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.

Plus: why the resume from Hawaii is a red flag, and what the law of inertia does to anesthesia groups that confuse stability with health.

Reimbursement parity does not raise costs in anesthesia. Compensation sits above reimbursement and subsidies fill the gap, so cutting one payer's rate changes who pays, not how much is paid.

The facilities that use QZ most are the ones least able to absorb the cut. Rural and underserved programs run closest to the margin, which makes this bad policy independent of the scope debate.

CRNAs can lose non-compete fights. In the Texas case, the new employer contractually agreed to cover legal costs and damages, and the court sided with the original group anyway. A buyout promise is not a shield. The covenant you signed is enforceable as written, and "I read online it's unenforceable" is not a legal strategy.

The line is solicitation, not competition. A non-solicit protects the group that gave you access to its surgeons and referrals without trapping you in place. Competing down the street is fair game. Taking the business with you is shady.

Switching costs are a strategy. A $30 million buyout stops being protection and becomes a hostage situation. Hospitals should be able to fire bad vendors at a price that hurts but doesn't kill.

Sign contracts like you plan airways. Have a plan A, B, and C for your exit before the honeymoon period ends, because the group that looks great at signing may not look great in year three.

Gary Keeling (VP of Anesthesia Services, Coronis RCM)

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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 math, not preference.

Plus: why anesthesia companies obsessed with growth keep losing contracts, and why CRNA residents work full-time hours unpaid while physician residents draw a salary.

Differentiation in anesthesia is no longer simply price. It is recruiting and retention, full stop. Culture is the product.

Hospitals don't replace groups that are performing. If a contract gets shopped, there was a problem, whatever the press release says.

Growth without product is a failure of leadership. The large groups losing contracts did it to themselves.

The workforce will sort itself in the next decade. The average anesthesiologist is 55. CRNA graduation just crossed 3,000 for the first time. 

Profit motive is not a disease. Imbalance is. Everyone you've ever hired has a profit motive, including you.

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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?

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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.

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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, and power shifts that happen around the OR we want to know what you think! Visit abouttherest.com to join the community and share what you want to hear next.

Get in Touch: [email protected]

A Human Content Production

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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, how executive presence shapes outcomes, why data transparency can backfire, and how accountability transforms teams from fragile to high-performing.

We also dive into the frameworks that shaped his leadership journey — from Crucial Conversations to The Four Agreements and Five Dysfunctions of a Team — and how every leader can apply them to grow themselves, their organizations, and the people they serve.

This isn’t theory. It’s frontline leadership, with all the scars, pivots, and resilience required to survive in one of healthcare’s most disrupted specialties.

Whether you’re a CRNA, SRNA, or a healthcare leader navigating change, this conversation is a masterclass in turning setbacks into systems, failures into frameworks, and words into lasting impact.

Keywords:

Anesthesia, CRNA Leadership, Healthcare Business, Executive Presence, Leadership Lessons, Nurse Anesthesiology, Organizational Growth, Accountability, Professional Development, Anesthesia Contracts, No Surprises Act, Healthcare Strategy, Team Building, Crucial Conversations, Five Dysfunctions of a Team

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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 explore how the AANA sets priorities, allocates resources, and adapts to both internal ambitions and external threats — and why the organization’s absence would have an almost immediate impact on CRNAs across the country.

Bill also shares his perspective on maintaining focus in an environment of relentless change, the leadership qualities that matter most in high-stakes healthcare advocacy, and how the AANA is positioning the profession for the future.

Whether you’re a CRNA, SRNA, or simply curious about the forces shaping nurse anesthesia, this conversation offers a rare inside look at the operational, strategic, and political realities of leading at the top.

Keywords:

Anesthesia, CRNA Leadership, Healthcare Advocacy, Professional Associations, Strategic Planning, Workforce Advocacy, Organizational Leadership, AANA, Healthcare Policy, Nursing Leadership

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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 disruption. We break down the shift from hospital dominance to ASC migration, the chilling effects of the No Surprises Act, and how private equity’s playbook fell apart.

But we don’t stop at systems. Randy also gets personal — reflecting on the cost of unchecked ambition, the value of thoughtful leadership, and the non-negotiables he now looks for in partners and teams.

Whether you lead a group, manage hospital operations, or just want to understand the business forces reshaping anesthesia, this conversation pulls no punches — and offers rare clarity from someone who’s led on every side of the table.

Keywords:

Anesthesia, CRNA Leadership, Healthcare Strategy, No Surprises Act, Workforce Crisis, Private Equity, Surgical Services, Hospital Operations, ASC Growth, Healthcare Leadership

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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 perspectives.

We also dive into the power of humor and education on social media, his 108K-strong Instagram following, and how his content brings awareness, advocacy, and levity to patients and practitioners alike.

If you're a CRNA, MD, administrator, or just someone trying to understand where anesthesia is headed — and how to lead within it — this is an episode you can’t miss.

Keywords:
Leadership, Anesthesia, Social Media, Burnout, Independent Practice

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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 must-know insights for every CRNA, anesthesiologist, and anesthesia group leader.

We talk about why most anesthesia lawsuits are defensible, how to avoid career-derailing mistakes, the truth behind insurance carriers and legal strategy, and what separates providers who bounce back from those who don’t. This is not just about risk — it’s about resilience, smart choices, and protecting your future.

Keywords: Malpractice, Anesthesia, Risk Management, Litigation, Informed Consent 

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