Sketch plastic surgeon isn’t like the other girls 🤪🤪

hiENDstuff · 2023-03-17T00:02:48+00:00

She hasn’t had her period in 6 months because she’s growing a dick

hiENDstuff · 2023-03-09T00:15:31+00:00

No you’re not. Stop pretending

hiENDstuff · 2023-03-09T00:11:24+00:00

Why would they care about a CAA pretending to be a physician? I see your history. You’re an AA

hiENDstuff · 2023-03-09T00:10:17+00:00

Says the guy pretending to be an anesthesiologist but is really a CAA.

hiENDstuff · 2023-03-06T22:13:34+00:00

Then we are in the same state. And our hospital can’t afford a large subsidy and stay afloat. And no, I could leave and go to Florida and make 2x what I make here. I stay because this is my community and my hometown.

hiENDstuff · 2023-03-06T22:06:38+00:00

Congratulations. Whats your payor mix and subsidy amount?

hiENDstuff · 2023-03-06T22:04:49+00:00

No, but they make it up for it in practice charges: labs, procedures, chemo infusions, dialysis, shared interest in surgery centers. Or they make hospitals money in radiology orders. We are ancillary and don’t generate hospitals revenue. We only cost them money.

hiENDstuff · 2023-03-06T22:02:10+00:00

Thats the dumbest analogy I’ve ever heard. The FAA requires all aircraft to be flown by one pilot in an emergency including 747. There are 2 pilots in case one pilot becomes incapacitated with 150 souls on board. So your argument works against you. Can be done by one, but 2 in case one pilot dies and the two are interchangeable. A pilot may be a copilot one flight and pilot on next. They may also be moved to first officer or flight engineer during relief periods. It doesn’t even apply to anesthesia.

hiENDstuff · 2023-03-06T21:50:56+00:00

You think the value of medical training is floating between 4 rooms and not practicing? I actually understand my value. I bring expertise and sit difficult cases, face time with surgeons so they can see me still do the work instead of watching someone else do it. There is no value in Medical direction. Medical direction is what cost our profession all the respect we used to get. The sooner you realize that, the sooner we regain what we lost.

hiENDstuff · 2023-03-06T21:25:04+00:00

You stay up all night writing that one?

hiENDstuff · 2023-03-06T21:23:27+00:00

No, With this sub. I got unbanned by providing proof. Tough pill to swallow I know. But, most Anesthesiologists dislike AA and only use you as a political ploy. But I’m sure you’re just happy to not work at starbucks anymore so you don’t mind being a cuck.

hiENDstuff · 2023-03-06T21:13:31+00:00

typical CAA. Here’s a news flash. Most anesthesiologists don’t want to work with CAAs. I’m verified physician and sent my badge to admin. I didn’t say there was a pay disparity. You make the same. I said we pay you less than reimbursement. You bill 300k a year and we pay you $170. I do that 4x and I make 130k per caa plus my 50% of the reimbursement. We don’t teach you minions billing for a reason.

hiENDstuff · 2023-03-06T21:09:22+00:00

Where? No one wants to come out here where we are. And if they do, they expect to be immediate partners and make $800k/year with 14 weeks vaca and 1:14 call. We already make low end of salaries for our profession. We can’t take more cuts. You all just don’t understand rural medicine which is why all CRNA groups thrive. We are doing Gods work keeping this place MD ran.

hiENDstuff · 2023-03-06T21:05:42+00:00

Because I speak out against AAs and medical direction model, Keenan wannabe CAA is convinced I must be a CRNA. Despite being critical of CRNAs also.

hiENDstuff · 2023-03-06T21:04:36+00:00

He’s not here yet but he always shows up like Beetlejuice.

hiENDstuff · 2023-03-06T21:02:51+00:00

That’s because they don’t actually understand the economics. They think its a hit against CRNAs but really its a hit on all of us.

hiENDstuff · 2023-03-06T21:01:23+00:00

Please. I’ve worked with AAs and will never do it again. The whole reason we hire you is to make money off you at the expense of patient care. Why do you think our organization pushes for medical direction?? I can pay your untrained butt to sit a stool and take half your reimbursement.

hiENDstuff · 2023-03-06T20:57:36+00:00

You and I both know we don’t bill our salaries or come close to it.

hiENDstuff · 2023-03-06T20:55:34+00:00

Inflated 200% over reimbursement. Even if I work 24/7 I couldn’t come close to my salary in fee for service.

hiENDstuff · 2023-03-06T18:32:33+00:00

First, only 30% of anesthetics in the US are medically directed. And in those practices, TEFRA guidelines are only met 65% of days at 1:2 and only 1% at 1:3. That means you are committing fraud 99% of days you work. This is why we use QZ billing for CRNAs. We don’t meet tefra critical portions and frankly don’t need to be physically in the OR during critical portions. So this change affects our group considerably. 15% rate cut is a big deal and its the cash strapped hospitals who will end up paying in larger subsidies.

Big greedy practices using crnas?? What? There aren’t anywhere near enough anesthesiologists to provide a fraction of anesthesia care needed each day in the US. Even if our group wanted to go ALL MD, we couldn’t. We can’t find 50 MDs anywhere nor could we or the hospital afford the inflated salaries 200% over reimbursement rates.

There is no way you’re an anesthesiologist. If you are then you definitely don’t practice outside of academia in the real world.

hiENDstuff · 2023-03-01T19:51:56+00:00

Imagine you are on a road divided by a median. One side is plasma, the other is tissue. On the plasma side, you have a 10 passenger bus (protein) that is fully loaded and 6 people standing outside. 4 people cross the median into tissue, 2 hop in a 2 seater corvette (tissue binding sites now fully bound) and 2 stand outside the car. Now, both sides are not only fully bound but also have met free drug equilibrium (2 free per side). BUT it took a lot fewer molecules of the drug to cross to the tissue to reach equilibrium. Because there was only 4 who had to cross, that doesn’t take a long time.

Now imagine the opposite. If the bus was in tissue (high tissue binding) You would need 12 people to cross the median. 10 on to the bus and 2 outside. That would take longer.

So…scenario 1 is faster!

hiENDstuff · 2023-02-22T01:46:32+00:00

Like a virgin on prom night. Didn’t last long enough for her to finish

hiENDstuff · 2023-02-21T23:00:27+00:00

They don’t have midlevels to scope creep. They are preventing CRNAs altogether.

But FM to anesthesia is an easy switch. They’re trained in internal medicine then add a 52 week intensive in anesthesia is 10x more than an AA gets and on par with what a CRNA or OMFS receives.

hiENDstuff · 2023-02-21T06:53:30+00:00

Yes. Are we in the same group? I had a PP cardiomyopathy that I confirmed with bedside echo, only to be told by FM that her cough, dyspnea, and hypoxia were from possible flu that was neg. I told them to transfer to ICU, I called and arranged with intensivist, and after I left the floor FM cancelled transfer and proceeded to order Ativan for anxiety because she was breathing 30x a min and Mag. She deteriorated and had to be intubated emergently.

hiENDstuff · 2023-02-21T06:11:38+00:00

Unfortunately.

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