Thread by @mass_marion

Pull up for a long thread about this @voxdotcom article with the subtitle "What the fight between @AnthemBCBS and anesthesiologists was really about." 1/12 🧵 @anesthesianews vox.com/policy/390031/…

I'm a pediatrician. For 15 years I did hospitalist work. That meant I went to difficult deliveries where mom and baby were sick, I saw sick patients in the ER that needed to be intubated, some had critical airways or hard to get IVs.
In these and many more cases, the patient NEEDED the anesthesiologists... the physicians that slept in the hospital to make sure the patient had an airway or IV access. They are the docs that the surgeons rely on to keep their patients alive while they cut into bodies to save lives. 2/12 🧵

Here is a slide from the study that the vox article referenced that indicates what anesthesiologists find hard about their job.
Besides the long hours and endless glut of regulations, it is 💯 true that despite a fair surprise medical billing law, anesthesiologists and other docs have to fight tooth and nail to get paid for work done because @HHSGov favored the insurers in the implementation of the law . They are fighting the 3rd party payers who were ALREADY paid by the patients.
It's not the docs who are abrogating their duty to patients, it's the 3rd party payers who are, including our government . 3/12🧵

In the vox article, the reporter states that anesthesiologist are one of the highest earning medical specialties.
What the author does not tell you is that almost 40% of them are doing extra clinical work for this money. So divest yourself of the notion it's a 9-5 job.
And given the dearth of anesthesiologists in rural areas, to stay open and keep patients safe, hospitals do pay more to get anesthesiologists to leave their families and come work for a weekend taking care of critically ill patients. 4/12 🧵medscape.com/slideshow/2024…

One anesthesiologist friend told me the most he ever made was $425k pre tax in a year he rarely saw his family.
It wasn't worth it, he is now working less and happier, even though there is a need and doing locums in rural areas and moonlighting is always available.
Do go back to #1 on this thread and think about the pressure of the job.
also think about how after 10, 20, 30 years, AFTER medical school, the pressure can really wear on you. 5/12 🧵

Now the survey itself referenced in the vox article.. 7000 respondents total, 4% were anesthesiologists... that makes a total of 280 anesthesiologists. There are 42,000 anesthesiologists in the country.
I would guess that since an honoraria was offered, it was the docs hustling that were more likely to answer, so the numbers are likely skewed higher
6/12🧵

I have a question for @voxdotcom
It is my understanding for many, if not all European countries, physicians do private work, as there are self paying patients who don't want to wait European style. Are those numbers part of the total salary?
Not to mention, that the extraordinary cost of getting the medical degree (average $243,483, with interest accruing during residency) was not mentioned in the article.
7/12 🧵

@A4Horg @CRCook1978 @AgnesSolberg @SashaShillcutt @texmed @PAMEDSociety @ASAGrassroots @ASALifeline @aclhart @ASAMonitor @voxdotcom @Free2CareHC @PPA_USA @doctorwes @DrOz @GeBaiDC @benshapiro @JDVance @VivekGRamaswamy Then I started wondering... how does Vox get paid?
They tell you on their website. Ah, advertising.
Spend a minute on the article itself and what pops up frequently?
8/12 🧵

@A4Horg @CRCook1978 @AgnesSolberg @SashaShillcutt @texmed @PAMEDSociety @ASAGrassroots @ASALifeline @aclhart @ASAMonitor @voxdotcom @Free2CareHC @PPA_USA @doctorwes @DrOz @GeBaiDC @benshapiro @JDVance @VivekGRamaswamy What popped up most frequently for me on the Vox site was ads for medications, both over the counter and prescription. Also some for Capitol One, so we know some of 'what's in your wallet' , Vox
@RobertKennedyJr @NicoleShanahan
9/12 🧵

@A4Horg @CRCook1978 @AgnesSolberg @SashaShillcutt @texmed @PAMEDSociety @ASAGrassroots @ASALifeline @aclhart @ASAMonitor @voxdotcom @Free2CareHC @PPA_USA @doctorwes @DrOz @GeBaiDC @benshapiro @JDVance @VivekGRamaswamy @RobertKennedyJr @NicoleShanahan Besides ads and membership, vox gets grants.
The one obvious health care related group that stood out was The National Institute of Health Care Management.
Never heard of them.
So I looked up their board of directors....
(next slide, please)
10/12 🧵

Wow, turns out that 15/17 of the board of directors for the National Institute of Health Care Management (who gives grants to Vox) are healthcare insurance people, 11 from Blue Cross, part of the Anthem family.
So could getting a grant from this organization compel them to write in an insurance company-favorable way?
Here's the board. nihcm.org/about-us/board…
11/12 🧵

USA🇺🇸 has tens of thousands of excellent physicians. We trained and want to care for our patients. Keep them well, We took an oath.
World of business and journalism would do well to let us do our job, earn our keep so that our profession is sustainable not throw shade on us.
To Vox, the reporter who wrote the article maligning the crucial field of anesthesia, know that the same applies here that I stated a few years back, when someone else took a shot at us physicians. ( he was polite enough to take his tweet down)
We are still here to take care of you
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