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The Future of Anesthesiology with David Rosen

by Sean Ruck, Contributing Editor | December 18, 2014
David Rosen
From the December 2014 issue of HealthCare Business News magazine

Dr. David Rosen is a practicing anesthesiologist with more than two decades of experience and a founder and the president Midwest Anesthesia Partners. He shared his experience with HCBN to discuss the future of the anesthesiology profession and his group’s approach.

HCBN: What was the rationale behind creating an anesthesiology group?
DR:
We talked with colleagues in the area and decided rather than just sharing staff, we could fully partner up. Our intention is to be able to better-preserve the art and science of anesthesia for our patients.

The media attention we’ve received has led to two outcomes. One, we have had other anesthesiologists have contact us to see if we’d be a good fit. And two, we’ve had about five different private equity groups interested in partnering or purchasing — but we want to remain independent of that type of group.

We’re stronger together than apart. By no means would we want everyone to join us, but we do want like-minded individuals interested in improving their quality and score. When you have a MAP anesthesiologist in your hospital, you’re working with someone above the norm.

HCBN: What challenges are anesthesiologists facing today?
DR:
It’s simple – uncertainty in how we’ll get paid, how we’ll be employed. Is MAP a sustainable idea or will we need to be part of a national or local health care system? Ultimately, there are three options. The first is to ignore the situation and hope things stay the same. The second is to resolve to work under a hospital. The third option is to remain independent and form a large organization which is what we just talked about. So not knowing how we’ll get paid makes it difficult to even recruit. When people are afraid, they do irrational things or things they would regret later on. There are constant drug shortages that affect our daily lives – it’s a more distant, yet immediate threat to us.

HCBN: And why wouldn’t you just work under a hospital to get that security?
DR:
I want to be able to point to quality scores — and say we’re in the top tier. We feel in the best way to do this is to preserve our autonomy and preserve our independence. With anesthesiology we’re expected to provide top service 365 days a week, 24 hours a day. We don’t believe it’s possible to provide that high level of service if you take the autonomy away from the individuals. Our group has the lowest perioperative morbidity and mortality – we’re ranked best in the nation.

By continuing to grow and get good contracts with payors, get good prices on malpractice insurance due to our size – we believe we can provide our service. If you take away the motivation to require the service you’re expecting, it will only hinder things. Yet, being a part of a larger organization means insurers will want to call us back. More attention is being paid to issues we raise and concerns we have.

HCBN: What should hospitals consider when looking for anesthesiologists?
DR:
I think anesthesiologists should be seen and not heard. Although they should have a strong presence on committees and quality reviews and cases in the ER. Hospitals should be asking specifically if a group has people trained in the most recent techniques like regional anesthesia or the use of ultrasound for example. Those technologies help with patient satisfaction, getting patients into recovery quicker etc. You don’t want a group with just one person knowing that because what happens if they’re on vacation? Do you have people trained in different subspecialities? These are not things that are make or break, but taking them all together — board certified, independent, experienced in the latest techniques, have their billing set up, they all should factor in.

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