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Did you really say $1000/hr? I am sure that’s so much better than paying mednax. /s And let’s be honest, how long can 1G/hr last?
"Doctors’ spat with Atrium Health spills into rare public view"
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Did you really say $1000/hr? I am sure that’s so much better than paying mednax. /s And let’s be honest, how long can 1G/hr last?
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That was a disaster. EM residency lost accreditation, CEO forced to resign after a vote of no confidence by the medical staff, referrals to hospital dried up with 7% decline in admissions, layoffs, etc. But the replacement group, USACS, is still there and they are trying to restore the residency.
Doubt the Atrium situation will play out quite as badly as Summa but who knows. One difference is that the transition at Atrium was planned farther in advance.
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The only thing CRNAs would never/can’t prove is being more qualified than MDs. Worst case scenario, we do our own cases and take a huge pay cut.
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Anybody heard of someone doing concierge, cash only anesthesia? If things go to total **** I think this could be an option for docs at or near financial independence.
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Surgery Center of Oklahoma is owned by an anesthesiologist and all their cases are cash-only so that would include anesthesia services.
We had an arrangement in my old group with several plastic surgeons. Cash only for all their cases. It was a great income stream to supplement our insurance and hospital work. I imagine one could hustle and do this individually if they wanted to.
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I’m hearing the rumor of a suicide among the ousted anesthesiologists. Can anyone confirm this?
D
deleted162650
A number of guys in my area do exclusively cash pay plastics.
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Yes.
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That’s so sad.
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Why do you care how long? Say it lasts 3 months. You work 40hour/week x4 weeks x 3 = 480K. Good for a year income. Then you have 9 months to rest and get another job.
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Why? A couple months' salary vs life?
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Physicians already have a higher suicide rate than the general population. This is not the thread to discuss why that is the case. However, it’s not difficult to think how job loss can be the tipping point for someone already thinking about it.
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I suppose if you can get 3 months of work at that rate. I’ve never heard of that amount is what I was trying to express.
Unemployment for some physicians may not be imaginable.
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I’m really sorry for your loss to anyone that worked with this gentleman. This whole situation is just awful.
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Jesus, really? A job is not worth this! It’s just a job! This is terrible.
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Yes, I've seen EXACTLY THIS first hand. Very sad.
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So sad to hear this. I work near to Charlotte and hadn't heard this news yet.
Physician suicide is a big problem. And stigmatizing people with mental health is one of the big reasons people never seek help before it's too late. They think it's a sign of weakness and as doctors have trouble asking for the help they need given the fear of job less or retribution.
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Physician suicide is a big problem. And stigmatizing people with mental health is one of the big reasons people never seek help before it's too late. They think it's a sign of weakness and as doctors have trouble asking for the help they need given the fear of job less or retribution.
Sent from my XT1710-02 using Tapatalk
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Today is D-Day in Charlotte. Lucky it’s on a Sunday, we will see how things go going forward.
This should be a cautionary tale for people thinking about selling their practices. Or if you’re going to sell, a clause should be inserted that if the AMC loses the contract, docs are free to be employed by the new group. They agree to that or no deal.
The payout from Mednax to each doc in a group this size couldn’t have been good enough for what’s happening to them now.
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I fully expect mednax made all the partners millionaires overnight. Maybe multi-millionaire. Most of the deal also bound the partners/shareholders to work for the practice for x years. So if I have a guaranteed salary, let’s say 300K on top of that cool mil for 5 years. If I was past my prime and there was no buy out money from my partners, this wouldn’t be a bad deal. Obviously, these people were short sighted, but I wouldn’t necessarily say they made a bad deal.
On the flip side, mednax/amc also don’t want to buy something and give it right back to you if you contributed to the business failure. I purchase IMGASMD, llc for a cool mil, and still have IMGASMD work there. But somehow the business didn’t survive, then hospital comes back to IMGASMD to work for them. Something in this isn’t right.
They made the deal, all parties are living the consequences of it...... some suffer more than others.
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life is rough =(
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This should be a wake up call to all those docs out there that think they can sell out and make a mint. You may have to pull up,your roots and relocate. Greed doesn’t pay off in the long run.
But if you live in a sh/t hole then who cares.
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I think they(amc) have been more selective on their buys, a lot of bumble f places probably missed their boats.
Now with envision going private, who knows that the “landscape” will be in a few years when it is ran into the ground..... I am cup half empty kinda guy.
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The only Mednax buyout I know any details of involved no upfront cash buyout. Rather, the practice owners got a yearly stock allocation for up to 7 years. I believe it was something like $200k in Mednax stock for each year they stayed on, up to 7 years, on top of their new (much lower) salary.
I heard the typical Mednax deal is private partners making say 700k a year get 1M to sign on for 3 years at 350K. Would seem to be a wash but they get the money upfront and as long term capital gains- much lower taxes (which by the way leads to my observation that if somebody had the right documentation they could probably make a good case for the whole scam being a big tax fraud). Anyway I hope these disasters will make hospitals ask, "Why do we let the AMCs make any money at all?" They are pure parasite-taking profit for no added value.
I don’t know about that. Maybe for some of the older guys who were on the cusp of retiring it was a good deal. My understanding is these guys/gals were doing well pre buyout. They had to be doing well to get any kind of decent payout from mednax. So then they are forced to stay employed at a lower salary for 3-5 years- how much did they really come out ahead? It’s a huge group, so the pot was split amongst many. I am hearing many middle aged docs from this group who got a buyout are now uprooting their families to start new employment. So now, let’s assume you have another buy in somewhere and you have left your established life. Sold your house, paid 8-10k to move all your stuff....
I don’t know their reasons for selling out, but this doesn’t look like it was a very good deal for a lot of them in the end. Maybe they thought they’d never get the boot.
I will never forget the advice of our group’s contract lawyer the first time I got to sit at the big boy table after I made partner and we were renegotiating our contract...he said “the exit clauses are the most important part of this contract”. That was a long time ago, but that’s still very applicable now.
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Southeast was a Ponzi scheme practice with no guarantee partnership. Charlotte was a very hard Job market to break into
Don’t feel sorry for the partners who sold out in 2010.
If the structure of the deal is similar to another practice i know with mednax. The partners should be set for life if they were smart with their money.
The deal involves a combination of straight cash payment (taxed favorably at 15%) but also mednax stock (which was still growing in 2010). PLUS and get this. Future payment due to their outpatient divisions (aka pain management/surgery center contracts)
My best estimate is on the low end each partner got min 2 million (taxed at 15%) That’s just bare min
So they continued to earn xxxx for next 7-8 years.
Remember how much stock market grew from 2010-2018.
Seriously that money they got front loaded even if they invested only 50% of it plus the stock money. You are talking 4 million easy.
But who knows what people lifestyle choices are.
So the partners who got paid should have been set for life.
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From even reading the last few posts, seems like everyone got a deal....
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Ha ha ha.
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That 200K is cash value adjusted yearly based on current Mednax's stock price or based on the stock price at buyout? If latter, Mednax stock price dropped half in the last 3 years, 200k then means 100k now.
Even at cash value, if the partners held the stocks more than a year to avoid short term capital tax, they still lose badly
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It has been estimated that the Mednax/SEA sale was a $150-200mil deal. If there were 80 partners at the time of the deal, you can get a ballpark of $$/partner. They were a very good practice before the sale so it still made sense only if you were within 5-10 years of retirement. All these deals are structured as an advance on future earnings. The buyers always get their money back.
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2.5 mil. Do i get a prize?!
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Wow, so they hired ~80 anesthesiologists with an average age of 51 yrs old!. I was expecting a much younger group
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Wow, CRNA are involved in MD anesthesiologist recruiting. MDA will be paired with CRNA for 3 months!
80 MDA, full time and part time. Wondering how many of them are PT.
average age 51. It can be new graduates and near-retiring MDs. I am more interested in median age.
they got way more than that per partner because Southeast was a pyramid scheme with relatively few docs getting the full payout.
The ones that sold out stopped needing money the day they sold out. The ones that got screwed with Mednax losing the contract were either new hires to Mednax since they took over or docs that weren't partners when Southeast sold out.
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Penalty for leaving the salaried job early?
The head CRNA claims they were involved in the interviewing. Consider the source. I asked about this, and they had no say in the end who got jobs according to the person I spoke with down there.
This is how you effectively transfer groups without freaking people out. Let the nurses feel like they have some control, when they really don’t. They are expendable pawns like everyone else.
My understanding is that the CRNA’s were employed by the hospital so we’re not bound by any non-compete. This probably made the transition a whole lot easier as the surgeons were used to the CRNA’s (surprise!! They really don’t care who signs the chart in 4:1 coverage) and the CRNA’s know how the OR’s run. That being said with the need to hire over 90 MD’s in 4 months they could not have been too selective...
They avoided the Michigan debacle by making them feel as if they were involved in the transition. That’s it. Wherry is smart.
It sounds like the surgeons did care who they brought in for docs. One of the pediatric surgeons has been particularly vocal apparently, and sort of became a de facto representative for the surgeons. Wherry has been working OT trying to keep people calm and reassured there would be a good stable of docs there July 1.
D
deleted126335
Anybody know how the first week went? Did the volume drop in anticipation of a sh1t storm?
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I used to think this. Then I worked along side of one of the first USAP home-base programs. Surgeons might not care until the care really starts to suffer from lack of oversight - as soon as the current contract is up, USAP is on the chopping block.
If you’re a consulting service like anesthesiology (or anything else), if your main referral base hates you that’s a bad place to be in. Something akin happened to this in Charlotte, along with price gouging.
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Definitely the peds and cardiac surgeons will care the most. Most probably the new practice had the peds and cardiac anesthesiologists meet and get to know the surgeons. Other departments like gen surg uro, gyn, ENT, Endo ect.. cogs in the wheel....
There was no debacle with the CRNAs because they were hospital employees prior to the switch and after the switch. Scope only took over the physicians.
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6 Ways to Ensure Clinical Quality While Switching Anesthesia Providers
“2. Meet a few weeks before the start date to go over policies and procedures. Dr. Wherry says the center administrator should meet with the new anesthesia group a few weeks in advance to discuss the center's policies and procedures. This particularly applies to pre-op screening processes and post-operative care processes. "If you've had trouble with the old group around pre-op screening processes, this is the opportunity to make changes," Dr. Wherry says. "For example, the old group may have been too stringent on a type of patient or required too much information." He says some surgery center leaders feel that their anesthesia group is not involved enough in the pre-op screening process, so this is a perfect opportunity to lay out expectations for the new providers.”
Guess the preop screening won’t be overly “stringent” now.
Total Anesthesia Solutions
Be wary if Wherry shows up at your hospital as a “consultant”
Mednax pays $200mil. Scope gets it for free. Wherry is very smart. This shows how much anesthesia practices are actually worth and how vulnerable we actually are. All hospitals and AMCs are watching this. The upside is that it will have a chilling effect on future AMC buyouts.
“2. Meet a few weeks before the start date to go over policies and procedures. Dr. Wherry says the center administrator should meet with the new anesthesia group a few weeks in advance to discuss the center's policies and procedures. This particularly applies to pre-op screening processes and post-operative care processes. "If you've had trouble with the old group around pre-op screening processes, this is the opportunity to make changes," Dr. Wherry says. "For example, the old group may have been too stringent on a type of patient or required too much information." He says some surgery center leaders feel that their anesthesia group is not involved enough in the pre-op screening process, so this is a perfect opportunity to lay out expectations for the new providers.”
Guess the preop screening won’t be overly “stringent” now.
Total Anesthesia Solutions
Be wary if Wherry shows up at your hospital as a “consultant”
Mednax pays $200mil. Scope gets it for free. Wherry is very smart. This shows how much anesthesia practices are actually worth and how vulnerable we actually are. All hospitals and AMCs are watching this. The upside is that it will have a chilling effect on future AMC buyouts.
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They can and do cause issues even as employees if they feel they don't have enough say in big transitions. So he did the smart thing and played along, letting them "orient" the new doctors for 3 months. The head CRNA got to tell the media the CRNAs had input in hiring, so the nurses were pacified. I personally hate that approach, at the end of the day they're working under these physicians' licenses so their opinions are meaningless, but I understand why people utilize it. Makes a huge transition much more peaceful.
It's kind of like the 50% off sale where they just jack up the prices 50% right before the "sale". Psychologically people feel like they got something, but they really didn't.
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Now this makes me sad. You’re meant to tell me, it wasn’t really a deal that I got?!
I know, it’s a traumatic day when you discover this.
Usually 3-5 years. They sold out in 2010. It’s 2018. It’s a mute point as most of the partners who wanted to leave already left if they wanted to.
