS doesn't count?

Gee...I don't know about you, but I would like my Blue Cross premiums to be lower.

Gee...I would sure like to pay uncle same a LOT less.

One way or another, the "patient" pays for their healthcare.

Whether or not the savings gets passed onto the "patient"...that's another story and a longer thread.


Now back to: BUELLER... BUELLER???? ANYONE??

of course you want to pay lower premiums and taxes; we all do. I just don't think that would happen regardless of how little each hospital pays for their anesthesia services.

 

[militarymd]

of course you want to pay lower premiums and taxes; we all do. I just don't think that would happen regardless of how little each hospital pays for their anesthesia services.

 

[cchoukal]

It's fine to be glib, but I guess I just don't see the connection between a hospital cutting costs by hiring a cheaper anesthesia group and patients getting lower insurance premiums. Obviously, it SHOULD work that way; I just can't imagine that it ever does. It's not like McDonald's cuts the price of cheeseburgers when beef prices go down; they just pocket the difference. Of course, this assumes their burgers are made of beef, which, well, you get the idea...

 

[militarymd]

It's fine to be glib, but I guess I just don't see the connection between a hospital cutting costs by hiring a cheaper anesthesia group and patients getting lower insurance premiums. Obviously, it SHOULD work that way; I just can't imagine that it ever does. It's not like McDonald's cuts the price of cheeseburgers when beef prices go down; they just pocket the difference. Of course, this assumes their burgers are made of beef, which, well, you get the idea...

Many hospitals are NOT for profit...in those hospitals, any revenue generated is reinvested into the hospital....to provide better services, etc.etc....benefiting the "patient"/"consumer"....

You are wanting to see a direct...take money from one pot and move over to another.

Healthcare is too complicated for that.

I'm just saying that overall attempts to decrease cost is good for the consumer.....and I'm asking...isn't that why we're all here....for the consumer/patient?

and I last time: Bueller?? Bueller???

 

[Tenesma]

not for profit re-invest to benefit patients??? are you kidding me?

any profit my community (non-profit) made last year was spent as follows
1) new luxury executive suite for upper management with nice carpet, nice furniture, big boardrooms, fancy flat screen TVs
2) new physicians lounge
3) new "stipends" for various big-hitter physicians
4) a new cell-phone/pager system
5) a 15% raise for management
etc...

all that non-profit means is that they can't share the profit with shareholders but it doesn't mean they can't squander the profit on crap...

maybe for image sake they upgraded some ICU beds with new bells and whistles...

 

[Planktonmd]

not for profit re-invest to benefit patients??? are you kidding me?

any profit my community (non-profit) made last year was spent as follows
1) new luxury executive suite for upper management with nice carpet, nice furniture, big boardrooms, fancy flat screen TVs
2) new physicians lounge
3) new "stipends" for various big-hitter physicians
4) a new cell-phone/pager system
5) a 15% raise for management
etc...

all that non-profit means is that they can't share the profit with shareholders but it doesn't mean they can't squander the profit on crap...

maybe for image sake they upgraded some ICU beds with new bells and whistles...

Yes,
This "not for profit" B.S. is a big joke.

 

[militarymd]

OK, I give up. There's no point in cutting costs.......


But STILL: Bueller???? Bueller???? Bueller????

 

[nedflanders]

I've been trying hard not to reply to this thread because Military is pretty hopeless to talk to. He keeps coming up with another argument once the previous one has been refuted. Unfortunately his arguments keep getting dumber and dumber.

Your rants about people willing to work for less makes no sense. The market ultimately regulates itself. Now if you have a monopoly on services in a particular area and you keep undercutting other groups in order to obtain that clout (something which we already argued against earlier in the thread for the benefit of the specialty and future compensation) and a great deal of residents wants to stay in that area then yes, you will get them to accept less money. All this does is drive down the salary for everyone in that area and if this is habitual all across the country then salaries will fall for all while the savings go to the hospital. Poor economics on the behalf of the specialty but it will be people like you at fault. If people want to accept less money, great for you, you get to keep some extra profit, or you could share that with your new hires, or maybe even attract stronger anesthesiologists by your "higher" salary. Don't put that money back into the healthcare system though because you'll have a hard time seeing it again (but maybe you'll have a nice new cafeteria).🙂

Your other point is even dumber. If you take a microeconomics course you'll easily realize how wrong you are, but it may be a bit difficult to conceptualize. You're saying by taking money out of the anesthesia pot it will trickle down into lower insurance premiums and save you $. Are you frickin kidding me? So take a million dollars out of the cost of anesthesia services at your group, it will trickle down to a 10 cents less per month in your premium. Tell me how YOU, the ANESTHESIOLOGIST are better off? You pay 10 cents less per month, but you lose $50,000 in salary. I don't know about everyone else, but I am there to keep my patients safe and comfortable while keeping my reimbursement at its maximum level. If you don't understand this then it just reinforces the common notion that doctors have some of the worst business sense.

 

[militarymd]

Hey Ned...

I'm glad there are guys like you around.

 

[zippy2u]

Oh yeah, ya mean Buehler as in George. www. georgebuehler.com Yacht designer of the finest kind. Check out "Emily" Now there's a boat ya can circumnavigate in. None of that plastic snot $&&^%$glass shiit all the boat manufacturers want ya to buy. Years ago when half the men in the USA weren't metrosexuals like today, ya threw one up in your backyard in a years time with your sons' help and crossed the pond under full sail with/without an auxiliary. Sigh... Regards, ----Zip

 

[drccw]

So today is Feb 1.. the first day of anesthesia services coverage by Seattle Anesthesia at NWH.

But Schneider said the hospital is prepared to rely for a while on temporary doctors, and he expects "no significant disruption of service, perhaps no disruption of service."

with one doc assigned to OB, and one locum available today Seattle Anesthesia covered 5 rooms. 5 rooms? how is that possible with 4 people. Well here was a first- two of the anesthesiologists had 2 rooms and were flip flopping cases! Impressive! It seems everyone is moving on. NWH will take a hit for a while as surgical volume will undoubtably decline. Surgeons will likely take their cases elsewhere instead of waiting. Seattle Anesthesia will find some locums to help and ultimately hire more people- I think that their goal is to hire 8 more people to staff the 9 rooms. It's going to be rocky there for a while and probably not a good place to be for a long while.

The rest of the docs? 8! were hired on by Swedish (though I think it also had to do with the outpatient surgery center contract that NW Anesthesia retained). I think some will be working per diem at the academic center. Most it seems have jobs.

the dust is settling, but is hasnt fully settled it seems.

 

[militarymd]

So today is Feb 1.. the first day of anesthesia services coverage by Seattle Anesthesia at NWH.


with one doc assigned to OB, and one locum available today Seattle Anesthesia covered 5 rooms. 5 rooms? how is that possible with 4 people. Well here was a first- two of the anesthesiologists had 2 rooms and were flip flopping cases! Impressive! It seems everyone is moving on. NWH will take a hit for a while as surgical volume will undoubtably decline. Surgeons will likely take their cases elsewhere instead of waiting. Seattle Anesthesia will find some locums to help and ultimately hire more people- I think that their goal is to hire 8 more people to staff the 9 rooms. It's going to be rocky there for a while and probably not a good place to be for a long while.

The rest of the docs? 8! were hired on by Swedish (though I think it also had to do with the outpatient surgery center contract that NW Anesthesia retained). I think some will be working per diem at the academic center. Most it seems have jobs.

the dust is settling, but is hasnt fully settled it seems.

From what I know, Seattle is a fairly saturated market with not many job openings, so where did all the anesthesiologists go?

Would you happen to know where and what type of jobs they got in such short notice?

 

[bubalus]

quite a few groups in the area were hiring this year. In a previous post, several groups were mentioned--Sweedish, Overlake, Tacoma, Bellingham, etc.

 

[militarymd]

quite a few groups in the area were hiring this year. In a previous post, several groups were mentioned--Sweedish, Overlake, Tacoma, Bellingham, etc.

So, did the 10 + anesthesiologists hop right over to these other groups?

Did they get immediate parity, or did these other groups treat them as new hires with a partnership track?


What I'm asking is....are they better off now that they've moved on...or was it better before they moved?

 

[bubalus]

I would imagine they got the standard offer, but not immediate partnership. If they didn't have to buy in, that would piss a lot of people off. Things might suck a bit for a couple years, but it's better than not having a job. Perhaps someone more in the know will shed a little more light on it.

 

[drccw]

From what I know, Seattle is a fairly saturated market with not many job openings, so where did all the anesthesiologists go?

Would you happen to know where and what type of jobs they got in such short notice?

1 went to overlake for sure
8 went to Swedish Hospital

The NW Anesthesia group still had the contracts for an outpatient center and a reproductive endocrinology center so I think a couple of them might be working there. It seems only 2-3 are still looking for jobs...

The job market here is good-> from what I understand all of the UW grads for this year who want to stay in Seattle have jobs....

 

[ASCistheway]

This exact same scenario happened not too long ago in Mt. Vernon WA. The entire groups was fired and the Bellingham Anesthesia group took over. Those of you in here hoping for a united front by anesthesiologists are living in another world. This is business. You were never trained for it. those who have the knack will be ahead of you. Those good MDs who just want a fair compensation but have no idea of what they are dealing with are going to see what the NW Hospital group saw. BTW I have a friend in the former group, He is now employed by the largest group in Seattle. I think it was Swedish or Norwegian or something like that. 🙂

 

[ASCistheway]

The ones from NW hospital who found jobs right away apparently had financial interest in the ASC and were able to carry that over with themselves to the new hospital.

When you are part of a group no matter how small it is, you follow where the group goes. So you better like the politics or else. Anesthesia groups in the last few years have had a golden rebirth but that is rapidly coming to an end. Both Obama and Hillary will change the compensation system drastically. The large groups will eventually become more like the academic groups with similar compensation packages. Those who have dared to venture outside of hospitals will have a little longer but they will also follow as either employees or shareholders. This antiquated system of independent contractor in a hospital is rapidly falling apart.

 

[racerx]

The ones from NW hospital who found jobs right away apparently had financial interest in the ASC and were able to carry that over with themselves to the new hospital.

When you are part of a group no matter how small it is, you follow where the group goes. So you better like the politics or else. Anesthesia groups in the last few years have had a golden rebirth but that is rapidly coming to an end. Both Obama and Hillary will change the compensation system drastically. The large groups will eventually become more like the academic groups with similar compensation packages. Those who have dared to venture outside of hospitals will have a little longer but they will also follow as either employees or shareholders. This antiquated system of independent contractor in a hospital is rapidly falling apart.

Hmmm...the user name is new (2 posts), but the message is eerily similar to another member's. Odd. 🙄

 

[ASCistheway]

Hmmm...the user name is new (2 posts), but the message is eerily similar to another member's. Odd. 🙄

well genius who am i?🙂


maybe we are both correct, eh?

 

[militarymd]

well genius who am i?🙂


maybe we are both correct, eh?

yeah...who are you? Can the mods tell?

 

[Planktonmd]

yeah...who are you? Can the mods tell?

Do you guys remember Ethermd?
🙂

Here is an example:

Wait a minute. If you do Pediatrics there will be a job for you. You will be in demand because so few Residents choose this area. But, you will be supervising Mid-Levels in the future because of Universal Health Care and Economics. Relax, there will be plenty of academic jobs available and some private practice ones as well.

If you want to AVOID the Mid-Levels doing some of your cases then you need Critical Care or Pain Management as they will remain Physician based.
Choose the area you like best. After all , it isn't all about the money.

 

[nociceptor]

It's the system. I didn't make it. I just work in it...

AND ONE MORE TIME:

What should we do with the people who are HAPPY AND WILLING TO WORK FOR WAGES THAT YOU THINK IS TOOO LOW????

MilitaryMD, I guess I will be your huckleberry. Obviously if someone wants to work for free then more power to them.

However there are more Gasworks jobs then there are people to fill them so the wage should rarely go down.

In theory though people who want to work for lower wages should be the exception.

To think that there are people going around who would rather work for a low wage then a high wage confounds me (it isn't that hard to do). It just doesn't seem American. We want the highest wage we can get in our chosen fields.

To go around and undercut other Anesth. as a way of life when there is no need for it seems almost diabolical.

 

[militarymd]

It's just bid'ness

No one wants to work for freee....or for less......just less than the guy who has the job that the first person has.

 

[goodoc]

This has gone on for quite some time, truth is no one is irreplacable, if your value, or percieved value is less then your cost then best brak out the CV, and look up some movers. No one is immune and I mean no one, as long as there are hungry lean individuals or groups out there who have the same or percieved same value stories like Seattles will continue. That is the American way.
Whining about is the French way.

 

[nedflanders]

MilitaryMD, I guess I will be your huckleberry. Obviously if someone wants to work for free then more power to them.

However there are more Gasworks jobs then there are people to fill them so the wage should rarely go down.

In theory though people who want to work for lower wages should be the exception.

To think that there are people going around who would rather work for a low wage then a high wage confounds me (it isn't that hard to do). It just doesn't seem American. We want the highest wage we can get in our chosen fields.

To go around and undercut other Anesth. as a way of life when there is no need for it seems almost diabolical.

Nociceptor, you don't have to respond to MilitaryMD....I already shut him up with this post (it collectively refuted all his points he had in this thread):

"I've been trying hard not to reply to this thread because Military is pretty hopeless to talk to. He keeps coming up with another argument once the previous one has been refuted. Unfortunately his arguments keep getting dumber and dumber.

Your rants about people willing to work for less makes no sense. The market ultimately regulates itself. Now if you have a monopoly on services in a particular area and you keep undercutting other groups in order to obtain that clout (something which we already argued against earlier in the thread for the benefit of the specialty and future compensation) and a great deal of residents wants to stay in that area then yes, you will get them to accept less money. All this does is drive down the salary for everyone in that area and if this is habitual all across the country then salaries will fall for all while the savings go to the hospital. Poor economics on the behalf of the specialty but it will be people like you at fault. If people want to accept less money, great for you, you get to keep some extra profit, or you could share that with your new hires, or maybe even attract stronger anesthesiologists by your "higher" salary. Don't put that money back into the healthcare system though because you'll have a hard time seeing it again (but maybe you'll have a nice new cafeteria).

Your other point is even dumber. If you take a microeconomics course you'll easily realize how wrong you are, but it may be a bit difficult to conceptualize. You're saying by taking money out of the anesthesia pot it will trickle down into lower insurance premiums and save you $. Are you frickin kidding me? So take a million dollars out of the cost of anesthesia services at your group, it will trickle down to a 10 cents less per month in your premium. Tell me how YOU, the ANESTHESIOLOGIST are better off? You pay 10 cents less per month, but you lose $50,000 in salary. I don't know about everyone else, but I am there to keep my patients safe and comfortable while keeping my reimbursement at its maximum level. If you don't understand this then it just reinforces the common notion that doctors have some of the worst business sense."

 

[militarymd]

Nociceptor, you don't have to respond to MilitaryMD....I already shut him up with this post (it collectively refuted all his points he had in this thread):

"I've been trying hard not to reply to this thread because Military is pretty hopeless to talk to. He keeps coming up with another argument once the previous one has been refuted. Unfortunately his arguments keep getting dumber and dumber.

Your rants about people willing to work for less makes no sense. The market ultimately regulates itself. Now if you have a monopoly on services in a particular area and you keep undercutting other groups in order to obtain that clout (something which we already argued against earlier in the thread for the benefit of the specialty and future compensation) and a great deal of residents wants to stay in that area then yes, you will get them to accept less money. All this does is drive down the salary for everyone in that area and if this is habitual all across the country then salaries will fall for all while the savings go to the hospital. Poor economics on the behalf of the specialty but it will be people like you at fault. If people want to accept less money, great for you, you get to keep some extra profit, or you could share that with your new hires, or maybe even attract stronger anesthesiologists by your "higher" salary. Don't put that money back into the healthcare system though because you'll have a hard time seeing it again (but maybe you'll have a nice new cafeteria).

Your other point is even dumber. If you take a microeconomics course you'll easily realize how wrong you are, but it may be a bit difficult to conceptualize. You're saying by taking money out of the anesthesia pot it will trickle down into lower insurance premiums and save you $. Are you frickin kidding me? So take a million dollars out of the cost of anesthesia services at your group, it will trickle down to a 10 cents less per month in your premium. Tell me how YOU, the ANESTHESIOLOGIST are better off? You pay 10 cents less per month, but you lose $50,000 in salary. I don't know about everyone else, but I am there to keep my patients safe and comfortable while keeping my reimbursement at its maximum level. If you don't understand this then it just reinforces the common notion that doctors have some of the worst business sense."

Are you from France???