YOY Anesthesiology Pay and Analyzing Demand

Erik Sunset: [00:00:00] Hello, and welcome back I’m Erik Sunset, your host to the DocBuddy journal. This is episode 39 being recorded on Tuesday, October 10th. And we’re back, we’re back after missing the last week. It ended up being a very short week for me, due to travel. We’re proud to have supported the New York state association of ambulatory surgery centers, better known as NYS a S C a where I was personally an exhibitor at the show. We also had team members in Minnesota at the Minnesota ASC event called the Nazca. New York was great. Met a lot of great attendees. We bumped into some friends over at HST pathways, among many other grades. Vendors and partners and folks that support the show and make everything happen there. I got to say the NYS a S C does a great job with their events. One of the highlights for me was the dinner that they hosted on Thursday evening. It had a very small, sort of a perfect amount of time [00:01:00] award ceremony, great speakers. It was a great reception and overall, just a fantastic event. We can’t wait to go back. Thank you in particular to Geovanna for making sure we had everything that we needed. And then to put a bow on that point for everyone that stopped by the DocBuddy booth. Thanks for your time. We’ll be in touch with you very soon to get you what you need. And now looking ahead to the end of this week, we’ll actually be supporting the bone society of Florida, which is part of the Florida orthopedic society or FOS. At their conference being held in west Palm beach this Thursday and Friday. So we’re obviously looking forward to showing off our Op Note solution. For all of the procedures that happen at surgery centers that these orthopedists will be doing. We’ll also be happy to give you a look at our clinic. And on-call based solutions as well. So I hope to see you there. If you’re a Florida based orthopod feared administrator for an orthopedic group or otherwise [00:02:00] affiliated with. An orthopedic practice. In the state of Florida. And we have covered a lot of ground to date on the DocBuddy journal from physician burnout to workflows. To the availability of physicians and the fact that they’re retiring early. As well as nurses for that matter and our lack of nurses in the healthcare ecosystem. But we wanted to spread the love around a little bit. Cause we haven’t talked a ton about anesthesiologists or anesthesia providers. Be the doctor or CRN or otherwise. Wanting to share some interesting data from solving Kotter’s 22 and 23 physician compensation and productivity report. But there’s good news. If you’re an anesthesiologist and that’s it, you’re paid jumped 10% in this period year over year. And that raised your median wage to about $478,000 per year. When you look at all of the specialties that [00:03:00] experienced an increase in pay, according to the Sullivan Cotter reports. The big winner year over year, though. We’re the hospitalist internal medicine folks. They got a 14% increase in median pay to just about 325 grand a year. So that’s great. You love to see that physician compensation is improving. Not everybody got the same type of an increase or an increase at all. Around their median pay, which is what their reports was showing us. And if you need a quick refresher on statistics, immediate value the median is the value in the middle of a dataset. Meaning that 50% of data points, heavy value, smaller or equal to the median. And the other 50% of data points have a value higher or equal to the median. So not an average, it’s not average pay. That works a little bit differently. There’s a little bit of math that happens in calculating an average. This is just the middle data point. [00:04:00] The point in the middle. But to my eye, there’s an interesting juxtaposition in play here because according to Adam Spiegel, who’s the CEO of north star anesthesia and an interaction that he had with Becker’s ASC. The juxtaposition is that reimbursement for anesthesia expenses through Medicare and insurance companies has actually declined. And if you’re paying any amount of attention at all to physician reimbursement this won’t be a surprise to you. To put it in high level terms. And this is a quote from Mr. Spiegel. It’s put it in high level terms. We’ve seen about a 20% increase in costs over the last couple of years for anesthesia providers. Both seen a decrease from payers. If you combine Medicare and other payers by five to seven. Percent. And what this means is that because reimbursement per anesthesia expenses with Medicare and private carriers, that it’s declined. Healthcare [00:05:00] organizations are having to subsidize a anesthesia care depending on the case. So whether you’re a hospital or an ambulatory surgery center, you may actually be coming out of pocket to have the level of anesthesia staffing you need for the amount of cases that you’re performing.

So Mr. Spiegel continues. Additionally, the current shift toward care team models also affects employment and compensation for anesthesiologists and CRNs with certified nurses. Being able to perform as anesthetists in many states is becoming more cost-effective to hire multiple CRNs, as opposed to multiple anesthesiologists. And he goes on. Now what’s interesting is that hasn’t slowed down the need for more anesthesiologists, because I think overall the pie is growing. So anesthesiologists probably aren’t growing at the same rate as CRNs in terms of demand. But the current demand way, way exceeds the number of anesthesiologists now, or that are coming [00:06:00] out of training.

You’ve heard that here before. The lack of physicians, the outright shortage of physicians that we’re going to be faced with nationally in the next handful of years, hopefully I can stretch out to the 23rd is it doesn’t seem like that’s going to be the case. Anesthesiologists are physicians as well. CRNs our providers as well. So when you see these trends around burnout and trends around retire early from your practice or choosing to not enter medicine at all, it’s not limited to just your primary care types or your orthopedics or any of your other sort of traditional doctors providing care surgical or not specialty or not.

Anesthesiology is experiencing the same shortage. And this is Again, not going to be news to anybody. That’s following the story very closely here. But Mr. Spiegel, rightly points out that the number of anesthesiologists in demand [00:07:00] way outstrips the number of anesthesiologists that are actually able to deliver anesthesia care.

So to go back to our juxtaposition, we said earlier that median pay for anesthesiologists is up 10% year over year. But when you look at the macro picture, the simple supply and demand curve here will tell you that if there. You know, far fewer anesthesiologists available to deliver care than are actually needed. The price for that care is going to increase. You’re going to have to wait longer. You may not be able to get it when you want it. So to me, it’s interesting that median pay is increased only 10% based on the outright. Shortage of anesthesiologists in the market. And we talked earlier about some of the events we’ve recently attended and we’ve, we’ve been all over the country this year. Literally coast to coast. Now that we’ve checked New York alpha list. But that’s a common theme that you hear from these ambulatory surgery center conference show floors is, you know, we, [00:08:00] we sell our workflow product, so a suite of workflow products, but still the question comes up. Do you have a way to get me more? Anesthesiology coverage. Do you know anybody that can, if you know any anesthesiologist looking, can you point them to me? And I wish I had a better answer that I just don’t know a ton of anesthesiologists to a to point in the direction of the surgery centers that we interact with. But whether in your you’re in New York, California, Arizona, Florida. Nationally, you can feel that pressure. And to go even a step beyond the pressure of being able to deliver care with anesthesia for a surgery center. I’m hearing this every week that goes by, we are having to reduce the amount of cases we perform because I don’t have X amount of staffing. To be able to do that. I can’t meet the demand for my cases, whether it’s surgical techs. Any of the other support staff that make procedures at the ASC possible? I don’t hear so much that there’s a lack of surgeons to perform the cases. And that’s whether that’s [00:09:00] as a management company owned facility or it’s privately owned by a group of physicians. I’m not hearing that. However, the lack of surgical texts, lack of anesthesia. Is making a tough financial situation, even tougher for surgery centers. Because they just don’t have the manpower or the woman power needed to perform the procedures that are on their schedule. So they’re having to move people down, through time, down through the calendar to a later date for hopefully there will be better staffing. Or they have a thin more thin thinner caseload for a given day.

So we’re just about a 10 minutes here, a little bit different format. We’re gonna gonna jump around on any different topics. So those are our thoughts on anesthesia. The thesis here is that there’s a physician shortage coming, starting to feel that crunch. Anesthesiologists are physicians to CRNs our providers as well. And this lack of anesthesia and the outright [00:10:00] lack of physicians that we’re going to face in the coming years, it’s going to mean waiting much longer for care. You may not be able to get it where you need it. And when you look towards the acute care side of things, so at the ASC things can generally run pretty smoothly. You don’t really have any emergency procedures happening at an ASC, obviously. So you’re able to plan your staffing for anesthesiologists. You’re able to treat that sort of as a little bit more of a business. You know, I needed on this day. Come in this day, you get paid for this day, et cetera. Whereas on the acute care side of things, when you’re thinking about a hospital emergency department, Well, you know, you hopefully don’t have any patients coming in with critical trauma care type needs, but, you know, gunshot wounds, car accidents. You know, the really the really bad stuff out there. Hopefully you don’t see it. But you can’t not have anesthesia available if you do get it right. And what I’m getting at here is the cost structure of healthcare facilities [00:11:00] and emergency departments needing to keep anesthesiologists on hand. It means that they have a outright cost center. If they’re not delivering that care, right. You can’t have an emergency room without any anesthesia services available. Not a very good one. Anyway, not one I would want to visit.

So with all that, we’re going to wrap up this episode. Thank you for listening on behalf of the entire DocBuddy team. If you are a Florida based orthopedic practice, we have a C at the bone society, Florida at the Hilton west Palm. This week. We’ll give you a look at op note. There’ll be a way to keep the orthopedist in your life. Happy. There’ll be able to generate op reports instantly from the point of care using their iPhone or Android device. That’s phone. Tablet happy to give you look at our enterprise solutions as well, which helped drive efficiencies of the practice and keep your docs out of their EHR. I don’t make them very happy. And even looking at products related to their work on call at the variety of facilities at which they are [00:12:00] credentialed and privileged. So as always, thank you for listening to the DocBuddy journal. To learn more about DocBuddy, please visit DocBuddy.com. We’ll be happy to set up a completely customized demonstration for you at a time. That’s convenient for you. Until next time, be sure you’re subscribed on apple podcast, Spotify and YouTube. And we’ll catch you again next week. Thanks everybody take care.