I also believe the same. The problem is that it is simple economics dictating the changes. It is easy to say that instead of introducing midlevels as physician-alternatives, malpractice reform should be targeted first to save costs. It is also easy to dig our heels into the ground and tell 'em what we believe to be true. The problem is that these things don't provide solutions. If you look at medicine as a production line, the analogy is that you don't need to pay a worker $40/hr to manually tighten lug nuts on a wheel with a spanner when a machine or human-machine combination can do it faster, and for less money. Of course, the manual tightner and his union is going to insist that one cannot put faith in a machine and fire the autoworker because the autoworker has been tightening lugnuts for 30 years and the passengers' lives depend on it. The problem is, that this argument doesn't make economic sense. We are trying to be those workers and the union. Ofc, now 10 people will come and say that I have no clue what anesthesia is and that my anology is completely BS. Sure. The problem is, that digging our heels and sticking to our beliefs is not going to help. For the policy makers, sacrificing some private practicing physicians is not a big deal if they can provide half-decent healthcare to a lot of people. There will be losses, and that is the nature of the game. The question is, how do we reinvent what we do. Or, better still, CAN we reinvent what we do in the bigger picture? Are we willing to accept that private practice anesthesia, which used to attract ~90% of graduating residents and where the money all lay, is going to be dead in the water, or do we fight the inevitable and get bruised even further? The analogy was a lay-person analogy, but the problem is that policymakers are laypeople. They like statistics on safety, efficiency, and other things, that don't exist yet. Why? Because everyone want to go into private practice! Circular problem, right? So, they will make decisions based on economic realities.
The next 20-30 years
- Thread starter ctsicu
- Start date
I also believe the same. The problem is that it is simple economics dictating the changes. It is easy to say that instead of introducing midlevels as physician-alternatives, malpractice reform should be targeted first to save costs. It is also easy to dig our heels into the ground and tell 'em what we believe to be true. The problem is that these things don't provide solutions. If you look at medicine as a production line, the analogy is that you don't need to pay a worker $40/hr to manually tighten lug nuts on a wheel with a spanner when a machine or human-machine combination can do it faster, and for less money. Of course, the manual tightner and his union is going to insist that one cannot put faith in a machine and fire the autoworker because the autoworker has been tightening lugnuts for 30 years and the passengers' lives depend on it. The problem is, that this argument doesn't make economic sense. We are trying to be those workers and the union. Ofc, now 10 people will come and say that I have no clue what anesthesia is and that my anology is completely BS. Sure. The problem is, that digging our heels and sticking to our beliefs is not going to help. For the policy makers, sacrificing some private practicing physicians is not a big deal if they can provide half-decent healthcare to a lot of people. There will be losses, and that is the nature of the game. The question is, how do we reinvent what we do. Or, better still, CAN we reinvent what we do in the bigger picture? Are we willing to accept that private practice anesthesia, which used to attract ~90% of graduating residents and where the money all lay, is going to be dead in the water, or do we fight the inevitable and get bruised even further? The analogy was a lay-person analogy, but the problem is that policymakers are laypeople. They like statistics on safety, efficiency, and other things, that don't exist yet. Why? Because everyone want to go into private practice! Circular problem, right? So, they will make decisions based on economic realities.
- Joined
- May 16, 2009
- Messages
- 1,145
- Reaction score
- 36
The savings doesn't go to the patient. It goes to the employer which is why surgeons and hospitals often support opt out- not to save patients money but to take money for anesthesia services/ a kickback.
- Joined
- Aug 26, 2004
- Messages
- 657
- Reaction score
- 269
- Joined
- Jan 13, 2010
- Messages
- 1,671
- Reaction score
- 480
The poster made a statement that wasn't true. All I was doing was providing a rebuttal. I'm not looking to hash out studies here, because we could do that all day, as you allude to.
- Joined
- Jul 16, 2003
- Messages
- 6,030
- Reaction score
- 3,810
PP is da bomb... just have to find the right ones.
D
deleted126335
They are harder to find now.
- Joined
- Jul 16, 2003
- Messages
- 6,030
- Reaction score
- 3,810
Yes, harder... but def. still there.
I've looked @ 4 jobs in the last 2 years.
1rst one: In the mountains: 450K no buy in, 7 weeks vacation.
2nd one: In the mountains, 400k 14 weeks vacation. Hospital employee.
3rd one: Dessert setting: 450-500K, 6 weeks vacation. 1 yr. to partnership.
4th one: Vacation location: 375K + 11 weeks. 1 year to partnership.
Of course, I've been very selective in what groups I contact, but they are def. still out there.
One of the above was a friend, so that one doesn't count.
I've passed on all the above, because I really like my BFE job.... and we've been hiring.
It's true that the current market is not as it was 10 years ago... but IMHO, the sky isn't falling either... although another 10 years might mean something else.
We will see.
I've looked @ 4 jobs in the last 2 years.
1rst one: In the mountains: 450K no buy in, 7 weeks vacation.
2nd one: In the mountains, 400k 14 weeks vacation. Hospital employee.
3rd one: Dessert setting: 450-500K, 6 weeks vacation. 1 yr. to partnership.
4th one: Vacation location: 375K + 11 weeks. 1 year to partnership.
Of course, I've been very selective in what groups I contact, but they are def. still out there.
One of the above was a friend, so that one doesn't count.
I've passed on all the above, because I really like my BFE job.... and we've been hiring.
It's true that the current market is not as it was 10 years ago... but IMHO, the sky isn't falling either... although another 10 years might mean something else.
We will see.
- Joined
- Apr 30, 2004
- Messages
- 4,151
- Reaction score
- 1,978
Once again - it would be smart if people understood about the "opt-out" and what supervision of CRNA's actually means.
"Opt-Out" relates to Medicare billing. That's all!
CRNA's can practice WITHOUT AN ANESTHESIOLOGIST in every state.
- Joined
- Apr 30, 2004
- Messages
- 4,151
- Reaction score
- 1,978
Where the hell did you get this idea?
- Joined
- May 28, 2008
- Messages
- 2,524
- Reaction score
- 3,129
- Joined
- Apr 30, 2004
- Messages
- 4,151
- Reaction score
- 1,978
Correct as far as the hospital bylaws - but those who think there are only 15 states where CRNA's can practice "independently" are totally incorrect. It does matter.
- Joined
- May 28, 2008
- Messages
- 2,524
- Reaction score
- 3,129
Whatever. This speciality is in the toilet anyway.
