Hospital drops contract, AMC sues hospital, Anesthesiologists sue AMC

[narcotics999]

However, if you’re a new hire, you wouldn’t have signed the NAPA noncompete agreement. I think it would be okay to work directly for the hospital as long as the terms are good. Hopefully the new position offered by the hospital is not requiring a noncompete. That would be hypocritical.

Better to work as a locum. 500$/hr, lol

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[nimbus]

The NAPA manager in the article sounds downright confused and apoplectic, but it seems pretty clear. NAPA probably promised the moon to Renown in order to get a contract signed. 4 months into it, when they couldn’t deliver and breached the contract (which is understandable in the current labor market) Renown exercised their right to cancel the contract. In the past, I’m sure NAPA breached contracts left and right without any consequence which the manager assumed would be the case here. Over the next decade or so, I think most anesthesiologists will be working directly for hospitals and AMCs will be out.

As this case illustrates: Hospitals need anesthesiologists. Anesthesiologists need hospitals. Nobody needs an AMC. It’ll be nice to get one layer of leeches out of healthcare.




"We service communities all over the country," said Justin Crain, a senior vice president of business operations for the national anesthesiologists.

"We are very disappointed that this is happening," Crain said. He said the legal battle with Renown has made recruiting doctors to Northern Nevada difficult.
Crain said a few anesthesiologists who are breaking their contracts have given notice, but the majority have not.
Crain, who oversees about 250 similar contracts with clients and hospitals, said what has happened with Renown is a mystery.
"I've never seen anything like this,” Crain said. “We negotiate in good faith for nine months, sign a three-plus contract, and four months into it we get a notice we are out. It just doesn't happen."

 

[dannyboy1]

The NAPA manager in the article sounds downright confused and apoplectic, but it seems pretty clear. NAPA probably promised the moon to Renown in order to get a contract signed. 4 months into it, when they couldn’t deliver and breached the contract (which is understandable in the current labor market) Renown exercised their right to cancel the contract. In the past, I’m sure NAPA breached contracts left and right without any consequence which the manager assumed would be the case here. Over the next decade or so, I think most anesthesiologists will be working directly for hospitals and AMCs will be out.

As this case illustrates: Hospitals need anesthesiologists. Anesthesiologists need hospitals. Nobody needs an AMC. It’ll be nice to get one layer of leeches out of healthcare.

Don’t know that this will be good for us. My feeling is that once the hospital is on the hook for anesthesia salaries they will see the “wisdom” of independent CRNA practice and change their bylaws accordingly. Now they don’t care so much because it’s the AMC’s money….

 

[narcotics999]

Don’t know that this will be good for us. My feeling is that once the hospital is on the hook for anesthesia salaries they will see the “wisdom” of independent CRNA practice and change their bylaws accordingly. Now they don’t care so much because it’s the AMC’s money….

AMC money? Where does AMC get the $? Often AMC requests a fat subsidy.

 

[GravelRider]

A New Legal Tactic to Protect Workers’ Pay

This article talks about the Federal Government’s recent interest in using antitrust lawsuits in order to protect worker pay. They are enforcing the Sherman Act in these cases, which was specifically cited in the statement of interest on the NAPA/Renown situation. Apparently executives and managers could face jail time if the courts side with the federal government in some of these cases.

 

[HemeOncHopeful19]

A New Legal Tactic to Protect Workers’ Pay

This article talks about the Federal Government’s recent interest in using antitrust lawsuits in order to protect worker pay. They are enforcing the Sherman Act in these cases, which was specifically cited in the statement of interest on the NAPA/Renown situation. Apparently executives and managers could face jail time if the courts side with the federal government in some of these cases.

I appreciate them helping out in this situation, but if the government is so worried about protecting our pay they could perhaps stop voting to cut our reimbursement every year...

 

[nimbus]

I appreciate them helping out in this situation, but if the government is so worried about protecting our pay they could perhaps stop voting to cut our reimbursement every year...

Despite the title of the link, I think the objective is actually to promote competition, not to protect our pay.

 

[UscGhost]

AMC money? Where does AMC get the $? Often AMC requests a fat subsidy.

It's going to come to this at some point for all groups.

1. Medicare cuts rates every year.
2. Commerical insurance cuts every year, or pushes hard with additional leverage as more OON billing laws pass
3. Population is aging (more Medicare)

So the writing is on the wall. Eventually it's going to get to the point where anesthesia is a fixed cost for the hospital since reimbursement won't cover our pay. Hospital will negotiate a higher rate from insurance since the hospitals have significantly more leverage than we do in order to compensate. And we will just be a line item cost.

Crnas aren't much cheaper or economically viable unless it's a large institution.

California might actually be one of the better areas since we aren't trapped by non-competes. So as a labor force, we can shift around depending on pay and benefits. Keeps hospitals and AMCs from lowballing.

Hospitals don't like to pay a subsidy..but when they are faced with a inability to get coverage for their ORs, they will pay up. Supply and demand has shifted greatly in favor of anesthesiologists.
AMCs can low-ball a contract..but if they can't hire then it's short lived. The non-compete contract artificially suppresses the market

 

[amyl]

Don’t know that this will be good for us. My feeling is that once the hospital is on the hook for anesthesia salaries they will see the “wisdom” of independent CRNA practice and change their bylaws accordingly. Now they don’t care so much because it’s the AMC’s money….

I agree. When I was a hospital employee the only thing that kept them from replacing us with crnas was the older surgeons who were unfamiliar with crnas and saw them as nurses unable to do the job. I don’t think the younger generations of surgeons care or will go to bat for us. This was also in Indiana one of the least crna friendly states - the whole Environment was anti crna…. We only had one when I started… she practiced independently but was only allowed to do some cases…. 5 years ago when I left they had 3 crnas… all practiced independently. Be very careful what you wish for here…. I know AMCs are seen as evil but how many hospital administrators have you ever worked with ? I guarantee you they will replace anesthesiologists with crnas as much as they think they can get away with.

 

[narcotics999]

Heard rumor that NAPA is losing Northwell contracts. 1000$/hr locums is coming?

 

[IMGASMD]

Heard rumor that NAPA is losing Northwell contracts. 1000$/hr locums is coming?

That will be a very funny day. Especially if NAPA enforces non compete.

 

[deleted941485]

That will be a very funny day. Especially if NAPA enforces non compete.

Northwell is a major system. If they lose it, they would probably know about it ahead of time. I can imagine the ****showbthat would ensue but I think northwell caught onto the fact that they can replicate whatever business model Napa uses

 

[OptionOffense]

Northwell is a major system. If they lose it, they would probably know about it ahead of time. I can imagine the ****showbthat would ensue but I think northwell caught onto the fact that they can replicate whatever business model Napa uses

Well, the former Winthrop in a similar community has had 2 changes in anesthesia companies in the past 5 years. Envision and now Somnia. Northwell from what I see in ads have been hiring their own Anesthesiologists at Staten Island and I think Lenox hill. So its slow. Maybe they will be making a major break. I know those 2 hospitals are where napa got their start. it was their 1st hospital. Who the hell will wanna work in long island

 

[epidural man]

Hospitals need anesthesiologists. Anesthesiologists need hospitals. Nobody needs an AMC.

Brilliant!

 

[deleted941485]

Well, the former Winthrop in a similar community has had 2 changes in anesthesia companies in the past 5 years. Envision and now Somnia. Northwell from what I see in ads have been hiring their own Anesthesiologists at Staten Island and I think Lenox hill. So its slow. Maybe they will be making a major break. I know those 2 hospitals are where napa got their start. it was their 1st hospital. Who the hell will wanna work in long island

I was curious so I looked up Long Island real estate prices. A 2000sqft home over most of the island is in the 800-1.5M range. Gross. All these changes but they’ll never be able to pay me enough to live there.

 

[narcotics999]

I was curious so I looked up Long Island real estate prices. A 2000sqft home over most of the island is in the 800-1.5M range. Gross. All these changes but they’ll never be able to pay me enough to live there.

That is cheap, compared to sf bay area and most of the LA.

The issue is property tax. 2.5-3%.