What do you guys think of this? I have a friend of a friend scenario. And this story - about me - was relayed to me by this friend this weekend. Many of the regulars here know my story. In a nutshell a little over a year ago I left my current practice in search of greener pastures. Stupid life mistake. My old practice took me back. A lot of pain and heartache later for me and my wife. We are not very far separated in this field. One of my close friends, and he is not medically connected, happens to be good friends with someone who is friends with one of the anesthesiologists in the practice I left. You with me? Three degrees of separation. So my close friend tells me that this other dude, his friend (who I've met and know in passing), is talking a couple of weeks ago with this anesthesiologist in the practice I left. The substance of the conversation is patio cookout talk about what's been going on his practice, etc. This anesthesiologist tells him about developments and what's been going on, who's come, who's left, etc. Not knowing that the dude knows me in passing, starts volunteering information about me. Should I mention that dude's an attorney? (Not that that really matters, but his sense about when to shut-up, not tip his hand, and let someone talk kicked in.) Needless to say, this attorney dude goes back to my close friend and relays the substance of the conversation to me. Now, this is all third-hand hearsay, of course, but essentially this anesthesiologist told the dude, "Yeah, he was a good doctor, but that's all he wanted to be. A doctor. He had no clue about how to make money." Now I know this anesthesiologist. I worked with him. He was a lazy sack of you-know-what. And a partner in the practice. But I have no idea what he meant by this statement. Was this a de facto admission that he was engaging in fraud? That he cut corners? That he let the CRNAs under his care do whatever they want? Overbilling? Billing for direction when it was really supervision? I don't know what such a statement means. I showed up. I worked. They billed for my services. And they made money. I think this was just a lot of ex post facto disparaging of character that goes on when someone leaves a practice. I've heard other things from others I've stayed in touch with in that practice. But this had no veneer on it. No filter. Still what worries me most is that this is the attitude of some anesthesiologists out there. Long ago they forgot that it is about the patient. They have put maximizing profit above all else. I have thought about this a lot over the past year. I've seen more and more anesthesia marketshare being gobbled up by AMCs who really only care about the bottom line. I've thought about this recently with the death of Joan Rivers and whether or not we'll ever get to the bottom of that, which I surmise has a lot to do with greed, cutting corners, and bowing to a VIP. I was compromised in that practice. I am constantly and continue to be concerned about giving good care. I recognized quickly that I was being put in potentially compromising situations. I want to be a doctor. What the hell is wrong with that? New residents and graduating residents: if you find yourself in this kind of situation, run don't walk away from that kind of practice. They are only going to exploit you, make you take all the risk, and trust me they won't be there if or when you get sued to defend you and the compromising position they put you in. It will be like scattering cockroaches when the lights are flipped on. It saddens me that there are people like this on our profession, both anesthesiologists who should know better but don't seem to care and nurses who care without knowing better. That is a recipe for disaster. And I saw a lot of questionable care. At least I had the good sense to extricate myself. I'm not worried about that guy. I've seen the way he practices. It's only a matter of time. He'll get his. Karma's a bitch.