Anesthesia Business Consultants

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Summer 2007


ISSUES OF THE DAY

As the spring conference schedule winds down many of us find ourselves asking the same question. Some excellent speakers have made some very interesting presentations on a wide variety of practice management topics at the Conference on Practice management in Phoenix and the Anesthesia Administrators’ Assembly in Seattle, but it is not quite clear what the big issues are. Or, to put it another way, it is not entirely obvious that there is, in fact, one overarching issue of the day. The national policy issues like Medicare reimbursement cuts and Pay for Performance continue to be a source of concern and discussion but one does not sense a high degree of urgency to take up the cause. While the ASA and other organizations like the Anesthesia Business Group are doing a great job of keeping us focused on realistic global strategies, it is pretty clear that most anesthesiologists and CRNAs are much more focused at a different level. Yes it is true that anesthesia practices are worried about having enough good people to meet the service requirements of their customers, but what they are really worried about is the potential impact of the surgicenter across the street or and the future of their current stipend.

Historians have suggested that the march of civilization involves a regular swinging of the pendulum of public opinion from the general to the specific. People become inspired by the big movements, civil rights and the rise of global terrorism, but they ultimately end up acting on their specific problems and challenges. Perhaps we are just in one of those periods of transition. It is hard to stay focused on the big picture when the local view looks so turbulent. When a long-term exclusive contract at a county hospital in Bakersfield, California is given to a staffing company from upstate New York with no experience in the state, one begins to wonder what is really driving such decisions. There is so much anecdoctal evidence of hospital administrations turning on their anesthesia practices is it any wonder many anesthesiologists are getting pretty anxious.

Our authors understand just how technical and specific the issues affecting our clients’ practices have become. They represent a diversity of regional perspectives, historical areas of focus and distinct vantage points. Marc Weiss gives us a western legal perspective on the concept of gainsharing, a notion that many of us find so intriguing but which attorneys have tried to tell us is so problematic given the Stark guidelines. Needless to say, Marc’s ideas provide some very thought-provoking options. Shena Scott writes to us from the deep south on a topic of key interest to anyone who has had to ask for financial support: what is the value of national survey information and how can we all help make it more relevant. Our internal staff share some of their insights as we all get ready for the implementation of a new set of diagnosis codes. We also have some thoughts for you to ponder with regard to the potential of ultrasound to guide your nerve blocks.

As always, we hope you find our articles relevant and timely as you sort out the critical issues for your particular practice, wherever it may be. Our only goal is to provide you with reliable and valuable options. If there are issues that you would like our panel of experts to address please let us know. We always love to hear from you and to know what matters in your next of the woods.

Sincerely,

Tony Mira,
President & CEO