All Branch Topic (ABT) Are people re-thinking getting out in COVID America?

[Kilgoretrout 65]

Just curious if covid has people thinking about staying in. Reimbursements are down, docs are getting fired or furloughed and the self employed have payroll to meet. Varies by specialty and locale of course. Are people seeing this as a blip to be brushed off or as a sign of the apocalypse? I am glad to have my guvment retirement funds deposited monthly.

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[DrMetal]

Just curious if covid has people thinking about staying in. Reimbursements are down, docs are getting fired or furloughed and the self employed have payroll to meet. Varies by specialty and locale of course. Are people seeing this as a blip to be brushed off or as a sign of the apocalypse? I am glad to have my guvment retirement funds deposited monthly.

Doubt it. People get out for a multitude of reasons, money being on them, more freedom being another. Most folks are pretty fed up with the mil and ready to get out when they make the decision to do so, I doubt COVID will influence them otherwise. All things depend on specialty though: the outpatient rheumatologist is hurting more these days than the hospitalist.

 

[HighPriest]

I’m out already, but it wouldn’t have changed my decision at all.

 

[armytrainingsir]

I know a GMO that extended one year to let things settle down a bit.

 

[pgg]

I'll get out when I cross the 20 mark in 2 years, and there is nothing I can imagine that will change that. I'm in the final weeks of a deployment (my 5th) that was extended because of COVID-19, and I'm just not sure I have enough in the tank to ever tolerate another 9-12 months away from home. There's also the fact that the Navy has closed its cardiac surgery programs (outside of Bethesda which is shared with the Army) and so as a cardiac anesthesiologist the Navy just doesn't have any work for me to do in my chosen subspecialty. I already have to rely on the VA and moonlighting to get cases and remain current (which has been working nicely both from a skill and supplementary income perspective). So for me I'd dare to say there's nothing that the military could offer me to stay, and nothing the civilian world could threaten to deter me from retiring as planned. I'm a termander and content to finish out my contract and leave.

It has been interesting to observe the civilian world during COVID-19 though, from the standpoint of what kind of practice I'll join afterwards. Lots of anesthesia groups have sold out in the last 5-10 years, where private practice partners (owners) became employees. The advertised deal was that they got a buyout (sometimes), and that they were trading the upside of high incomes and control, for the security and stability of being part of a larger organization that could absorb bumps, negotiate better insurance rates, and so on. And COVID-19 has exposed that security for the thin lie it was; they've been laid off, or forced to take paid time off, or simply furloughed, or even had their contracts unilaterally and illegally altered in the style of Darth Vader. Not that the private docs were unscathed when their cases halted and billing stopped, but at least they enjoy the upside during good times, and have a reason to slog on during the bad times.

I suppose it's added a little appeal to an academic practice, or a larger multispecialty group, where dips in case load and collections might not be quite so catastrophic. I never had much attraction to being an employee of the large national management companies but now I'm even more likely to avoid them like the plague they are.

 

[Gastrapathy]

I know a GMO that extended one year to let things settle down a bit.

For a GMO going back to residency, I’m not sure I get the logic. I do think that if you were a BC physician getting out in 2020-2021 and geographically tied to a tighter market, you might want to pause for a year. I’m pretty sure I would have still bailed given how frustrated I was at that point but it might have made it harder.

 

[Slevin]

For a GMO going back to residency, I’m not sure I get the logic. I do think that if you were a BC physician getting out in 2020-2021 and geographically tied to a tighter market, you might want to pause for a year. I’m pretty sure I would have still bailed given how frustrated I was at that point but it might have made it harder.

Well if hospitals aren’t generating revenue and some are going to fail and have to close you’d hate to be at a residency program at a facility like this otherwise you wind up like those residents at the Philadelphia hospital hat had to close a year or so ago.

 

[armytrainingsir]

For a GMO going back to residency, I’m not sure I get the logic. I do think that if you were a BC physician getting out in 2020-2021 and geographically tied to a tighter market, you might want to pause for a year. I’m pretty sure I would have still bailed given how frustrated I was at that point but it might have made it harder.

If I understand him correctly, he doesn't start until July 2021. his plan was to work urgent cares until then but those job leads dried up for him, so he is just gonna stay in and relax until next year.

 

[Gastrapathy]

Makes sense. He matched an advanced spot so there’s a delay. Think I’d still GTFO rather than risk it

 

[orbitsurgMD]

. . . COVID-19 has exposed that security for the thin lie it was; they've been laid off, or forced to take paid time off, or simply furloughed, or even had their contracts unilaterally and illegally altered in the style of Darth Vader. Not that the private docs were unscathed when their cases halted and billing stopped, but at least they enjoy the upside during good times, and have a reason to slog on during the bad times.

I suppose it's added a little appeal to an academic practice, or a larger multispecialty group, where dips in case load and collections might not be quite so catastrophic. I never had much attraction to being an employee of the large national management companies but now I'm even more likely to avoid them like the plague they are.

The real nature of the private equity phenomenon in my field was unmasked in this pandemic: mass furloughs, layoffs for non-physician staff, principals forced to work unpaid, all under the majority control of the 51% Wall Street owners. The equity holders have at least their cash components of their buyouts to comfort and secure them. Now as some of these practices re-open, I suspect there will be permanent shedding of staff and even professionals servicing business lines deemed less profitable.

 

[militaryPHYS]

I think this will further accelerate the shift from small private practice to the large hospital systems that provide baseline salary with less productivity incentives. It is just like the amateur stock market investor who experiences their first crash and subsequent bear market that causes them to sell everything and hoard cash/CDs/bonds. They are emotionally scarred and don't want the risk exposure during bad times so they give up the potential gains of the good times.

People that don't want the risk might consider staying in until we are truly recovered. People that are protected from the risk based on stage of career or specialty probably won't think twice about getting out.