Seattle Hospital Fires all its Anesthesiologists

[militarymd]

Ned, you haven't anwered my question....and everyone knows it...

Just ANSWER it.

You 're working...."taking good care of your patients" ...fat, dumb, and happy...with your subsidy from the hospital....


Some young pup who is younger , slimmer, and faster than you....comes around and says to the hospital, "I want Ned's job, and I'll do it for NO subsidy".....

What do you say to the young pup?

Please address this....because you have not....you 're hiding behind your high flutting microeconomics talk....which btw we all know about.

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[Coastie]

In this case, it depends on a few things:

Is the younger guy truly faster and better?
What will the collective surgeons say about the quality of your care as compared to the younger pup?
What kind of deal do you have with the hospital administrator, what kind of relationship, and are the people making the financial decisions willing to place a price on your subjective relationship with them, your percieved skills, and services?


In other words, with a combination of personal relationships and quality, can you convince the bean counters that you are in fact worth the subsidy while the younger guy, while cheaper, is in reality a loss for them overall?

If you can convince them, ie, if you're more valuable, you keep your job. If not, you move.

How's that, military?

Ned, you haven't anwered my question....and everyone knows it...

Just ANSWER it.

You 're working...."taking good care of your patients" ...fat, dumb, and happy...with your subsidy from the hospital....


Some young pup who is younger , slimmer, and faster than you....comes around and says to the hospital, "I want Ned's job, and I'll do it for NO subsidy".....

What do you say to the young pup?

Please address this....because you have not....you 're hiding behind your high flutting microeconomics talk....which btw we all know about.

 

[Coastie]

P.S. Some people may ask "how do I become more valuable"?

Well, two ways: quality of care and relationships.

1) Quality of care: Be an awesome anesthesiologist. Fast, efficient, non-whiny, hard working. Take the extra call, extra cases, and through interactions with staff and other physicians, show them that you are not only truly adding to the patient's care, but the overall environment of work in the OR. Do some post-op rounding, care in the ICU, even if it's going to be hard to be reimbursed.

2) Relationships: Hospital committees, administrative positions, playing golf with the CEO, having your kids play together. While not always as important as #1, at key times, it can be just as, if not more important.

Military, is this intern way off in his analysis?

In this case, it depends on a few things:

Is the younger guy truly faster and better?
What will the collective surgeons say about the quality of your care as compared to the younger pup?
What kind of deal do you have with the hospital administrator, what kind of relationship, and are the people making the financial decisions willing to place a price on your subjective relationship with them, your percieved skills, and services?


In other words, with a combination of personal relationships and quality, can you convince the bean counters that you are in fact worth the subsidy while the younger guy, while cheaper, is in reality a loss for them overall?

If you can convince them, ie, if you're more valuable, you keep your job. If not, you move.

How's that, military?

 

[militarymd]

Believe it or not....surgeons DON'T care who's turning the dials....as long as the patients go into and out of the OR...dead or alive.

 

[nedflanders]

Are you from France???

Military you seem like you are more from France with your socialistic, lets save the system money, one-payor for all, while the anesthesiologist gets paid less. Sounds awesome.

 

[nedflanders]

Ned, you haven't anwered my question....and everyone knows it...

Just ANSWER it.

You 're working...."taking good care of your patients" ...fat, dumb, and happy...with your subsidy from the hospital....


Some young pup who is younger , slimmer, and faster than you....comes around and says to the hospital, "I want Ned's job, and I'll do it for NO subsidy".....

What do you say to the young pup?

Please address this....because you have not....you 're hiding behind your high flutting microeconomics talk....which btw we all know about.

You know about economics. Your post about lowering anesthesia costs to save you money on your health insurance shows me how much economics you get. Explain that post buddy. Where is your response???

As to the young pup (which I am) - like I said in my earlier post if you have reading comprehension and can extrapolate, you can't stop the single person, but if we're strong and collective as a specialty and VALUE our services and our skillset, then we can maintain the benefits for all (while a couple poor sports like you tries to put our specialty in a downward spiral).

 

[militarymd]

You know about economics. Your post about lowering anesthesia costs to save you money on your health insurance shows me how much economics you get. Explain that post buddy. Where is your response???

As to the young pup (which I am) - like I said in my earlier post if you have reading comprehension and can extrapolate, you can't stop the single person, but if we're strong and collective as a specialty and VALUE our services and our skillset, then we can maintain the benefits for all (while a couple poor sports like you tries to put our specialty in a downward spiral).

That explains EVERYTHING.

I was referring to lowering overall costs...on the larger scale...where lowering costs is a benefit to everyone in the system........while you are taking the statement literally ,comprehending at an elementary/literal level.

 

[militarymd]

You know about economics. Your post about lowering anesthesia costs to save you money on your health insurance shows me how much economics you get. Explain that post buddy. Where is your response???

As to the young pup (which I am) - like I said in my earlier post if you have reading comprehension and can extrapolate, you can't stop the single person, but if we're strong and collective as a specialty and VALUE our services and our skillset, then we can maintain the benefits for all (while a couple poor sports like you tries to put our specialty in a downward spiral).

how do you think AMC's work? it is not a single person....it is a GROUP of people coming together, saying that they will take less pay than the CURRENT group of people who are taking more pay.

Are you telling me that we should band together and they them They are NOT allowed to work for less?

 

[nedflanders]

That explains EVERYTHING.

I was referring to lowering overall costs...on the larger scale...where lowering costs is a benefit to everyone in the system........while you are taking the statement literally ,comprehending at an elementary/literal level.

Your post said to eliminate subsidies (costs) which will lower overall costs which is a benefit to everyone in the system (EXCEPT ANESTHESIOLOGISTS)!!!!
I broke it down into a simple example for you. You lower costs for your hospital system translates into a new cafeteria (and if it trickles down into your insurance premiums - great 10 cents off per month) while costing your salary $100,000.

Smart move.

 

[militarymd]

Your post said to eliminate subsidies (costs) which will lower overall costs which is a benefit to everyone in the system (EXCEPT ANESTHESIOLOGISTS)!!!!
I broke it down into a simple example for you. You lower costs for your hospital system translates into a new cafeteria (and if it trickles down into your insurance premiums - great 10 cents off per month) while costing your salary $100,000.

Smart move.

Not for the guy who got your job...Smart move for him, becuase he went from no job to HAVING a job.

Change your point of view....trying seeing it from the other guys/gals perspective.....

 

[nedflanders]

how do you think AMC's work? it is not a single person....it is a GROUP of people coming together, saying that they will take less pay than the CURRENT group of people who are taking more pay.

Are you telling me that we should band together and they them They are NOT allowed to work for less?

Okay, done with this thread. If you're for the AMC model we got fundamental differences. I'm a young pup who cares about the future of our specialty and also think the AMC model is leading out specialty in a downward spiral (much like you and your views - undercutting other groups). Of course AMCs are allowed, I am saying its not good for our specialty. There are multiple threads on this on SDN.

Coastie as well as others on previous threads have some nice points on how to strengthen your group and yourself. Also if any of you attend the ASA, they usually have some discussions from groups who have prevented an AMC for successfully winning a RFP. Highly suggested.

Military if you are in a desirable area then yup, salaries do trend downwards as there is always a constant supply of eager grads willing to take your job for less because they NEED to be in the area (NYC, Miami - AMC land, etc.). In the majority of the country however, this is not the case (see Seattle's problems) and we as a group can do a lot to protect that position.

Military, see you on another thread.

 

[militarymd]

The future of our specialty lies in ADVANCED training of our physicians...Critical Care Medicine (me),....Pain...peds....NOT sitting on your stool and telling people that you should be paid a "fair" salary, when a nurse can do 95% of what you do.

The future lies in understanding the economics of our healthcare system...less $$ for ALL of us...while MORE and MORE complex work is falls into OUR REALM of responsiblity.

The "gravy" cases that used to pay for our Ferrari's and BMW's WILL become non-physician cases...as is the same for many other specialties...

Sitting there crying foul is not the way to make our specialty stronger.

Making our specialty one of high competition is how we make our specialty stroonger...

I make more than my share of money, but it's because someone, somewhere felt that I added value to their system...as soon as this "value" is not wanted anymore, I can count on a decrease in my pay....OR I will have to take what I bring to the table up another step....

It's business...It's competition....it's the future....

AND i'm glad you're not going to reply anymore.

 

[johankriek]

Believe it or not....surgeons DON'T care who's turning the dials....as long as the patients go into and out of the OR...dead or alive.

maybe where you are they dont care.. where I am they CARE a great deal..

 

[johankriek]

That explains EVERYTHING.

I was referring to lowering overall costs...on the larger scale...where lowering costs is a benefit to everyone in the system........while you are taking the statement literally ,comprehending at an elementary/literal level.

even if we all took a 50 percent pay cut across the board. it wouldnt appreciably decrease healthcare costs. your statement is telling about your understanding of healthcare expenditures..

 

[lakerjock]

The future of our specialty lies in ADVANCED training of our physicians...Critical Care Medicine (me),....Pain...peds....NOT sitting on your stool and telling people that you should be paid a "fair" salary, when a nurse can do 95% of what you do.

The future lies in understanding the economics of our healthcare system...less $$ for ALL of us...while MORE and MORE complex work is falls into OUR REALM of responsiblity.

The "gravy" cases that used to pay for our Ferrari's and BMW's WILL become non-physician cases...as is the same for many other specialties...

Sitting there crying foul is not the way to make our specialty stronger.

Making our specialty one of high competition is how we make our specialty stroonger...

I make more than my share of money, but it's because someone, somewhere felt that I added value to their system...as soon as this "value" is not wanted anymore, I can count on a decrease in my pay....OR I will have to take what I bring to the table up another step....

It's business...It's competition....it's the future....

AND i'm glad you're not going to reply anymore.

Hmmm...so still think that nurses can do our job...awesome. Lay back, take it, allow substandard care to be delivered and instead subspecialize to avoid confrontation with non-physician providers...sounds like a great plan to me. It's great to add value and I'm all for more training, but anesthesia should be performed only with anesthesiologists involved - a care team model is fine.

 

[militarymd]

maybe where you are they dont care.. where I am they CARE a great deal..

Hmmm...so still think that nurses can do our job...awesome. Lay back, take it, allow substandard care to be delivered and instead subspecialize to avoid confrontation with non-physician providers...sounds like a great plan to me. It's great to add value and I'm all for more training, but anesthesia should be performed only with anesthesiologists involved - a care team model is fine.

How's you guys's shoulders and arms.....must be sore.....and tired.....





from all that patting you're giving yourselves on your backs.

 

[BLADEMDA]

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 weak.

You are on to something. Please forward to www.barackobama.com for his health care plan in 2009.

 

[BLADEMDA]

so competition teaches you how to do more for less...

well, i can agree that you can cut costs by using less anesthetic gas and less zofran - and maybe if you are really disgusting you can re-use ET tubes after wiping them with an alcohol wipe...

how does it help the practice of anesthesia or the business of anesthesia?

it may force you to become more efficient if you have large overhead - otherwise it looks like i am going to have to tell you what competition really means

it means an anesthesiologist is going to have to work more hours and take on more risks for less pay --- if that is good for our field then this sucks...

More good ideas for 2009 health care policy. Forward to www.hillaryclinton.com

 

[BLADEMDA]

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 have seen this before in Florida. Entire Group in a medium sized hospital was "let go" over subsidy issue. CEO thought he could do better with NO SUBSIDY. He was wrong and was fired. This hospital now pays TWO TIMES the original requested subsidy to an AMC. The greedy AMC even wants more when volume goes down. This hospital NEVER recovered all its case load and is running at 75% of the original case volume it had with the "old" Group.

Fortunately, this type of scenario can be very helpful in negotiations with current and future CEO's. A prefect example of benefiting from someone else's misery. Will Seattle learn its lesson the hard you? You bet as millions will be lost in case revenue over this issue. Most likely, the CEO will be canned.

 

[deleted126335]

.

 

[coprolalia]

Anyone have any updates on the situation in Seattle?

The Cloverfield monster just landed there. It's wreaking havoc on the town. The film, shot on a camcorder by some unsupecting victim trying to "capture the moment", will turn up shortly and be plastered on movie screens throughout the country during the summer of 2009.

-copro

 

[UTSouthwestern]

I got a postcard in the mail yesterday asking me to apply for a job there. No kidding.

 

[nociceptor]

I got a postcard in the mail yesterday asking me to apply for a job there. No kidding.

Out of curiosity, and knowing what you know.

Do you even entertain the idea since you know they are going to screw you over so that you know what being screwed over looks like? or do you throw away the post card? or?


sorry, I can't find an appropriate picture

 

[adamkiewicz]

BUMP. Just wanted to update. Looks like Northwest Hospital merged with UW in 2009. They're hiring for that hospital currently and I was looking for more information.




seattletimes
/seattle-news/northwest-hospital-medical-center-to-become-part-of-uw-medicine-system/

Northwest will remain a separate nonprofit, tax-exempt entity — retaining its name and separate staff, billing system and union contracts — but two Northwest trustees will serve on the board of UW Medicine. Bill Schneider, Northwest’s CEO, will report to Ramsey.

Northwest lost nearly $13 million last year, its first loss since 2003. But Schneider said he did not seek to align with UW Medicine out of financial concerns.

Rather, he said, becoming part of UW Medicine will strengthen Northwest in ways it couldn’t on its own, including piggybacking on UW’s electronic medical-records system.

“We are a strong and economically viable” hospital, Schneider said. And “we want to make sure that we (stay) strong.”



Wonder why they lost money in that year...
(new account. can't link)

 

[deleted162650]

That’s one hell of a bump.

 

[B-Bone]

GasWork.com - Reference #244238

 

[caligas]

That’s one hell of a bump.

It’s funnier when they don’t realize it’s a decade-bump and try to argue with someone that is probably dead now.

 

[SeniorWrangler]

Northwest Hospital is merging with UWMC and will be "UWMC North" in the future and administered from the UW mothership.

 

[dchz]

Out of curiosity, and knowing what you know.

Do you even entertain the idea since you know they are going to screw you over so that you know what being screwed over looks like? or do you throw away the post card? or?


sorry, I can't find an appropriate picture

RIP UTSW, wish i got the chance to know him IRL, being from Plano and all...