Struggling Anesthesia Management Companies

[Noyac]

I now know of two AMC's ( Somnia and Apollo) who are losing their contracts with local hospital after failing to follow through on promise after promise. Somnia is failing because they can't offer anything but locums physicians to cover their crnas. And this is in a opt-out state. The conditions are so deplorable that they are down to one full time doc and that one is leaving soon. The Apollo collapse is something I heard today so I don't have details.

Is this a trend?

Are any of you seeing these companies struggle to maintain their existence in your area?

---

Members don't see this ad.

 

[Planktonmd]

I now know of two AMC's ( Somnia and Apollo) who are losing their contracts with local hospital after failing to follow through on promise after promise. Somnia is failing because they can't offer anything but locums physicians to cover their crnas. And this is in a opt-out state. The conditions are so deplorable that they are down to one full time doc and that one is leaving soon. The Apollo collapse is something I heard today so I don't have details.

Is this a trend?

Are any of you seeing these companies struggle to maintain their existence in your area?

The small AMCs are hurting but the big ones are expanding and getting stronger, eventually the big ones will swallow the small ones.

 

[Noyac]

So Somnia and Apollo are small ones?

 

[Man o War]

I now know of two AMC's ( Somnia and Apollo) who are losing their contracts with local hospital after failing to follow through on promise after promise. Somnia is failing because they can't offer anything but locums physicians to cover their crnas. And this is in a opt-out state. The conditions are so deplorable that they are down to one full time doc and that one is leaving soon. The Apollo collapse is something I heard today so I don't have details.

Is this a trend?

Are any of you seeing these companies struggle to maintain their existence in your area?

@Noyac, yes. I know of one surgery center where an AMC was dumped and one is getting ready to get dumped at a local hospital....for all the issues you mentioned above. Good riddance.

 

[nimbus]

AMCs do not have a long-term time horizon. They acquire sites and practices as rapidly as possible so they can demonstrate rapid revenue growth to their investors. The day-to-day management of an actual anesthesia practice is an afterthought to some of these outfits.

 

[nycitygas]

NAPA lost Westchester a year ago. It must have been a huge contract.

I think the AMCs that will continue to expand and thrive are those positioned in highly desirable areas and pay decent salaries (Mednax & Sheridan). Sheridan might be Satan, but 400K/yr to work 45 hours a week and live on the beach isn't the worst thing in the world. The contract/salaries offered by Somnia/Premier are appalling in comparison.

Who are replacing the AMCs? Other AMCS or true private groups?

 

[deleted126335]

Hospital boards all debate the same circle of life over and over. Option three is flying south for the winter or permanently because of excess numbers of anesthesia personnel.

1. We can do this. Employ the docs and CRNAs, do the billing (board member who has medical billing company), manage internally. Our surgeons and nurse managers are here every day and know how the OR/OB/ICU runs.

2. Outside AMC. This is what they do. Only anesthesiologists can optimally manage (exploit) other anesthesiologists. Their interests are our interests.

3. Private group. We have had clinical/malpractice disasters and crap service. Let's get this liability off our plate and incentivize a private group properly so they have the hustle to work hard and make more and give them carrot of ownership.

After one of the above turns to **** they go to one of the other options.

 

[criticalelement]

This specialty is going nowhere as long as they (we) keep aligning ourselves with the hospital for the exclusive contract. They want us to help them run the Operating room.. I consider myself a visitor just like the surgeons. I dont work for them. My job is the patient not the day to day running of the OR.

 

[risnwb]

This specialty is going nowhere as long as they (we) keep aligning ourselves with the hospital for the exclusive contract. They want us to help them run the Operating room.. I consider myself a visitor just like the surgeons. I dont work for them. My job is the patient not the day to day running of the OR.

Good luck with that...

 

[PainDrain]

I heard of one smaller AMC losing contracts and almost tanking a few years ago but the founder sold out to a larger AMC when he realized he was in over his head. He burned so many bridges it killed his business.

I am also watching an AMC at a place locally because they can't staff it. They are constantly advertising jobs and that can't look good to a hospital CEO when your AMC can't keep people longer than 3 months.

 

[Noyac]

This specialty is going nowhere as long as they (we) keep aligning ourselves with the hospital for the exclusive contract. They want us to help them run the Operating room.. I consider myself a visitor just like the surgeons. I dont work for them. My job is the patient not the day to day running of the OR.

Well, that's one way to look at it.
I'm with risnwb on this one, GOOD LUCK WITH THAT!!!
I'd love to be in your locale. I'd take your group over in a heartbeat.
That is, if your contracts are even worth a crap.

Here's the DEAL.
You are not a surgeon!
Pts don't come to the hospital to see the World Renouned Dr Criticalelement.
I'm not saying that you are not worth visiting. Just that pts don't know that you are.
And nothing is gonna change this.

You can sit back and just do cases or you can make the OR flow smooth. That's as simple as I can put it.
The more you keep surgeons out of administrators offices the more secure your job is. It sucks but it is reality.

 

[ether123]

NAPA lost westchester, NY Downtown, and north Shore has just started their own anesthesia group at their ambi centers. There has been an exodus of physicians from NAPA syosset, Glen Cove, and Franklin hospitals. This group behaves like they know they are going down and have stopped caring.

 

[aneftp]

Some of these AMCs will learn the hard way. Or they simply don't care as long as they shave money off the top and move on. They still make a profit. And just move on to their next contract theft.

Somnia took over my friend contract years ago. They were all MD group. They made around $500-550k with 10 weeks off. But they worked like dogs 65-70 hours a week.

When Somnia took over they offered 325k and 7 weeks. (Shaving money off the top). The problem is MD were still working 60-65 hours a week. Morale gets low with those hours and pay.

Hospital administrators lost their job. However Somnia still played "give us another chance". They still kept the contract and upped md salary to 350-375k. Brought in crnas. Now Mds work 50-55 hours which is tolerable.

That's how these AMCs work. It's trial by fire. They learn on the fly. They win some thus lose some.

 

[urge]

Here's the DEAL.
You are not a surgeon!
Pts don't come to the hospital to see the World Renouned Dr Criticalelement.
I'm not saying that you are not worth visiting. Just that pts don't know that you are.
And nothing is gonna change this.

You can sit back and just do cases or you can make the OR flow smooth. That's as simple as I can put it.
The more you keep surgeons out of administrators offices the more secure your job is. It sucks but it is reality.

This is why I think that our outcomes should be looked into and made public.

If they want 95y/o grand ma with renal failure, chf, and hx of strokes to do well, then I'm sure they would have no qualms asking for criticalelement if he were the top guy around.

The hospital would have to treat you like an MVP at the major leagues.

 

[deleted50478]

T

This is why I think that our outcomes should be looked into and made public.

If they want 95y/o grand ma with renal failure, chf, and hx of strokes to do well, then I'm sure they would have no qualms asking for criticalelement if he were the top guy around.

The hospital would have to treat you like an MVP at the major leagues.

there probably wouldn't be any mvps, but there might be some people to avoid.
Also, people would want to avoid sick pts to pad their stats. Surgeons do it.

 

[criticalelement]

, GOOD LUCK WITH THAT!!!
I'd love to be in your locale. I'd take your group over in a heartbeat.
That is, if your contracts are even worth a crap.

Here's the DEAL.
You are not a surgeon!
Pts don't come to the hospital to see the World Renouned Dr Criticalelement.
I'm not saying that you are not worth visiting. Just that pts don't know that you are.
And nothing is gonna change this.

You can sit back and just do cases or you can make the OR flow smooth. That's as simple as I can put it.
The more you keep surgeons out of administrators offices the more secure your job is. It sucks but it is reality.

Let me explain something to you. Nobody gives a damn who you are and what you do for them. They want to take advantage of you for themselves. Understand that. The more you bend over for hospital management the more they screw you. The harder they will grab your waist and thrust themselves into your bottom. You wanna let hospital nurses and nursing execs and admin execs tell you how to practice? Spread those cheeks baby. Get ready to take it in Balls deep. Theyre having a good ole time with your opening. You want to be an invertebrate. Go for it. I choose to stand up for myself. I am not operating room management. If you want my opinion, Ill give it to you with a fee attached... Nobody screws criticalelement except MRS critical element.

 

[pjl]

I enjoy the control over the OR flow. What is good for the OR flow is good for me with regards to maximizing cases in a set time period, and choosing what cases I can delay/get to go ahead allows me to manage the OR in a way that matches my personal staffing.
To ignore the OR management portion means that you are at the whims of the nurse/high school educated OR manager, and a much weaker position than if you control the flow of the OR.
And yes, doing a good job controlling the OR flow does make surgeons happier and administration happier. I am also happier when I get to say "No, you will follow Dr. X, you do not get to go now"

 

[Noyac]

Let me explain something to you. Nobody gives a damn who you are and what you do for them. They want to take advantage of you for themselves. Understand that. The more you bend over for hospital management the more they screw you. The harder they will grab your waist and thrust themselves into your bottom. You wanna let hospital nurses and nursing execs and admin execs tell you how to practice? Spread those cheeks baby. Get ready to take it in Balls deep. Theyre having a good ole time with your opening. You want to be an invertebrate. Go for it. I choose to stand up for myself. I am not operating room management. If you want my opinion, Ill give it to you with a fee attached... Nobody screws criticalelement except MRS critical element.

Fair enough!
You handle it your way and I'll handle it my way.

Also, if I was in the environment you describe, I would probably be as bitter as you seem to be. Fortunately, my OR environment is much different.

 

[criticalelement]

Also, if I was in the environment you describe, I would probably be as bitter as you seem to be. Fortunately, my OR environment is much different.

We are all in the same environment. Different faces same names. There is a nurse, a patient a surgeon and us. Out of all four, Im the bully, not the nurse or the surgeon

 

[nimbus]

Let me explain something to you. Nobody gives a damn who you are and what you do for them. They want to take advantage of you for themselves. Understand that. The more you bend over for hospital management the more they screw you. The harder they will grab your waist and thrust themselves into your bottom. You wanna let hospital nurses and nursing execs and admin execs tell you how to practice? Spread those cheeks baby. Get ready to take it in Balls deep. Theyre having a good ole time with your opening. You want to be an invertebrate. Go for it. I choose to stand up for myself. I am not operating room management. If you want my opinion, Ill give it to you with a fee attached... Nobody screws criticalelement except MRS critical element.

It's not bending over for anybody. It's being proactive to make a collegial well-functioning work environment for MYSELF. I'm the one who has to be there. I'm in the OR more than all the surgeons and most of the staff. Thankfully we have a fantastic, friendly group. I have no problem helping this place run smoother.

 

[nimbus]

We are all in the same environment. Different faces same names. There is a nurse, a patient a surgeon and us. Out of all four, Im the bully, not the nurse or the surgeon

Seriously you should have been a lawyer.

 

[NOsaintsfan]

This is why I think that our outcomes should be looked into and made public.

If you can figure out a way to make that happen that could be the ticket. With as lawsuit happy as our country is you would see family's going to court because grandmaw had a bad outcome and the hospital used inferior care (CRNA).

 

[Stank811]

The two management companies in my state are struggling as well with recruitment and from what I hear are falling out of favor with the hospital systems.

 

[gasdoc77]

Let me explain something to you. Nobody gives a damn who you are and what you do for them. They want to take advantage of you for themselves. Understand that. The more you bend over for hospital management the more they screw you. The harder they will grab your waist and thrust themselves into your bottom. You wanna let hospital nurses and nursing execs and admin execs tell you how to practice? Spread those cheeks baby. Get ready to take it in Balls deep. Theyre having a good ole time with your opening. You want to be an invertebrate. Go for it. I choose to stand up for myself. I am not operating room management. If you want my opinion, Ill give it to you with a fee attached... Nobody screws criticalelement except MRS critical element.

This sums up my practice to a "T". I find myself conflicted as a full partner (the newest) in a much older practice that has displayed no backbone, putting them in the predicament you describe. I find myself almost looking forward to the implosion. At least I won't potentially regret walking away from a partnership in this practice climate.

 

[gascopper]

Are you sure you would want to move away from a partnership??

 

[gasdoc77]

Are you sure you would want to move away from a partnership??

Far from sure. It's something I have debated for a while now.

 

[gascopper]

partnership is partnership my friend. im a pain fellow and would LOVE to be in your shoes. no partnership or business is perfect, but its your baby...don't leave it.

 

[HenryH]

Anyone know how Northstar is doing these days?

 

[Hockeyguy]

I was helping the guys out in Vail when Apollo sniped their contract. Great group of docs, for the most part. Heartbreaking to see that happen I hope they get the contract back and a healthy subsidy. Apollo sucks!

 

[norwood]

Anyone know how Northstar is doing these days?

Still the employer of last resort for has-beens, won't-bes, and people temporarily or permanently stuck somewhere

 

[HenryH]

Still the employer of last resort for has-beens, won't-bes, and people temporarily or permanently stuck somewhere

LOL, sounds like the kind of place most people wouldn't want to end-up working for. Just out of curiosity, do you know how they're faring in terms of finances/revenue and the frequency with which they're securing new contracts (as well as renewing current ones)?

 

[nycitygas]

They are growing quite rapidly actually. Northstar is the "lowest cost option" for most hospitals-they seem to be growing through competitive bidding rather than buying out groups.

Looks like a terrible place to work but they pay above market rate in most areas. I assume the cost differential is made up with exorbitant hours or through CRNA 1:6-8 supervision.

 

[HenryH]

They are growing quite rapidly actually. Northstar is the "lowest cost option" for most hospitals-they seem to be growing through competitive bidding rather than buying out groups.

Looks like a terrible place to work but they pay above market rate in most areas. I assume the cost differential is made up with exorbitant hours or through CRNA 1:6-8 supervision.

That's too bad; they have the contract with the local hospital system where I live, and I was hoping they'd be likely to lose it sooner or later....

 

[GA8314]

I now know of two AMC's ( Somnia and Apollo) who are losing their contracts with local hospital after failing to follow through on promise after promise. Somnia is failing because they can't offer anything but locums physicians to cover their crnas. And this is in a opt-out state. The conditions are so deplorable that they are down to one full time doc and that one is leaving soon. The Apollo collapse is something I heard today so I don't have details.

Is this a trend?

Are any of you seeing these companies struggle to maintain their existence in your area?

I feel that so many hospitals are getting burned by the sales pitch with very little value added, and yes, the permanent "temp" anesthesiologists coming in that it's inevitable for hospital executives to share their horror stories. I can see the tide turning already.

Having quality docs with ties to the communities they serve isn't a commodity and hospitals are finding this out very quickly it seems. Too bad some pain needs to happen first, but I've heard and am aware of several such cases.

 

[GA8314]

Good luck with that...

My thoughts exactly.

 

[GA8314]

Let me explain something to you. Nobody gives a damn who you are and what you do for them. They want to take advantage of you for themselves. Understand that. The more you bend over for hospital management the more they screw you. The harder they will grab your waist and thrust themselves into your bottom. You wanna let hospital nurses and nursing execs and admin execs tell you how to practice? Spread those cheeks baby. Get ready to take it in Balls deep. Theyre having a good ole time with your opening. You want to be an invertebrate. Go for it. I choose to stand up for myself. I am not operating room management. If you want my opinion, Ill give it to you with a fee attached... Nobody screws criticalelement except MRS critical element.

LOL

Dude, you are being your own worst enemy. I get it. You are jaded. Maybe you're venting. But, that attitude WILL NOT serve YOU. Consider that.

 

[GA8314]

They are growing quite rapidly actually. Northstar is the "lowest cost option" for most hospitals-they seem to be growing through competitive bidding rather than buying out groups.

Looks like a terrible place to work but they pay above market rate in most areas. I assume the cost differential is made up with exorbitant hours or through CRNA 1:6-8 supervision.

I have witnessed this recently from a distance. They ousted a large group I am familiar with (the group deserved to lose it for sure from what I've heard though). Now they are hiring and we'll see how that goes.

****I strongly suspect that there will be opportunities for GOOD anesthesiologists, with drive and business acumen to retake some of these contracts from the AMC's in the near future.

 

[Mman]

Are any of you seeing these companies struggle to maintain their existence in your area?

I am aware of an American (Mednax) location that is less than happy with their services and will be considering backing out of their deal. Surgeons have major complaints with the rotating cast of characters sitting in their room every day that they no longer recognize. We will see if it continues to implode.

 

[Noyac]

I am aware of an American (Mednax) location that is less than happy with their services and will be considering backing out of their deal. Surgeons have major complaints with the rotating cast of characters sitting in their room every day that they no longer recognize. We will see if it continues to implode.

I believe that is one of their biggest issues is the "rotating cast of characters".

 

[GA8314]

I believe that is one of their biggest issues is the "rotating cast of characters".

Yep. "Characters" being the key phrase. Also, the "value proposition" seems really weak in reality. I really believe this will be a trend that comes and goes. Will all of them go by the wayside? Not likely, but I think the momentum is going to slow down a bit. I do not believe it's a foregone conclusion that all PP groups get consumed or lose contracts to the AMC's. I just don't think the model is that sustainable. We'll see.

 

[amyl]

Local grapevine is that Somnia is in trouble in one hospital.... However the admin may be an even bigger mess - not sure about the solvency of the hospital even so... Also from local grapevine north star is in trouble nearby... Can't find Drs or crnas n tons of locums etc - varying quality etc. surgeons unhappy etc. they were offering 425 w q10 call and still can't find bodies. Both are towns in the Midwest. Basically bfe

 

[sevoflurane]

Local grapevine is that Somnia is in trouble in one hospital.... However the admin may be an even bigger mess - not sure about the solvency of the hospital even so... Also from local grapevine north star is in trouble nearby... Can't find Drs or crnas n tons of locums etc - varying quality etc. surgeons unhappy etc. they were offering 425 w q10 call and still can't find bodies. Both are towns in the Midwest. Basically bfe

I've heard this story many times. Perfect timing for the right person(s) to string a good group together and get a nice subsidy from the hospital in return for a smooth running OR and happy surgeons.
In the end, good administrators realize that it's a big headache to deal with these poorly run AMCs that are only in it for the bottom line (most of them don't care who is giving anesthesia so long as they have the "contract").
BFE is somewhat sheltered because nobody in their right mind will work for an AMC in BFE. Therefore AMC quality in BFE is usually pretty terrible (as are the subpar locums trying to fill the hole).

 

[BuzzPhreed]

I believe that is one of their biggest issues is the "rotating cast of characters".

Yep. "Characters" being the key phrase. Also, the "value proposition" seems really weak in reality. I really believe this will be a trend that comes and goes. Will all of them go by the wayside? Not likely, but I think the momentum is going to slow down a bit. I do not believe it's a foregone conclusion that all PP groups get consumed or lose contracts to the AMC's. I just don't think the model is that sustainable. We'll see.

This is what the idiots in the adminisphere don't always understand. An FTE is not an FTE is not an FTE. We are not "interchangeable". We've worked hard in my current arrangement to make sure that they understand that a large part of the success and growth our hospital has encountered over the past 7 years is in large part based on what we've brought to the table.

Unfortunately the changing characters lately seem only to be in administration. And each time these new idiots come on board there is a painful learning curve... that an FTE is not an FTE is not an FTE. (And none of them are physicians so they don't really have a clue what we do in the first place.)

 

[Wiscoblue]

I've heard this story many times. Perfect timing for the right person(s) to string a good group together and get a nice subsidy from the hospital in return for a smooth running OR and happy surgeons.
In the end, good administrators realize that it's a big headache to deal with these poorly run AMCs that are only in it for the bottom line (most of them don't care who is giving anesthesia so long as they have the "contract").
BFE is somewhat sheltered because nobody in their right mind will work for an AMC in BFE. Therefore AMC quality in BFE is usually pretty terrible (as are the subpar locums trying to fill the hole).

The only problem is, most of these hospitals are in low reimbursement areas with high Medicare and Medicaid. You couldn't put a group together to oust the CMG.


Sent from my iPad using Tapatalk

 

[HenryH]

I've heard this story many times. Perfect timing for the right person(s) to string a good group together and get a nice subsidy from the hospital in return for a smooth running OR and happy surgeons.
In the end, good administrators realize that it's a big headache to deal with these poorly run AMCs that are only in it for the bottom line (most of them don't care who is giving anesthesia so long as they have the "contract").
BFE is somewhat sheltered because nobody in their right mind will work for an AMC in BFE. Therefore AMC quality in BFE is usually pretty terrible (as are the subpar locums trying to fill the hole).

I'm curious about how all of this works. Northstar currently has the contract with the local hospital network in my area (actually, about 6 months ago, they bought the previous AMC that formerly had the contract) and from what I've heard, they're constantly operating the "revolving door" of losing, hiring, then again losing (I.e., "rinse and repeat") anesthesia providers. But here's the weird part -- my understanding is that the surgeons aren't particularly happy with Northstar's service and the constant shuffling of anesthesia providers, and yet, at the same time, I have been told that it doesn't matter because the surgeons "have no clout." So if the surgeons are the critical, primary revenue-earners for the hospital, then how is it that their grievances carry apparently no influence whatsoever with the hospital's administration?

It's probably worth mentioning that even though my area definitely doesn't qualify as BFE (population is 250k-300k), the payer mix is supposedly in the range of 80-85% Medicare/Medicaid/indigent (I.e., no coverage whatsoever). Generally speaking, is it even possible for an anesthesia group running 1:4 supervision to be profitable in this particular payer demographic? Or are significantly expanded supervision ratios (e.g., 1:6 - 1:8) the only way to make this kind of situation "work?"

 

[sevoflurane]

The only problem is, most of these hospitals are in low reimbursement areas with high Medicare and Medicaid. You couldn't put a group together to oust the CMG.
Sent from my iPad using Tapatalk

Not in my old neck of the woods. My old hospital looked like a spa. Beautiful in and out. Great place to work, just terrible location.

I'm curious about how all of this works. Northstar currently has the contract with the local hospital network in my area (actually, about 6 months ago, they bought the previous AMC that formerly had the contract) and from what I've heard, they're constantly operating the "revolving door" of losing, hiring, then again losing (I.e., "rinse and repeat") anesthesia providers. But here's the weird part -- my understanding is that the surgeons aren't particularly happy with Northstar's service and the constant shuffling of anesthesia providers, and yet, at the same time, I have been told that it doesn't matter because the surgeons "have no clout." So if the surgeons are the critical, primary revenue-earners for the hospital, then how is it that their grievances carry apparently no influence whatsoever with the hospital's administration?

It's probably worth mentioning that even though my area definitely doesn't qualify as BFE (population is 250k-300k), the payer mix is supposedly in the range of 80-85% Medicare/Medicaid/indigent (I.e., no coverage whatsoever). Generally speaking, is it even possible for an anesthesia group running 1:4 supervision to be profitable in this particular payer demographic? Or are significantly expanded supervision ratios (e.g., 1:6 - 1:8) the only way to make this kind of situation "work?"

In BFE, you get a subsidy because of location. When you negotiate $50 a unit for all medicaid/medicare, then things tend to even out. You are also a very valued commodity to the OR environment when you form a group and bring stability... especially if you are replacing a terrible AMC with bad outcomes that can devastate the reputation of a regional or community hospital.
I've been there and lived that.

 

[nimbus]

I'm curious about how all of this works. Northstar currently has the contract with the local hospital network in my area (actually, about 6 months ago, they bought the previous AMC that formerly had the contract) and from what I've heard, they're constantly operating the "revolving door" of losing, hiring, then again losing (I.e., "rinse and repeat") anesthesia providers. But here's the weird part -- my understanding is that the surgeons aren't particularly happy with Northstar's service and the constant shuffling of anesthesia providers, and yet, at the same time, I have been told that it doesn't matter because the surgeons "have no clout." So if the surgeons are the critical, primary revenue-earners for the hospital, then how is it that their grievances carry apparently no influence whatsoever with the hospital's administration?

Existing surgeons may actually less leverage in BFE where there may only be one hospital in town. I practice in an area with 13 hospitals in a 15 mile radius. Most of our surgeons have privileges at 3 or more hospitals so they can easily shift their cases elsewhere. It wouldn't be so easy in BFE.

 

[nimbus]

Not in my old neck of the woods. My old hospital looked like a spa. Beautiful in and out. Great place to work, just terrible location.




In BFE, you get a subsidy because of location. When you negotiate $50 a unit for all medicaid/medicare, then things tend to even out. You are also a very valued commodity to the OR environment when you form a group and bring stability... especially if you are replacing a terrible AMC with bad outcomes that can devastate the reputation of a regional or community hospital.
I've been there and lived that.

Wow! $50 for Medicaid I can only dream. Sounds like anesthesia Shangrila.

 

[sevoflurane]

Existing surgeons may actually less leverage in BFE where there may only be one hospital in town. I practice in an area with 13 hospitals in a 15 mile radius. Most of our surgeons have privileges at 3 or more hospitals so they can easily shift their cases elsewhere. It wouldn't be so easy in BFE.

Quite the opposite in many areas. If you don't like it in BFE you leave town...! 🙄 and you never know what the hospital is going to get.

Physician retention is an ongoing endeavor in many places. I wrote a LOR for one of my old orthopod friends when he was jumping ship at the same time I was. Once administration caught wind of that he suddenly received a huge retention raise (think >90% orthopod MGMA).

I love the sound of that... Physician Retention.

 

[sevoflurane]

Existing surgeons may actually less leverage in BFE where there may only be one hospital in town. I practice in an area with 13 hospitals in a 15 mile radius. Most of our surgeons have privileges at 3 or more hospitals so they can easily shift their cases elsewhere. It wouldn't be so easy in BFE.

While this is true, don't undermine the fact that said hospitals can hire their "own" surgeons and get rid of the existing surgeons priveleges at said facility (for better or worse).