Anesthesia Deconstructed: Science. Policy. Realities.

Mike MacKinnon and Joe Rodriguez

Anesthesia Deconstructed: Unraveling the Complexities of Modern Anesthesia Practice

Founded in 2018 by Mike MacKinnon, DNP, FNP, CRNA, FAAN, and later joined by co-host Joe Rodriguez, DNAP, CRNA, Anesthesia Deconstructed is an award-winning podcast that consistently ranks as the nation's top-downloaded anesthesia podcast, with two of the most well-known CRNAs in the country as hosts. We feature industry experts from across the spectrum, exploring scientific issues, policy matters, and the day-to-day realities of anesthesia practice.

Our mission is to deconstruct complex topics, recognizing that the truth often lies in the nuanced middle ground rather than at extremes. We bring unique value to our listeners by examining the nexus of clinical practice, education, and policy, offering insights that go beyond any single perspective.

Join us for thought-provoking discussions that bridge the gap between theory and practice in the world of anesthesia.

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Episodes

FTC Loses, and Non-Competes Remain - Understanding Different Types of Restrictive Covenants and What It Means for You
Sep 30 2024
FTC Loses, and Non-Competes Remain - Understanding Different Types of Restrictive Covenants and What It Means for You
SEASON 7 BEGINS! Keywords for this Episodeanesthesia, non-compete agreements, legal challenges, FTC, healthcare law, CRNA, anesthesia practice, employment contracts, state laws, anesthesia updatesSummaryIn this episode of Anesthesia Deconstructed, host Joe Rodriguez first discusses the latest updates in the field of anesthesia, including legal challenges faced by CRNAs and anesthesiologists, the AANA's bold lawsuit against the federal government, and updates on his personal practice at Guide Anesthesia, which is evolving out of Arizona Anesthesia Solutions. The conversation delves into the implications of non-compete agreements, the recent FTC ruling, and the nuances of state laws regarding these contracts. Scott Weavil, a legal expert, shares insights on negotiating employment contracts and the importance of understanding the legal landscape for healthcare professionals. The episode emphasizes the need for transparency and informed decision-making in anesthesia practice.TakeawaysThe AANA has initiated a lawsuit against the government over reimbursement issues.Non-compete agreements can serve legitimate business purposes but can also restrict employee mobility.The FTC's nationwide ban on non-compete agreements has been struck down by a Texas court.State laws regarding non-compete agreements vary significantly across the U.S.Negotiating employment contracts is crucial to avoid restrictive covenants that may hinder career growth.Understanding the legal implications of non-compete agreements is essential for healthcare professionals.The public needs to be informed about the qualifications of their healthcare providers.Non-solicitation agreements are often more common than non-compete agreements in certain regions.Healthcare professionals should be cautious of non-compete clauses that may limit future employment opportunities.The conversation highlights the importance of balancing individual and corporate interests in healthcare.Chapters00:00Updates! 10:34Scott Intro13:58Legitimate Business Purposes of Non-Competes17:18The FTC Ban on Non-Competes20:33State Laws on Non-Competes23:17Challenging Non-Competes25:35Differentiating Non-Competes and Non-Solicits28:13The Future of Non-Competes30:21ConclusionSend us a textFollow us at:InstagramFacebookTwitter/X
Point A: CRNAs Propose Significant Change to AANA Board Selection
Jul 23 2024
Point A: CRNAs Propose Significant Change to AANA Board Selection
SummaryThe conversation discusses three main changes proposed by the Leadership Identification Committee (LIC) for the American Association of Nurse Anesthesiology: increasing the number of directors from seven to nine, increasing the term for directors from two years to three years, and changing the progression of the president to a three-year term. The rationale behind these changes is to decrease turnover, increase the number of eligible people for executive positions, and provide more support to region directors. The conversation also addresses concerns about the time commitment for directors and the potential impact on decision-making, cost, and the role of the professional staff. The conversation explores the proposal to increase the number of directors on the board, extend the terms of the vice president and president-elect, and create continuity in executive leadership roles. The main themes discussed include the benefits of having more directors to support state leaders, the financial feasibility of the proposal, the potential risks of electing the wrong person into an important position, the need for continuity and experience in executive roles, and the importance of informed voting.  The conclusion is an editor's note, where our host, Joe Rodriguez, expresses his view after taking time consider the conversation.  KeywordsAANA, association, Leadership Identification Committee, directors, term, turnover, executive positions, region directors, time commitment, cost, professional staff, board directors, executive leadership, continuity, experience, informed votingTakeawaysThe proposed changes aim to decrease turnover, increase the number of eligible people for executive positions, and provide more support to region directors.Increasing the term for directors from two years to three years allows for more continuity and experience on the board.Expanding the number of directors from seven to nine helps to reduce the workload for region directors and aligns with the growth of the association.Concerns about the time commitment, decision-making, cost, and the role of the professional staff are important considerations in the discussion.The financial feasibility of the proposal was assessed and deemed affordable.There is a potential risk of electing the wrong person into an important position, but the board can address disruptive behavior and provide coaching to mitigate this risk.Having continuity and experience in executive roles can lead to better decision-making and representation of members' interests.Informed voting is crucial, and members should take the time to understand the proposals and make informed decisions.Chapters00:00Introduction and Background of the Proposed Changes02:51Increasing the Term for Directors from Two Years to Three Years10:14Expanding the Number of Directors from Seven to Nine18:09Considerations and Approval of the Proposed Changes31:16Enhancing Support for State Leaders33:56Assessing Financial Feasibility37:12Creating Continuity in Executive Roles41:31Decreasing Turnover and Ensuring Continuity45:37Mitigating Risks and Addressing Poor Leadership48:42Moving Away from Personal Agenda Items59:40Encouraging Informed VotingConclusion: Editor's NoteSend us a textFollow us at:InstagramFacebookTwitter/X
Did CMS Actually Miss an Opportunity To Reduce the Anesthesia Shortage?
Jul 19 2024
Did CMS Actually Miss an Opportunity To Reduce the Anesthesia Shortage?
SummaryThe conversation discusses the topic of rural pass-through and its impact on the anesthesiologist shortage. It explores the idea of including physician anesthesiologists in rural pass-through and whether it would be an effective solution. The conversation also delves into the concept of shortage and how it can be addressed by utilizing anesthesia providers to their maximum potential. The importance of deregulation and allowing local experts to make decisions about anesthesia models is emphasized. The conversation concludes with a discussion on title misappropriation and the need for transparency in using the terms 'physician anesthesiologist' and 'nurse anesthesiologist'.Keywordsrural pass-through, anesthesiologist shortage, physician anesthesiologists, CRNAs, shortage solution, utilization of anesthesia providers, deregulation, local decision-making, title misappropriation, transparencyTakeawaysIncluding physician anesthesiologists in rural pass-through may not have a significant impact on the anesthesiologist shortage.Utilizing anesthesia providers to their maximum potential can help address the shortage.Deregulation and allowing local experts to make decisions about anesthesia models is crucial.Transparency in using the terms 'physician anesthesiologist' and 'nurse anesthesiologist' is important to avoid confusion.Key Quotes "Rural pass-through is about providing compassionate care close to home for rural facilities across rural America.""The idea here is to subsidize the ability for people to get care close to home and be economically efficient in doing it.""The shortage is artificial because of model selection and facilities."Chapters00:00Introduction and Background on Rural Pass-Through01:15Understanding the Purpose of Rural Pass-Through03:04The Inaccuracy of the Article's Premise on Mitigating the Anesthesiologist Shortage08:51Utilizing Anesthesia Providers to Address the Shortage19:22The Importance of Deregulation and Local Decision-Making in Anesthesia Models25:03Addressing Title Misappropriation for Transparency in Anesthesia CareSend us a textFollow us at:InstagramFacebookTwitter/X
Should C-Sections Be Performed on an Outpatient Basis? Florida is going to find out.
Jul 16 2024
Should C-Sections Be Performed on an Outpatient Basis? Florida is going to find out.
SummaryThe conversation discusses the topic of out-of-hospital cesarean sections and the potential risks and implications. Dr. Matt Mazurek, a physician anesthesiologist and assistant professor of anesthesiology at Yale School of Medicine, provides insights and raises concerns about the definition of low-risk cesarean deliveries, the dangers of complications during and after the procedure, and the lack of resources and training in outpatient settings. The conversation also touches on the financial incentives and potential cherry-picking of patients by private equity-owned medical facilities. The need for increased access to obstetrical care and support for OBs in rural areas is highlighted as a more effective solution to address maternal morbidity and mortality rates. Keywordsout-of-hospital cesarean sections, risks, complications, low-risk deliveries, resources, training, financial incentives, private equity, access to care, maternal morbidity, maternal mortalityTakeawaysDefining low-risk cesarean deliveries is challenging and depends on various factors.Complications during and after cesarean sections can be life-threatening, especially in outpatient settings.The financial incentives of performing cesarean sections may lead to an increase in unnecessary procedures.Investing in more OBs and supporting them financially is crucial to improve access to obstetrical care in rural areas and reduce maternal morbidity and mortality rates.Key Quotes"OB is still very dangerous, both in the OR and postoperatively""It's much more common and more likely to happen in this particular group. So do we really want to gamble with people's lives in this setting?""It has happened and it's happened to younger, healthier patients out of the blue."Chapters00:00Introduction and Background01:23The Challenges of Defining Low-Risk Cesarean Deliveries06:01The Financial Incentives and Potential Risks of Outpatient C-Sections08:20Improving Access to Obstetrical Care in Rural AreasSend us a textFollow us at:InstagramFacebookTwitter/X
RAISING ARIZONA Pt. 1: Arizona's Zero to Hero Story with Ali J. Baghai, CRNA, AZANA Past President and Guide Anesthesia | AzAS Managing Partner
Jul 9 2024
RAISING ARIZONA Pt. 1: Arizona's Zero to Hero Story with Ali J. Baghai, CRNA, AZANA Past President and Guide Anesthesia | AzAS Managing Partner
Episode Summary: In this episode, Joe Rodriguez talks with Ali Baghai about his journey and impact as a CRNA in Arizona. Ali shares his experiences in CRNA advocacy, the evolution of anesthesia practice in Arizona, and his role in significant legislative changes. They also discuss the nuances of owning an anesthesia business and life in Arizona.Highlights:IntroductionJoe Rodriguez introduces the episode and welcomes Ali Baghai.Brief discussion about the uniqueness of Ali's name and CRNA role.Ali's BackgroundAli shares his background, including his early involvement in CRNA politics.Discusses his time as state president and the changes in Arizona's CRNA landscape since 2009.Initial Involvement in CRNA AdvocacyAli's journey from student representative to board member.The transformation of Arizona's job market and practice landscape for CRNAs.Key Meeting in 2012Joe and Ali reminisce about a pivotal meeting in 2012 with other CRNA leaders.The decision to aim for opt-out and the creation of the political action committee (PAC).Legislative Success StoriesAli's experience with legislative processes and passing key bills.The significance of Senate Bill 1336 and the Surgeon Immunity Law.Opt-Out SuccessDiscussion about Arizona becoming an opt-out state.The ripple effect of Arizona's opt-out status on other states.Dental Anesthesia RegulationAli's involvement in dental anesthesia regulation since 2019.The challenges and outcomes of the new rules for pediatric safety and provider registration.Business Ownership in AnesthesiaAli's perspective on owning an anesthesia business.The challenges and rewards of being a business owner in the healthcare field.Arizona LivingAli shares his love for living in Arizona, comparing it to his hometown of Boston.Highlights of Arizona's climate, outdoor activities, and overall lifestyle.Closing RemarksJoe thanks Ali for his contributions to the CRNA community and the state of Arizona.Final thoughts on the importance of advocacy and leadership in healthcare.Key Takeaways:The importance of CRNA advocacy and policy changes in improving anesthesia practice.The impact of legislative victories on CRNA practice and patient care.The challenges and rewards of owning an anesthesia business.The unique lifestyle and opportunities in Arizona.Guest Information:Ali Baghai - CRNA, former state president, and key advocate for CRNA practice improvements in Arizona.Joe Rodriguez - Host, CRNA, and managing partner in an anesthesia group.Call to Action:Subscribe to our podcast for more insightful conversations on healthcare and anesthesia.Visit our website for more information on CRNA advocacy and resources.Note to Listeners: Don't forget to leave us a review and share this episode with your colleagues and friends in the healthcare community! Your support helps us bring more valuable content to you.Send us a textFollow us at:InstagramFacebookTwitter/X
FTC Update With Simon Willman, JD and What It Means for Anesthesia Providers
Jun 25 2024
FTC Update With Simon Willman, JD and What It Means for Anesthesia Providers
Episode Summary: In this episode, Joe Rodriguez welcomes back Simon Willman, Esq., former in-house counsel for one of the largest orthopedic groups in the country. They discuss the Federal Trade Commission's recent vote to ban non-compete agreements and its implications for healthcare professionals and practice owners.Key Topics Covered:Pre-Session: State-Level Updates from Louisiana, Maryland, and Pennsylvania Introduction:Welcome and introduction of Simon Willman, Esq.Background on Simon's experience with Health Outcomes Performance Company and Core Orthopedics.FTC's Vote to Ban Non-Competes:Overview of the FTC's recent vote to ban non-compete agreements.The timeline for the ban going into effect (120 days post-publication).Legal challenges from the U.S. Chamber of Commerce, the Business Roundtable, the Texas Association of Business, and the Longview Chamber of Commerce.Implications for Healthcare Professionals:Simon's insights on how the ban might affect providers and practice owners.Potential benefits for healthcare providers who can move freely between employers.Concerns for business owners regarding the impact on enterprise value and capital investments.Details of the FTC's Final Rule:Summary of the key points of the final rule.Explanation of the difference between non-compete and non-solicitation agreements.Potential legal interpretations and challenges ahead.Non-Competes vs. Non-Solicitation:Breakdown of how non-solicitation agreements differ from non-competes.Discussion on whether non-solicitation agreements might serve as a backdoor to enforce non-competes.Legal Considerations and Advice:Practical advice for healthcare providers dealing with non-competes.The importance of understanding the legal landscape and potential court interpretations.The potential costs and implications of legal challenges.Federal vs. State Jurisdiction:Explanation of how the jurisdiction might shift from state to federal courts.The impact of this shift on enforcement and legal proceedings.Sale of Business Exception:Discussion on the exception for bona fide sales of businesses.How this exception might apply to equity owners and business transactions.Final Thoughts and Advice:Simon's final comments on the significance of the FTC's rule.Advice for healthcare providers and practice owners navigating this evolving legal environment.Outro:Joe and Simon wrap up the discussion.Teaser for the next episode.Key Quotes:"If I'm in your audience's shoes as providers and as practice owners, I think this is significant and I don't think this is just pure speculation." - Simon Willman"Everyone should have a right to earn a living, I think." - Joe RodriguezResources Mentioned:Becker's Healthcare article on the FTC vote.The FTC's final rule on non-competes.Connect with Us:Disclaimer: The content of this podcast is for informational purposes only and does not constitute legal advice. Listeners should consult their own legal advisors for specific guidance related to their circumstances.Send us a textFollow us at:InstagramFacebookTwitter/X
We Became The Top Anesthesia Podcast in the United States AND Episode Previews
Jun 14 2024
We Became The Top Anesthesia Podcast in the United States AND Episode Previews
SummaryThe podcast, Anesthesia Deconstructed, has become the number one anesthesia podcast in the United States (Apple Podcasts - subsection: Medicine) due to its focus on deconstructing issues and having thoughtful and respectful conversations. The host, Joe Rodriguez, discusses his involvement in the The Nurse Anesthesiologist Facebook Group (TNAG)  and the importance of creating a space for sharing ideas and discussing issues. He addresses a screenshot from another Facebook group that accuses him and others of monopolizing information platforms. Rodriguez clarifies his involvement and highlights the diversity of perspectives in the group. He also previews upcoming episodes on topics such as FTC banning non-competes, CRNA advocacy, interprofessional collaboration, and the CRNA-friendly environment in Arizona.Keywordsanesthesia podcast, deconstructing issues, respectful conversations, Facebook groups, sharing ideas, diversity of perspectives, upcoming episodes, FTC banning non-competes, CRNA advocacy, interprofessional collaboration, CRNA-friendly environment, ArizonaTakeawaysAnesthesia Deconstructed is the number one anesthesia podcast in the United States due to its focus on deconstructing issues and having thoughtful and respectful conversations.Creating spaces like the TNAG group allows for the sharing of ideas and discussions on anesthesia-related issues.Rodriguez clarifies his involvement in the group and highlights the diversity of perspectives and respectful conversations that take place.Upcoming episodes will cover topics such as FTC banning non-competes, CRNA advocacy, interprofessional collaboration, and the CRNA-friendly environment in Arizona.TitlesPreviewing Upcoming Episodes: FTC Banning Non-Competes, CRNA Advocacy, and MoreCreating a Space for Sharing Ideas: The Neuroscientist-Anesthesiologist Facebook GroupSound Bites"Anesthesia Deconstructed: The number one anesthesia podcast in the United States.""Wanting to have really good and thoughtful conversations, and trying to do it in a respectful way.""Creating a place where people can share ideas and discuss issues without constant attacks."Chapters00:00Introduction and Podcast Success01:26The Importance of Thoughtful and Respectful Conversations07:59CRNA Advocacy: Empowering Anesthesia Professionals08:29Interprofessional Collaboration: Enhancing Patient Care11:43Arizona: A Model for CRNA-Friendly Regulatory EnvironmentyJQW7fxVgyEr3PINhg7sSend us a textFollow us at:InstagramFacebookTwitter/X
Mike MacKinnon is Back!  Massachusetts Opt Out and What it Means vs
Jun 7 2024
Mike MacKinnon is Back! Massachusetts Opt Out and What it Means vs
SummaryIn this conversation, Joe Rodriguez interviews Michael McKinnon,  podcast founder, CRNA, and assistant program director at National University. They discuss two topics: the supervision clarification advisory opinion from the Arizona Board of Nursing and the opt-out of Medicare Part A physician supervision requirements in Massachusetts. McKinnon shares his perspective on these issues and emphasizes the importance of removing barriers to competition and promoting a level playing field in healthcare.KeywordsCRNA, supervision clarification, advisory opinion, Arizona Board of Nursing, AA, opt-out, Medicare Part A, physician supervision, MassachusettsTakeawaysRemoving barriers to competition and promoting a level playing field in healthcare is important.The supervision clarification advisor opinion from the Arizona Board of Nursing allows CRNAs to supervise other health professionals.The opt-out of Medicare Part A physician supervision requirements in Massachusetts eliminates the perception of supervision and reduces liability concerns for CRNAs.The opt-out also simplifies contract negotiations and promotes collaboration between CRNAs and surgeons.CRNAs should have the opportunity to choose the model of care that best suits their practice and the needs of their patients.More states should consider opting out of Medicare Part A physician supervision requirements to improve access to care and increase provider options.Chapters00:00Introduction and Background of Michael McKinnon01:04Supervision Clarification Advisor Opinion in Arizona05:21Opposition to Anti-Competitive Legislation09:31Opting Out of Medicare Part A Supervision Requirements in Massachusetts12:20Impact of Opting Out on CRNAs and Service Line Management16:29Future Plans and ConclusionSend us a textFollow us at:InstagramFacebookTwitter/X
Navigating New Frontiers: NorthStar Anesthesia's Approach to Modern Anesthesia Challenges
Apr 15 2024
Navigating New Frontiers: NorthStar Anesthesia's Approach to Modern Anesthesia Challenges
Introduction:In this episode of "Anesthesia Deconstructed," we delve into the evolving landscape of anesthesia services with two leading figures from NorthStar Anesthesia: Randall Moore, DNP, MBA, CRNA, Chief CRNA, and Jim Roberts, MD, Chief Medical Officer. Together, they shed light on NorthStar's innovative strategies in navigating staffing shortages, private equity involvement, and the complexities of the post-No Surprises Act era.Guest Insights:Randall Moore brings a wealth of experience in anesthesia management and clinical excellence, offering a unique perspective on the role of advanced practice anesthesia professionals in addressing current challenges.Jim Roberts shares his insights from the viewpoint of medical leadership, emphasizing the importance of strategic partnerships and quality care in the face of industry shifts.NorthStar's Journey:A brief overview of NorthStar Anesthesia, detailing its foundation, mission, and evolution into a leading national anesthesia services provider.Key Topics:Addressing Staffing Shortages: Strategies and initiatives employed by NorthStar to combat the ongoing staffing challenges in healthcare, particularly within anesthesia services.Private Equity and Corporate Investment: An examination of the role of private equity in healthcare, specifically in anesthesia services, and how NorthStar navigates these issues.Thriving Post-No Surprises Act: Discussion on the impacts of the No Surprises Act on anesthesia services, with a focus on NorthStar's adaptive strategies to ensure financial stability and patient satisfaction.Blueprint for Success: Insights into NorthStar's operational, clinical, and strategic methodologies that have positioned them for success in a rapidly changing healthcare environment.Why It Matters:This episode offers a glimpse into the operational and strategic mindset of one of the leading anesthesia services providers, highlighting actionable strategies for navigating modern healthcare challenges. It serves as an invaluable resource for anesthesia professionals, healthcare administrators, and anyone interested in the intersections of healthcare policy, management, and clinical excellence.Send us a textFollow us at:InstagramFacebookTwitter/X
Revolutionizing Recruitment: The MOTION Behind Transforming Anesthesia Careers
Apr 8 2024
Revolutionizing Recruitment: The MOTION Behind Transforming Anesthesia Careers
Introduction:Welcome to a groundbreaking episode of "Anesthesia Deconstructed," where we delve into the forces reshaping the landscape of anesthesia and healthcare recruitment. Today, we're thrilled to have Jarod Collins with us, a visionary behind "MOTION" - a pioneering platform set to redefine how anesthesia professionals navigate their career paths.Guest Spotlight:Jarod Collins, Executive Vice President, Strategic Partnerships at MedGeo Ventures, is part of the innovative team that developed "MOTION," a platform described as the “Zillow of CRNA jobs”. This episode explores Jarod's journey, the genesis of "MOTION," and its mission to bring transparency, efficiency, and quality to healthcare recruitment.What's New:Introduction to "MOTION," a cutting-edge job search platform designed for the modern anesthesia professional. Unlike traditional job boards, "MOTION" emphasizes quality metrics and user-friendly design to connect talent with the right opportunities.Why It Matters:Elevating Job Searches: Discover how "MOTION" moves beyond the limitations of outdated platforms, offering a streamlined, intuitive experience for both job seekers and employers.Quality Over Quantity: Learn about the unique approach "MOTION" takes to ensure listings are of the highest quality, making it easier for professionals to find meaningful employment.Impact on Anesthesia Careers: Understand the potential of "MOTION" to transform the career trajectories of CRNAs, anesthesiologists, and other anesthesia professionals through better job matches and career insights.A Step Towards Innovation: This episode sheds light on how "MOTION" represents a broader shift towards innovation and quality in the healthcare industry, setting a new standard for how job markets operate.Send us a textFollow us at:InstagramFacebookTwitter/X