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 egotiating
a contract with your hospital? Need a stipend for
undercompensated services? Thinking of adding intensive
care unit coverage and wondering if it is feasible?
ASA offered help with these crucial aspects of anesthesiology
practice and many more at its Conference on Practice
Management on February 4-6, in San Francisco, California.
2005 President Eugene P. Sinclair, M.D., predicted
that by 2030, Medicare would exceed 50 percent of
the gross billings of a typical anesthesiologist.
Shena Scott, M.B.A., and Genie Blough, M.B.A., presented
data from a recent Medical Group Management Association
hospital contracting survey that indicate stipends
from hospitals to anesthesiology departments have
increased both in number and absolute value. Sixty-two
percent of groups receive a stipend, and as the percentage
of government payers increases, so does the stipend.
The mean stipend for academic groups was $3.87 million,
and for private groups, $1.51 million.
Michael Belman, M.D., Medical Director of Blue Cross
of California, presented “pay for performance”
as a flourishing guideline for contracting and payments.
During a breakout, James S. Hicks, M.D., described
a 360-degree mechanism for evaluating anesthesiologists.
Asa C. Lockhart, M.D., detailed indications for seeking
outside help for practice problems. He used the term
“stabilization/rehabilitation support”
rather than “stipend.” Attendees also
learned how to calculate the impact and costs of inefficient
operating rooms. This spreadsheet is available at
<www.ASAhq.org/Newsletters/2004/09_04/KOAMAutilization$.xls>.
Michael Scott, J.D., former ASA Director of Governmental
and Legal Affairs, insightfully addressed the impact
of drug abuse on anesthesiology, pointing out an education
program that can be viewed at <www.ASAhq.org/clinical/curriculum.pdf>
(see related article).
Dana Simpson, Esq., discussed how to reduce medical
liability costs through risk-retention groups, risk-purchasing
groups, captive insurers and hospital stipends. He
advised combining asset protection with any reduced
insurance coverage.
An evolving anesthesiology business model presentation
predicted a three-year turnover rate of 80 percent
for practice managers. A take-home message: Treat
your managers well if you value their service! Marc
Miller, M.B.A., pointed out that the shortage of anesthesiologists,
currently estimated to be 6,000-7,000, would continue
until 2008. Fifty percent of hospitals with more than
100 beds need more anesthesiologists.
Instructors from the ASA Certificate in Business Administration
(CBA) program organized presentations on leadership
and generational issues. Anesthesiologists perceive
jobs differently depending on their generations. Groups
will find it increasingly advantageous to accommodate
many job options, including part-time positions, nonpartnership
tracks and positions without call.
The CBA program, directed by Asa C. Lockhart, M.D.,
M.B.A., begins each spring. You can find details on
the ASA Web site at <www.ASAhq.org/conted/cba.htm>.
The Committee on Practice Management oversees this
program, with the on-site instruction held in The
Woodlands, just minutes from Houston International
Airport in Texas. Registration for both the Conference
on Practice Management and the CBA program opens each
year at the ASA Annual Meeting.
The ABCs of practice resuscitation available at these
meetings are as essential for practice viability as
basic cardiac life support is for patients.
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Susan G. Dobbs Curling, M.D., is President,
North Houston Anesthesiologists, and is an anesthesiologist
at Northeast Medical Center Hospital, Humble,
Texas. |
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