This is How Lucrative AMCs Are

[circulus vitios]

You make it sound like it's so easy. Hey, let's just start a company and we can be the next AMC, better yet maybe even the Google of Anesthesia.

You're right. Let's just keep bitching about it on the internet and berating partners for selling practices that they built with their money and hard work.

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[Baller MD]

You're right. Let's just keep bitching about it on the internet and berating partners for selling practices that they built with their money and hard work.

Isn't that what forums are for? For discussion? What the hell do you expect them to do? Please don't say start an AMC competitor.

 

[deleted171991]

You're right. Let's just keep bitching about it on the internet and berating partners for selling practices that they built with their money and hard work.

What money? What's the "big" investment in starting a highly-lucrative anesthesia group? I have about the same respect for these people as I would for Costco selling out its employees to Walmart.

 

[seinfeld]

When i was applying for medical school my goal was not to one day own my own business,it was to become a physician. I wanted to practice medicine. In 5 years of practice i spend more of my "free" time making sure the business is running well than ensuring my knowledge is up to snuff.

Why do i spend so much time running the business then? If you put your head in the sand, eventually you ll get run over. I don't want a massive salary, but someone has to protect it. I wish i could just be a doctor and not a businessman.

AMCs offer relief for many of us who could care less about the business.

Definitely agree with MMAN. The only people I owe anything to are my parents for obvious reasons, my loving wife for running a house full of chaos (often without me) and my kids who have come to learn that sometimes a complete strangers poor heath gets my attention and not them. Sure there is a need to protect our territory but when i die "you" won't be there and they will.

 

[circulus vitios]

What money? What's the "big" investment in starting a highly-lucrative anesthesia group?

I have about the same respect for these people as I would for Costco selling out its employees to Walmart.

Legal costs, fringe benefits, malpractice insurance, etc?

 

[aneftp]

You're either not comprehending or purposely being thick. If someone locks-up a market, you can't compete with them. This is the definition of a monopoly.

Exactly. It doesn't even have to be a monopoly in medicine. Look at the orange county example I made above.

pretty soon physicians will challenge why corporations can leverage their bargining power but docs can't merge. Something has got to give.

 

[aneftp]

You're right. Let's just keep bitching about it on the internet and berating partners for selling practices that they built with their money and hard work.

Not exactly hard work.

Most who have sold out have just lucked out being right time right place. Anesthesia had a great run for almost the past 12-13 years. There were lean years between 1994-1998 in many big city northeast and west coast areas.

But most of the people selling out was bot due to hard work. Mainly luck and timing.

 

[aneftp]

You are right on the first point about NO SUBSIDY means the AMC has a more difficult time stealing the anesthesia contract. But, you are wrong about the second point as the AMC Collects 30% more money from the private payers compared to the old group which results in ZERO subsidy from the hospital.

If the AMC could pay the CEO/hospital a $1 million per year for the lucrative contracts they would kick out the "all MD" model and replace it with the ACT. Currently, that "kickback" of $1 million is illegal but in the future model where ACOs dominate the AMC has a big advantage over "all MD."

I used to think that the ACO meant the death of the AMC but I am no longer certain this is the case. Instead, AMCs can hire cheap labor and run an efficient department to staff the ACO which is something many hospital CEOs don't know how to do.

ACO's are not gaining popularity.

http://capsules.kaiserhealthnews.org/?p=20879

1/3 of the model aco have aborted after one year. Why should hospitals take financial risk trying to improve patient care which is subjective and has too many varying factors when they can just leverage their monopoly powers they have in their respective regions.

 

[IanMcGalt]

You're right. Let's just keep bitching about it on the internet and berating partners for selling practices that they built with their money and hard work.

Ha ha ha. What practice? You mean showing up each day and doing cases? If they didn't do it someone else would have done it just as well. It's not like these people improved anesthesia or anything. Anesthesiologists don't have practices. We take care of the surgeons' patients.

 

[nimbus]

Not exactly hard work.

Most who have sold out have just lucked out being right time right place. Anesthesia had a great run for almost the past 12-13 years. There were lean years between 1994-1998 in many big city northeast and west coast areas.

But most of the people selling out was bot due to hard work. Mainly luck and timing.

Many of us lived and worked through the bad mid-90s. I had an offer of $110k to do pedi hearts in Long Beach, Ca. That's how bad it was. It's not really a matter of good timing. It is more a matter of staying in the game long enough to see both the good times and the bad.

 

[aneftp]

Many of us lived and worked through the bad mid-90s. I had an offer of $110k to do pedi hearts in Long Beach, Ca. That's how bad it was. It's not really a matter of good timing. It is more a matter of staying in the game long enough to see both the good times and the bad.

I'll buy some of your argument (being in the game long enough to see both good and bad). I know salaries were very low in the mid 90s. My brother is 10 years older than me. And $110K is all he got with full call schedule back in the mid 90s doing cardiac as well. Those were his two offers in NYC proper and Washington DC proper.

But my point is it's not just all hard work. There is always some element of luck and timing.

 

[BLADEMDA]

I'll buy some of your argument (being in the game long enough to see both good and bad). I know salaries were very low in the mid 90s. My brother is 10 years older than me. And $110K is all he got with full call schedule back in the mid 90s doing cardiac as well. Those were his two offers in NYC proper and Washington DC proper.

But my point is it's not just all hard work. There is always some element of luck and timing.

So, let me get this straight. I know a guy who got paid $80K for his first year post Residency. He was a "slave" to the group for many years not making any real money until year 4. This person lived through the bad times and now has the opportunity to sell out to an AMC. Were you there to help him when he was earning $80K? Now that an AMC wants to buy him out he "owes" some younger dude the opportunity to earn the money he never did?

I don't get any of this stuff. You people don't realize the screw job some of these "sell-outs" had to endure during their careers. All you see is that the "evil" AMC is out there. Well, the AMC pays well over $300K to a FRESH NEW graduate which means that "sell out" guy may have had to work 10 years before he/she earned the same amount of money the AMC is offering today.

My point in this post is that $300K plus for a reasonable job in a decent location is a nice way to start your career. AMCs are probably more fair than many groups which pretend to offer partnership only to screw over the new graduate.

These days fairness is hard to find and one should value that over the salary in my opinion.

 

[aneftp]

So, let me get this straight. I know a guy who got paid $80K for his first year post Residency. He was a "slave" to the group for many years not making any real money until year 4. This person lived through the bad times and now has the opportunity to sell out to an AMC. Were you there to help him when he was earning $80K? Now that an AMC wants to buy him out he "owes" some younger dude the opportunity to earn the money he never did?

I don't get any of this stuff. You people don't realize the screw job some of these "sell-outs" had to endure during their careers. All you see is that the "evil" AMC is out there. Well, the AMC pays well over $300K to a FRESH NEW graduate which means that "sell out" guy may have had to work 10 years before he/she earned the same amount of money the AMC is offering today.

My point in this post is that $300K plus for a reasonable job in a decent location is a nice way to start your career. AMCs are probably more fair than many groups which pretend to offer partnership only to screw over the new graduate.

These days fairness is hard to find and one should value that over the salary in my opinion.

No that's not the point I wanted to make. The point is say out of a group with 20 partners who have "sold out". If you go on average who practiced during the lean times. Out of those 20 partners. You may have maybe 5-6 guys who were with the original group during the lean times back in 1994-1998. That means the other 15 partners who joined later during the good times just happened to "luck out" if the group decided to sell out. Thus my quote...."most" people just luck out when they decide to sell out. I never said all people.

Of course private practice groups abuse the young. I've come from a family of anesthesiologists. I see how my sisters was burned badly by one of the top 3-4 groups in the Washington DC area during one of their 5 year partnership tracks. She was making 120, 140,160,180K even into the early 2000s in hope of a partnership. While the partners were making easily 500K plus.

 

[IanMcGalt]

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[Baller MD]

So, let me get this straight. I know a guy who got paid $80K for his first year post Residency. He was a "slave" to the group for many years not making any real money until year 4. This person lived through the bad times and now has the opportunity to sell out to an AMC. Were you there to help him when he was earning $80K? Now that an AMC wants to buy him out he "owes" some younger dude the opportunity to earn the money he never did?

I don't get any of this stuff. You people don't realize the screw job some of these "sell-outs" had to endure during their careers. All you see is that the "evil" AMC is out there. Well, the AMC pays well over $300K to a FRESH NEW graduate which means that "sell out" guy may have had to work 10 years before he/she earned the same amount of money the AMC is offering today.

My point in this post is that $300K plus for a reasonable job in a decent location is a nice way to start your career. AMCs are probably more fair than many groups which pretend to offer partnership only to screw over the new graduate.

These days fairness is hard to find and one should value that over the salary in my opinion.

Wait, what? I though you said (although I could be wrong) that this is the new low in anesthesia?

 

[Mman]

Of course private practice groups abuse the young. I've come from a family of anesthesiologists. I see how my sisters was burned badly by one of the top 3-4 groups in the Washington DC area during one of their 5 year partnership tracks. She was making 120, 140,160,180K even into the early 2000s in hope of a partnership. While the partners were making easily 500K plus.

Of course some private practice groups "abuse the young", but not all. Our group has never not made a partnership track physician a partner. I know several others as well that have only excluded somebody when they obviously had a major personality/professional clash and notified those people well in advance that they wouldn't become a partner.

 

[deleted126335]

Being a bad person isn't luck. Their real luck is that the generation before THEM weren't as bad of people as they are and didn't sell out so frequently.

Of course some private practice groups "abuse the young", but not all. Our group has never not made a partnership track physician a partner. I know several others as well that have only excluded somebody when they obviously had a major personality/professional clash and notified those people well in advance that they wouldn't become a partner.

Mman, that is not enough. You see you are a bad person if you do exactly as you have been doing and sell your practice to the hospital or AMC. You care nothing for those that come after you.

 

[BLADEMDA]

Wait, what? I though you said (although I could be wrong) that this is the new low in anesthesia?

My exact words were " the glass is half full" so please don't misquote me. The new "low" in anesthesia will be when the AMC starts paying $200K for a new graduate and they have a long line of applicants for the job.

What we are seeing is the Commoditization of anesthesia; the same thing which went on with other "services" like cell phone carriers, pizza prices, etc. We are a "service" industry and guys like WalMart/Mednax can do it cheaper.

If you want to practice "medicine" and not be in a service industry I suggest another specialty.
However, if anesthesia is your sort of gig be prepared for the AMC or hospital employed position as that is the future in this field. IMHO, a PGY-1 starting in July 2014 has an 80% chance (or more) that he/she will be employed by a hospital, academic center or an AMC after residency.

 

[aneftp]

My exact words were " the glass is half full" so please don't misquote me. The new "low" in anesthesia will be when the AMC starts paying $200K for a new graduate and they have a long line of applicants for the job.

What we are seeing is the Commoditization of anesthesia; the same thing which went on with other "services" like cell phone carriers, pizza prices, etc. We are a "service" industry and guys like WalMart/Mednax can do it cheaper.

If you want to practice "medicine" and not be in a service industry I suggest another specialty.
However, if anesthesia is your sort of gig be prepared for the AMC or hospital employed position as that is the future in this field. IMHO, a PGY-1 starting in July 2014 has an 80% chance (or more) that he/she will be employed by a hospital, academic center or an AMC after residency.

Anesthesia is still a very labor intensive commodity. You can take cashier's away and use self checkout lines. But ORs still need to be staffed.

Mednax doesn't do it cheaper. In fact, most can agree Mednax costs the system more with their demands for higher reimbursement.

 

[Mman]

Anesthesia is still a very labor intensive commodity. You can take cashier's away and use self checkout lines. But ORs still need to be staffed.

Mednax doesn't do it cheaper. In fact, most can agree Mednax costs the system more with their demands for higher reimbursement.

Mednax does cost the system more right now and then as the money is drained they will chip away at their cost of doing business to maintain profitability so they will lower the physician salaries.

What I'm not convinced of entirely, however, is that physicians would be better off not working for them in that future scenario. For example, if a partner in a group makes $500K a year right now and for Mednax he'll make $400K, in 10 years would he be better off making $300K from Mednax than what he'd make on his own? It's quite possible that small private groups with minimal negotiating power will simply cease to be profitable in any way and will just go under on their own. Now I don't know that one way or another, but it's certainly within the realm of possibility.

 

[BLADEMDA]

Mednax has pricing power and name recognition as one of the leaders in anesthesia services. They may cost the system more right now but they will be able to lower costs over time. I see the AMCs as the organizations which will determine staffing ratios of MD to CRNAs. They have every incentive to increase those ratios over time provided surgeons and administrators don't complain about the quality of the care.

As for the all MD model, that model will hold up as long as there are private insurance companies footing the bill and not the hospital CEO via a subsidy.

 

[BuzzPhreed]

This is what I think some of you aren't understanding.

When you are a partner in private practice you're an owner of a practice and you make the business decisions, whether good or bad. It is your business and you decide how to run it. In that instance it is necessary to have contractual employment arrangements with your fellow partners, especially if you don't fully trust one (or more) of them, to make sure you know how things are going to go if conflict arises.

When you become an employee, you give most of this away. Sure they will tell you that they're not going to interfere with medical decisions, but you will also have no say in how many CRNAs you're required to direct, where your assignments may be, what the rules are regarding call and coverage, etc. This is all laid out in the corporate business plan which is not necessarily negotiated with you or by someone who has your best interests.

Why on earth would you sign an employment contract in that situation?

They should - by default - provide you medical malpractice coverage and tail if you join them. If they're not promising you a shareholder stake you shouldn't give them any more than what is normally fair notice at any other job. This is the only way I would ever take an AMC job, including those current what-are-really AMC jobs masquerading as private practice jobs.

There has to be gold in the handcuffs. Otherwise they're just handcuffs.

 

[aneftp]

This is what I think some of you aren't understanding.

When you are a partner in private practice you're an owner of a practice and you make the business decisions, whether good or bad. It is your business and you decide how to run it. In that instance it is necessary to have contractual employment arrangements with your fellow partners, especially if you don't fully trust one (or more) of them, to make sure you know how things are going to go if conflict arises.

When you become an employee, you give most of this away. Sure they will tell you that they're not going to interfere with medical decisions, but you will also have no say in how many CRNAs you're required to direct, where your assignments may be, what the rules are regarding call and coverage, etc. This is all laid out in the corporate business plan which is not necessarily negotiated with you or by someone who has your best interests.

Why on earth would you sign an employment contract in that situation?

They should - by default - provide you medical malpractice coverage and tail if you join them. If they're not promising you a shareholder stake you shouldn't give them any more than what is normally fair notice at any other job. This is the only way I would ever take an AMC job, including those current what-are-really AMC jobs masquerading as private practice jobs.

There has to be gold in the handcuffs. Otherwise they're just handcuffs.

Mednax and Sheridan are self insured so they do cover malpractice including tail.

 

[BuzzPhreed]

Mednax and Sheridan are self insured so they do cover malpractice including tail.

This shouldn't require you signing a contract. It should therefore be an automatic part of employment.

 

[BuzzPhreed]

My point is, if we're going to go all the way and make doctors nothing more than "employees" in the organization subject to the whims and flights of fancy of management, then go all the way. Nurses and techs don't sign employment contracts. All a contract does in that situation is tie you to a potentially sh*tty job. It's a disincentive for them to treat you well. Nothing more.

 

[seinfeld]

If you sign a contract that in no way protects your rights or benefits you, then yes, you are stupid for signing a contract.

However most contracts have give and take for both sides. If you don't like the negotiations then walk away. If you don't have a contract and are an " at will " empolyee like nurses and techs then you don't have the same legal protections for firing, dismissal, protections in case of disability, etc

 

[BLADEMDA]

80% of all anesthesia graduates in 2018 will end up working for a hospital or AMC. Those are the facts so get used to it.

If you don't sign the contract then someone else will. It's that simple.

 

[IanMcGalt]

80% of all anesthesia graduates in 2018 will end up working for a hospital or AMC. Those are the facts so get used to it.

If you don't sign the contract then someone else will. It's that simple.

Not just that, but if you don't sign the contract, you better apply for another residency because good anesthesia jobs are a thing of the past thanks to the sellout facilitated AMC takeover.

The idea that taking a bad job is a choice is a joke because there aren't (many) good jobs anymore.

 

[IlDestriero]

I wonder if the stability of academic positions will lead to a widespread increase in competition for jobs at da' U? The good academic spots already are quite competitive.

 

[deleted126335]

I wonder if the stability of academic positions will lead to a widespread increase in competition for jobs at da' U? The good academic spots already are quite competitive.[/QUOTE
Academic positions are also subject to market forces, although because of politics tend to lag the market. I have little doubt that these folks will also be working harder for less going forward.

 

[aneftp]

This shouldn't require you signing a contract. It should therefore be an automatic part of employment.

Most smaller AMCs that employ W2 do not provide tail coverage.

Almost every group partnership "employee" contract for 1-5 years involves no tail coverage. Buyer beware.

We all know a "tail" is worth anywhere between $10-40k. That needs to be included in the total calculation when figuring out W2 (partnership track/AMC employee).

A W2 with no benefits is probably the worst contract anyone can sign. Better off being an "employee of AMC" for 1099 status. Although one must be careful for irs tax reasons the classification of 1099 status.

 

[aneftp]

I wonder if the stability of academic positions will lead to a widespread increase in competition for jobs at da' U? The good academic spots already are quite competitive.

Won't name specific academic places since I know quite a few.

But I know personally quite a few who aren't happy with their increase clinical work load in academics. Used to be just the junior faculty being the worker bees. But even the more senior (not the top top dogs). But many of the more senior faculty are being asked to do more clinical work.

Less BS "non clinical" time when faculty show up at 8am. Have breakfast. Chit chat. Take a morning nap. Than go home around 12-1230pm like at a certain Midwestern academic institution.

 

[aneftp]

Not just that, but if you don't sign the contract, you better apply for another residency because good anesthesia jobs are a thing of the past thanks to the sellout facilitated AMC takeover.

The idea that taking a bad job is a choice is a joke because there aren't (many) good jobs anymore.

There are bad jobs out there. As people get smarter. The beauty of anesthesia is you don't need to work "full time".

It's better to work 3 days a week for around $150k. Than "supplement income" filling coverage gaps. You can easily make $250k working 40 hours a week this way no call no weekends. No stress.

 

[Substance]

an overabundance of residency positions is what enables corporate interference. look to pathology as an example. the scarce commodities are worth the most.

 

[BLADEMDA]

an overabundance of residency positions is what enables corporate interference. look to pathology as an example. the scarce commodities are worth the most.

We agree here. That said, Anesthesiology has INCREASED the number of Residency positions over the past few years. In adition, more practices bill "QZ' and this means heavier utilization of cheaper CRNA labor over expensive Anesthesiologists. The net sum is AMCs are in the driver's seat.

 

[BuzzPhreed]

We all have a clear handle on the problem. I'm trying to suggest solutions.

First solution is solidarity. If new grads refuse to sign sh*tty contracts and tough it out for a little while doing locums or whatever, eventually these "practices" will have to change tactics.

Second solution is prior proper planning. Early in your residency (especially if you are in a big one) start making friends and trying to learn the business. I would've loved to have been able to plan starting at CA1 to look at an area with some of my residency buds and put in an RFP bidding for a contract. That would've been fun. But you get so tied up in residency that this becomes hard. And you have to possess both a spirit of entrepreneurship and willingness to work with people you trust.

Lastly the other solution is legal. Simply put there may be some non-statutory legal challenges via the Sherman anti-trust act that a lot of these big groups are violating. This would require at this point getting the FTC or some other labor organization behind you that would be willing to bankroll such a lawsuit because we are the relative Davids to their Goliath at this point.

 

[Mman]

Second solution is prior proper planning. Early in your residency (especially if you are in a big one) start making friends and trying to learn the business. I would've loved to have been able to plan starting at CA1 to look at an area with some of my residency buds and put in an RFP bidding for a contract. That would've been fun. But you get so tied up in residency that this becomes hard. And you have to possess both a spirit of entrepreneurship and willingness to work with people you trust.

What would've been fun is seeing the look on a hospital administrator's face while reading an RFP submitted by a bunch of non board certified residents wishing to take over a contract for services at their hospital. While theoretically possible, no hospital wants an entire department staffed by people 1 day removed from residency.

 

[deleted126335]

What would've been fun is seeing the look on a hospital administrator's face while reading an RFP submitted by a bunch of non board certified residents wishing to take over a contract for services at their hospital. While theoretically possible, no hospital wants an entire department staffed by people 1 day removed from residency.

My fellow residents and I had the same pipe dream. Not enough accumulated knowledge, business savy, financial resources, plus being totally untested. Even though we were from a big name program. Just not feasible.

 

[BuzzPhreed]

I know of at least one instance where this was done. It was led by a former faculty member where I trained and he hand-picked people to go with him. The hospital was so disgruntled with the shoddy mostly absentee group who was there before who basically let the CRNAs rule the roost that they were happy to turn it over.

I know of it because I am in it. While the arrangement is still a hospital-owned group, we have total control over day-to-day operations and call the shots. Why I ever left this in the first place just leaves me with a "what was I thinking" in my mind. I'm glad they took me back.

I'm sure there are plenty of academic guys who are sick of the bullsh*t that could be persuaded into such an arrangement. Find a mentor... and a potential future business partner.

 

[BLADEMDA]

I know of at least one instance where this was done. It was led by a former faculty member where I trained and he hand-picked people to go with him. The hospital was so disgruntled with the shoddy mostly absentee group who was there before who basically let the CRNAs rule the roost that they were happy to turn it over.

I know of it because I am in it. While the arrangement is still a hospital-owned group, we have total control over day-to-day operations and call the shots. Why I ever left this in the first place just leaves me with a "what was I thinking" in my mind. I'm glad they took me back.

I'm sure there are plenty of academic guys who are sick of the bullsh*t that could be persuaded into such an arrangement. Find a mentor... and a potential future business partner.

And you can outbid an AMC whose Reimbursement is 30% higher than yours per unit? Plus, the AMC pays a lower wage than your senior academic guy is earning now giving them another advantage.

The only chance you have is if they want all MD anesthesia and no subsidy is required. Even then the AMC has successfully outbid private MD groups for the contract (e.g., ask Noyac).

Sorry, but the AMC wins the bid 99/100 times in most scenarios.

 

[IanMcGalt]

And you can outbid an AMC whose Reimbursement is 30% higher than yours per unit? Plus, the AMC pays a lower wage than your senior academic guy is earning now giving them another advantage.

The only chance you have is if they want all MD anesthesia and no subsidy is required. Even then the AMC has successfully outbid private MD groups for the contract (e.g., ask Noyac).

Sorry, but the AMC wins the bid 99/100 times in most scenarios.

Does their bid involve a big envelope of cash on the ceo's desk?

 

[BuzzPhreed]

And you can outbid an AMC whose Reimbursement is 30% higher than yours per unit? Plus, the AMC pays a lower wage than your senior academic guy is earning now giving them another advantage.

The only chance you have is if they want all MD anesthesia and no subsidy is required. Even then the AMC has successfully outbid private MD groups for the contract (e.g., ask Noyac).

Sorry, but the AMC wins the bid 99/100 times in most scenarios.

In the words of Janet Jackson...



It all depends on how much B.S. the hospital wants to deal with. In our case we offer a better product. Less concern about dealing with an "unknown" contractor rather than dealing with us, who's not going to nickel-n-dime them for all sorts of "uncontracted" B.S.

This is the new model. Pay me a good salary = I'll happily work for you. In my case, $400k+ bennies. And I work about 35-40 hrs/week with home call. The "profit" is tied-up in how they bundle services.

This is the only paradigm that's going to survive. And I'm already in it.

 

[aneftp]

What would've been fun is seeing the look on a hospital administrator's face while reading an RFP submitted by a bunch of non board certified residents wishing to take over a contract for services at their hospital. While theoretically possible, no hospital wants an entire department staffed by people 1 day removed from residency.

Well hospital administrators in the past have been fooled (and still continue to be fooled) by these "business minded anesthesia management company".

Someone just needs to go in an talk the talk.

Case in point what happened to a certain hospital in California. Idiots let go of stable stable all MD group. Fooled by "savvy AMC". In the end the hospital administrators all lost their jobs within 12 months because of chaos that came about.

Remember most hospital administrators have no real world experience on the floors or in the OR. It's like an NBA coach or GM who has never played basketball.

They got no clue and can be sweet talked by savvy people who present charts graphs of "efficiency, savings, more profit". All buzz words to hospital administrator.

And u don't even have to mention "non board certified".

Most new AMC take overs often involve bringing in anesthesia "providers" many with shady past. Hospital administrators have no clue.

 

[chmd]

I seriously hope you're joking. Resistance is futile. You will be assimilated.

All your base are belong to us.

Definitely kidding. Even though corporations are people, I don't believe they should practice anesthesiology.

 

[user3]

since there has been discussion here regarding an increase in anesthesia residency positions, I decided to research data on this. Is this data regarding #'s of graduating residents accurate?

https://www.acgme.org/acgmeweb/Port...s/2012-2013_ACGME_DATABOOK_DOCUMENT_Final.pdf
page 60: This reports 1,585 individuals completing an anesthesiology residency in 2012.

https://www.acgme.org/acgmeweb/Port.../2007_2008_ANA_ANA_Current_ACGME_DataBook.pdf
page 87: This reports 1,479 individuals completing an anesthesiology residency in 2007.

If so, that is only a 7% increase over 5 years.

 

[nimbus]

since there has been discussion here regarding an increase in anesthesia residency positions, I decided to research data on this. Is this data regarding #'s of graduating residents accurate?

https://www.acgme.org/acgmeweb/Port...s/2012-2013_ACGME_DATABOOK_DOCUMENT_Final.pdf
page 60: This reports 1,585 individuals completing an anesthesiology residency in 2012.

https://www.acgme.org/acgmeweb/Port.../2007_2008_ANA_ANA_Current_ACGME_DataBook.pdf
page 87: This reports 1,479 individuals completing an anesthesiology residency in 2007.

If so, that is only a 7% increase over 5 years.

That data is accurate but you need to look farther back. Historically 1500 graduates per year is a LOT.

There were only around 300 matching into anesthesia in 1996, down from 1000 in 1992. About 500 in 1997 and 600 in 1998. That's what turned the market around in 2000.

We will need to see similar disastrous match years to see a shift in opportunities again. Even AMCs will pay top dollar for any warm body if there isnt enough talent to go around.

Another Wall Street Journal article profiling a Stanford trained anesthesiologist who can't find a decent job would do the trick. But we're not there yet.

 

[deleted126335]

That data is accurate but you need to look farther back. Historically 1500 graduates per year is a LOT.

There were only around 300 matching into anesthesia in 1996, down from 1000 in 1992. About 500 in 1997 and 600 in 1998. That's what turned the market around in 2000.

We will need to see similar disastrous match years to see a shift in opportunities again. Even AMCs will pay top dollar for any warm body if there isnt enough talent to go around.

Another Wall Street Journal article profiling a Stanford trained anesthesiologist who can't find a decent job would do the trick. But we're not there yet.

That won't do it. In the 90s the med students had alternatives. there were more than a thousand unfilled spots in the match every year (across all specialties). Now there are plenty of students (US grads) who can't match anywhere. They will keep coming. They won't be as qualified as they have been, they won't want to work as hard because of a lack of interest in the field and lack of rewards, but they will keep coming absent a major increase in residency slots.

 

[aneftp]

That won't do it. In the 90s the med students had alternatives. there were more than a thousand unfilled spots in the match every year. Not there are plenty of students who can't match anywhere. They will keep coming. They won't be as qualified as they have been, they won't want to work as hard because of a lack of interest in the field and lack of rewards, but they will keep coming absent a major increase in residency slots.

Just to add in addition to a 30% increase in anesthesiology residency slots the past 6-7 years. The anesthesiology slots had hovered between 1000-1100 for close to 20 years (to the best of my knowledge from 1989-2009)

The number of lcme medical slots has increased around 20-25% the past 10 years as well.

Used to be between 15000-16000 slots for almost 25 years. Now close to 21000 slots.

As a side note. I still get a kick when the media states med school applications at their highest (48000 applicants) in 2013 for those 21000 slots.

Yet they never mention 1995-1996 years when 46000 applicants where competing for close to 16000 slots. 1995-1996 are still the toughest years to get into lcme med schools.

 

[Mman]

Just to add in addition to a 30% increase in anesthesiology residency slots the past 6-7 years. The anesthesiology slots had hovered between 1000-1100 for close to 20 years (to the best of my knowledge from 1989-2009)

What has been the % increase in the number of anesthetics given in the US in the last 20 years? What has been the % increase in number of ORs?

 

[aneftp]

What has been the % increase in the number of anesthetics given in the US in the last 20 years? What has been the % increase in number of ORs?

Good question. Tried googling the answer but don't have a solid link to provide.

But I know the number of anesthetics hasn't increased by 30% in the past 6-7 years. The data is all over the place. The ASA claims 40 million. The AANA claims 32 million. Who knows what the real number is each year.