Episodes

Anesthesia coverage is now the single most cited financial headache for surgery center leaders in the country, and MD-only care is disappearing fast: QZ billing is up 15%, team-based coverage is up 30%, and CRNA-involved cases have nearly doubled in Florida over 14 years. Joe Rodriguez sits down with Randy Moore, Chief CRNA and Chief Strategy Officer at North Star Anesthesia, and first-time guest Andrew Woodmancey, founder and managing partner of Anesthesia Operations Consultants, a mid-sized consulting firm based in Florida, to break down what's actually driving these numbers. They don't agree on all of it. The conversation opens with a new VMG Health survey on where anesthesia subsidies are headed in 2026, then moves into the billing data behind the shift away from MD-only care. Andrew, brought on as the non-clinical voice in the room, argues the real economic problem is reimbursement and industry infighting, not scope-of-practice fights. Joe pushes further, arguing that cr…

Six days before a federal rule was set to take effect, the courts stepped in. The Department of Education tried to redefine who counts as a professional, a move that would have capped student loans for nurse anesthetists and the advanced-practice clinicians training behind them. The courts said the challenge is likely to succeed and hit pause. This week I sat down with Tracy Young, twenty-six years in the field, and Randy Moore, who runs anesthesia at enterprise scale, to work through what the ruling actually means and what it does not. It is a win in a battle, not the war. We get into the argument a federal regulator made that landed harder than we wanted to admit, why a rule written to require supervision is now being used against us, and where the line sits between what government should decide and what the people doing the work should. Plus the student-loan fight both parties get half-right, and why credentials stopped predicting who can lead. Good information first. Then…

Joe Rodriguez (co-founder, Guide Anesthesia) sits down with Randy Moore (EVP and National Chief CRNA, NorthStar Anesthesia) and Gary Keeling (VP of Anesthesia Services, Coronis RCM). Three seats, three vantage points on the same business. Let the spicy takes flow. First docket: the Arizona reimbursement fight. Gary calls the QZ cut a pure money grab. Randy steelmans the insurer's lobbyist before dismantling him, and explains why the hospitals least prepared to absorb the hit will be the ones paying it. Joe walks through why reimbursement parity doesn't raise costs when subsidies fill the gap, and tells the story of the insurer that paid patients directly for eight years. Second docket: the Texas non-compete case. Gary argues exits should hurt but not kill. Randy says hospitals deserve the right to fire bad vendors, but a $30 million buyout is anti-competitive. Joe draws the line between covenants that trap clinicians and the non-solicit rule that just says don't be shady. Plu…

Joe Rodriguez sits down with Randy Moore and Tracy Young, to work through the week's hardest stories. Let the spicy takes flow! Reimbursement: UnitedHealthcare stops paying for physical status. Oklahoma and Louisiana fight back with legislation. Tracy makes the case that anesthesia has been commoditized, and that hospital subsidies taught payers they never have to pay full price. Private equity: California and Oregon pass laws to curb PE in medicine. Tracy argues we legislate against bad actors instead of punishing them. Randy defends consolidation, then explains why the Oregon deal was a playbook of what not to do. And the line nobody else will say: hospitals don't fire anesthesia groups that are doing a good job. Workforce: AA bills fail in Iowa and Minnesota. Joe argues the entire AA strategy asks the wrong question. Tracy disagrees with both hosts and predicts a sorted market: CRNA-centric facilities on one side, MD and AA medical-direction models on the other, driven by …

The FTC just notched its second win against the biggest roll-up in anesthesia history. Welsh Carson settled first. Now USAP. So who actually won, and who pays next? Joe Rodriguez sits down with Randy Moore and Gary Keeling for the kind of conversation that usually happens at the bar after the conference, not on the record. No "where did you go to school" warm-ups. Just three operators reading the headlines everyone else is misreading. Gary drops the frame that defines the episode: this is two Goliaths at war. Private equity built 70 percent market share with borrowed money. Insurers answered with the No Surprises Act and rate cuts. Now IDR is swinging back, hospitals are eating the shortfall through subsidies, and the FTC just stepped into the ring. Anesthesia providers are standing in the middle of all of it. Then the gloves come off on the anesthesiologist assistant fight. Sixty bills in thirty years. Gary says there's enough work for everybody and braces for the hate mail.…

Along life’s winding roads we’ve each worked tirelessly to hone our skills and ultimately become the excellent clinicians we are today. But what happens when being great in the OR isn't enough? Each week on About the Rest, Joe Rodriguez, DNAP, CRNA, gets into the weeds on the definitive podcast for fellow CRNAs and MDs who want to understand how our profession actually works behind the scenes… warts and all. The spiritual sibling of the award-winning podcast Anesthesia Deconstructed, About the R...

Anesthesia Deconstructed is sunsetting, but the conversation is just getting started. Joe and Mike announce Joe’s new podcast, “About the Rest!” Get ready for the next chapter of critical career-driven discussions exploring the leadership, performance, and business of a career in anesthesia. Simply stay subscribed to this feed to automatically follow as Season One begins May 2026 (don’t worry, old eps of Anesthesia Deconstructed aren’t going anywhere). As we navigate the systems, incentives, an...

In this powerful and unfiltered episode, Dr. Joseph Rodriguez — CRNA, former state and national leader, faculty member, and host of Anesthesia Deconstructed — takes us inside the real lessons of anesthesia leadership. From COVID-era disruption to contract losses, difficult boardroom conversations, and the relentless financial pressures of today’s anesthesia market, Joe shares stories that few leaders are willing to tell. Each story carries a hard-won lesson: why leadership is never just a title...

In this candid and wide-ranging episode, we sit down with Bill Bruce — CEO of the AANA, representing over 65,000 CRNAs and SRNAs nationwide — to pull back the curtain on what it really takes to lead the profession’s largest and most influential organization. From balancing the competing demands of members, boards, and limited resources, to navigating constant political, clinical, and industry noise, Bill explains how the CEO’s role is equal parts strategist, mediator, and pressure point. We exp...

In this bold and revealing episode, we sit down with Randy Moore — former military CRNA, past CEO of the AANA, and now a top executive at one of the country’s largest anesthesia organizations — to explore how the anesthesia market unraveled, and why no one stopped it. From workforce blind spots to failed strategic planning, Randy walks us through the early warning signs that went unheeded, the flawed assumptions that fueled collapse, and the slow-motion crises that turned into full-blown disrup...

In this candid and wide-ranging conversation, we sit down with Dr. Brian Schmutzler — anesthesiologist, social media educator, and Executive Vice President of Medical Affairs at CCI Anesthesia — to unpack what it really means to lead in modern anesthesia. From the realities of staffing rural hospitals without anesthesiologists to fighting burnout, navigating private equity, and fiercely defending provider scope and safety, Brian shares hard-earned insights from both clinical and corporate perspe...

What REALLY happens when you’re named in a malpractice lawsuit? In this eye-opening episode, Joe Rodriguez sits down with Paul Lefebvre, lead claims professional and risk advisor, and Andrew Clark, head of business development at Physicians Preferred Medical — an anesthesia-specific malpractice carrier — to pull back the curtain on malpractice litigation. From the first call after an adverse event to depositions, defense strategies, and courtroom realities, this conversation is packed with mu...

Anesthesia is evolving — and so are its leaders. In this special episode of Anesthesia Deconstructed, we dive into the dynamic shifts happening across the anesthesia landscape, where Certified Registered Nurse Anesthetists (CRNAs) and anesthesiologists are stepping into new leadership roles across clinical, operational, and educational domains. Our expert panel — including leaders from Norstar Anesthesia, Rutgers University, Sound Physicians, Guide Anesthesia, and BPI Anesthesia — explores what...

Keywords CRNA, nursing education, TikTok, Confident Care Academy, mentorship, cardiac anesthesia, online learning, healthcare, nursing community, media impact Summary In this engaging conversation, Joseph Rodriguez speaks with Chrissy Massaro, a prominent CRNA and founder of Confident Care Academy. They discuss the evolution of nursing education in the age of social media, the challenges faced by new nurses transitioning to CRNAs, and the importance of mentorship. Chrissy shares her jou...

In this conversation, Joseph Rodriguez and Mike MacKinnon discuss the evolution of CRNA programs, the impact of prep courses, and the importance of surrounding oneself with the right people for career success. They critique the economics of anesthesia services, explore fair market value in compensation, and address regulatory challenges faced by CRNAs, particularly in California. The dialogue emphasizes the need for critical thinking in the interview process and the implications of high compensa...

Description: In this episode of Anesthesia Deconstructed, Joe Rodriguez dives deep with Dr. Jed Wolpaw, creator of the ACCRAC podcast and a leader in anesthesia education. Together, they discuss Jed’s unique path from history teacher to anesthesiologist, the critical importance of civil discourse, and universal learning principles that transcend medicine. With insights on podcasting, education, and the future of anesthesia, this episode offers something for every professional passionate about...

SEASON 7 BEGINS! Keywords for this Episode anesthesia, non-compete agreements, legal challenges, FTC, healthcare law, CRNA, anesthesia practice, employment contracts, state laws, anesthesia updates Summary In 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 G...

Key Points: Importance of the AANA to CRNA economy Proposed bylaw changes and resolutionsSupport for Board Term Extension (Bylaw 2) (with caveats) and Virtual Business MeetingsOpposition to Board Expansion (Bylaw 3) and Automatic Leadership Succession (Bylaw 4)Rationale behind each positionSummary: Joe shares his views on proposed AANA changes, advocating for longer board terms and virtual meetings while opposing board expansion and automatic leadership succession. He emphasizes the need...

Summary The 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 ...

Summary The 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 ...

Summary The 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 f...

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: Introduction Joe Rodriguez introduces the episode and welcomes Ali Baghai. Brief discussion about the uniqueness of Ali's name and CRNA ...

In this special July 4th episode, we explore the significance of American independence and its impact on the CRNA profession. We discuss the foundations of American governance and how these ideals have shaped our national identity. The episode presents two key messages: addressing current societal tensions and highlighting CRNAs as a unique American innovation in healthcare. The podcast emphasizes the exceptional position of CRNAs in the United States, noting their level of autonomy and economi...

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 Sim...