In today’s challenging healthcare landscape, it’s getting harder by the day to practice anesthesiology.
Anesthesiologists are under increasing pressure to innovate and perform from hospitals, regulators, and even patients. So when planning your career, it’s important to choose an anesthesia group with the resources to support you as well as a positive culture that matches your values.
In today’s post, I’ll share how joining a national, democratic partnership has helped me enjoy both my career in healthcare leadership and the practice of medicine.
The future of anesthesiology
The practice of anesthesiology is changing rapidly. In the current era of healthcare reform and shrinking margins, it’s no longer enough to provide excellent clinical care. Hospitals and health systems also expect you to:
- Integrate with other perioperative care services in order to improve outcomes while lowering costs.
- Improve surgical services efficiency.
- Provide excellent customer service.
- Boost hospital reputation and surgery referrals.
- Participate in hospital-wide improvement initiatives and committees—often without additional compensation or training.
In order to meet these demands, it’s important to develop your leadership skills and to understand the business and regulatory landscape of perioperative care. However, this sort of education isn’t usually prioritized or offered. Many independent groups rotate leadership roles among their senior partners without offering additional training or compensation. As a result, many anesthesiologists lack the interest and skills to meet the efficiency, administrative, and participation demands of their hospitals.
And finally, the cost of managing an anesthesiology practice has skyrocketed in recent years. New regulations require infrastructure improvements such as EHR integration and HIPAA-compliant applications. Anesthesiologists also expend considerable resources on revenue-cycle management (collections and billing). And perhaps most importantly, smaller groups generally have less negotiating power with payers—and less time to spend on complex, back-to-back negotiations.
Anesthesia practice models
So as an anesthesiologist, how can you choose the right anesthesia group that will help you meet your long-term career goals?
First, it’s important to consider a group’s values. Often, your job satisfaction and longevity with a practice will sink or swim depending on cultural fit. For example, if you like having a say in finances and decisions affecting patient care, it’s important to find a group that offers you a voice in day-to-day practice matters.
Second, if you value ownership, assess the group’s commitment to remaining independent. You won’t want your partnership to turn around a few months or years down the road and sell itself to private equity.
Finally, make sure you are comfortable with the level of autonomy you will have over day-to-day practice matters. Most large, national groups retain some central control, though the picture varies widely. Some factors to consider:
- If you join the group, will you have a voice and vote on group decisions?
- Which decisions will be made by the national leadership, and which will be made by individual practice sites?
Is leadership constructed of business people, financiers, or physicians? Each of those groups has unique perspectives that affect their decisions and the organization’s culture.
The perfect fit
If you’re currently looking for a group that will offer an ideal blend of support, autonomy, and work-life balance, I can empathize.
Our independent anesthesia group met with many potential affiliation partners as well as investors before we found a solution that was an ideal match for our democratic values. In 2014, we voted to join Vituity because of the cultural fit, management support, and physician ownership.
Vituity is a multispecialty practice that provides acute care services to hospitals and health systems across the country. It’s currently the only national, democratic group for anesthesiologists that is 100% physician-owned and -led with no outside investors, shareholders, or private equity.
Like the largest anesthesiology groups, Vituity provides a strong practice management infrastructure that supports recruiting, contracting, consulting, continuing education, and much more. Best of all, our anesthesiology practice sites maintain a large degree of local autonomy over their everyday decisions and finances.
Perks of Anesthesia Partnership
I have seen the decision to affiliate with Vituity benefit both individual anesthesiologists and anesthesia groups in many ways. Here are a few of the highlights:
1. New quality programs and initiatives
My own group used Vituity’s consultants and quality experts to bring new innovations to our hospitals. These included an “expedited recovery form surgery” program for colon cancer patients. We also worked with one hospital’s emergency medicine team (a fellow Vituity practice—another advantage of multispecialty integration) to create a hip fracture protocol that greatly reduced time to surgery and length of stay for these vulnerable patients.
2. Better payer relations with less effort
Joining Vituity drastically reduced the amount of time our anesthesiologists spent negotiating with payers while generally improving reimbursement rates. Vituity practice management staff handles most of the contracting with occasional input from our medical directors. What used to take hours of our time can now be handled through a few emails.
3. Access to legal and professional services
Vituity’s legal, malpractice, and regulatory experts help to steer anesthesia groups away from potential pitfalls that can arise in this increasingly complex healthcare environment.
4. Leadership development and opportunities
As a physician-owned and -led partnership, Vituity has a strong interest in developing both clinical and business leaders. All Vituity anesthesiologists have access to online and in-person leadership development programs. Promising candidates can also take advantage of Vituity’s Integrated Leadership Development Program, which provides intensive mentoring with the partnership’s top executives, who are also practicing physicians. These opportunities would be almost impossible to replicate within an independent anesthesia group. Senior residents can apply for the Administrative Fellowship for a fast track to leadership.
5. Extra duty compensation
Vituity pays stipends to anesthesiologists who take on certain leadership roles at our practice sites and hospitals.
6. Benefits of shared ownership
Vituity is 100% physician-owned and -led. Our partners are accountable to one another—not to shareholders or investors—and directly share in the profits of their work.
As shared owners, we value the work-life balance of our partners. This means that we work hard to keep our practices staffed and pitch in to relieve the burden when a colleague experiences hardship. What’s more, Vituity’s Joy in Medicine initiative equips us with the tools we need to combat stress and burnout while building long, fulfilling careers.
Choose the right anesthesia group for you
Choosing a practice home is one of the most crucial decisions you will ever make as an anesthesiologist. The wrong anesthesia group can be a stumbling block that sets your career back by years. On the bright side, the right group can free you to serve your patients and hospitals in new and exciting ways while finding joy in the practice of medicine.