What happened in Charlotte?

[caligas]

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Members do not see this ad.

 

[caligas]

All the anesthesiologists left when they didn’t make HQ2 short-list?

 

[leggo_my_ecmo]

"Adult and Pediatric Cardiac Anesthesiologists: Locally based anesthesia group in the Charlotte area. Recruiting anesthesiologists to join a team of adult and pediatric cardiothoracic anesthesia providers and to participate in a redesigned anesthesia department based on the Perioperative Surgical Home concept. MD will rotate between two large hospitals in the greater Charlotte NC area. 100% supervision of highly skilled CRNAs for primarily cardiac, thoracic, and vascular cases."

Ugh

 

[Nivens]

Please let there be something left when I finish...

 

[dhb]

Ouch sand paper condom.

 

[Rocky222Balboa]

"
Physician-owned and operated, ScopeNC is managed by a team of skilled professionals who understand how to navigate clinical practices through the operational challenges and complexities facing today’s anesthesiologists. The ScopeNC management team releases ScopeNC anesthesiologists from the demands of business and financial management, allowing them to deliver the highest caliber anesthesia care using the latest best practices and technological advances. Our physician leaders are deeply involved in the delivery of both high-quality clinical care and outstanding customer service to all perioperative stakeholders."

Who are the physicians who own and operate this? Are they anesthesiologists?

 

[skypilot]

"Adult and Pediatric Cardiac Anesthesiologists: Locally based anesthesia group in the Charlotte area. Recruiting anesthesiologists to join a team of adult and pediatric cardiothoracic anesthesia providers and to participate in a redesigned anesthesia department based on the Perioperative Surgical Home concept. MD will rotate between two large hospitals in the greater Charlotte NC area. 100% supervision of highly skilled CRNAs for primarily cardiac, thoracic, and vascular cases."

Ugh

When will it end? At some point I will apply to work as a "highly skilled CRNA." instead of getting involved in this bull****.

 

[NICMAN]

It is all the talk here in North Carolina.

 

[pocafx]

I should rank my prelim first and switch residencies...

 

[Mman]

Please let there be something left when I finish...

this is the implosion of American. Will be interesting to see what happens with those noncompetes....

 

[Mehd School]

I should rank my prelim first and switch residencies...

Any program that placed a lot of emphasis on Surgical home went to the bottom of my list. I didn't apply to Duke.

Hell, one program actively replaced 3 electives with surgical home months and THEN told me that one of my bigger responsibility my CA-3 year there would be to train the SRNAs. They won't be ranked.

 

[Nivens]

Any program that placed a lot of emphasis on Surgical home went to the bottom of my list. I didn't apply to Duke.

Hell, one program actively replaced 3 electives with surgical home months and THEN told me that one of my bigger responsibility my CA-3 year there would be to train the SRNAs. They won't be ranked.

Woa.

 

[BLADEMDA]

this is the implosion of American. Will be interesting to see what happens with those noncompetes....

I'm not sure Mednax had those contracts. Back in my day there were 2 large Groups in Charlotte. Mednax bought one group out around 2010 (not sure of the exact date) and then bought out the big group in Raleigh (2012?).

 

[Mman]

I'm not sure Mednax had those contracts. Back in my day there were 2 large Groups in Charlotte. Mednax bought one group out around 2010 (not sure of the exact date) and then bought out the big group in Raleigh (2012?).

it is. Mednax bought out the bigger group (Southeastern) that was at Carolinas Medical Center, the big level 1 trauma center in Charlotte, that also was at several smaller hospitals. They did not buy out the smaller outlying Presbyterian group (that I think has a different name now), but the job descriptions in these posts are straight out of what Mednax was covering in Charlotte. I had heard rumors for 2+ years that place was going down and this appears to be the nail in the coffin with jobs being posted.

 

[Mman]

Any program that placed a lot of emphasis on Surgical home went to the bottom of my list. I didn't apply to Duke.

10 or 20 years from now, that will probably be the only model that exists.

 

[BLADEMDA]

it is. Mednax bought out the bigger group (Southeastern) that was at Carolinas Medical Center, the big level 1 trauma center in Charlotte, that also was at several smaller hospitals. They did not buy out the smaller outlying Presbyterian group (that I think has a different name now), but the job descriptions in these posts are straight out of what Mednax was covering in Charlotte. I had heard rumors for 2+ years that place was going down and this appears to be the nail in the coffin with jobs being posted.

All I see for certain is one AMC being replaced by another. Plus, the largest medical center, Carolinas Medical Center, isn't mentioned in any of the ads.

 

[deleted126335]

Who owns the new entity? Docs or suits or both?
Are they taking all the business at the hospitals, or doing a carve out?
Are they going to a (more) CRNA intensive model?

 

[Rocky222Balboa]

They say the firm is called scopenc which, according to their website is physician own.

 

[Mehd School]

10 or 20 years from now, that will probably be the only model that exists.

I hope not, but I also doubt it. I was at 4 programs this year that sampled and dumped that model within 24 months.

 

[caligas]

this is the implosion of American. Will be interesting to see what happens with those noncompetes....

Yeah, need to see some precedent that they are not enforceable. Fails the common sense test that physicians working at CMC (or wherever) would have to leave because their AMC lost the contract.

 

[Mman]

I hope not, but I also doubt it. I was at 4 programs this year that sampled and dumped that model within 24 months.

I would not use the past experience of residency programs as evidence of much of anything in regards to this.

 

[aneftp]

Why do u feel sorry for this place? Or places in North Carolina.

If it’s mednax. Than the docs got their cash already. And stayed their mandatory 3 years to cash out. They move on. It’s a business.

And look at the wording of the new AMC taking over. It’s “physician leaders”. This is not the same as “physician owned”. It’s purposely worded that way to mislead the public to thinking its being lead by docs when it’s just being lead by corporations and suits.

 

[Mman]

And look at the wording of the new AMC taking over.

Just to be clear, there is not another AMC taking over at this point. There is merely one advertising for hires to see if they can get the contract. A job does not need to exist to advertise for it. They are throwing lures out to see what bites.

 

[Psai]

Any program that placed a lot of emphasis on Surgical home went to the bottom of my list. I didn't apply to Duke.

Hell, one program actively replaced 3 electives with surgical home months and THEN told me that one of my bigger responsibility my CA-3 year there would be to train the SRNAs. They won't be ranked.

Wow not only are they actively robbing you of an education, they want you to give away those skills for free so they can rob you of a future

 

[ShaggyDog]

I remember when the greensboro stuff came up, Mednax was offering starting salaries of $500k. Few weeks later, this new group had an identical posting.
I think that mednax contracts for raleigh and charlotte are being renegotiated soon.

Carolinas Health System and UNC Healthcare have been in merger talks, so I wonder if that might give the facilities an excuse to leave mednax.

 

[Cookie]

Anybody have any information about the private group around Raleigh , it is called Regional Anesthesia, I believe they are part of Duke !

 

[Mehd School]

I would not use the past experience of residency programs as evidence of much of anything in regards to this.

Seems like a relatively useful litmus test in my opinion. Current generation of Anesthesiologists weren't trained in the surgical home model. Current residency training is basically looking 10 years into the future. If it's failing on the front lines of training, then there isn't much reason to believe it will pick up steam out in private practice when people aren't motivated to use it due to unfamiliarity.

 

[Mman]

Seems like a relatively useful litmus test in my opinion. Current generation of Anesthesiologists weren't trained in the surgical home model. Current residency training is basically looking 10 years into the future. If it's failing on the front lines of training, then there isn't much reason to believe it will pick up steam out in private practice when people aren't motivated to use it due to unfamiliarity.

surgical home will have nothing to do with the comfort level of the physicians "using it". It will be dictated by the insurance payers and hospital systems. There will be no other option.

 

[deleted126335]

surgical home will have nothing to do with the comfort level of the physicians "using it". It will be dictated by the insurance payers and hospital systems. There will be no other option.

If and only if it controls costs.

 

[Mman]

If and only if it controls costs.

that will be determined after it already happens. As a specialty, we still need to be ready to deal with it (like it or not).

 

[GA8314]

Any program that placed a lot of emphasis on Surgical home went to the bottom of my list. I didn't apply to Duke.

Hell, one program actively replaced 3 electives with surgical home months and THEN told me that one of my bigger responsibility my CA-3 year there would be to train the SRNAs. They won't be ranked.

Yeah. F.ck that. Honestly, you should out that program. That's total BS and they need to be addressed for such nonsense.

 

[GA8314]

The PSH thing doesn't scare me one bit from a skills competency perspective. We go to medical school. Do a broad based clinical base year before our anesthesia specific training. We are physicians first. We review entire lists of medications, testing, labs.... on a daily basis. How difficult could a PSH be? Sure, there are the structural issues (still being worked out mind you), no the least being payment models.. But, the medicine? Bring it. I don't think this takes "extra" training in in residency per se. Maybe a month to get acclimated with the system. But, we know the medicine.

 

[AdmiralChz]

The PSH thing doesn't scare me one bit from a skills competency perspective. We go to medical school. Do a broad based clinical base year before our anesthesia specific training. We are physicians first. We review entire lists of medications, testing, labs.... on a daily basis. How difficult could a PSH be? Sure, there are the structural issues (still being worked out mind you), no the least being payment models.. But, the medicine? Bring it. I don't think this takes "extra" training in in residency per se. Maybe a month to get acclimated with the system. But, we know the medicine.

Agreed. ACGME requires a two-week pre-op rotation as it is anyway https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/040_anesthesiology_2017-07-01.pdf (page 21), this basically is PSH if you throw in post-op care (two-week rotation also required).

 

[flightnurse2MD]

Wow not only are they actively robbing you of an education, they want you to give away those skills for free so they can rob you of a future

But I did medical school and planned on a residency with a likely fellowship just so I can drink coffee in the lounge and not intubate patients...

 

[GA8314]

But I did medical school and planned on a residency with a likely fellowship just so I can drink coffee in the lounge and not intubate patients...

I know you are kidding but you bring up a good point. Not enough docs in ACT models regularly intubate. This has been my experience across an array of geographies and practices.

I regularly say to the CRNA "you push, I tube this one?" (They know it's not really a question"), in our ACT model. I personally feel this is very important.

 

[caligas]

I read the Asa propaganda about PSH, but still don’t know what it means from a Practical standpoint. Does it mean I see patients in a pre op clinic? Who pays me for that?

 

[deleted162650]

Who pays me for that?

Couldn't you bill for a pre-op clearance visit the same way a PCP could? This would be separate from the immediate pre-op assessment that is part of the anesthesia bill. I don't think there's anything that says you have to be FM/IM/Cards trained to bill for that.

 

[caligas]

Couldn't you bill for a pre-op clearance visit the same way a PCP could? This would be separate from the immediate pre-op assessment that is part of the anesthesia bill. I don't think there's anything that says you have to be FM/IM/Cards trained to bill for that.

Looks like you can if you can document medical necessity.

 

[Mman]

I know you are kidding but you bring up a good point. Not enough docs in ACT models regularly intubate. This has been my experience across an array of geographies and practices.

I regularly say to the CRNA "you push, I tube this one?" (They know it's not really a question"), in our ACT model. I personally feel this is very important.

Unfortunately I only get to intubate the hard ones. I almost never get the easy ones. I'm fairly certain I could still slam dunk the chip shots I don't get to practice on routinely.

 

[Mehd School]

The PSH thing doesn't scare me one bit from a skills competency perspective. We go to medical school. Do a broad based clinical base year before our anesthesia specific training. We are physicians first. We review entire lists of medications, testing, labs.... on a daily basis. How difficult could a PSH be? Sure, there are the structural issues (still being worked out mind you), no the least being payment models.. But, the medicine? Bring it. I don't think this takes "extra" training in in residency per se. Maybe a month to get acclimated with the system. But, we know the medicine.

That's great and all, but I'm not going into Anesthesia to round on patients and have longitudinal care.

 

[dmk5n]

Who owns the new entity? Docs or suits or both?
Are they taking all the business at the hospitals, or doing a carve out?
Are they going to a (more) CRNA intensive model?

I think in North Carolina a physician must own the anesthesia contract rather than corporation.
So likely a puppet dictator for suits.
North Carolina is Mordor so beware. Even infiltrated pain medicine there.

 

[vector2]

I know you are kidding but you bring up a good point. Not enough docs in ACT models regularly intubate. This has been my experience across an array of geographies and practices.

I regularly say to the CRNA "you push, I tube this one?" (They know it's not really a question"), in our ACT model. I personally feel this is very important.

A few times a week I have to bail out crnas or residents with a difficult tube, but I like the advice of just doing some routine ones on weeks when things are going smoothly. In addition to that, my advice for new attendings is to really try to familiarize yourself with the Pyxis, the cart, infusion pumps, and supply room if you're coming to a new hospital / using unfamiliar equipment.

 

[GA8314]

A few times a week I have to bail out crnas or residents with a difficult tube, but I like the advice of just doing some routine ones on weeks when things are going smoothly. In addition to that, my advice for new attendings is to really try to familiarize yourself with the Pyxis, the cart, infusion pumps, and supply room if you're coming to a new hospital / using unfamiliar equipment.

Indeed. This is important. Yeah, it's a good thing to tube some chip shots just for fun with some frequency, for many reasons.

 

[mick2003]

I'd be interested in working in Charlotte if this is the real deal. Could someone please fill me in on any details as to what is happening with the anesthesiology group at Carolinas Medical Center. Thanks

 

[projectpat]

Are there highly skilled CRNAs involved? I can't tell

 

[Twiggidy]

Yeah. F.ck that. Honestly, you should out that program. That's total BS and they need to be addressed for such nonsense.

I agree with this. The program should be outed and if they can't fill the program then it's their own fault.

 

[caligas]

I'd be interested in working in Charlotte if this is the real deal. Could someone please fill me in on any details as to what is happening with the anesthesiology group at Carolinas Medical Center. Thanks

Charlotte is a nice city, but what about this job sounds appealing?

 

[mick2003]

Charlotte is a nice city, but what about this job sounds appealing?

The geography and growing instability in my current group. Don't want to go into an unfriendly or unstable situation, however.

 

[deleted697535]

I hope you guys can fight this hard. Eventually there will be mds that can no longer do cases on their own if they only supervise

 

[studentoflife]

Woa.

Can you tell me which programs these are so I know not to apply to them?