Why Anesthesia Groups Fail, Another View
This is one of several responses to previous AnesthesiaReviews blog posts on why anesthesia groups fail. (This blog post was contributed by Tim Adams, MD, Managing Partner, Alabama Anesthesia of Huntsville, LLC.)
"Certainly, there are lots of reasons, but one you have not written about is the way in which groups are put together. Doctors become partners based on years of service rather than their ability to contribute to the organization. Most physicians do not fully understand what it means to be an owner. The ownership status brings responsibilities and risks, but most docs are oblivious to these small business realities. They only view partnership in terms of what it gets them - more money and a vote at the meetings. Partnership, especially in a group practice with the anesthesia care team model, often results in a sense of entitlement and reward, with no acknowledgement at all of what it means to own a business.
Symptoms of a group in trouble:
- The leadership of the group, the chief, and all other "administrative" jobs get rotated on a regular basis without any real thought. In essence, many groups feel each MD is equal and therefore should be treated equally.
- The group can't do anything without a majority vote and manage by consensus. Sure, some things require a vote, but those are few and far between.
- The anesthesiologists do not respect the CRNA's in any meaningful way, but talk down to them and treat them like second-class citizens in the OR. I was witness to this before….it's a self defensive mechanism by anesthesiologists to justify their jobs, sometimes to themselves."
Take Home Points:
- Key roles in groups should be assigned by ability, not by rotation.
- Ownership status in an anesthesia group brings responsibilities and risks
- An anesthesia group is a business, but this reality is not always acknowledged by anesthesia professionals
- An anesthesia group in the ACT model demands respect among anesthesia professionals