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Episode 03: Anesthesia Careers In A Multispecialty Medical Group w/ Dr. Adam Blomberg

Jan 11, 2019

This Episode

Interview w/ Dr. Adam Blomberg

You Will Learn

  • Career considerations for anesthesia practice in a multi-specialty group.
  • How young physicians can capitalize on opportunities for leadership growth.
  • Can smaller practices maintain autonomy after acquisition by a larger group?

Resources & Links

Episode 03: Anesthesia Careers In A Multispecialty Medical Group w/ Dr. Adam Blomberg

Show Notes

In this episode I talk to Dr. Adam Blomberg about  his role at Envision Physician Services. 

We discuss career opportunities at a multi-specialty services company like Envision, the differences (and similarities) between the different anesthesia groups operating under Envision’s umbrella, and the importance of strong leadership in healthcare organizations to maintain high standards of care.

Show Transcript

 
Justin: [00:12] This week’s guest is Dr Adam Blomberg of envision physician services. Envision is a multi-specialty medical group that provides staffing, technology, education, and support for physicians of various specialties, including anesthesia, as well as support for hospitals and medical facilities. This week’s episode is designed to help you understand what the practice of anesthesia in the context of a multi-specialty corporation might look like. Okay. Welcome to the anesthesia success podcast. I’m your host, Justin Harvey. I have a very special guest with us today. Dr Adam Blomberg, I had the pleasure of meeting Dr Blomberg a few weeks ago at the asa meeting out in San Francisco where Dr Blomberg was participating in a panel talking about how residents and fellows can achieve their dream job and I thought that was great content that I would love to bring to the audience of this podcast. Dr Blomberg is the current chief of anesthesiology to the memorial healthcare system in Florida, which is the fifth largest public health care system in the country. In addition, he’s the regional medical director for envision physician services as well as envisions national education director in the anesthesiology division, Dr Blomberg. Thank you very much for joining us today. 
Dr. Blomberg: [01:40] Thank you, Justin. Thanks for having me. 
Justin: [01:42] So to kick us off here, why don’t you just give us a brief overview of kind of your career arc, Dr Blomberg and just tell us, you know, from training to the role in which you currently find yourself. Take us along that road and tell us some of the decision points along the way. 
Dr. Blomberg: [01:56] Perfect. I think that you summed it up is that I have a couple of different hats within envision and I think that I’ve been afforded these opportunities because of the ability and the success and the leadership above me, which is very important. So your wife has an anesthesia resident, correct? 
Justin: [02:12] That’s right, yeah. She’s a CA one at University of Pennsylvania.  
Dr. Blomberg: [02:15] So when I was given an opportunity to continue my training up at Brigham and Women’s at Harvard for residency. There was my first taste of medical leadership when during my CA three year I was appointed chief resident, but the class that, and historically it’s interesting, leaders come from good clinicians, right? That strong in the operating room. They lead in the operating room, but there’s really no development of leadership and that was my first taste as as a chief resident is I had fantastic mentors at the Brigham and when I became chief resident, they took me under their wing and I realized that having a seat at the table at a hospital in department really matters and you can show, share your voice and your and your colleagues’ voice. 
Dr. Blomberg: [03:06] So from there I came back home to south Florida where I started working at memorial regional hospital, which is the one of the facilities within the memorial healthcare system. Like you said, memorial healthcare system is a six hospital system that’s a extremely large public health trust system and I was an anesthesiologist at one of those hospitals from the. I was a hard working anesthesiologist and that’s what I want to stress is first and foremost. Quality of clinical care is the most important. And for the first couple years I proved my worth in the operating room. Worked very hard in the operating room, providing great clinical care. And from there I was given opportunities to move beyond the operating room. And I started noticing that there was initiatives that my chief and my sheave wanted to put throughout the hospital, put throughout the company and I just started volunteering. 
Dr. Blomberg: [03:50] Right. I think I’ll do it. I started taking that next step of doing things beyond the operating room in my spare time, whether it be create pathways, rather create grand round, whether it creates CME modules, whatever it was. I volunteered to do what, when there was committees in the hospital, I started volunteering to be on committees and that was my second step in leadership is I had a fantastic chief and vice chief that really guided me and allowed me the opportunity and I think that’s pretty much sums up all of envision, is that they provided those resources to me and, and I think that we provide our resources to our clinicians to grow if needed, if that’s what they want. Great. So from there, I became vice chief of the department. A couple years after that I became chief of the department at the memorial regional hospital. 
Dr. Blomberg: [04:31] And this year I became the chief of the whole healthcare system. our facilities. Each one of our facilities in the memorial healthcare system has a chief and chief and I took the role as chief of the system and a regional medical director, which means I have multiple facilities that I oversee and I’m pretty much the bridge in the gap between our corporate entity and the hospital sees suites to our clinicians and our leadership on the ground and that’s one of the biggest things that people have to understand is that the chiefs on the ground run their departments. I mean, it’s not some corporate entity that tells you how you run your department. Our, our role is as a regional medical director and from a corporate perspective is to provide the resources to our clinicians on the ground through our site medical directors for them to run their departments how they want. That’s pretty much my story to where I am today. And then from an education side, I am national education director and in that role, my job is to ensure that all of our clinicians, over 500 anesthesia programs around the country have clinical resources to have their CMS to have evidence based medicine. And to know the latest best practices. 
Justin: [05:34] Excellent. Thanks Dr. Blomberg, you said something at the beginning that I want to touch on. You said, you know, during training as a chief resident, you know, you were given this seat at the table and you had other clinicians who are more experienced than you. Who brought you in to, you know, develop some leadership skills. Can you talk a little bit about kind of what that experience was like for you? 
Dr. Blomberg: [05:51] Yeah, that was eyeopening. You always think of a physician or clinician being on the steps of medicine, right? Providing fantastic clinical care, and that’s when I really realized that it’s beyond that, that a true clinician leader, you know, there there’s fantastic clinicians that are providing great clinical care and that’s what they want to do and they provide great clinical care. But to be a clinical leader and a physician leader, you need to have a seat at the table. You need to sit with your c suite, you need to sit at the hospital, administration, you to sit with your with the people who make decisions with you to really ensure that your team has a voice and that’s where I learned that because as a chief resident I had a seat at the table. The department at the Brigham was fantastic about that. Do two chief residents, myself and my coach, chief resident. We had a seat at the table. We had a seat with the interviews. We had a vote with the interviews we were, we had to say of the residence. 
Justin: [06:47] Great. I want to pivot a little bit, so I’d love to unpack envision and what envision is specifically, you know, with their, their involvement in the anesthesia department and I know that, you know, it’s a national, I think anesthesia management company. Would it be fair to say and would love to multi specialty. Multi specialty. Okay, great. And we’d love to just unpack what is envisioned. How does anesthesia specifically function under the envision umbrella and what does that mean? 
Dr. Blomberg: [07:11] Yeah. Fantastic question. To envision physician services as a physician service company, multi-specialty many specialties at that provide a services to our local hospital clients and each individual facility has a leadership structure, so envision manages the contracts and envision manages the overall entities, however, it’s a local clinicians on the ground that integrate within the healthcare system that integrate within their hospital that provide the leadership on the ground from the link between the local leadership and the corporate governance. Is that role of that regional medical director to ensure that our clinicians on the ground have the resources necessary to provide the value to the hospitals and to provide the great clinical care to the patients and they’re really invested in all their clinicians. Right? So we provide education, we provide CMS, we provide those resources to ensure that the clinicians have that ability to provide that care. 
Justin: [08:09] How many anesthesiologists are currently employed with envision, 
Dr. Blomberg: [08:12] so the greater than 5,000 anesthesia clinicians, we have over $25,000 total clinicians within all the specialties. And that’s extremely beneficial. As an as health care environment changes the ability to be in a hospital system and to know that there’s multi-specialty is within the hospital that all worked for the same company with the same goals, with the same mission, with the same values is extremely important to know that I’m providing care in the operating room, but perhaps the ed or perhaps the radiologist or perhaps a neonatologist all work under the same company. I know that I have confidence that those clinicians know the same values that I have for the client. Right. For the, for the hospital system it these have used. It provides that. They know that they have the trust. There’s an infrastructure behind them to provide that. Right. That makes sense. In that context, 
Justin: [09:02] I’m curious about, you know, you mentioned envision is essentially it sounds like a corporate partnership among local groups of local clinicians and local practices to be able to help them with some of the management hospital negotiation types of things and to equip them and so providing those services to maybe focus on the practice, the clinical side a little more. Would you say that’s okay, 
Dr. Blomberg: [09:21] so it allows the clinicians to be clinicians and that’s that’s the the truth that allows us to worry about the business of medicine. It allows us to worry about the, the benefits and the HR. It allows our infrastructure to take their worries, that billing it takes, it allows our infrastructure to take that burden from them down. It allows them to focus on the patient and that’s what we want and the chief on the ground, the site medical director, they’re gonna run their department under our resources, under our guidance. They’ll run their department and we’ll provide them initiatives, clinical initiatives we rolled that will provide them with best practices, will provide all of that to say medical directors to run their department and the best way possible. 
Justin: [10:04] Got It. That makes sense. And so it, it sounds to me like there’s some uniformity with regards to philosophy, with regards to some of the infrastructure with envision practices, but there’s probably also some diversity among types of practices that are partnered with envision. Would you say that so 
Dr. Blomberg: [10:20] yeah, there are a lot of diversity within the. Within each practice, and that’s the benefit, right? As we continue to grow, we have subject matter experts all around the country, so in the past when you had a small group or a local region of our we call subject matter experts, it’s not necessarily a true subject matter expert and as we get clinicians from all areas of the country, whether it be the west coast, the east coast and north, the south, the Midwest, every one of these clinicians has something to add and that’s the benefit is we can pull together from an educational standpoint, we can pull together all this knowledge and these advisory can we put an advisory council together, which is a group of subject matter experts have a sub specialty so that when it went up facility in small town America has a question. They know that they can reach out to their colleagues, whether it be on the east coast of the United States, the west coast, the United States. They’re not alone, they’re not on an island. They have people behind them to support that. Got It, 
Justin: [11:17] and so it sounds like, you know, if I’m a, if I’m a fellow or if I’m a resident, I’m coming up through the ranks and I’m getting ready to, I’m considering perhaps a first or maybe a second role as an attending. If I’m looking at, you know, and envision practice, it’s probably more relevant to my situation to understand more about that unique practice and how it functions rather than the partnership with envision is a component of the way that practice functions, but there’s probably other site specific clinic specific considerations that are going to factor into that decision. 
Dr. Blomberg: [11:47] Yeah, of course when I tell people when they’re looking for their jobs, I tell them to look at the fit in the hospital, right? To ensure that the hospital that that local staff at the local hospital, that they have a fit there that’s going to be their home, that’s where they’re going to provide a great clinical care that’s going to be their community. Right? The triple aim, you know, the Ihi triple aim is, is community part of it as community. That’s their community, whether it be hospital in small town America or a hospital in large town USA, right? That’s their community, so they need to fit into there. From there, they need to ensure that the, the, the, the hospital and the group has the resources to be successful. Healthcare environment’s changing and there’s a lot of resources necessary from back office support to to contracting that these groups need and we provide that support to all of our clinicians. 
Dr. Blomberg: [12:40] Can you maybe give one or two specific examples of one of those resources being applied in the life of a practice and the way that that frees up clinicians to focus on the patient? Of course education, right? Let’s say let’s CME education. We provide our. All of our clinicians, all of their CME is necessary for their state medical license except for estate specific CME, right? Every state has state specific CME but we provide enough CME for them, but these CME’s aren’t just given. Right? They’re there through best practice, university based grand rounds that they can watch that are a year old that are the latest evidence based medicine. They go watch that video. Take the, take the core so it’s to benefits they get the CME and they get the knowledge so that that person who may be in a small town hospital that doesn’t necessarily have time to read the latest articles, although I do promote, obviously they should be reading their articles or they can’t get to the asa or they can’t get to their state special specialties society meeting. 
Dr. Blomberg: [13:35] They have the ability to know the best practices, which also takes us to a, we have a peri-operative module program called tempo, which rolls out to all of our clinicians that have best practice and pathways so that a clinician on the ground doesn’t necessary have to recreate an Iraqi pathway or recreate or colorectal pathway or recreate an orthopedic multimodal pain management or an opioid free program. We have those together. Well, I don’t want to say they’re rigid, right? They’re, they’re, they’re broad enough to allow them to be introduced to any practice but narrow enough to allow guidance. we also provide, you know, that’s on the education side. Now, from an operations standpoint, every clinician, every facility has a practice manager or director of operations and they are in. Their role is to make sure that clinicians have their benefits, make sure that clinicians have their hr, make sure that their clinicians are enrolled with the, with the third, you know the payers, right? That’s their job. They don’t, so the clinician doesn’t have to worry about them. Take a step farther and billing and revenue cycle management. We do all the billing and revenue cycle management, so the. So if you’re in a smaller practice and you don’t have that ability, you may be doing that on your own. You got it. Is there a predominant site of service that envisioned practices would be operating in or is it kind of equally distributed between like maybe a community hospital or a smaller clinic? Our ambulatory surgery, a surgery centers, 
Dr. Blomberg: [14:52] remember we’re multispectral or neonatology radiology, emergency medicine, hospital medicine and the Tito. A multitude of specialties in a multiple different types of facilities, whether it be a large quantity care academic center or a small one or two bedroom community hospital. No, it’s one or two operating a community hospital or to a small ASC from all specialties, so. So there’s not one type of facility we’re in any type of facility. 
Justin: [15:16] So I think something that’s it’s helpful to continue to unpack is under helping our listeners understand what is an envision standard consideration and what, what things are going to vary by practice. 
Dr. Blomberg: [15:28] So that’s. I don’t think their standards I want to get away. I don’t necessarily think we need to use the words Taylor. I think that’s a different word may be that we see that our values and our mission of what we really want to provide our clinicians. Right. Providing, you know, the value of providing great clinical care with support and resources and opportunities I think is the most important. As far as quality metrics. We do report quality metrics back so all the clinicians get a quality report and how they’re doing from quality. So I don’t think that the standard, but I think that’s for all conditions in any specialty in any group. I think quality is, is the gold standard, but we do provide that to our clinicians. We provide reports, a 
Justin: [16:09] clinician. Okay, great. And with regards to going back again to this fellow, a resident who’s getting ready to transition to this first role as an attending, obviously one of the things that they’re thinking about, well there’s probably two main considerations. One is the role as far as clinical duties and the other is going to be compensation. So how much variability between the different anesthesia practices in envision exists with those two factors and is it like a very wide spectrum or is it a more a more narrow spectrum? 
Dr. Blomberg: [16:39] Yeah, so, so good question. So there are many different types of compensation structures and I think it’s all locally dependent. Okay. It all depends on where they are locally as far as compensation. The compensation structures varies greatly, right? Depending on geographic location, facility type of practice, and what type of practice they choose. 
Justin: [16:58] Right. As far as the comp structure goes, is it a salary plus bonus or are they gonna be looking at rv use and production, or does that vary as well? 
Dr. Blomberg: [17:07] So it all varies, right? That’s the, that’s the biggest thing. Somebody will need to notice his. It’s standard at a, at a local geographic location, but it varies by geographic. 
Justin: [17:15] Okay, got it. That makes perfect sense. And with regards to equity, profit sharing opportunity in the local practices, is that similarly varies, 
Dr. Blomberg: [17:24] remember you’re working for a corporation. Right. Okay. So even though when I say local practice, I’d say local practice, that’s local practice from a clinical standpoint, but like I said, income and compensation varies geographically, so there’s different structures depending on the facility type where they are in the country and what type of practice they choose. 
Justin: [17:42] Great. Makes Sense. Something else I’m curious about, you know, you describe your career trajectory starting obviously more on the clinical and then to the, to the point where you are today. We’re doing some administrating and liaising between envision and local practices as far as. Well, it’s probably doing some clinical work still, I would imagine. Is that right? 
Dr. Blomberg: [18:03] Yes. I still practice clinically. number one, I love it, you know, that’s what I trained to do. I trained to be a physician and an anesthesiologist, so I, I love practicing in the operating room in and providing that clinical care. So I have multiple jobs, I mean that that job of a regional medical director is to make sure that all of my site medical directors and my cheese have the resources that were given to me by my regional medical director before me, and then he got promoted to become a vice president and now his job is to make sure all of his regional medical directors have the resources and support that his vice president before him dead. But I still practice clinically, you know, I still love being in the operating room. There’s nothing like taking care of a patient and knowing that, that you have that ability. Yeah. 
Justin: [18:46] And as far as, you know, people considering maybe making that transition or beginning to consider what does it look like to start moving from 100 percent clinical to taking on more leadership and administrative roles. Can you describe kind of how that transition worked for you and maybe some important things to think about? 
Dr. Blomberg: [19:04] So, great question. So I think that our listeners have to understand is that we as a company provide a wide variety of opportunities for clinicians, right? So some clinicians want to be that, that fantastic clinician in the operating room writing great clinical care. We ensure that that opportunity is there for them some and want to pursue that administrative role and we provide that as well. We have leadership development courses, we have advanced leadership development courses. We have pillars courses for those individuals that want to become leaders and I say we because we’re all envisioning we’re. We’re personally invested in our clinicians and I’m personally invested in all of my clinicians and my site medical directors and I need to be sure that they have the support. So that transition piece becomes what somebody wants, right? Do I think internally when somebody on the ground, they need to decide what do they want out of their career? Do they want to be clinically focused and only clinically focused or do they want administrative roles and I think once internally somebody recognizes that. I think after that it’s the role of the site medical director of the regional medical director to ensure that number one, that person is. If they are interested in there, are they capable? Do they have the ability? And if they have the abilities, how do we get the best out of them? And that’s some of those courses is there’s book clubs or Leadership Book Club. There’s a tremendous amount of opportunity for them. 
Justin: [20:21] Conversely, you know, if someone is interested in just maintaining a more clinically focused career trajectory, that opportunity would also be open to them. 
Dr. Blomberg: [20:30] Of course not. We have many clinicians in my practice that provide great clinical care and that’s what they want. They want to provide fantastic clinical care in the operating room, or out of operating room and that’s what they want to do. 
Justin: [20:43] And with regards to a physician being more interested beginning that pivot to the administrative side is their credentials or any types of experience or any, anything that you look for in particular other than obviously the raw materials of leadership that would incline you to offer someone that type of opportunity. 
Dr. Blomberg: [21:00] So great question. I think the foundation right? Think of it like a house. The foundation is clinical care, right? So you have to be a fantastic clinician to take that next step for. The first thing that somebody needs to do when they come out of training is to build that foundation of clinical care so that they’re the go to person from the surgeons in the hospital. You know, you can’t be respected as a leader if you don’t provide that clinical care, if you’re not politically savvy to get the respect to the surgeons and your colleagues, number one. So that’s number one. Number two, as far as credentialing, another no credentials, it’s basically ensuring that you have the ability and that that’s up to the your, your leaders above you to recognize that and to provide whether it be book clubs, whether it be books, whether it be courses, whether it be emerging leaders, programs that advance leaders, programs, pillared courses, everything that we have. 
Dr. Blomberg: [21:49] It’s up to us to ensure that that clinician on the ground gets it. But, but I would say the most important thing for any of your listeners who are coming out of training is build that foundation of a house. Right? Think of it. A house. If you were to build a house without the foundation, it would fall down and I tell this to people when, you know, I have some people come out of practice with advanced degrees beyond them beyond MD and they want to get right evolved. I tell them, no, take a step back. You have your whole career ahead of you build the foundation. 
Justin: [22:17] Yeah, I think that’s absolutely great advice. That makes a ton of sense. So you know, you keep coming back to this idea of leadership and I think that’s really important, especially you know, as an organization grows, the leadership effectiveness becomes more and more important to the continuity of that organization as well as to, you know, the excellence of care administered. So I’m curious, I’d love to hear a story maybe about a leader or two who has been impactful for you and maybe just give us a little illustration of what that’s looked like in the, in the context in which you have operated. Of course. So 
Dr. Blomberg: [22:47] I’ve had fantastic mentors, leaders above me, everybody that was ahead of me that when I first started my career, my current vice chief, when I went out, my current by sheep point, when I started my career, my vice chief at the time was extremely instrumental in my career. He became, he got promoted to chief within six months after I have my department. After I started and right away the two of us got along. I, I, he saw that I was the guy that ran the board, that I was in the operating room. I was knee deep in all the cases, whatever anybody needed. I was there to help. There was something called overhead. I was the first or second one of the operating room to help out. So he saw that and he really took me under his wings. He started giving me books, leadership books. 
Dr. Blomberg: [23:26] He put me on committees. He appointed me to multiple high level committees in the hospital. Um, it was interesting. He would go to a lot of those meetings as well, wouldn’t say anything. And then afterwards he pulled me aside and he would say, you know, maybe you should consider doing it this way, you should consider doing it that way. And that was very instrumental. And then he moved down to regional medical director. He pointed me to be chief and now when he moved up to vice president, I, I moved into digital as regional medical director. And to this day he still, we were in a meeting last week, a very high level c suite meeting. And he did the same thing. He was there just listening. And as a vice president, he needs to be there afterwards. He said, you know, I may have considered it doing this way, and he’s right. You know, in hindsight I should have probably done it that way. However, I mean, the way I did nothing, nothing was wrong about it, but he’s still to this day giving me that mentorship and guidance. 
Justin: [24:17] Yeah, that’s a great. I love that example of that principled feedback that’s, you know, listening first and then offering constructive insight that can be so valuable for young professionals of any field, but especially in the context of, you know, medical leadership, I have to imagine that’s really impactful for you. 
Dr. Blomberg: [24:35] The end of the day, you need to have the support outside of the work, job out of your job, you know, the support at home is extremely important. There was many late nights, many early mornings without the support structure outside of the hospital. it, it’s very difficult. So that’s another thing is, is to understand their expectations and to understand that, you know, when you take on more and more leadership, you may not be in the operating room on this day, but you’re at a meeting until eight, nine, 10, 11:00 at night. Right. So, so things change differently, so you need to have that support at home. 
Justin: [25:08] Yeah, totally. And you know, as a physician spouse, that’s something I can obviously relate to, even being married to a resident. it’s, it’s very, very demanding. And you know, as your career progresses, I can see how essential that must be. Absolutely. It doesn’t stop. It’s good to get to establish that at the outset. 
Dr. Blomberg: [25:24] It doesn’t stop. It changes. It definitely doesn’t stop. It changes. 
Justin: [25:28] So I’m curious, you know, you have, you’ve seen a lot obviously through the course of your career, different, um, clinical contexts and then leadership roles. Taking that context and applying it to what you see young physicians stepping into now, especially in anesthesia and pain, are there any specific challenges that you see them facing that perhaps you didn’t have to face or maybe that are just evolving that you think they should be aware of? 
Dr. Blomberg: [25:52] Another great question. The landscape is changing and what I tell them is what they see today is going to be different five years from now. The healthcare environment is, is constantly changing to be successful. They need to be adaptable, flexible with the environment. There’s things that you can control and things you can control. Right. I would say that there’s more and more focused on patient experience, which there should be a than there was when I first came out of training there. There’s more and more focus on value and clinical quality than when I first came out of training to a clinical quality was always important, but there was no value tied to it. Now with MACRA, there’s value and compensation tied to it, so I think that people coming out and need to understand that and I think that the clinicians that got lost two, three, four years ago, flexible enough, the changing environment of healthcare and I think that you get that one or two ways. You either are innately born with the ability to be flexible and that’s not many people are like that or you had the leaders above you that guide you to be flexible and for you to know that you have a support infrastructure that you provide the critical care and I’m going to let my leaders really take on the changes in healthcare environment. Do you need to have the support structure and the ability to be flexible? 
Justin: [27:12] Yup. So in that context, you know, I’m interested, you know, you mentioned the evolving landscape and this is true in all kinds of places, you know, with technology and, and in my field of finance and wherever we look, we see the change happening at a quicker and quicker rate so that the world that we die in is gonna look nothing like the one we were born into and that’s only getting truer as time passes. And in that context, I’m curious what your, what your thoughts are about a consolidation with regards to anesthesia practice and you know, envision is an embodiment of that trend and what do you see as the pros and cons of the way that that’s transpiring? 
Dr. Blomberg: [27:46] So great question. I think consolidation continued to occur. I see that consolidation is good for the patient. I think that because of consolidation, it allows critical quality to improve because it brings entities together and clinicians together to share best practices. So from a clinical standpoint, I think it’s excellent. Um, I think it needs to be done. I think the hospital, they’re going to continue to consolidate to ensure that hospitals have values and quality. From a con standpoint, I don’t necessarily think that there is a con except for people who may not be adaptable and flexible and our rigid may not understand that just because there was consolidation doesn’t mean that you’re necessarily losing control of your clinical autonomy. Right? That, that’s the biggest thing is people think consolidation means you lose autonomy. And I think it’s the opposite. I think consolidation provides a resources for you to maintain your autonomy. 
Justin: [28:40] Great. Great insight. Um, so I have one question that I want to close with that I asked all my clinicians. anesthesia is a very demanding profession obviously, and as I’m experiencing firsthand on the spousal side of that right now, and it requires a lot of sacrifice for you and the people around you. So I’d love to hear from you a brief story or maybe two reflecting on your proudest moments as a practitioner and something that made you glad that you do what you do. 
Dr. Blomberg: [29:06] So I think that all my days are rewarding, whether my days in the operating room we’re rewarding because of taking care of patients or my days an administrative role, rewarding because those are the days that I’m ensuring that my multiple facilities and multiple conditions all have the ability and all have the resources to provide that quick, great clinical quality and there’s definitely times that I’ve come home and I’ve shared stories with my wife, you know, very sick trauma patients that I didn’t think were going to live in the trauma surgeon and myself and the Trna broke down silos and really became a team for that patient. You know, we had a young, young kid I’ll never forget who was in a motor vehicle crash, very seriously injured and you know, the, as the team, we saved his life. And I think those are the rewarding to see the family when you walk out of the operating room and you see the family and you saved them, there’s nothing better. And, and that’s when all your time and effort is worth it. Great. 
Justin: [30:04] That’s a great answer. well Dr Blomberg. It’s been a pleasure chatting with you. Thank you for joining us on the anesthesia success podcast. My pleasure. Hey, Justin here. This may shock you to learn, but I am actually not a full-time podcast podcaster. I also run a financial planning company called quantify planning, where I work closely with anesthesia and pain docs to build and implement customized financial plan. If you’re interested in working with a financial planner who knows many of the ins and outs of your profession, shoot me an email or head on over to quantify planning.com. For more information, if you’re a resident or fellow, I can also offer you a free student loan analysis if you’re interested, but there might be a waiting list, so check out the link over there to see if you’re interested in learning more about the topics we discussed today. Head over to anesthesia success.com to join our community residents and attendings and others to ask a question or get more free resources. If and only if you liked this episode, please leave us a review and subscribe. Thank you very much for listening to the anesthesia success podcast.

Show produced By:

Dan Gummel & Justin Harvey

Show Music:

Great Scott:  Don’t Hold Back

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