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[DrOwnage]

That ain’t happening.

Agreed. I think the only way it truly happens is if a partnership is reached with the hospital administration to form some kind of subsidy which translates into a higher pooled unit.

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[nimbus]

Agreed. I think the only way it truly happens is if a partnership is reached with the hospital administration to form some kind of subsidy which translates into a higher pooled unit.

With AB72 (which caps OON billing) in California, the prospects for better commercial rates going forward are dim. The cost of living remains very high so the only way to recruit adequate manpower is for hospitals and other facilities to make up the difference.

We’ve left facilities and I think you guys have too. With the manpower shortage, it’s just not worth struggling and giving up vacations in order to staff low paying facilities. Leaving kills 2 birds with one stone.

 

[nimbus]

ours has improved slowly but continually for years. Benefits of starting out at a low point, but also being a growing area with more and more jobs.

Ours has too. Also low starting point and a vigorous local economy.

 

[narcotics999]

With AB72 (which caps OON billing) in California, the prospects for better commercial rates going forward are dim. The cost of living remains very high so the only way to recruit adequate manpower is for hospitals and other facilities to make up the difference.

We’ve left facilities and I think you guys have too. With the manpower shortage, it’s just not worth struggling and giving up vacations in order to staff low paying facilities. Leaving kills 2 birds with one stone.

Who are staffing the hospitals your group left? AMC? 400$/hr locums coming?

 

[narcotics999]

have an offer for a 6p-6a noctunist shift sun-thurs with crna coverage. most days done by midnight. is 450k a resonable for this position?

1st, tell us that you are the employee, not the employer pretending to be an employee.

2nd, Nocturnist sucks.

3rd, schedule, weeks off. Most days mean what percentage?

4th, with so few details, I feel you are more like the recruiting person.

 

[BLADEMDA]

have an offer for a 6p-6a noctunist shift sun-thurs with crna coverage. most days done by midnight. is 450k a resonable for this position?

Ok. Vacation/PTO? Benefits? High Cost of living area? So, the pay is reasonable in a non high cost area with a decent benefit package which includes vacation like 7-9 weeks off.

 

[sevoflurane]

450k for 60 hrs availability all during the night?
If it’s home call with minimal call in it could be ok for a few years, but honestly not remotely feasible for most people @450k.
Ask for 12+ weeks off and 600k+.
My resident buddy did this for a few years at the salaries above 5 yrs ago. Was not sustainable for him and his family.

 

[pgg]

450k for 60 hrs availability all during the night?
If it’s home call with minimal call in it could be ok for a few years, but honestly not remotely feasible for most people @450k.
Ask for 12+ weeks off and 600k+.
My resident buddy did this for a few years at the salaries above 5 yrs ago. Was not sustainable for him and his family.

Also, a full time job doing nothing but end-of-day main OR "cleanup" as the add-on butt pus and lap choles wind down, is not going to be a good case mix for new grads. Same reason I think it's unwise for new grads to do full time locums. There's a skill and learning curve cost to this kind of work that can harm a career.

 

[nimbus]

Who are staffing the hospitals your group left? AMC? 400$/hr locums coming?

Sound Anesthesia. They are still trying to recruit permanent staff and locums. Don’t know rates.

 

[Dr. Rude]

Sound Anesthesia. They are still trying to recruit permanent staff and locums. Don’t know rates.

they have the reputation of being the worst of the worst. VERY pro-CRNA, top of their license, training them in every technical procedure. Etc., etc.

 

[GravelRider]

have an offer for a 6p-6a noctunist shift sun-thurs with crna coverage. most days done by midnight. is 450k a resonable for this position?

No. Ask for more…a lot more. You haven’t provided nearly enough details, but I can tell you it’s a bad gig. Night work sucks and you are very likely to burn out. They are offering the job that way because the people there now are burning out from the night coverage. Why would the people there now not want to just take call and get a post call day off? I’m not opposed to jobs that have people rotate through a night float type coverage, but these nocturnist-only type of anesthesia jobs smell very fishy to me.

 

[IMGASMD]

they have the reputation of being the worst of the worst. VERY pro-CRNA, top of their license, training them in every technical procedure. Etc., etc.

They advocate QZ billing. So you can be supervising 1:whatever number they want.

 

[Dr. Rude]

They advocate QZ billing. So you can be supervising 1:whatever number they want.

"Supervising" in this case means doing just enough to be compliant with relevant state law and med staff bylaws and being the fire department and liability sponge.

 

[DirtDocMD]

they have the reputation of being the worst of the worst. VERY pro-CRNA, top of their license, training them in every technical procedure. Etc., etc.

Their “Anesthesia CEO” (not over all of Sound, but over the anesthesia division), is Phil Eichenholz, the former CEO/founder of Northstar. The chief CRNA is Andi Damron, the former chief anesthetist of, yep, Northstar.

 

[amyl]

How’s sound doing in their markets?? I’m figuring the firefighter model is just a transition until they can get away with crna only… I know a few Northstar groups that have gone 100% crna only

 

[nimbus]

they have the reputation of being the worst of the worst. VERY pro-CRNA, top of their license, training them in every technical procedure. Etc., etc.

How’s sound doing in their markets?? I’m figuring the firefighter model is just a transition until they can get away with crna only… I know a few Northstar groups that have gone 100% crna only

It was an MD only hospital before. Looks like they are transitioning to a model where ORs will be staffed MD only while OB will be CRNA only. The problem is that it is a bad payor mix hospital and all the other groups in town are also recruiting. A modest house in the area surrounding the hospital still costs $1mil whether you are an MD or a CRNA. Even CRNAs need homes so they will have to pay up for CRNAs too.

 

[nimbus]

No. Ask for more…a lot more. You haven’t provided nearly enough details, but I can tell you it’s a bad gig. Night work sucks and you are very likely to burn out. They are offering the job that way because the people there now are burning out from the night coverage. Why would the people there now not want to just take call and get a post call day off? I’m not opposed to jobs that have people rotate through a night float type coverage, but these nocturnist-only type of anesthesia jobs smell very fishy to me.

There is a longitudinal study of nurses showing a correlation between poor health outcomes and night work too.

 

[Ashers]

Super simple contract. I had hourly pay (OR hours only) that increased over 3 years to the max at 3 years that sounded awesome. At the end of my first year (and $100k pay cut that sucked up for the light at the end of tunnel), I was told that they were going to change my pay rate which decreased significantly from promised, and I had to agree to it or leave. (They said, "please don't leave! Everyone loves you!") So I left a few months later. They could change the pay rate whenever they wanted. Fortunately, 30 day notice written into the contract for both sides.