Why do you think current M4s aren’t heeding the warnings of Anesthesia being “dead”?

[ERRES2288]

We have hired a doc almost every single year for probably 15+ years, sometimes 2 in a year. The funny thing is, we have had multiple people turn down our offers in the last 5 years.

All on the partnership track?

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[Mman]

All on the partnership track?

yes aside from a few docs that just wanted part time non call positions

 

[Stone Cold]

@4:57

 

[coffeebythelake]

The only benefit to radiology that i can see is that youre shielded from surgeon bs in the OR. During my radiology rotation in med school, surgeons actually came to the reading rm for questions and asking for help with images,

They just talk **** behind your back. Thats not shielding.

 

[scoopdaboop]

 

[Justice4all]

damn, she clearing 300k nice. Can't knock it if she putting that much hours in

 

[Zekchar]

damn, she clearing 300k nice. Can't knock it if she putting that much hours in

I'm glad she posted that video. The closer the CRNA pay is to ours, the more admins will question why pay so much for an inferior product that offers less liability protection.

 

[Stone Cold]

Her bi-weekly paycheck is $11,950 pre-taxes which amounts to over $310-320k if she's married (assuming from her tax deductions). I've seen full time anesthesiologists making $350k in cities with 50k pop or higher. This is ridiculous based on what CRNA's get paid while having a ton of lesser debt

 

[Justice4all]

Charleston WV. Newly minted.
Can't pay me to relocate there.


Re admins, most don't care and only look at the bottom line but whenever their relatives need surgery, they want MD only.

 

[scoopdaboop]

Her bi-weekly paycheck is $11,950 pre-taxes which amounts to over $310-320k if she's married (assuming from her tax deductions). I've seen full time anesthesiologists making $350k in cities with 50k pop or higher. This is ridiculous based on what CRNA's get paid while having a ton of lesser debt

She hid her hours. She's prolly working way more than average CRNA. But you right, having the opportunity to become a physician is so easy now (carribean, DO schools), that these people who choose to be NP/PA/CRNA and treated like physicians are kind of sad. They have this "backdoor" way and want to be treated like physicians but in fact, any monkey with half a brain can enter nursing school, and then go along be a CRNA, etc. But that's neither here nor there. The problem with tons of debt in medical schools etc. is a different problem that's perpetuated by school admins etc, has nothing to do with CRNA pay/their tuition.

 

[ineedhelpplse]

She hid her hours. She's prolly working way more than average CRNA. But you right, having the opportunity to become a physician is so easy now (carribean, DO schools), that these people who choose to be NP/PA/CRNA are kind of sad. They have this "backdoor" way and want to be treated like physicians but in fact, any monkey with half a brain can enter nursing school, and then go along be a CRNA, etc.

If she's getting >300k as a CRNA I would say she has more of a brain than the people who go to Caribbean medical schools or take out >300K in student loans to go to a DO school and do family med/peds. Those Caribbean medical schools will literally take anyone who applies so I don't really see that as a more respectable option.

 

[Stone Cold]

She hid her hours. She's prolly working way more than average CRNA. But you right, having the opportunity to become a physician is so easy now (carribean, DO schools), that these people who choose to be NP/PA/CRNA and treated like physicians are kind of sad. They have this "backdoor" way and want to be treated like physicians but in fact, any monkey with half a brain can enter nursing school, and then go along be a CRNA, etc. But that's neither here nor there. The problem with tons of debt in medical schools etc. is a different problem that's perpetuated by school admins etc, has nothing to do with CRNA pay/their tuition.

She actually put up a video titled "Do I call myself a Doctor"...I mean the audacity



Nursing associations and lobbying groups play a crucial role in regulating the pay of CRNA's and NP's in general...they're also the prime reason why more and more states are allowing CRNA's to practice without the supervision of an anesthesiologist

 

[scoopdaboop]

If she's getting >300k as a CRNA I would say she has more of a brain than the people who go to Caribbean medical schools or take out >300K in student loans to go to a DO school and do family med/peds. Those Caribbean medical schools will literally take anyone who applies so I don't really see that as a more respectable option.

Fair enough. Going to a Caribbean is probably not financially wise, and obviously going to CRNA school is a decent career choice. I said people that do this and want to be treated like physicians is the problem. And so many of them do want to be treated like that, and that's where the problem is; because if you do want that, then go to a medical school. Gettng into A medical school isn't even difficult. It's completing medical school that's hard.

 

[Stone Cold]

If she's getting >300k as a CRNA I would say she has more of a brain than the people who go to Caribbean medical schools or take out >300K in student loans to go to a DO school and do family med/peds. Those Caribbean medical schools will literally take anyone who applies so I don't really see that as a more respectable option.

Increasing the role of CRNAs wouldn't affect Family Med or Peds job but Anesthesiologists alone. None of the NP/PA roles in those FM/Peds are paid even close to their physician counterparts

 

[scoopdaboop]

She actually put up a video titled "Do I call myself a Doctor"...I mean the audacity



Nursing associations and lobbying groups play a crucial role in regulating the pay of CRNA's and NP's in general...they're also the prime reason why more and more states are allowing CRNA's to practice without the supervision of an anesthesiologist

Can't tell if you're just trying to trigger people lmao. yeah she said she doesn't introduce herself as one.

 

[Stone Cold]

Can't tell if you're just trying to trigger people lmao. yeah she said she doesn't introduce herself as one.

Nope, not tryna trigger anyone and no offense to CRNAs. Simply pointing out that they'd increasingly want to be on par with physicians not just in terms of pay but responsibility and recognition

 

[Justice4all]

I will be happy to do my own cases and not be liable for their independent practices.

 

[leaverus]

damn, she clearing 300k nice. Can't knock it if she putting that much hours in

She's fresh out of school. Damn, I made less than that my first 3 years as an attending and I guarantee I was putting in more hours than she is and in a HCOL than middleofnowhere, WV. Wtf, I need to go back and demand a retroactive raise from that b@stard of a former employer.

 

[Man o War]

Let’s not pretend these CRNAs making that kind of money are working in the locations or the hours hardly any of us would consider desirable. I know a handful of CRNAs making mid to upper-mid 200s taking constant call in crap locations. You couldn’t pay me enough to take those jobs honestly....so they’re filling a need even though I wholeheartedly disagree with them not having supervision, it’s just not safe nor is it in the best interest of the patient.

 

[scoopdaboop]

I mean this chick is 99 percent mgma. Or even more than that. The 25 percent mgma anesthesia Md is higher

 

[deleted126335]

I mean this chick is 99 percent mgma. Or even more than that. The 25 percent mgma anesthesia Md is higher

You are assuming that she is being truthful.

 

[Stone Cold]

Let’s not pretend these CRNAs making that kind of money are working in the locations or the hours hardly any of us would consider desirable. I know a handful of CRNAs making mid to upper-mid 200s taking constant call in crap locations. You couldn’t pay me enough to take those jobs honestly....so they’re filling a need even though I wholeheartedly disagree with them not having supervision, it’s just not safe nor is it in the best interest of the patient.

She lives Charleston, WV which isn't really bad with a pop of 51k and is the largest city in WV. It makes sense if she was living in the middle of no where in the states bordering Canada

 

[Southpaw]

I was gonna say... I know it’s WV and all and this board only cares about LA and NYC, but she’s making > 300k living in a state capital. And she just got outta school! I’m jealous!

Her job sounds better than @anbuitachi. She probably makes more. And that dude has no cme fund. And he takes like 8 24-hr calls in a one week timeframe. And his surgeons call him ‘anesthesia’ only on good days. And the admins dont let him in the nurses lounge much less the MD lounge. Matter of fact, I bet @anbuitachi has to call THAT CRNA for induction.

 

[anbuitachi]

I was gonna say... I know it’s WV and all and this board only cares about LA and NYC, but she’s making > 300k living in a state capital. And she just got outta school! I’m jealous!

Her job sounds better than @anbuitachi. She probably makes more. And that dude has no cme fund. And he takes like 8 24-hr calls in a one week timeframe. And his surgeons call him ‘anesthesia’ only on good days. And the admins dont let him in the nurses lounge much less the MD lounge. Matter of fact, I bet @anbuitachi has to call THAT CRNA for induction.

 

[Rich91]

Let’s not pretend these CRNAs making that kind of money are working in the locations or the hours hardly any of us would consider desirable. I know a handful of CRNAs making mid to upper-mid 200s taking constant call in crap locations. You couldn’t pay me enough to take those jobs honestly....so they’re filling a need even though I wholeheartedly disagree with them not having supervision, it’s just not safe nor is it in the best interest of the patient.

anyone who chooses nursing school if they have the capacity of med school to become a crna is making a extremely short sighted choice, 3 more years and you can be a fully fledged DO anesthesiologist making 1.75-2x the pay...at 2 years yes crna school was a value proposition, but nowadays even uncompetitive specialities that rely more on enthusiam like psych are making 300-350k for 40-45 hr weeks, especially with psych nps under them

why make 270k working 55 hours a week when you can make 500-550k working 55 hours a week for only 3 years more education,

AND then theres the massive issue of looming oversaturation, of which physicians are vastly better protected against

the only way to fight PE taking a bigger cut or medicare for all is to unionize all anesthesia providers, otherwise good luck with PE shaving off 20% of MD income and 30% of crna income

 

[Drwine]

Doom and gloom for anesthesiology and medicine is not new. If the internet existed back in 1965, this post would have been timed to coincide with the advent of Medicare. Roughly 20 years later it would be adopting DRGs. That coincided with when I decided to switch into anesthesia. A wise mentor told me that in spite of the doom and gloom he was doing much better than when he started in 1959 and I am thankful I listened to him.
In 1992, it would have been timed to Hillary Clinton's plan to remake healthcare and Obamacare after that. The naysayers have been spouting the same message for over 50 years. Kudos to the medical students and keep ignoring them.

 

[Zekchar]

the only way to fight PE taking a bigger cut or medicare for all is to unionize all anesthesia providers

This right here is key. If Biden wins and the country starts implementing more democratic ideas, this is going to be the biggest difference maker. I look forward to being able to collectively bargain. If nurses can do it, so can we. If police officers and firefighters can do it, so can we. Everyone is an essential worker and ultimately this will be the trump card.

I concede that this will make for worsened healthcare overall. No problem. My husband and I will use the private system and pay out of pocket for legitimate needs. The British system is the way forward. Cheap and readily available medicine for everyone, but if you want something more, cut the check. Medicine is a commodity and I will be happy to provide it for the right price while having the security of a steady union job.

 

[histidine]

You guys actually believe in the MGMA numbers? Those numbers are fabricated to benefit employers so that when they lowball you 300k you think you're getting a fair offer. There are several states that mandate public salaries for public workers. Look up what CRNAs make at University of California medical centers...its 200k-250k to work 36 hours a week. Many do per diem/part time at private practices on their weeks off and pull in another 100k.

 

[MirrorTodd]

You guys actually believe in the MGMA numbers? Those numbers are fabricated to benefit employers so that when they lowball you 300k you think you're getting a fair offer. There are several states that mandate public salaries for public workers. Look up what CRNAs make at University of California medical centers...its 200k-250k to work 36 hours a week. Many do per diem/part time at private practices on their weeks off and pull in another 100k.

I dont know about that. If they offer me 300k. I'd laugh and say the median is somewhere around 450k, so unless they have major comps I'm walking.

 

[IMGASMD]

I dont know about that. If they offer me 300k. I'd laugh and say the median is somewhere around 450k, so unless they have major comps I'm walking.

There’s a group, as recent as 2 years ago, offered low 2’s for full time employment. No calls, granted.... but 2’s. If you’re fellowship trained and BC, maybe mid 2’s.

 

[MirrorTodd]

There’s a group, as recent as 2 years ago, offered low 2’s for full time employment. No calls, granted.... but 2’s. If you’re fellowship trained and BC, maybe mid 2’s.

24 weeks off right?

 

[IMGASMD]

24 weeks off right?

Right.........

 

[GassYous]

There’s a group, as recent as 2 years ago, offered low 2’s for full time employment. No calls, granted.... but 2’s. If you’re fellowship trained and BC, maybe mid 2’s.

That is so predatory I don't know what to say.

 

[IMGASMD]

That is so predatory I don't know what to say.

Com’on that’s not even the best part...... the best part is, it’s a five year partnership. That’s right folks, five. Because it’s soooo good, that some people joined the partnership track before there were even spots open. Took one guy 7 years. Also you won’t get many weekday calls, Friday and Saturday calls in the beginning.....

True story.

 

[BLADEMDA]

Com’on that’s not even the best part...... the best part is, it’s a five year partnership. That’s right folks, five. Because it’s soooo good, that some people joined the partnership track before there were even spots open. Took one guy 7 years. Also you won’t get many weekday calls, Friday and Saturday calls in the beginning.....

True story.

Supply vs Demand. Very few great partnerships avail so some are willing to gamble on a 5 year track. 3 year track for USAP with a pseudo partnership vs 5 years for a real partnership with greater than 95th MGMA. I can see why some sign up.

 

[Twiggidy]

I was gonna say... I know it’s WV and all and this board only cares about LA and NYC, but she’s making > 300k living in a state capital. And she just got outta school! I’m jealous!

Her job sounds better than @anbuitachi. She probably makes more. And that dude has no cme fund. And he takes like 8 24-hr calls in a one week timeframe. And his surgeons call him ‘anesthesia’ only on good days. And the admins dont let him in the nurses lounge much less the MD lounge. Matter of fact, I bet @anbuitachi has to call THAT CRNA for induction.

A: I lol’d
B: In my book Charleston, WV is the middle of nowhere, but I’m a coastal elite lol

 

[IMGASMD]

Supply vs Demand. Very few great partnerships avail so some are willing to gamble on a 5 year track. 3 year track for USAP with a pseudo partnership vs 5 years for a real partnership with greater than 95th MGMA. I can see why some sign up.

The buy in is just too great, I think. It’s at least over a million conservatively, more if it’s true mgma 95th%.

 

[Twiggidy]

The buy in is just too great, I think. It’s at least over a million conservatively, more if it’s true mgma 95th%.

For a 5 year buy-in that practice had better be EXCELLENT. I mean the only reason they’re looking is due to death or retirement. It should be an ”offer you can’t refuse” type practice. Even 3 years is pushing it. I feel like 2 years is fair for both the applicant and the employer as it’s plenty of time for both to evaluate.

 

[Neopolymath]

For a 5 year buy-in that practice had better be EXCELLENT. I mean the only reason they’re looking is due to death or retirement. It should be an ”offer you can’t refuse” type practice. Even 3 years is pushing it. I feel like 2 years is fair for both the applicant and the employer as it’s plenty of time for both to evaluate.

Right, what exactly are you going to learn about someone year 5 versus year 1-2? NOTHING.

 

[deleted126335]

Right, what exactly are you going to learn about someone year 5 versus year 1-2? NOTHING.

How much more can we f$ck you?

 

[Neopolymath]

How much more can we f$ck you?

Apparently a lot given these positions fill.

 

[scoopdaboop]

You guys actually believe in the MGMA numbers? Those numbers are fabricated to benefit employers so that when they lowball you 300k you think you're getting a fair offer. There are several states that mandate public salaries for public workers. Look up what CRNAs make at University of California medical centers...its 200k-250k to work 36 hours a week. Many do per diem/part time at private practices on their weeks off and pull in another 100k.

Okay first of all, MGMA sends a survey to physician groups to report data... not some hospital group that'll say their neurosurgeon makes 200k. Also, the CRNA working at the medical centers, i'm looking at em now make 200K base + with over 100K often coming from overtime pay; as in they're working a lot.

 

[Status Sciaticus]

There’s a group, as recent as 2 years ago, offered low 2’s for full time employment. No calls, granted.... but 2’s. If you’re fellowship trained and BC, maybe mid 2’s.

Metro Anesthesia in Dallas does this. 250K 1099 for 3 years. 250k is insulting on its own, but then they just bend you over with the 1099. What a ****ty setup.

 

[GassYous]

Metro Anesthesia in Dallas does this. 250K 1099 for 3 years. 250k is insulting on its own, but then they just bend you over with the 1099. What a ****ty setup.

At least you can do the employer contribution to 401k! As well as the employer tax heh

Group at Good Samaritan hospital in Long Island also bends people over with a 5 year track. Unnecessarily long, they screw over the new guys with tough cases and they are losing contracts to Northwell. No guaranteed partnership and no guarantee of the group's future either. Fantastic! No wonder people would rather be employed by the hospital system. The guy on the phone was super shady too, wouldn't even give any details about the job.

 

[Status Sciaticus]

At least you can do the employer contribution to 401k! As well as the employer tax heh

Group at Good Samaritan hospital in Long Island also bends people over with a 5 year track. Unnecessarily long, they screw over the new guys with tough cases and they are losing contracts to Northwell. No guaranteed partnership and no guarantee of the group's future either. Fantastic! No wonder people would rather be employed by the hospital system. The guy on the phone was super shady too, wouldn't even give any details about the job.

Yep these groups can go **** themselves. Its a shame that there arent any major players in texas which is where I have to end up unfortunately due to geographical restraints

 

[IMGASMD]

At least you can do the employer contribution to 401k! As well as the employer tax heh

Group at Good Samaritan hospital in Long Island also bends people over with a 5 year track. Unnecessarily long, they screw over the new guys with tough cases and they are losing contracts to Northwell. No guaranteed partnership and no guarantee of the group's future either. Fantastic! No wonder people would rather be employed by the hospital system. The guy on the phone was super shady too, wouldn't even give any details about the job.

Why don’t you come for a visit.......
Famous last words.

 

[pgg]

There’s a group, as recent as 2 years ago, offered low 2’s for full time employment. No calls, granted.... but 2’s. If you’re fellowship trained and BC, maybe mid 2’s.

Location, location, location

Some people would work for less than that to live in a "desirable" place.

 

[deleted126335]

Location, location, location

Some people would work for less than that to live in a "desirable" place.

I would give anesthesia for free if I got to live in the Playboy mansion. That's my idea of a desirable place.

 

[IMGASMD]

Location, location, location

Some people would work for less than that to live in a "desirable" place.

Yes. Like nyc and getting paid minimum wage.... I totally understand. But this was not nyc. This was more for the promise land, of mgma 95%.... in five years if you’re lucky, 7 if you aren’t.

 

[BLADEMDA]

Yes. Like nyc and getting paid minimum wage.... I totally understand. But this was not nyc. This was more for the promise land, of mgma 95%.... in five years if you’re lucky, 7 if you aren’t.

What's the alternative? One can choose to live rather humbly and work for an AMC or try for the gold at the end of the rainbow. The difference between the income of an AMC vs 95th percentile MGMA is almost double per year. Over a 25-30 year career this is worth multiple millions more in savings to those willing to put in the 5 years.

Do I think the current system of billing $120 per unit is going to persist? No. I think 3-4 years after Biden/Harris wins the White House the shift in healthcare will be very obvious. Obama passed the ACA and Biden along with the Democrat Senate in 2021 are going to pass more revisions to the ACA allowing a public option along with an early medicare option (for those 60 years and older). This will mark another shift away from private insurance carriers towards government single payer healthcare.

But, I think the current system has at least 8-10 years left in it before undergoing radical change towards a complete single payer system. I do think that will happen in my lifetime but it is going to take another much more progressive administration to push for and pass a 100% single payer system. That could be Harris or AOC down the road.