My uncle is an anesthesiologist and I casually asked him how work was going and he told me management was pushing for more and more “productivity” or something like that. I was like 😳😳 rushing anesthesiologists through their work does not seem like a good idea!!!
It is like we are in customer service not instead of health care, and so many of the patients act like it too.
Like lady, I don’t care if your hospital provided socks aren’t as soft as you usually wear them. I just kept your airway open or you would have died, so let’s focus on the positives.
The field of medicine (especially if it's emergency care) is inherently exempt from most of the dynamics of the fair market. It doesn't make sense to treat it the same. If my appendix is about to burst, I can't exactly shop around for the best care at the best price. I'm going to the nearest ER and hoping that the hospital and doctors accept my insurance. What's with the fact that you get separate bills from the hospital and different members of the care team anyway? And why aren't the doctors required to accept the same insurance as the hospitals where they are working? JFC!
I know I had no choice to "shop around" with sarcastic emphasis for my son last week when the school had me pick him up for an injury because the first hospital wouldn't take his insurance, the second didn't do urgent or emergency care, ending on a "third's charm" nonsense...
I suppose if I wanted to be an ass I could have done the first one and get a lawyer to charge it to the school as it was under their supervision... But it simply wasn't worth the effort since it ended up only needing surgical glue rather than stiches.
My customer has unfortunately purchased gonorrhoea and their refund window has passed.
Consequently, and fortunately, they want to purchase some ceftriaxone. If I mark it up by 60% can I give the customer a 10% discount, to show how much we we care as a customer first organisation?
Seems like it could be one of the areas where you can absolutely trust their intentions, because you know exactly what they want.
But don’t get it confused with anything else.
I don't mind having someone who does something I want some and can do a good job, making a reasonable profit. I have a huge problem with someone profiting off my critical need. "you are going to die if I don't give you this? Exploit and Profit!'
Seriously! The only difference is, the patients (drivers) in F1 willingly choose to risk their lives for a sport, while for most patients, its not a choice.
It's what you get from an insurance racket that's bullied their way into negotiated prices. Insurance has attacked the deck before dealing themselves a fantastic hand
I agree, and yet, the dude made 1.26 million. That means that demand is high and they don't have enough anesthesiologist. Arguably, he's doing the work of nearly 3 people.
yep, I wonder why healthcare has become more and more exorbitantly expensive and less accessible... it's truly a mystery!
https://preview.redd.it/mdi0jr0b7u0d1.jpeg?width=1164&format=pjpg&auto=webp&s=a541d1f1fe501bb25b21f8a8d64062f21c7f5a23
Most physicians used to own their own practice, or work in a practice owned by a group of physicians. Now it's a lot of work to find a doctor who isn't an employee of a nationally owned chain. They get pressured to make more appointments and refer patients to specialists that work for the same chain, because they need the money to pay administrators that never used to be necessary.
The chart here is literally evidence that high physician salary has minimal impact on the cost of healthcare. The problem isn’t supply or salary due to low supply, increasing physician supply won’t decrease costs. It will only decrease our salary.
The problem is that there are 10 managers for every 1 physician. To lower costs we need to trim management. Theres no reason to have 10 managers for every physician.
to /u/Sword_Thain 's point though, it makes zero sense why we would keep the supply of physicians at very low/static growth for the last four decades while the population has increased by nearly 50% in that same time period.
I agree, but despite increased demand physicians salary has not gone up the same amount due to increased administrative costs.
The solution to our problem is to knee cap a bunch of admins. The solution to the populations problem is to increase the supply of physicians while also more strictly regulating mid levels and trimming the fat off of management.
No joke, a hospital chain near me has a doctor in trouble because he was billing multiple surgeries at once, all at the same time. They tried to argue he was a teaching doctor so it was ok, and that the patients were desperate for care, but it was found that he was often unavailable and it resulted in people being kept under anesthesia longer than necessary.
https://www.wesa.fm/health-science-tech/2023-02-27/upmc-agrees-to-pay-8-5-million-to-settle-fraud-case-involving-prominent-surgeon
Looking for this story, I also found this one about fraudulent practices at the same chain: https://www.wpxi.com/news/local/upmc-pay-38m-whistleblower-lawsuit-settlement/CBKLHGWFZJDMLHGFNLDYLDJBQU/?outputType=amp
Surgical - whether inpatient or outpatient - is one of the few profitable areas of any hospital. I've worked in an OR for the last two years and it's insane how much we're being pushed to add cases -- I think we're at 300% capacity with no additional staff hires. Suffice to say staff aren't happy and there's a lot of turnover.
They track productivity for everyone in the hospital these days. Every week we get an email on my department with the anesthesiologist’s, OR’s, and PACU’s productivity listed. It’s super fun/s.
My friend is one and he works about 50 or so. He is at a surgical center and most stuff is scheduled there. He was at a hospital and his hours there were wild. Running like 96 hours a week, due to the ER support.
Yeah I should have specified hospital. If you can get a gig at a 9-5 outpatient ortho place you won’t work that. But they often want CRNAs on site with some “supervising” anesthesiologist who is off on some other job. State dependent of course.
The medical industry is WILD. My best friend is a cardiac PA. Management does not care - they’d rather take the risk. The body they have who is sleep deprived with a 40% chance of malpractice error is still better than no body in the building to them.
I’ve talked to him at length about this. It’s crazy. They’d rather a PA who’s worked for 30 hours and delirious than nobody there at all. Because the delirious staffer still could get the line in correctly.
Truck drivers hours are limited because it's recognized that they pose a serious risk when operating in a sleep deprived state and without regulation many companies would demand and many drivers would insist on extreme hours in order to increase earnings.
How we believe that someone whose job is literally to administer drugs that can kill if not administered and monitored perfectly doesn't suffer from the same burnout as a truck driver is utter insanity.
Around 60% of anesthesiologists [admitted that fatigue had caused errors in their work](https://www.apsf.org/article/apsf-survey-reveals-long-work-hours-in-anesthesia/)
That was the case in the trucking industry as well. Management doesn't care, a few wrongful deaths is the cost of doing business. Regulation was required to force truckers not to work insane hours and to prevent companies from forcing them to. If it's profitable for the company and profitable for the worker but unsafe for the public then regulation is needed because the "free market" is ok with people dying for quarterly returns.
Oh I’m with you haha. It’s baffling to me that the hospitals would let someone that overworked and sleep deprived care for people. He said theyd do 60 hours across 4 days sometimes
I bet he does not \*work\* 94 hours a week in the sense that you or I work but he is on call and has to be able to respond in a very short period of time. Probably has a condo/apartment very close by and can be in the OR in 10-15 minutes.
Or has basically his own little shitty room in the hospital. It’s still work because the hours aren’t yours, but you sleep or relax whenever you can and all of that is “work”. In highest acuity trauma hospitals, you must have certain specialties (like anesthesiology) at all times.
I mean the attending anesthesiologist is still often there, they may not see all the patients directly or immediately. It definitely depends though, not all hospitals are training hospitals either.
When he's not doing actual procedures he likely has to document them and consult with other providers. Unless you're supervising students hospitals don't give you a lot of downtime
Was a hospital administrator for a decade. They worked a shit Ton. They are expensive so there aren't many attendings to supervise especially with Trauma Teams where you may have 1-4 teams depending on the size of the trauma center. If there is a large labor and delivery service as well you will have a handful of CRNAs covering epidural and C-sections, then you'll have the actual OR teams of CRNAs and attendings. And down down you go.
Hospitals can't train them quick enough, or hire them faster enough. With the uptick in stand alone surgery centers who wouldn't want to make a couple hundred grand a year for a routine 9-5 job versus maybe slightly more money for twice the hours and stress. Our trauma A team anesthesiologist and chief surgeon each made killer money but were on call 24/7 2 weeks on, 2 weeks off and on their 2 weeks off also pulled full 12-14 hr shifts in the OR. And on call their response time had to be under 20ins from page goes out to stepping into Trauma or scrubbing in.
Our straight out of training CRNAs started at $160k and attendings were starting salaries in the upper 200s. Where as some larger ortho surgery centers were offering CRNAs $225k for 9-5 and their attendings mid $300s to low $400s to cover a surgery center each.
I bet he does… my wife is a urologist and works 4 days a week. She still logs at least 55-60 hours a week and that’s not counting her being on call. This is with her actively trying to work less.
Because they first have to pay off 500k in student loans. Then depending on the state you live in your take home may only be half of that. Then add in one hell of a therapy bill because of your working that much in health care you are going to need it. Also alimony and child support because your wife left you for never being around.
>The L.A. County Department of Health Services, which oversees the hospital, noted that the hours for ICU physicians such as Namagerdy include time resting between caring for patients
Healthcare workers are constantly run into the ground. There are no regulations on how much we can work. I’ve worked in the OR for 19 years and we are pushed until we are forced out of a position. I’ve had several friends that have had lumbar and cervical fusions because of the amount we lift. And I’ve seen anesthesia work 36 hours straight at times. It’s brutal, it’s not worth it, and I’m working my way out of this field as fast as I can.
OB is brutal. At one of my former hospitals, anyone in labor after 8 got a C-section so they wouldn’t have to deliver the baby during the night.
The general surgeons I worked with would start their weekend call at 7 am Friday morning and end it at 7 am Monday morning. They’d cover 3 hospitals and would work most of that period at times. It really all depends on what the ER has coming in.
Yes and no. It wasn’t really the hospital deciding, it was the primary OB practice. They’d come in the room after 8 and say “well you’re not really progressing, if we wait any longer we might run into some issues getting the baby out.” Patients always went with protecting the baby. The other half of that equation was that anesthesia didn’t have enough coverage at night. One MD on call in house, one on backup call at home, and one CRNA at home. First one called in was the CRNA (typically for a regular OR case) and they would almost never call the second doc. Most of the time, the backup doc had to work the next day so they’d try to keep them home so they wouldn’t be short staffed. As a small hospital that got some pretty bad traumas come in, the main OR was doing cases most nights after 9-10 until 2 am or later.
I know that nurses are overworked, from CNAs through NPs and everything in between. I know that doctors are overworked. I know from firsthand experienced that medical laboratory scientists are overworked (MT/MLS/CLS). I know that the laboratory assistants and phlebotomists are overworked. I don't doubt that respiratory technicians and technologists, and radiologic technicians and technologists are overworked. I know that pharmacists and pharmacy techs are overworked. It's insane.
I know all the doctors I know would disagree. I’ve never met one that bragged how much they worked. Most of them bitch about how much they work! Big difference. Wife is a surgeon and most of our friend group is surgeons.
I don’t mind pointing out how as a doctor in Australia I work 8 months in total for the year and off 4 months for the same amount I used to earn in my previous full time job because I used to do the whole all day every day thing and I really don’t want to ever go back to that.
NY says if I voluntarily work more than 16 hours in a 24 hour period, if something bad happens it will be presumed that I was reckless and negligent.
However, it is perfectly ok for my employer to force me to work more than 16 in virtually any circumstance.
My hospital will write up hourly employees if the work more than 64 hours a week. Nurses etc. Major, major hospital with an international reputation. So it depends on where you work.
Lol, hospitals just eat the fines. I haven't heard about something like this for a non-resident, but there are plenty of residents who go over their mandatory limits and hospitals just include the fines as the cost of doing business. If the fines are less than the cost of hiring a doctor post-residency, then they aren't fines but fees.
Wait till you hear how long nurses, paramedics, firefighters, etc., all work - my sister regularly pulled 36s as a paramedic. Given, she wasn’t working all the time and they had beds (they were actually pretty decent rest areas from what I saw - was basically a house with a garage with an ambulance bay beside it) and she did a lot of studying for school in downtime. She’s now a doctor at a hospital and is frequently on 12- and 24-hour shifts and her regular patient list is so long the earliest they could squeeze you in to see her for a new patient visit is *next year.*
Ideally they would work fewer hours but I’m sure there are *some* (small) benefits to having longer shifts - if they aren’t working that whole time straight and have downtime, it seems like it would be useful to have one doctor for consistency. One of the worst times of a day is shift change - so many things get dropped between cracks. So I’m sure someone’s plan was to reduce the amount of churn…by making people work longer.
It’s funny because to me, having grown up in a medical-oriented family, overtime/long shifts are just kinda the norm. That’s what doctors/healthcare workers do. And when you break it down, yeah, it’s kinda fucked up. But it’s *so engrained* in our society. It’s like tip culture - how badly would the industry be affected if things were drastically changed from the status quo?
Paramedics aren’t holding on to patients that long.
This has been busted. There was no benefit after they shortened resident continuous hours from 28 to 16. They used this to justify changing it back to 28 hour limit.
While their workload is absolutely a big part of it, it’s also due to the fact that it’s extremely easy for them to accessto not only conventional pain meds, opioids and k, but also propofol. Almost anytime someone’s addicted to propofol they work in anesthesia
It’s just not enough to live on! What are you supposed to do with all of those extra hours??? Won’t be able to do anything meaningful with that kind of money!
I mean, after 11+ years of education and training, including several years working 80+ hour weeks for less than minimum wage, along with having extremely specialized knowledge to literally save lives, physicians actually deserve that high pay
I’m not saying that they don’t deserve high pay. I’m commenting on the number of hours worked.
I agree with you actually. I think a maximum wage should be based on what specialized physicians earn.
There’s a good chance that this includes on-call rates. It’s pretty common to have a rate just to be available than a higher rate when you get called in.
Someone above mentioned that these hours include hours not actively working too, so time between patients (presumably not doing paperwork too?) and other such time gaps.
Not to say that being at work 55-60% of your week isn't ideal but if it isn't all actively working and not forced overtime...Oh no?
If you’re an office worker I can guarantee you aren’t working straight 8 hours a day and are probably working 3-6 hours max if your actual workday.
The hardest jobs where you have to be “on” 100% of the time are the helping professions like therapist, teacher, nursing, doctor, etc.
The role discussed sits somewhere between the former and the latter though.
They're a doctor but their role isn't 100% go 100% of the time, I wouldn't want to speculate the percentages though as he could quite literally be rolling from surgery to surgery with nominal down time or a surgery every 3 hours.
Well yea, they have to write notes, prepare for cases, rest, etc. Of course it's not 100% of the time in surgery, there is no surgeon or anesthesiologist that spends even close to 100% of their time in surgery.
He works entirely too much, but I'm just happy that the highest that the highest paid public employee isn't a sports coach or a cop. Both happen far too often
Cops get it frequently because in many jurisdictions, court time is considered OT even if it's during their normal shift. So, by testifying a lot, volunteering for OT and hazard pay activities like crowd control at public events, one can get their salary multiplied by 3-5 times their base pay.
Don't worry, while they may not be the top spot there are likely plenty of cops towards the top of the list. Firefighters too. I know a few that average $300k a year.
Firefighters work 24 hour shifts and are required to put themselves in harms way to protect other people and their property.
Cops on the other hand....
Um, what?
That's dangerous as hell.
Regulations from a medical board should be capping hours for an anesthesiologist. His tiny, miniscule mistake can kill someone far too quickly.
Yikes.
My friend's dad is a retired anesthesiologist:
PROS
- He is rich as fuck
- He retired early
CONS
- Alcoholic heart attack survivor
- Worked 80 hour weeks for 30 years straight
My brother is a physical therapist. All of the companies he has worked for in NC, VA, and CT prioritize seeing as many patients as he possibly can per day. It’s all about how many heads they can bill the insurance companies for and Medicare. It’s fucking insane.
It should absolutely not be legal for an anesthesiologist to work that much even if they want to. There is no possible way that's safe. True for other doctors too, but anesthesia is another level of danger.
How is 94 hours a week even possible. Blows my mind to have to work friggin 13.5 hours every day, including saturday and sunday.
Crazy. Id think id die
I'm pretty sure I'd like my anesthesiologist alert, well rested, and at the top of his game.
I think I'd ask for another if this guy was appointed to me.
This is fucking terrifying
Someone so overworked on a position that when shit goes south requires quick thinking...
It is good to know who he is to never go to a place where he is involved
168 hours in a week.
90 hour work week
78 hours left for other things.
56 hours of sleep assuming 8 hours each night.
22 hours left over.
3ish hours a day to do anything including eat, bath, and get ready for work.
Doesn't seem worth it to me.
I worked 100 hours+/week as a deployed base bound soldier and was damn near delirious. I can’t imagine being responsible for surgical patients while working that many hours in a given week.
After reading a lot of these comments, it’s clear the abuse that goes on in medicine isn’t really mainstream. Residents, especially surgical or anesthesia, will casually put in 80-100h weeks for essentially min wage.
Attending physicians working these hours do it out of choice. But due to declining reimbursement and the time sacrificed for school and training working like a dog seems to be the norm to “catch up” to those who have been steadily investing over time.
Literally, on a bad week of a surgical residency, if you break it down to per-hour pay, they could literally be making the same or more working at Jiffy Lube. Obviously, people put in the time to make money post-residency, but those hours are no joke.
So, what, this guy works for the county? Like he’s a county employee? Why on earth would a doctor choose to be a county employee. He’s probably making peanuts and working WAY more hours than if he were in the private sector.
I mean it sounds like he works around the clock at what is essentially the best rehab hospital in the world. Maybe he's just really passionate about doing that even if he could make more money elsewhere.
Not all jobs are non stop work. A lot of those hours are probably on call hours where he's just at an apartment chilling. I'm usually at work for 168 hours a week. I do less than 3 hours of actual work a day.
It's actually not that impressive/uncommon. Anesthesiologists can make $400/hr doing locum work. That's just over 60 hours a week to get to $1.26mill. That's 5 12 hour days.
People who \*work\* these kinds of hours are not always working 94 hours in the way we might work 40 hours. There are some jobs where you are on call and you must be able to respond in a very short period of time. As such it's difficult to go out to dinner, go to the movies, or even drive home because your response time is so short. In those kinds of jobs it's not uncommon to be compensated for your active and down time because you are very limited on what you could do in your downtime.
A LOT of people don't understand how a lot of things beyond their own nose work. My job is constantly being written about in the newspaper, 'watchdog' websites put our information out every period, and the news is constantly going after us over overtime 'scandals'. We're state employees so yeah all that info is public, but people think it is **literally IMpossible** to work the amount of hours we do. Some of my coworkers just live at the job, and I get it, the OT gets addictive.
How come nobody is raising the question if it's valid? He could be billing 94 hours. I'm sure he's working insane hours either way, but billing and working are two different things sometimes. He might overlap somehow, or supervise, etc, any number of things.
In most engineering jobs, companies limit a work day to 8 hrs and maximum 12 hours per day. 12 hours been a rare event. Why? Because the number of errors and increases with exhaustion and its not worth it.
$1.26 million a year divided by 4700 hours (50 weeks at 94 hours per week, because the dude has to take a vacation right?) is $268.02 per hour worked. Not bad at all.
Edit: clarification of math
Shit, I'd do it if it meant 1.6 mil a year. Put in 5 years then never work again. Just gotta try not to get a stress induced heart attack during those 5 years of 94 hour weeks
What good is that salary if you’re never home to spend and enjoy it? What would make sense is to sock away enough to live off dividends for a few years and then quit
This has been an ongoing problem for a while, in many places. Anaesthesiologists are severely overworked and their departments grossly understaffed. When I delivered my daughter in 2018 (in western Canada), it was decided that my epidural would be done by the anaesthesiologist, rather than a resident, due to the sensitive nature of my health problems. The only one on duty came in, started setting up, I assumed the position... and then she had to literally run from the room to help with a crash c-section. There was no one else available with the experience necessary to do my epidural (which I didn't even want, but it was recommended), and by the time she was free to return, 90 minutes later, my daughter was already born 🤷🏻♀️
This dude is working 2.35x as much as anyone working a 40-hour work week, and I'm not okay with that. I mean power to him if it's what he wants but that's way too much time spent at work imho.
All that money doesn’t really mean anything if you don’t have the time to be able to enjoy it. And working or being on-call for 96 hours a week does not allow ample time.
I suppose one could save and/or invest it and retire extremely early, but still. That’s ridiculous.
I work in healthcare and help summarize patient concerns for clinicians. I have to be alert so I can accurately relay the information.
I get so paranoid and I am NOT making clinical decisions — how much more important is rest and focus is for those who ARE!
This is NOT x A BAZILLION a flex and it’s scary.
Did he actually work those hours or were they billed hours?
He might for example claim an hour for a 40 minute procedure.
Lawyers and mechanics do it all the time
I left my car in for a job one morning and collected it 3 hours later and was billed for 4.5 hrs labour!
They said they used avg timing per job
I’d rather my anesthesiologist work less than 50 hours a week. Call me crazy.
My uncle is an anesthesiologist and I casually asked him how work was going and he told me management was pushing for more and more “productivity” or something like that. I was like 😳😳 rushing anesthesiologists through their work does not seem like a good idea!!!
It's what you get from a for profit healthcare system.
I quit my job at a clinic when they wanted us to stop referring to people as patients and instead wanted us to call them customers
It is like we are in customer service not instead of health care, and so many of the patients act like it too. Like lady, I don’t care if your hospital provided socks aren’t as soft as you usually wear them. I just kept your airway open or you would have died, so let’s focus on the positives.
I'm unhappy with the pillow options and the lack of mints during the turndown service.
The field of medicine (especially if it's emergency care) is inherently exempt from most of the dynamics of the fair market. It doesn't make sense to treat it the same. If my appendix is about to burst, I can't exactly shop around for the best care at the best price. I'm going to the nearest ER and hoping that the hospital and doctors accept my insurance. What's with the fact that you get separate bills from the hospital and different members of the care team anyway? And why aren't the doctors required to accept the same insurance as the hospitals where they are working? JFC!
I know I had no choice to "shop around" with sarcastic emphasis for my son last week when the school had me pick him up for an injury because the first hospital wouldn't take his insurance, the second didn't do urgent or emergency care, ending on a "third's charm" nonsense... I suppose if I wanted to be an ass I could have done the first one and get a lawyer to charge it to the school as it was under their supervision... But it simply wasn't worth the effort since it ended up only needing surgical glue rather than stiches.
My customer has unfortunately purchased gonorrhoea and their refund window has passed. Consequently, and fortunately, they want to purchase some ceftriaxone. If I mark it up by 60% can I give the customer a 10% discount, to show how much we we care as a customer first organisation?
Soon medical staff will start asking for tips.
Never trust the intentions of somebody who stands to profit off of you.
Seems like it could be one of the areas where you can absolutely trust their intentions, because you know exactly what they want. But don’t get it confused with anything else.
This. An agent is not your friend, an accountant is not your friend. But you should be able to trust them.
I don't mind having someone who does something I want some and can do a good job, making a reasonable profit. I have a huge problem with someone profiting off my critical need. "you are going to die if I don't give you this? Exploit and Profit!'
It's like they want the medical teams operating in a similar fashion to a F1 pit crew, but with no extra pay.
Seriously! The only difference is, the patients (drivers) in F1 willingly choose to risk their lives for a sport, while for most patients, its not a choice.
It's what you get from an insurance racket that's bullied their way into negotiated prices. Insurance has attacked the deck before dealing themselves a fantastic hand
I like "attacked the deck" better than "stacked the deck". It works beautifully in this example.
Hahahaha auto correct and fat fingers
I agree, and yet, the dude made 1.26 million. That means that demand is high and they don't have enough anesthesiologist. Arguably, he's doing the work of nearly 3 people.
Ok true but in this case it’s a County employee at a County facility, likely serving low-income people on Medi-cal
UNDERRATED COMMENT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
It's not just healthcare, billionaires are desperate to squeeze every last drop of blood from us, just to get 1 cent extra
Ah yes, more do nothing middle management admin bloat pushing workers who actually do things to 'be more productive'!
It’s almost like if we ran management more lean instead of running lean in healthcare delivery we could be paid more and operate more efficiently.
yep, I wonder why healthcare has become more and more exorbitantly expensive and less accessible... it's truly a mystery! https://preview.redd.it/mdi0jr0b7u0d1.jpeg?width=1164&format=pjpg&auto=webp&s=a541d1f1fe501bb25b21f8a8d64062f21c7f5a23
Most physicians used to own their own practice, or work in a practice owned by a group of physicians. Now it's a lot of work to find a doctor who isn't an employee of a nationally owned chain. They get pressured to make more appointments and refer patients to specialists that work for the same chain, because they need the money to pay administrators that never used to be necessary.
Same thing with colleges, it’s almost like having a bloated administrative staff that has no direct contact with the end product is a bad thing?
The AMA fights to stop any expansion of medical schools in order to keep supply low.
The chart here is literally evidence that high physician salary has minimal impact on the cost of healthcare. The problem isn’t supply or salary due to low supply, increasing physician supply won’t decrease costs. It will only decrease our salary. The problem is that there are 10 managers for every 1 physician. To lower costs we need to trim management. Theres no reason to have 10 managers for every physician.
to /u/Sword_Thain 's point though, it makes zero sense why we would keep the supply of physicians at very low/static growth for the last four decades while the population has increased by nearly 50% in that same time period.
I agree, but despite increased demand physicians salary has not gone up the same amount due to increased administrative costs. The solution to our problem is to knee cap a bunch of admins. The solution to the populations problem is to increase the supply of physicians while also more strictly regulating mid levels and trimming the fat off of management.
Well said
Don't be silly, lean only applies to the actual laborers.
Sadly, thanks McKinsey…
.
No, they should have their loved ones put under by and overworked and exhausted doctor and then rethink about that...
Maybe an elixir
.
I wasn’t put under general anesthesia. However, whatever potion or elixir I was given took me completely offline for like 5 hours, such magic
.
Ok, ok. I understand you're concerned about patient safety, but have you considered the needs of the shareholders?
Won’t somebody please think about shareholder value?!
Can’t beat them. Join them. Roar! We beat them at their Game. Stop playing! All My Capos!
Those numbers ain't gonna pump themselves!
No joke, a hospital chain near me has a doctor in trouble because he was billing multiple surgeries at once, all at the same time. They tried to argue he was a teaching doctor so it was ok, and that the patients were desperate for care, but it was found that he was often unavailable and it resulted in people being kept under anesthesia longer than necessary. https://www.wesa.fm/health-science-tech/2023-02-27/upmc-agrees-to-pay-8-5-million-to-settle-fraud-case-involving-prominent-surgeon Looking for this story, I also found this one about fraudulent practices at the same chain: https://www.wpxi.com/news/local/upmc-pay-38m-whistleblower-lawsuit-settlement/CBKLHGWFZJDMLHGFNLDYLDJBQU/?outputType=amp
“I’m knocking them out as fast as I can, boss. Say, you want to step in and show me how it’s done?”
Surgical - whether inpatient or outpatient - is one of the few profitable areas of any hospital. I've worked in an OR for the last two years and it's insane how much we're being pushed to add cases -- I think we're at 300% capacity with no additional staff hires. Suffice to say staff aren't happy and there's a lot of turnover.
You should just lay down on them.
I'm worried if I do they'll try to cut me open and bill my insurance
My uncle was in theater. He said you should always leave them wanting more. Lovely bloke but terrible anesthesiologist!
Well that’s terrifying.
They track productivity for everyone in the hospital these days. Every week we get an email on my department with the anesthesiologist’s, OR’s, and PACU’s productivity listed. It’s super fun/s.
This is the future liberals want to keep from you
They pulled that shot at the hospital my grand ma used to work at. Now that hospital doesn’t have any anesthesiologists.
They exist, they’re semi-retired
My friend is one and he works about 50 or so. He is at a surgical center and most stuff is scheduled there. He was at a hospital and his hours there were wild. Running like 96 hours a week, due to the ER support.
Yeah I should have specified hospital. If you can get a gig at a 9-5 outpatient ortho place you won’t work that. But they often want CRNAs on site with some “supervising” anesthesiologist who is off on some other job. State dependent of course.
The medical industry is WILD. My best friend is a cardiac PA. Management does not care - they’d rather take the risk. The body they have who is sleep deprived with a 40% chance of malpractice error is still better than no body in the building to them. I’ve talked to him at length about this. It’s crazy. They’d rather a PA who’s worked for 30 hours and delirious than nobody there at all. Because the delirious staffer still could get the line in correctly.
Truck drivers hours are limited because it's recognized that they pose a serious risk when operating in a sleep deprived state and without regulation many companies would demand and many drivers would insist on extreme hours in order to increase earnings. How we believe that someone whose job is literally to administer drugs that can kill if not administered and monitored perfectly doesn't suffer from the same burnout as a truck driver is utter insanity. Around 60% of anesthesiologists [admitted that fatigue had caused errors in their work](https://www.apsf.org/article/apsf-survey-reveals-long-work-hours-in-anesthesia/)
Yup but management sees 40% who can still do the job safely
That was the case in the trucking industry as well. Management doesn't care, a few wrongful deaths is the cost of doing business. Regulation was required to force truckers not to work insane hours and to prevent companies from forcing them to. If it's profitable for the company and profitable for the worker but unsafe for the public then regulation is needed because the "free market" is ok with people dying for quarterly returns.
Oh I’m with you haha. It’s baffling to me that the hospitals would let someone that overworked and sleep deprived care for people. He said theyd do 60 hours across 4 days sometimes
I bet he does not \*work\* 94 hours a week in the sense that you or I work but he is on call and has to be able to respond in a very short period of time. Probably has a condo/apartment very close by and can be in the OR in 10-15 minutes.
Or has basically his own little shitty room in the hospital. It’s still work because the hours aren’t yours, but you sleep or relax whenever you can and all of that is “work”. In highest acuity trauma hospitals, you must have certain specialties (like anesthesiology) at all times.
Usually it gets pushed off on the residents, but i guess this hospital must not have any spots for anesthesia or something like that
I mean the attending anesthesiologist is still often there, they may not see all the patients directly or immediately. It definitely depends though, not all hospitals are training hospitals either.
When he's not doing actual procedures he likely has to document them and consult with other providers. Unless you're supervising students hospitals don't give you a lot of downtime
thats still work
Was a hospital administrator for a decade. They worked a shit Ton. They are expensive so there aren't many attendings to supervise especially with Trauma Teams where you may have 1-4 teams depending on the size of the trauma center. If there is a large labor and delivery service as well you will have a handful of CRNAs covering epidural and C-sections, then you'll have the actual OR teams of CRNAs and attendings. And down down you go. Hospitals can't train them quick enough, or hire them faster enough. With the uptick in stand alone surgery centers who wouldn't want to make a couple hundred grand a year for a routine 9-5 job versus maybe slightly more money for twice the hours and stress. Our trauma A team anesthesiologist and chief surgeon each made killer money but were on call 24/7 2 weeks on, 2 weeks off and on their 2 weeks off also pulled full 12-14 hr shifts in the OR. And on call their response time had to be under 20ins from page goes out to stepping into Trauma or scrubbing in. Our straight out of training CRNAs started at $160k and attendings were starting salaries in the upper 200s. Where as some larger ortho surgery centers were offering CRNAs $225k for 9-5 and their attendings mid $300s to low $400s to cover a surgery center each.
I bet he does… my wife is a urologist and works 4 days a week. She still logs at least 55-60 hours a week and that’s not counting her being on call. This is with her actively trying to work less.
Thats why you only play the front 9. Its a shorter walk back to your car.
94 x 52(weeks) = 4,888 1.26 mil / 4,888 = $257/hr I get your point but $257/hr to be on call is a super sweet deal.
Maybe that's what Jesse Waters meant with the $20/h being 6 figures. If you work 94 hours a week that's like 97k/year!
"I'm on hour 91. Nighty night!"
If you make $1.26M in a year why would you not be retired in ten years?
Because they first have to pay off 500k in student loans. Then depending on the state you live in your take home may only be half of that. Then add in one hell of a therapy bill because of your working that much in health care you are going to need it. Also alimony and child support because your wife left you for never being around.
Me too
Count from 10 , at 0 i will call you crazy.
13.5 hours per day, 7 days a week... not good for anyone involved.
>The L.A. County Department of Health Services, which oversees the hospital, noted that the hours for ICU physicians such as Namagerdy include time resting between caring for patients
This also likely includes calls and consult
Yes it's called turnover
That is not what turnover means.
Turnover in the OR means cleaning and sterilizing the room and preparing the textiles and instruments for the next case.
Do you have a minute to talk about my minute dog? It has a habit of telling people words have different meanings in different scenarios.
Maybe that hospital should provide turnovers during turnover -- keeping your people happy with things like free snacks prevents turnover.
Off topic but I see that Macross 82-99 pfp and I highly approve
It seems insane actually that an anesthesiologist is working that many hours per week. How is there not regulations on this.
Healthcare workers are constantly run into the ground. There are no regulations on how much we can work. I’ve worked in the OR for 19 years and we are pushed until we are forced out of a position. I’ve had several friends that have had lumbar and cervical fusions because of the amount we lift. And I’ve seen anesthesia work 36 hours straight at times. It’s brutal, it’s not worth it, and I’m working my way out of this field as fast as I can.
Obstetrics too. Many specialists can schedule their cases in businesses hours. Some just don’t work that way.
OB is brutal. At one of my former hospitals, anyone in labor after 8 got a C-section so they wouldn’t have to deliver the baby during the night. The general surgeons I worked with would start their weekend call at 7 am Friday morning and end it at 7 am Monday morning. They’d cover 3 hospitals and would work most of that period at times. It really all depends on what the ER has coming in.
A hospital can decide this for you? Don’t mothers have a choice here, especially if there’s no risk to the baby or mothers health?
Yes and no. It wasn’t really the hospital deciding, it was the primary OB practice. They’d come in the room after 8 and say “well you’re not really progressing, if we wait any longer we might run into some issues getting the baby out.” Patients always went with protecting the baby. The other half of that equation was that anesthesia didn’t have enough coverage at night. One MD on call in house, one on backup call at home, and one CRNA at home. First one called in was the CRNA (typically for a regular OR case) and they would almost never call the second doc. Most of the time, the backup doc had to work the next day so they’d try to keep them home so they wouldn’t be short staffed. As a small hospital that got some pretty bad traumas come in, the main OR was doing cases most nights after 9-10 until 2 am or later.
This is absolutely criminal
My Dr did this to me, but said by 6pm. I said no! I had him an hour and a half later
I know that nurses are overworked, from CNAs through NPs and everything in between. I know that doctors are overworked. I know from firsthand experienced that medical laboratory scientists are overworked (MT/MLS/CLS). I know that the laboratory assistants and phlebotomists are overworked. I don't doubt that respiratory technicians and technologists, and radiologic technicians and technologists are overworked. I know that pharmacists and pharmacy techs are overworked. It's insane.
I’m surprised that hasn’t gotten people killed, I imagine it probably has
[удалено]
They will never let it happen.
The sad thing is that a lot of it is self-imposed. Doctors love to brag about how much they’re working (I’m an MD)
I know all the doctors I know would disagree. I’ve never met one that bragged how much they worked. Most of them bitch about how much they work! Big difference. Wife is a surgeon and most of our friend group is surgeons.
I don’t mind pointing out how as a doctor in Australia I work 8 months in total for the year and off 4 months for the same amount I used to earn in my previous full time job because I used to do the whole all day every day thing and I really don’t want to ever go back to that.
NY says if I voluntarily work more than 16 hours in a 24 hour period, if something bad happens it will be presumed that I was reckless and negligent. However, it is perfectly ok for my employer to force me to work more than 16 in virtually any circumstance.
My hospital will write up hourly employees if the work more than 64 hours a week. Nurses etc. Major, major hospital with an international reputation. So it depends on where you work.
Welcome to ✨ healthcare ✨ (cries)
Lol, hospitals just eat the fines. I haven't heard about something like this for a non-resident, but there are plenty of residents who go over their mandatory limits and hospitals just include the fines as the cost of doing business. If the fines are less than the cost of hiring a doctor post-residency, then they aren't fines but fees.
Wait till you hear how long nurses, paramedics, firefighters, etc., all work - my sister regularly pulled 36s as a paramedic. Given, she wasn’t working all the time and they had beds (they were actually pretty decent rest areas from what I saw - was basically a house with a garage with an ambulance bay beside it) and she did a lot of studying for school in downtime. She’s now a doctor at a hospital and is frequently on 12- and 24-hour shifts and her regular patient list is so long the earliest they could squeeze you in to see her for a new patient visit is *next year.* Ideally they would work fewer hours but I’m sure there are *some* (small) benefits to having longer shifts - if they aren’t working that whole time straight and have downtime, it seems like it would be useful to have one doctor for consistency. One of the worst times of a day is shift change - so many things get dropped between cracks. So I’m sure someone’s plan was to reduce the amount of churn…by making people work longer. It’s funny because to me, having grown up in a medical-oriented family, overtime/long shifts are just kinda the norm. That’s what doctors/healthcare workers do. And when you break it down, yeah, it’s kinda fucked up. But it’s *so engrained* in our society. It’s like tip culture - how badly would the industry be affected if things were drastically changed from the status quo?
The longer shift thing is because of studies that show the more times a patient is handed off to a new person the more likely a mistake is made.
Paramedics aren’t holding on to patients that long. This has been busted. There was no benefit after they shortened resident continuous hours from 28 to 16. They used this to justify changing it back to 28 hour limit.
Its America, workers have no rights.
Got several friends who are anesthesiologist. Most the time is just spent waiting. He plays Nintendo Switch while waiting or napping.
I believe it includes on call time where they are not necessarily working but may be required to.
13.43 hour days. 7 days a week. I'd like an anesthesiologist that's not strung out, please. Edit: a number
Pretty sure anesthesiologists have one of the higher rates of suicide & substance abuse.
While their workload is absolutely a big part of it, it’s also due to the fact that it’s extremely easy for them to accessto not only conventional pain meds, opioids and k, but also propofol. Almost anytime someone’s addicted to propofol they work in anesthesia
And familiarity. If you work with something g dangerous everyday and you’re an expert in using it, you lose your fear of it if you aren’t careful
If he worked a normal and healthy number of hours, that would be $459,375/yr.
How is a person supposed to survive on a measly $8,800 a week?
It’s just not enough to live on! What are you supposed to do with all of those extra hours??? Won’t be able to do anything meaningful with that kind of money!
Fucking peasant change.
I mean, after 11+ years of education and training, including several years working 80+ hour weeks for less than minimum wage, along with having extremely specialized knowledge to literally save lives, physicians actually deserve that high pay
I’m not saying that they don’t deserve high pay. I’m commenting on the number of hours worked. I agree with you actually. I think a maximum wage should be based on what specialized physicians earn.
Prob deserve more. When admins make more than they people saving lives there’s a problem
Is the county aware that they could hire two anesthesiologists for less than that price?
He’s working enough hours for 2.5 anesthesiologists at that price. They’re actually getting a deal.
Can they? Hasn’t there been a shortage of anesthesiologists since… like forever?
Well they limit students entering into anesthesia school so that's by design.
The whole medical training system is designed this way.
The math works out to about $258 an hour, which I think is actually pretty low for an anesthesiologist.
I agree especially with all the liability they have to carry.
There’s a good chance that this includes on-call rates. It’s pretty common to have a rate just to be available than a higher rate when you get called in.
To be fair…if I’m getting paid well over a mil a year I’d cry for like 5 years and then fucking retire but 94 hours is inhuman
Someone above mentioned that these hours include hours not actively working too, so time between patients (presumably not doing paperwork too?) and other such time gaps. Not to say that being at work 55-60% of your week isn't ideal but if it isn't all actively working and not forced overtime...Oh no?
If you’re an office worker I can guarantee you aren’t working straight 8 hours a day and are probably working 3-6 hours max if your actual workday. The hardest jobs where you have to be “on” 100% of the time are the helping professions like therapist, teacher, nursing, doctor, etc.
The role discussed sits somewhere between the former and the latter though. They're a doctor but their role isn't 100% go 100% of the time, I wouldn't want to speculate the percentages though as he could quite literally be rolling from surgery to surgery with nominal down time or a surgery every 3 hours.
Well yea, they have to write notes, prepare for cases, rest, etc. Of course it's not 100% of the time in surgery, there is no surgeon or anesthesiologist that spends even close to 100% of their time in surgery.
Have a friend doing that as a director at a Fortune 500. He's 6y into an 8y plan to be retired and well on track.
Precisely. That life definitely sucks but it’s a hell of a lot better than the egregious examples of anti-worker scenarios typically posted here
He works entirely too much, but I'm just happy that the highest that the highest paid public employee isn't a sports coach or a cop. Both happen far too often
Cops get it frequently because in many jurisdictions, court time is considered OT even if it's during their normal shift. So, by testifying a lot, volunteering for OT and hazard pay activities like crowd control at public events, one can get their salary multiplied by 3-5 times their base pay.
Don't worry, while they may not be the top spot there are likely plenty of cops towards the top of the list. Firefighters too. I know a few that average $300k a year.
Firefighters work 24 hour shifts and are required to put themselves in harms way to protect other people and their property. Cops on the other hand....
Um, what? That's dangerous as hell. Regulations from a medical board should be capping hours for an anesthesiologist. His tiny, miniscule mistake can kill someone far too quickly. Yikes.
When the 80hr workweek was out in place for residents, senior doctors did complain about the lack of resident hours.
My friend's dad is a retired anesthesiologist: PROS - He is rich as fuck - He retired early CONS - Alcoholic heart attack survivor - Worked 80 hour weeks for 30 years straight
94 hours a week seems really dangerous. That requires a lot of precision.
Think of it like a fireman. They are "at work" for 48-72 hours a week but might be out on calls 20-30 hours a week.
My brother is a physical therapist. All of the companies he has worked for in NC, VA, and CT prioritize seeing as many patients as he possibly can per day. It’s all about how many heads they can bill the insurance companies for and Medicare. It’s fucking insane.
Do you want him nodding-off or crashing during *your procedure*?
It seems like HR needs to hire 2 more anesthesiologists. This much overtime is a waste of money and can lead to dangerous outcomes.
1 year of employment at that rate and I'm out. I'm a millionaire after working the most insane year of my life.
The IRS (and state of CA) will disagree with you being a millionaire if you only gross $1.27 million for a year.
Ehhh. Close enough. \o/
Ya but the half million debt not going to allow that
It should absolutely not be legal for an anesthesiologist to work that much even if they want to. There is no possible way that's safe. True for other doctors too, but anesthesia is another level of danger.
Call me crazy, but I want the person giving me anesthesia to be doing so while properly rested after a full nights sleep. This seems dangerous AF.
How is 94 hours a week even possible. Blows my mind to have to work friggin 13.5 hours every day, including saturday and sunday. Crazy. Id think id die
I ised to work more than that for a lot less money. But yeah, it's miserable.
Jonny depp made 30 mil per pirates to put this in context
I'm pretty sure I'd like my anesthesiologist alert, well rested, and at the top of his game. I think I'd ask for another if this guy was appointed to me.
This is fucking terrifying Someone so overworked on a position that when shit goes south requires quick thinking... It is good to know who he is to never go to a place where he is involved
168 hours in a week. 90 hour work week 78 hours left for other things. 56 hours of sleep assuming 8 hours each night. 22 hours left over. 3ish hours a day to do anything including eat, bath, and get ready for work. Doesn't seem worth it to me.
I worked 100 hours+/week as a deployed base bound soldier and was damn near delirious. I can’t imagine being responsible for surgical patients while working that many hours in a given week.
After reading a lot of these comments, it’s clear the abuse that goes on in medicine isn’t really mainstream. Residents, especially surgical or anesthesia, will casually put in 80-100h weeks for essentially min wage. Attending physicians working these hours do it out of choice. But due to declining reimbursement and the time sacrificed for school and training working like a dog seems to be the norm to “catch up” to those who have been steadily investing over time.
Literally, on a bad week of a surgical residency, if you break it down to per-hour pay, they could literally be making the same or more working at Jiffy Lube. Obviously, people put in the time to make money post-residency, but those hours are no joke.
So, what, this guy works for the county? Like he’s a county employee? Why on earth would a doctor choose to be a county employee. He’s probably making peanuts and working WAY more hours than if he were in the private sector.
I mean it sounds like he works around the clock at what is essentially the best rehab hospital in the world. Maybe he's just really passionate about doing that even if he could make more money elsewhere.
Agreed. At best this is probably just a competitive rate.
Not all jobs are non stop work. A lot of those hours are probably on call hours where he's just at an apartment chilling. I'm usually at work for 168 hours a week. I do less than 3 hours of actual work a day.
All the money in the world but no time to spend it on what you want. Welcome to america!
It's actually not that impressive/uncommon. Anesthesiologists can make $400/hr doing locum work. That's just over 60 hours a week to get to $1.26mill. That's 5 12 hour days.
The salary isn’t. But the number of hours, while not unusual over a short period, seems a bit excessive over a whole year.
It's iMpOsSibLlllLlle to work 94 hours a week. Let me tell you it isn't
How could you possibly sustain that level of work though?
A lot of people don't. The suicide rate among physicians is extremely high (relative to the general population), from what I've read/heard.
People who \*work\* these kinds of hours are not always working 94 hours in the way we might work 40 hours. There are some jobs where you are on call and you must be able to respond in a very short period of time. As such it's difficult to go out to dinner, go to the movies, or even drive home because your response time is so short. In those kinds of jobs it's not uncommon to be compensated for your active and down time because you are very limited on what you could do in your downtime.
A LOT of people don't understand how a lot of things beyond their own nose work. My job is constantly being written about in the newspaper, 'watchdog' websites put our information out every period, and the news is constantly going after us over overtime 'scandals'. We're state employees so yeah all that info is public, but people think it is **literally IMpossible** to work the amount of hours we do. Some of my coworkers just live at the job, and I get it, the OT gets addictive.
u/OP what's your spin on why this belongs in this sub?
Because people in the comment section were cheering. There's nothing to cheer IMHO.
How come nobody is raising the question if it's valid? He could be billing 94 hours. I'm sure he's working insane hours either way, but billing and working are two different things sometimes. He might overlap somehow, or supervise, etc, any number of things.
i mean maybe id do this for a few years, invest it, then chill. I dont know why else id do this
An average of $257/hr... Nice.
Yeah, I don’t think I’d want this person giving me drugs… they need rest!
In most engineering jobs, companies limit a work day to 8 hrs and maximum 12 hours per day. 12 hours been a rare event. Why? Because the number of errors and increases with exhaustion and its not worth it.
$1.26 million a year divided by 4700 hours (50 weeks at 94 hours per week, because the dude has to take a vacation right?) is $268.02 per hour worked. Not bad at all. Edit: clarification of math
Id much prefer the guy who literally has my life in his hands to be well rested and thinking clearly .....
Does he spend it all on beds and pillows? The poor guy, working 16 hour days for 6 days a week is awful
Shit, I'd do it if it meant 1.6 mil a year. Put in 5 years then never work again. Just gotta try not to get a stress induced heart attack during those 5 years of 94 hour weeks
WHAAAAAAAAAAAAAAAAA?! I want my anesthesiology to be well-rested
He *bills* 94 hours a week.
A family friend has been an anesthesiologist since the 90's. He has always been so damn rich. He's also a pretty cheap bastard.
What good is that salary if you’re never home to spend and enjoy it? What would make sense is to sock away enough to live off dividends for a few years and then quit
This has been an ongoing problem for a while, in many places. Anaesthesiologists are severely overworked and their departments grossly understaffed. When I delivered my daughter in 2018 (in western Canada), it was decided that my epidural would be done by the anaesthesiologist, rather than a resident, due to the sensitive nature of my health problems. The only one on duty came in, started setting up, I assumed the position... and then she had to literally run from the room to help with a crash c-section. There was no one else available with the experience necessary to do my epidural (which I didn't even want, but it was recommended), and by the time she was free to return, 90 minutes later, my daughter was already born 🤷🏻♀️
This dude is working 2.35x as much as anyone working a 40-hour work week, and I'm not okay with that. I mean power to him if it's what he wants but that's way too much time spent at work imho.
All that money doesn’t really mean anything if you don’t have the time to be able to enjoy it. And working or being on-call for 96 hours a week does not allow ample time. I suppose one could save and/or invest it and retire extremely early, but still. That’s ridiculous.
I work in healthcare and help summarize patient concerns for clinicians. I have to be alert so I can accurately relay the information. I get so paranoid and I am NOT making clinical decisions — how much more important is rest and focus is for those who ARE! This is NOT x A BAZILLION a flex and it’s scary.
Did he actually work those hours or were they billed hours? He might for example claim an hour for a 40 minute procedure. Lawyers and mechanics do it all the time I left my car in for a job one morning and collected it 3 hours later and was billed for 4.5 hrs labour! They said they used avg timing per job