Vital Times 2020 - 83

SPECIAL FEATURES

Practice Without Fear:
Advice for Residents on the
Future of Our Profession
Karen Sibert, MD, FASA

How do we avoid becoming irrelevant or extinct, like Kodak, Xerox, Sears
and now Hertz? It's time to face the future.
The days are over when it was enough to learn to deliver anesthesia competently
in order to get a decent job. We need to do more to establish our value beyond
simply putting patients to sleep and waking them up.

Y

ou may be weary of
being told that our
profession is facing
a time of unprecedented
threat-from third-party
payors, the government,
and advanced practice and
nonphysician practitioners.
You've heard it so often
that your brain is tuning
it out. Is the threat level exaggerated for dramatic
effect? Is it better just to go on with your day and not
think about it at all?
That would be a mistake. The real question is,
how should we deal with the upcoming " market
adjustment " that almost certainly will result in lower
anesthesiologist compensation? In the face of gloomy
reality checks, how can we promote pride in our
profession and recruit the best medical students?
How can we continue research that will reduce risk
and improve outcomes? How do we avoid becoming
irrelevant or extinct, like Kodak, Xerox, Sears and now
Hertz? It's time to face the future.

The Threats Are Real
Unfortunately, the " unprecedented threat " claim is all
too real. Department chairs everywhere worry that
they will not be able to maintain the compensation
rates that anesthesiologists have enjoyed up to now.
Why?
*	

In August, Medicare announced significant
proposed payment cuts for anesthesiologists, to
take effect on January 1, 2021.1 The anesthesia
conversion factor is likely to be cut by 10% unless
Congress takes action to stop it.

*	

On October 26, the US Government Accountability
Office (GAO) issued a long-awaited report on the
two-thirds difference between private insurance
and Medicare payments for anesthesiology
services.2 The ASA hoped the Medicare rates
would be seen as unfair and unreasonably low.
The GAO's conclusion: Since there has been no
adverse effect on access to anesthesia care, there
is no reason for Medicare to increase payments.

Annual Publication 2020

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Vital Times 2020

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