AMCs Post Covid19

[dannyboy1]

No such language in my contract either, and my group cut pay by 50% with simply an email. No new signed contracts.

We’re expecting small amount of elective cases to resume May 4, then back to almost full schedule May 11. However, the company won’t commit to paying us full salary once volume picks back up for fear of collections lagging. No definitive time table.

We all have non-competes, and this is clearly breaching contract.

A 50 percent pay cut should result in 50% less hours at work. The scheduling people in your group should make sure that people are only working 5/10 days. That way you have set the standard and if/when volume returns you can be compensated accordingly.

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[IMGASMD]

It depend how the practice is acquired, no? If there is something In the contract saying if material decline or whatever the wording is, they have right to terminate.... but I haven’t seen that they can just unilaterally cut salary.

Amc salary physicians for a reason. You are required to finish the rooms. But flip side should be true, but probably isn’t, if there is no work, you should still be paid at a set salary.

 

[Ronin1]

It depend how the practice is acquired, no? If there is something In the contract saying if material decline or whatever the wording is, they have right to terminate.... but I haven’t seen that they can just unilaterally cut salary.

Amc salary physicians for a reason. You are required to finish the rooms. But flip side should be true, but probably isn’t, if there is no work, you should still be paid at a set salary.

It all depends on the specific language in the contract. People that joined after our acquisition have very different language in their contracts essentially without cause termination clauses.

 

[IMGASMD]

It all depends on the specific language in the contract. People that joined after our acquisition have very different language in their contracts essentially without cause termination clauses.

Exactly. The partners who sold, may have to take the bulls hit because they’ve already gotten paid....
young grads, who signed up for a “standard contract” shouldn’t get penalized because the company isn’t doing well. Then terminate and pay a severance package like real corporate America.

I haven’t reconciled with this kind of baloney. When they want me (a new grad naive anesthesiologist) work as a partner to finish whatever work is assigned by the hospital; however, with muddy language about calls, bonus, 401k contribution, or what have you. Cannot play both sides. If I am a salaried employee, do it like the rest of the real companies. If I am a partner, pay me the bonus at the end of the year.

 

[Ronin1]

Exactly. The partners who sold, may have to take the bulls hit because they’ve already gotten paid....
young grads, who signed up for a “standard contract” shouldn’t get penalized because the company isn’t doing well.

It’s exactly the opposite. Pre acquisition guys will get paid because they have better contracts. New guys not so much

 

[IMGASMD]

It’s exactly the opposite. Pre acquisition guys will get paid because they have better contracts. New guys not so much

Then even worse!
I just cannot comprehend why we are letting them getting away with this.

I know why, because we are stupid. We don’t have a good sense of how business is ran. We trade stability for opportunities. In the interim we are just sheep being taken advantages of.

 

[C4C]

Well we got our first paycheck today with a 30%reduction in base pay from envision. Our letter to corporate also went out regarding their breach of contract. At least in my contract if they breach non compete is voided. My thoughts are they will cure the breach in 60 days rather than let us walk

Do not wait. Walk now.

That 30% reduction is coming on top of all the profit they are skimming from every case you do, every weekend or evening call you take, every chance you run the risk of being sued. They don't work weekends or holidays. They don't have to waste time on CME. They don't waste money on licensing or MOCA.

The only reason you should have thrown your lot in with them was for stability. You were giving up tremendous upside to limit your downside. But now that times are tough, they think they can welsh on their deal? No way.

Be a man and walk away, or the next time they screw you it will be worse.

 

[aneftp]

Do not wait. Walk now.

That 30% reduction is coming on top of all the profit they are skimming from every case you do, every weekend or evening call you take, every chance you run the risk of being sued. They don't work weekends or holidays. They don't have to waste time on CME. They don't waste money on licensing or MOCA.

The only reason you should have thrown your lot in with them was for stability. You were giving up tremendous upside to limit your downside. But now that times are tough, they think they can welsh on their deal? No way.

Be a man and walk away, or the next time they screw you it will be worse.

And go where?

if you are in a big city chances not many open jobs right now.

many people have families to support. Mortgages and car payments and student loans. $10-15k a month in expenses. Unless someone has immediate job and fully credentialed. It’s the dumbest idea to immediately quit with nothing line up.

You can do It If you single and no kids.

 

[AdmiralChz]

I’d be really suspect of really any group that isn’t doing paycuts right now. Unless you are using your largely idle work force to staff others areas of the hospital (e.g. ICU) if needed. Our volumes are down over 50% how in the world could we afford to pay ourselves the same, for now?

Only a 30% cut In this environment is an amazing deal. Mine is substantially more, even if it’s temporary.

However, we Will still be somewhat short going forward so are still hiring. Been hearing a lot of offers being rescinded or start dates pushed back.

 

[IMGASMD]

I’d be really suspect of really any group that isn’t doing paycuts right now. Unless you are using your largely idle work force to staff others areas of the hospital (e.g. ICU) if needed. Our volumes are down over 50% how in the world could we afford to pay ourselves the same, for now?

Only a 30% cut In this environment is an amazing deal. Mine is substantially more, even if it’s temporary.

However, we Will still be somewhat short going forward so are still hiring. Been hearing a lot of offers being rescinded or start dates pushed back.

Some private groups took out the small business loan and asked employees to chip in are doing “okay.” Staff the hospital with an intubation team, and/or helping with ICU is at least a way to generate some revenue.

From what I heard, it’s 30% cut across the board. You still have places, like Florida Sheridan country, who are still running rooms with “urgent” cases. You also have places like NY/NJ that there is no possibility to run any surgeries, unless they’re truly ASA4E. The fact that both situations are getting the same cut does not seem “fair”.

 

[ambiturner]

Let’s also remember that in a lot of cases these contracts say nothing about RVU targets, profitability, etc to guarantee a salary. For many groups, if you did cases all night or slept you would see the same paycheck. You don’t see a cut of profit when times are good, so why should you see cuts to a BASE SALARY when times are bad?

For private practice it makes sense to be taking a cut right now. But for people employed, in academics, etc, the trust in the deal that was taken has been shaken permanently. Another case of privatizing the profits and socializing the losses. I think a lot of people going through this will come out with the understanding that the risk involved in seemingly safe jobs is higher than previously understood.

 

[vector2]

Let’s also remember that in a lot of cases these contracts say nothing about RVU targets, profitability, etc to guarantee a salary. For many groups, if you did cases all night or slept you would see the same paycheck. You don’t see a cut of profit when times are good, so why should you see cuts to a BASE SALARY when times are bad?

For private practice it makes sense to be taking a cut right now. But for people employed, in academics, etc, the trust in the deal that was taken has been shaken permanently. Another case of privatizing the profits and socializing the losses. I think a lot of people going through this will come out with the understanding that the risk involved in seemingly safe jobs is higher than previously understood.

"Trust in the deal" will be shaken for many industries, even beyond healthcare. Just look at Shake Shack, Ruth's Chris, and Envision (KKR). These are publicly traded companies that exist in a capitalistic system. By definition they have great access to capital markets, but instead of doing the responsible thing and raising equity and/or debt through those markets in order to meet payroll, they reached their grubby little hands into a government pot meant for actual small businesses or cut salaries when times are tough.

 

[BLADEMDA]

"Trust in the deal" will be shaken for many industries, even beyond healthcare. Just look at Shake Shack, Ruth's Chris, and Envision (KKR). These are publicly traded companies that exist in a capitalistic system. By definition they have great access to capital markets, but instead of doing the responsible thing and raising equity and/or debt through those markets in order to meet payroll, they reached their grubby little hands into a government pot meant for actual small businesses.

The PPP should have excluded large businesses from the start. In fact, the entire law is questionable because the Federal govt. could have instituted a Federal unemployment insurance program along the lines of a universal basic income model. This means if you lose your job then you file for Federal assistance directly with a $2,000 per month guarantee of income. This way only those truly unemployed would have collected federal funds and the cost of the program would have been 200 billion instead of 650 billion.

I think the structure of the PPP was well intentioned but extremely wasteful of tax dollars.

Potbelly says it will return $10 million small business loan, following others after outrage

Potbelly, which received the maximum loan amount, has a market cap of $71.2 million.

www.cnbc.com

 

[pgg]

many people have families to support. Mortgages and car payments and student loans. $10-15k a month in expenses.

People with debt living like ballers.

$10-15K/month in expenses, student loans. WTF are people thinking. It's the Wal-Mart greeter buying a 70" flatscreen, writ large.

 

[Mad Jack]

Yes. But the hospital does not like independent CRNA practice. That will change when they are the ones paying the salaries.

You're forgetting that the major role of anesthesiologists supervising CRNAs is as a liability sponge. Having a level of supervision affords the hospital attorney the ability to throw you and the CRNA under the bus.

 

[vector2]

People with debt living like ballers.

$10-15K/month in expenses, student loans. WTF are people thinking. It's the Wal-Mart greeter buying a 70" flatscreen, writ large.

I'm hoping he meant $10-15k in expenses including the mortgage, two car notes, student loan payments, and other misc...


The keeping up with the Joneses thing is killer though, and some people just don't have any self-control. I closed on my first real home a year and a half ago and we bought a $460k house (which was an average to below average ask in our nice neighborhood) which needed a little work. The loan officer saw how much I made and the fact that I didn't have a lot of debt and I thought I was insane or something for going with a house that "modest"....kept saying you're pre-approved for SOOO much more, as if it was some kind of personal insult that my wife and I didn't want a million dollar loan.

 

[BLADEMDA]

I'm hoping he meant $10-15k in expenses including the mortgage, two car notes, student loan payments, and other misc...


The keeping up with the Joneses thing is killer though, and some people just don't have any self-control. I closed on my first real home a year and a half ago and we bought a $460k house (which was an average to below average ask in our nice neighborhood) which needed a little work. The loan officer saw how much I made and the fact that I didn't have a lot of debt and I thought I was insane or something for going with a house that "modest"....kept saying you're pre-approved for SOOO much more, as if it was some kind of personal insult that my wife and I didn't want a million dollar loan.

The average American spends as much or more than he/she earns. It's the American way of life. Although I admit Nordic countries like Sweden seem to have caught the spending bug as well. Household purchases, which means a lot of debt, fuels this economy. Ask yourself how many people can really afford that luxury automobile costing $70-$100K? Or, that brand new truck at $58K. Financing is the key to this economy.

 

[BLADEMDA]

 

[BLADEMDA]

 

[nimbus]

If there’s any upside to COVID-19 I think it may make people think about paring back a hyper consumptive lifestyle. Oil prices and GDP be damned.

 

[pjl]

I'm hoping he meant $10-15k in expenses including the mortgage, two car notes, student loan payments, and other misc...


The keeping up with the Joneses thing is killer though, and some people just don't have any self-control. I closed on my first real home a year and a half ago and we bought a $460k house (which was an average to below average ask in our nice neighborhood) which needed a little work. The loan officer saw how much I made and the fact that I didn't have a lot of debt and I thought I was insane or something for going with a house that "modest"....kept saying you're pre-approved for SOOO much more, as if it was some kind of personal insult that my wife and I didn't want a million dollar loan.

Lol, try paying cash and seeing the looks.

 

[dannyboy1]

If there’s any upside to COVID-19 I think it may make people think about paring back a hyper consumptive lifestyle. Oil prices and GDP be damned.

As long as they still hyper consume surgical procedures.....

 

[D P356]

Do not wait. Walk now.

That 30% reduction is coming on top of all the profit they are skimming from every case you do, every weekend or evening call you take, every chance you run the risk of being sued. They don't work weekends or holidays. They don't have to waste time on CME. They don't waste money on licensing or MOCA.

The only reason you should have thrown your lot in with them was for stability. You were giving up tremendous upside to limit your downside. But now that times are tough, they think they can welsh on their deal? No way.

Be a man and walk away, or the next time they screw you it will be worse.

good post. I had a discussion with a friend about this. If you’re employed, a potential decrease in revenue is not your risk to take.
A large windfall of financial success/bonus is not yours to be had, either.
Stability is nice. But when that gets compromised, it’s very disappointing and you then have a decision to make.

 

[Pluto201]

My employer approached us for “voluntary” pay reduction we told them to piss off!


Sent from my iPhone using Tapatalk

 

[Ipassgas]

I work for a tiny AMC. Super tiny. The boss/owner proposed furloughs for those that wanted it, and was mulling pay cuts. Every single one of us expected to be paid, per the contract or we would walk.
We don't get the honey in summer, but we don't freeze in winter either. That was the deal. It still is.
We go to the unit to help out, and the hospital is kicking some cash to him. They all know that without us, there is no anesthesia department, thus, no surgery gravy train.

 

[deleted126335]

I work for a tiny AMC. Super tiny. The boss/owner proposed furloughs for those that wanted it, and was mulling pay cuts. Every single one of us expected to be paid, per the contract or we would walk.
We don't get the honey in summer, but we don't freeze in winter either. That was the deal. It still is.
We go to the unit to help out, and the hospital is kicking some cash to him. They all know that without us, there is no anesthesia department, thus, no surgery gravy train.

You will never make or lose more money per unit of time in your life than negotiating. Gotta be prepared for the other guy to call...whether or not it is a bluff.

 

[abolt18]

I work for a tiny AMC. Super tiny. The boss/owner proposed furloughs for those that wanted it, and was mulling pay cuts. Every single one of us expected to be paid, per the contract or we would walk.
We don't get the honey in summer, but we don't freeze in winter either. That was the deal. It still is.
We go to the unit to help out, and the hospital is kicking some cash to him. They all know that without us, there is no anesthesia department, thus, no surgery gravy train.

Is this how conversations went?

 

[skypilot]

Do not wait. Walk now.

That 30% reduction is coming on top of all the profit they are skimming from every case you do, every weekend or evening call you take, every chance you run the risk of being sued. They don't work weekends or holidays. They don't have to waste time on CME. They don't waste money on licensing or MOCA.

The only reason you should have thrown your lot in with them was for stability. You were giving up tremendous upside to limit your downside. But now that times are tough, they think they can welsh on their deal? No way.

Be a man and walk away, or the next time they screw you it will be worse.

Besides the fact that they put your company billions of dollars in debt, the executives have also been compensating themselves quite well over the past few years. If you as the employee don't get the cash you are owed, it goes to the gamblers who leveraged your company to the hilt in hopes of striking it rich. You lose your leverage when you quit. So just make sure you get the compensation you were contracted to receive.

Envision Executive Salaries:
Robert J. Coward, Former Executive Vice President and President Physician Services, $2,587,803
William A. Sanger, Former Executive Chairman, $8,699,518
Randel G. Owen, Former Executive Vice President and President Ambulatory Services, $2,235,419
Christopher A. Holden, President and Chief Executive Officer, $7,323,638
Claire M. Gulmi, Former Executive Vice President Chief Financial Officer and Secretary, $1,786,160
Craig A. Wilson, Senior Vice President, General Counsel and Secretary, $1,548,475
Kevin D. Eastridge, Executive Vice President and Chief Financial Officer, $1,158,969
Patrick B. Solomon, Senior Vice President and Chief Strategy Officer, $971,700

 

[BLADEMDA]

Besides the fact that they put your company billions of dollars in debt, the executives have also been compensating themselves quite well over the past few years. If you as the employee don't get the cash you are owed, it goes to the gamblers who leveraged your company to the hilt in hopes of striking it rich. You lose your leverage when you quit. So just make sure you get the compensation you were contracted to receive.

Envision Executive Salaries:
Robert J. Coward, Former Executive Vice President and President Physician Services, $2,587,803
William A. Sanger, Former Executive Chairman, $8,699,518
Randel G. Owen, Former Executive Vice President and President Ambulatory Services, $2,235,419
Christopher A. Holden, President and Chief Executive Officer, $7,323,638
Claire M. Gulmi, Former Executive Vice President Chief Financial Officer and Secretary, $1,786,160
Craig A. Wilson, Senior Vice President, General Counsel and Secretary, $1,548,475
Kevin D. Eastridge, Executive Vice President and Chief Financial Officer, $1,158,969
Patrick B. Solomon, Senior Vice President and Chief Strategy Officer, $971,700

Besides those salaries Envision has a lot of "dead weight" mid management guys who do like 10-15 hours of clinical work per week while earning $600K salaries. There are likely at least 10 of those people. Upper management people are in the $500-$700K range (another 10-12) and they perform no clinical work at all.

The reason they can have so much fat is two fold:

1. They are able to bill Insurance companies at $130 per unit. But, if that decreases to $100 per unit then that extra fat really hurts.

2. They pow low wages with poor benefits. Literally, their employees are paid $50-$100K less EACH in total compensation vs the fair market. That compensation amount really adds up when you have thousands of employees.

Hospitals and Physicians would both be better off without AMCs. Once the revenue side is no longer skewed to the AMC they offer no benefit to the hospital IMHO.

 

[skypilot]

Besides those salaries Envision has a lot of "dead weight" mid management guys who do like 10-15 hours of clinical work per week while earning $600K salaries. There are likely at least 10 of those people. Upper management people are in the $500-$700K range (another 10-12) and they perform no clinical work at all.

The reason they can have so much fat is two fold:

1. They are able to bill Insurance companies at $130 per unit. But, if that decreases to $100 per unit then that extra fat really hurts.

2. They pow low wages with poor benefits. Literally, their employees are paid $50-$100K less EACH in total compensation vs the fair market. That compensation amount really adds up when you have thousands of employees.

Hospitals and Physicians would both be better off without AMCs. Once the revenue side is no longer skewed to the AMC they offer no benefit to the hospital IMHO.

A group of docs serving the hospital in their local community is going to try to provide high quality service to their surgeons and their patients, as well as a decent quality of life to their partners and employees.

A company that is several billion dollars in debt is only thinking "how can we get the revenue per unit as high as possible, and how can we get the cost per unit as low as possible. We don't really care what it takes to make it happen. We have a debt payment coming up.

Hey, lets also try suing the indigent patients who show up for treatment in hopes of squeezing a few dollars out of that revenue stream.
Lets also add some surprise, out of network bills to the mix to try to get our revenue per unit even higher.

Why are they able to bill the insurance companies $130 per unit when the local group can only bill $100 per unit?

 

[46Long]

Besides those salaries Envision has a lot of "dead weight" mid management guys who do like 10-15 hours of clinical work per week while earning $600K salaries. There are likely at least 10 of those people. Upper management people are in the $500-$700K range (another 10-12) and they perform no clinical work at all.

The reason they can have so much fat is two fold:

1. They are able to bill Insurance companies at $130 per unit. But, if that decreases to $100 per unit then that extra fat really hurts.

2. They pow low wages with poor benefits. Literally, their employees are paid $50-$100K less EACH in total compensation vs the fair market. That compensation amount really adds up when you have thousands of employees.

Hospitals and Physicians would both be better off without AMCs. Once the revenue side is no longer skewed to the AMC they offer no benefit to the hospital IMHO.

Is the billing per unit that high? 130?

 

[BLADEMDA]

Is the billing per unit that high? 130?

Typically, private groups are billing insurance providers (in network) around $80-$110 per unit. MMan's group may still be getting $120 per unit from several insurance companies. I found $100 per unit to be more the norm for the best contracts.

Envision, through its scope and scale, has been squeezing insurance companies for $120-$130 per unit or threatening to go out of network. The out of network rate is $180 per unit. So, because of their size and scale most insurance companies agree to pay Envision their TOP rate. These days the insurance companies are fighting back and lowering their rates. Envision is now "lucky" to get $120 per unit with some demanding the $100 per unit in network rate. This is putting a damper on profits.

Remember, every year Envision would go to the the insurance company and try to squeeze another 5 units to remain in network. The Physicians didn't get a raise while envision would increase their profit margin each year. This shell game was a reason why KKR bought them out. Envision really doesn't have much of a long term model in place so the upper management people want to get as much money NOW as humanely possible out of the company.

 

[46Long]

Typically, private groups are billing insurance providers (in network) around $80-$110 per unit. MMan's group may still be getting $120 per unit from several insurance companies. I found $100 per unit to be more the norm for the best contracts.

Envision, through its scope and scale, has been squeezing insurance companies for $120-$130 per unit or threatening to go out of network. The out of network rate is $180 per unit. So, because of their size and scale most insurance companies agree to pay Envision their TOP rate. These days the insurance companies are fighting back and lowering their rates. Envision is now "lucky" to get $120 per unit with some demanding the $100 per unit in network rate. This is putting a damper on profits.

Remember, every year Envision would go to the the insurance company and try to squeeze another 5 units to remain in network. The Physicians didn't get a raise while envision would increase their profit margin each year. This shell game was a reason why KKR bought them out. Envision really doesn't have much of a long term model in place so the upper management people want to get as much money NOW as humanely possible out of the company.

Geez last time i looked at those rates they were closer to 30-50 bucks a unit..

 

[skypilot]

Typically, private groups are billing insurance providers (in network) around $80-$110 per unit. MMan's group may still be getting $120 per unit from several insurance companies. I found $100 per unit to be more the norm for the best contracts.

Envision, through its scope and scale, has been squeezing insurance companies for $120-$130 per unit or threatening to go out of network. The out of network rate is $180 per unit. So, because of their size and scale most insurance companies agree to pay Envision their TOP rate. These days the insurance companies are fighting back and lowering their rates. Envision is now "lucky" to get $120 per unit with some demanding the $100 per unit in network rate. This is putting a damper on profits.

Remember, every year Envision would go to the the insurance company and try to squeeze another 5 units to remain in network. The Physicians didn't get a raise while envision would increase their profit margin each year. This shell game was a reason why KKR bought them out. Envision really doesn't have much of a long term model in place so the upper management people want to get as much money NOW as humanely possible out of the company.

I think its "humanly" not "humanely" or maybe "inhumanely"

This suggests that the AMCs do add some value in the form of Oligopoly power, which allows us to negotiate a higher rate for our services. Of course we could do the same thing with large regional partnerships, without the added drag of billions of dollars in debt or overcompensated executives.

The only remaining option for the AMCs to preserve their business model is to drive down their unit costs. That could be accomplished by thinning their management ranks, or by using the ACT model of one Anesthesiologist supervising a gaggle of CRNAs, or just by driving down salaries with a hammer.

Or they could keep the shell game going as long as possible, and then exit with a bankruptcy. Then start the game all over again!

 

[BLADEMDA]

I think its "humanly" not "humanely" or maybe "inhumanely"

This suggests that the AMCs do add some value in the form of Oligopoly power, which allows us to negotiate a higher rate for our services. Of course we could do the same thing with large regional partnerships, without the added drag of billions of dollars in debt or overcompensated executives.

The only remaining option for the AMCs to preserve their business model is to drive down their unit costs. That could be accomplished by thinning their management ranks, or by using the ACT model of one Anesthesiologist supervising a gaggle of CRNAs, or just by driving down salaries with a hammer.

Or they could keep the shell game going as long as possible, and then exit with a bankruptcy. Then start the game all over again!

That's why they cut salaries by 30%. The company is so poorly run that they literally didn't have the funds available to pay their physicians money owed from 2019. That money was part of the physician's salary from 2019 not 2020. So, not only is the pay low, the benefits poor the company basically took away the expected metric bonus which most physicians count on as part of their low salaries.

I think after this move to cut pay and not pay bonuses recruiting will be affected greatly. The company will try to keep the hospitals understaffed as long as possible while working the remaining staff harder for less pay. That is the plan going forward. I do think pay will be restored to contractual levels in 4-6 months but the workload will be greater.

I can not recommend a job with most AMCs. They are dead end jobs without pay raises or advancement. I truly feel sorry for those that spend their career working for subpar pay in a dead end job.

 

[skypilot]

That's why they cut salaries by 30%. The company is so poorly run that they literally didn't have the funds available to pay their physicians money owed from 2019. That money was part of the physician's salary from 2019 not 2020. So, not only is the pay low, the benefits poor the company basically took away the expected metric bonus which most physicians count on as part of their low salaries.

I think after this move to cut pay and not pay bonuses recruiting will be affected greatly. The company will try to keep the hospitals understaffed as long as possible while working the remaining staff harder for less pay. That is the plan going forward. I do think pay will be restored to contractual levels in 4-6 months but the workload will be greater.

I can not recommend a job with most AMCs. They are dead end jobs without pay raises or advancement. I truly feel sorry for those that spend their career working for subpar pay in a dead end job.

I don't mind the dead end job, the lack of advancement, and the subpar pay (within reason ) as long as my location and quality of life are great.

The understaffed hospital could be a problem though. Q4 call for the rest of my life could be a problem too. Being shat upon by the administration can also be a problem for me.

Seems like the Envision bondholders will get stiffed. And the employees will leave like rats from a sinking ship.

When do the class action suits from the Employees begin? When does the hospital say that Envision is in breach because they are not properly staffing the hospital?

 

[Ronin1]

Envision will continue to be able to staff in desirable areas. We never have a shortage of Applicants for jobs even though it is an AMC.

 

[46Long]

I think after this move to cut pay and not pay bonuses recruiting will be affected greatly.

Not to mention the horrendous PR that this has generated from this debacle. IF you dont have money to weather 3 months of loss, youre doing something wrong.

Perhaps the necessity to have a 2 or 3 people call me to remind me to write my procedure note will cease.. Those folks are prob making almost 30 % of what im making i bet and have similar bennies.

 

[aneftp]

KKR the parent company has like 50 billion in net assets AFTER EXPENSES. This company is not bankrupt. This is all a shell game in the private equity leverage buyout market splitting up assets into so many parts to shield their butts from actually owning up to bad purchases.

but government keeps allowing the fat cats to suffer zero consequences to keep the money machine going With these types of purchases.

 

[kmurp]

Not to mention the horrendous PR that this has generated from this debacle. IF you dont have money to weather 3 months of loss, youre doing something wrong.

Perhaps the necessity to have a 2 or 3 people call me to remind me to write my procedure note will cease.. Those folks are prob making almost 30 % of what im making i bet and have similar bennies.

Our PP group doesn’t have the money to weather three months of little surgery. So we did a PPP loan, furloughed CRNAs and will take a big pay cut this year. No ideas on 2021 at this point.

 

[aneftp]

Our PP group doesn’t have the money to weather three months of little surgery. So we did a PPP loan, furloughed CRNAs and will take a big pay cut this year. No ideas on 2021 at this point.

You and other Attendings who have been out in practice 5 plus years CAN WEATHER 3 more months Heck you should be able to weather 24 Months still paying mortgage car payments and student loans.

Serious are docs living on less than 3 months savings?

I think there is a psychological aspect of “not making money” vs Animal survival (current protestors who are simply out of money and need to work to pay the bills)

 

[kmurp]

You and other Attendings who have been out in practice 5 plus years CAN WEATHER 3 more months Heck you should be able to weather 24 Months still paying mortgage car payments and student loans.

Serious are docs living on less than 3 months savings?

I think there is a psychological aspect of “not making money” vs Animal survival (current protestors who are simply out of money and need to work to pay the bills)

Of course I personally have money to pay my bills. Our group, however, does not have the money to pay full salary much like Envision.

 

[deleted126335]

KKR the parent company has like 50 billion in net assets AFTER EXPENSES. This company is not bankrupt. This is all a shell game in the private equity leverage buyout market splitting up assets into so many parts to shield their butts from actually owning up to bad purchases.

but government keeps allowing the fat cats to suffer zero consequences to keep the money machine going With these types of purchases.

The parent company may not feel that Envision is worth the risk of putting more money into it. The whole AMC model is in question. Also, depending on how they set it up, each site could its own LLC and they may let some individual practices go by the wayside while keeping the ones that have more long term viability- After sucking every nickel they can out of the ones that they plan to dump.

 

[IMGASMD]

The parent company may not feel that Envision is worth the risk of putting more money into it. The whole AMC model is in question. Also, depending on how they set it up, each site could its own LLC and they may let some individual practices go by the wayside while keeping the ones that have more long term viability- After sucking every nickel they can out of the ones that they plan to dump.

Hate to say it. But isn’t that the American Corporate way?

“Trim the fat”, fatten it up, send for slaughter.

 

[aneftp]

Of course I personally have money to pay my bills. Our group, however, does not have the money to pay full salary much like Envision.

Ok than. Let’s not act like the sky is falling. My sister is a partner up north. Hasn’t worked for 5 weeks (her choice) to avoid the virus. All MD practice. No work. No pay. Simple

I see so many of these posts. “Oh my, we can’t survive any longer”. All BS for 95% plus of attendings In anesthesia world who have been out in practice longer than. 5 years
There are real workers who out of jobs. Out of money. No access to credit cards. They are out of time. It’s all about perspective.

Now, if you are new grad with family of 4-5 to put food on the table and $2000 student loan payments $3000 mortgage payments. I would be sympathy.

 

[chocomorsel]

Ok then.

 

[deleted126335]

Hate to say it. But isn’t that the American Corporate way?

“Trim the fat”, fatten it up, send for slaughter.

Yeah, but docs are more used to being business owners who do the trimming. Being the ones being trimmed is a different and unwelcome perspective.


Sent from my iPhone using SDN mobile

 

[cowbydoc]

Ok than. Let’s not act like the sky is falling. My sister is a partner up north. Hasn’t worked for 5 weeks (her choice) to avoid the virus. All MD practice. No work. No pay. Simple

I see so many of these posts. “Oh my, we can’t survive any longer”. All BS for 95% plus of attendings In anesthesia world who have been out in practice longer than. 5 years
There are real workers who out of jobs. Out of money. No access to credit cards. They are out of time. It’s all about perspective.

Now, if you are new grad with family of 4-5 to put food on the table and $2000 student loan payments $3000 mortgage payments. I would be sympathy.

Most private groups are designed to have zero money left in the bank at the end of the fiscal year (usually calendar year). It is a YUGE tax advantage to do this. I’m assuming this is more what Kmurp is talking about. The timing of the pandemic also times with the lowest cash on hand for most private groups. So when people are saying “woe is me” most are referring to this situation and the difficulty in paying employees of the group. That is what our group is struggling with. We have great employees in a tight market and want to keep them.

 

[narcotics999]

Our PP group doesn’t have the money to weather three months of little surgery. So we did a PPP loan, furloughed CRNAs and will take a big pay cut this year. No ideas on 2021 at this point.

Personally I think that is not moral for Doc to take PPP free money. Then the hedge fund, lawyers, etc applied. So whatever...

 

[kmurp]

Personally I think that is not moral for Doc to take PPP free money. Then the hedge fund, lawyers, etc applied. So whatever...

Fair enough. We used much of it to bring back CRNAs and pay our billing staff. We hope that this will also help us o have enough cash to restart the practice at full payroll when we ramp back up before our AR comes in.