Hospital drops contract, AMC sues hospital, Anesthesiologists sue AMC

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dannyboy1 said:
We know they have a problem getting people. The market is the best it’s ever been. Demand an hourly wage. You might work hard but at least you will get paid.
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Agree
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IlDestriero said:
The losers are the new hires that never got the 7 figure pay day. The old guard knew what they were giving up. I hope they stick it to the AMC, but I can’t feel sorry for people that sold the group for profit. Private equity and medicine shouldn’t be partners. All PE cares about is ROI, and if they burn it to take the loss and move on, they don’t care about the down the line issues with that either.
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Yeah I feel bad for the new folks stuck. Taking a job, start a family, maybe have a house you just bough 6 months ago, then stuck in the middle of the hospital and AMC without a job
 
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OptionOffense said:
Honestly, with all due respect for all of your hard work, you guys look like suckas for penning that explanation. Just take your **** and move on. Its like asking your ex gf to take you back. Shame on you for being tied to the community that you cant imagine leaving.
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harsh words to a guy that has given quite a bit to this forum over years, i'd give him the benefit of the doubt.....you may be right but i'd be interested in hearing sevo elaborate
 
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Zekchar said:
I agree with much of what is being said in this thread. If offered a million-dollar buyout, don't hesitate and take it. If someone else takes the million-dollar buyout, don't begrudge them. You are just jealous, envious, and wish one were being offered to you.

Overall, do the bare contractually obligated minimum but not the slightest bit more. Make hay while the sun is shining. Stop acting like an owner if you are an employee. You do not get the upside and shouldn't therefore don't suffer through the downside. There is no loyalty. Get yours and get out.

Can we also please stop talking about the hospitals and patients suffering when talking about these things. It's disingenuous. The vast majority of us do not (should not) care about the hospital nor patients as a whole. You are an employee whose job it is to take care of patients scheduled in your room or in the rooms you're supervising. Nothing more, nothing less. If they fire you today, you take a locum gig the following week and relocate elsewhere for a perm position. The end. It's not personal, it's business.

You have no say in the relationship between the hospital, AMCs, and the community. You're there to do a job under the most lucrative of circumstances to yourself and then go home. Stop pretending otherwise. Everything else is just marketing and social media posturing.
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lol truth bomb

disingenuous, perfect choice of words
 
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Non competes should have some instances where they don't stand. This is one of them. If the AMC tells you they can't structure your employment contract like that they are FOS
 
I did some of my training at University of Nevada Reno and worked in both Renown and VA hospital. My family has a cabin in south lake Tahoe and we love the area. There are a few small private groups still in the area. I'd probably choose the small private groups just to see usap and Napa fail.
 
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anes121508 said:
With all that said, does your group have a buyin or immediate partnership?

I hope that if your group's opinion is that the hospital admin is unstable and cash out is always on the table.....then you are transparent with new hires and aren't working them for a discount with the hopes they make partner in 5 years.
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Our last hire was 5 years ago, and at that time we DID have a “buy-in”(made 75% partner pay the first year, 85% the second). It’s always been a two year track. Just had a position open a few months back, and changed that to 90%, then 95% (year 1 and 2)for current interviewees, for obvious reasons. Things are NOT what they used to be, things change.

We did have discussions with one group (during one of those contract controversies with the hospital, 3-1/2 years ago), and we DID inform the “non-partner” (18 months into 2 year track) that we WOULD cut them in EQUALLY, if a buyout occurred (even before making partner).

Things aren’t what they used to be, and expecting a large “buy-in” with things being that unpredictable certainly wouldn’t be appropriate, these days.
 
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DirtDocMD said:
Things aren’t what they used to be, and expecting a large “buy-in” with things being that unpredictable certainly wouldn’t be appropriate, these days.
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It would be appropriate if you can get away with it.
 
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OptionOffense said:
Whatever happened to the Mednax group in fairfax va. That huge group. I never see ads for that place.. must be a lucrative place to work
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interviewed a couple docs that were there when they first sold out and were looking to bail. Said it got worse since it turned over to NAPA, was far better as Mednax. IIRC that was one of the first 2 or 3 groups in the country that sold out to American (Piedmont and Raleigh being the other original ones).
 
DirtDocMD said:
Our last hire was 5 years ago, and at that time we DID have a “buy-in”(made 75% partner pay the first year, 85% the second). It’s always been a two year track. Just had a position open a few months back, and changed that to 90%, then 95% (year 1 and 2)for current interviewees, for obvious reasons. Things are NOT what they used to be, things change.

We did have discussions with one group (during one of those contract controversies with the hospital, 3-1/2 years ago), and we DID inform the “non-partner” (18 months into 2 year track) that we WOULD cut them in EQUALLY, if a buyout occurred (even before making partner).

Things aren’t what they used to be, and expecting a large “buy-in” with things being that unpredictable certainly wouldn’t be appropriate, these days.
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That's reasonable and consistent with your message, glad to hear that!
 
It seems that Renown must have made peace with the local anesthesiologists. I must have received five offers from different recruiters in the last week of January...but nothing since them.

I hope Sevo was able to stick it to his corporate overlords. I have, in general, very few sympathies for hospitals anymore, but it doesn't sound like they were the bad guys. In fact, it sounds like they may have even been honorable. They held their lips and let the anesthesiologists (with whom they seem to have had a great relationship) be seduced by a big buyout. When the buyout when predictably into the crapper, they told the Private Equity Know-It-Alls where they could stick it, and did what they could to get their old familiar anesthesiologists back. Perhaps my take is ill-informed, but that's how it appears to me.

Sevo's should be a cautionary tale. The guys who were able to retire between the sale and the blowup are laughing their a$$e$ off right now, while all the folks whose labor they sold out are left in the lurch. Sucks to be them.
 
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I was contacted today for big money in the ‘Lake Tahoe area’ for a several month gig - are we sure this had a happy ending?
 
Renown looking for locums. $290/hr for 8 hour guarantee. Bonus pay for license and minimum hours worked.
 
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ans2021 said:
Renown looking for locums. $290/hr for 8 hour guarantee. Bonus pay for license and minimum hours worked.
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Who to contact? NAPA?

I have a friend who may be interested. He has NV license.
 
Both USAP and NAPA and various agencies have ads up for the area. Some offering $600k+ for cardiac. There was a shortage of anesthesia in the area before any of the disputes became public. Seems like a good opportunity for anybody who likes the mountains.
 
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Anyone know what the latest is? Napa still enforcing non compete?
 
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Last edited:
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www.kolotv.com

Surgeries will continue at Renown, legal action may follow

The threat of a disruption of surgeries at Renown Medical Center has passed. The legal dispute that led to it is unresolved.
www.kolotv.com www.kolotv.com

www.2news.com

Renown Terminates Contract, Surgery Staffing at Risk of Lawsuits

In a briefing Tuesday, April 5, Renown Health weighed in on camera about its anesthesiology staffing issue.
www.2news.com www.2news.com


I see this as great news, since Renown kicked out NAPA.

I hope the new group wins if NAPA files suit, which it sounds like everybody expects them to do. I'm 100% rooting for the anesthesiologists, but everybody reading this should think twice before signing a non-compete clause. The anesthesiologists willingly signed it. Then they unilaterally chose to ignore it. I'm sure NAPA's lawyers will have an easy time making hay out of that in court.

It's too bad that the insiders will be unable to speak freely about this case, leaving only us outsiders to speculate. If ever there were a good use of a throwaway account--or a discussion in the private forum--this would be it.
 
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I’m only speculating, but it’s interesting that NAPA seems to be surrendering pretty easily. I’m guessing they want to avoid a high profile and messy legal battle that will inevitably bring them a lot of bad press in a case that the DOJ has entered an opinion on. The problem for them is it sets a pretty big precedent going forward for other hospital systems that have been unhappy with the NAPA model (we’re looking at you Northwell/NSLIJ…your move now). Is NAPA avoiding the legal battle now and hoping for an administration change in a couple of years with a new DOJ that has different priorities?

www.jdsupra.com

Department of Justice suggests that employee non-competes could be criminally prosecuted | JD Supra

On 25 February the U.S. Department of Justice (DOJ) submitted a statement of interest in a Nevada State court lawsuit filed by a group of...
www.jdsupra.com www.jdsupra.com

The above was an interesting article of the DOJ’s “statement of interest” in this case. It states that “DOJ’s position opens the door to the possibility of criminal prosecution for employee non-compete agreements.” They are basically saying that non-competes violate Section 1 of the Sherman Act, which “prohibits agreements between two or more individuals or independent entities that unreasonably restrain trade.”

No matter how you slice this, it’s kind of a big deal. There seems to be increasing scrutiny into private equity medicine. I hope it continues.
 
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So everyone feels that working for the hospital will be better than working for NAPA? Guess again. You are still working for the same sharks whose goal is to work you to the bone while paying as little as possible. Also, the hospital has the power to make structural changes to the anesthesia delivery model to your detriment. (I.e. 1:8 coverage, independent CRNA practice ect. The AMC does not have the ability to do that as easily)
Regarding the non compete:
This is the one instance where NAPA might have a legitimate case. The hospital is essentially dissolving the NAPA group, which may have invested significant resources in establishing the practice. It’s completely different than a single doc going to work down the block and being prevented from doing so with the laughable assertion that you are somehow “stealing business”….
 
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dannyboy1 said:
So everyone feels that working for the hospital will be better than working for NAPA? Guess again. You are still working for the same sharks whose goal is to work you to the bone while paying as little as possible. Also, the hospital has the power to make structural changes to the anesthesia delivery model to your detriment. (I.e. 1:8 coverage, independent CRNA practice ect. The AMC does not have the ability to do that as easily)
Regarding the non compete:
This is the one instance where NAPA might have a legitimate case. The hospital is essentially dissolving the NAPA group, which may have invested significant resources in establishing the practice. It’s completely different than a single doc going to work down the block and being prevented from doing so with the laughable assertion that you are somehow “stealing business”….
Click to expand...
Well, there’s this:

“Physicians employed by a hospital or healthcare system CAN unionize as long as they are actual employees. Typically, this means being paid a salary reported on a W-2 form. Salaried doctors at public hospitals can also unionize. This necessary status as an employee excludes supervisors.”

I’m kinda hit or miss on unions, but issues such as 60-70 hour work weeks/every other weekend call/call running into next day’s work(30-36 hours straight work), are EXACTLY the kinds of things that unions are supposed to address.

It’d be nice if there were, say, a “society” of Anesthesiologists (cough, cough) that was willing to make some recommendations/guidelines regarding “onerous” work schedules, that some unionized Docs could show to hospital employers.
 
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dannyboy1 said:
This is the one instance where NAPA might have a legitimate case. The hospital is essentially dissolving the NAPA group, which may have invested significant resources in establishing the practice. It’s completely different than a single doc going to work down the block and being prevented from doing so with the laughable assertion that you are somehow “stealing business”….
Click to expand...

Please, please, please let this go to trial, then. I would absolutely love to have NAPA executives testify in court exactly what "significant resources" they invested into a stable, 73-year old group of that didn't endure to age 75 under their "secret sauce" leadership. Outside of seducing the partners with big checks, what did they do??

I'm most familiar with Denver, where USAP bought the two big groups in town, then raised rates on the insurers, then forced the doctors to utilize Anesthesia Assistants. Please, please, please! Let's force some private equity schmuck to tell a jury (who will all either have been patients or have loved ones that were patients) that their "secret sauce" was getting monopoly power to raise prices and reduce quality.
 
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C4C said:
Please, please, please let this go to trial, then. I would absolutely love to have NAPA executives testify in court exactly what "significant resources" they invested into a stable, 73-year old group of that didn't endure to age 75 under their "secret sauce" leadership. Outside of seducing the partners with big checks, what did they do??

I'm most familiar with Denver, where USAP bought the two big groups in town, then raised rates on the insurers, then forced the doctors to utilize Anesthesia Assistants. Please, please, please! Let's force some private equity schmuck to tell a jury (who will all either have been patients or have loved ones that were patients) that their "secret sauce" was getting monopoly power to raise prices and reduce quality.
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Blah, blah, blah, “metrics”. “Compliance”. I’m sure they could throw a “synergy”, in there, too....
 
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C4C said:
Please, please, please let this go to trial, then. I would absolutely love to have NAPA executives testify in court exactly what "significant resources" they invested into a stable, 73-year old group of that didn't endure to age 75 under their "secret sauce" leadership. Outside of seducing the partners with big checks, what did they do??

I'm most familiar with Denver, where USAP bought the two big groups in town, then raised rates on the insurers, then forced the doctors to utilize Anesthesia Assistants. Please, please, please! Let's force some private equity schmuck to tell a jury (who will all either have been patients or have loved ones that were patients) that their "secret sauce" was getting monopoly power to raise prices and reduce quality.
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Don't underestimate what massive financial resources, good communication skills, and $1,000/hr attorneys can do.
 
C4C said:
Please, please, please let this go to trial, then. I would absolutely love to have NAPA executives testify in court exactly what "significant resources" they invested into a stable, 73-year old group of that didn't endure to age 75 under their "secret sauce" leadership. Outside of seducing the partners with big checks, what did they do??

I'm most familiar with Denver, where USAP bought the two big groups in town, then raised rates on the insurers, then forced the doctors to utilize Anesthesia Assistants. Please, please, please! Let's force some private equity schmuck to tell a jury (who will all either have been patients or have loved ones that were patients) that their "secret sauce" was getting monopoly power to raise prices and reduce quality.
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True. That being said, this is not the story of a random doc who joined without a buyout, and now just wants to move on to another job, and is prevented from doing so by the vindictive AMC. These are former partners in the group who likely received millions of dollars in exchange for the group, essentially going back on the deal. Not so sure that will play as well in court as some seem to think….
 
dannyboy1 said:
True. That being said, this is not the story of a random doc who joined without a buyout, and now just wants to move on to another job, and is prevented from doing so by the vindictive AMC. These are former partners in the group who likely received millions of dollars in exchange for the group, essentially going back on the deal. Not so sure that will play as well in court as some seem to think….
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I would say it is complicated by the fact that they sold out to a company (Mednax) that then sold them to NAPA. I’m sure their contract allowed for that but I wouldn’t exactly say they were “going back on the deal” any more than Mednax did when they sold them to NAPA.
 
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dannyboy1 said:
True. That being said, this is not the story of a random doc who joined without a buyout, and now just wants to move on to another job, and is prevented from doing so by the vindictive AMC. These are former partners in the group who likely received millions of dollars in exchange for the group, essentially going back on the deal. Not so sure that will play as well in court as some seem to think….
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If NAPA has an easy case here then why don’t they seem to be fighting it? They have a lot to lose if a precedent is set where the hospital can terminate the contract and the anesthesiologists can regroup and contract with that same hospital.

It also brings forward a larger question of non-competes in a situation like this. All things considered, the anesthesiologists were just employees/workers for NAPA. If two larger entities (NAPA and the hospital) have a disagreement that cause them to terminate a contract, why should the employees have a non-compete enforced that would prevent them from earning a living? In this situation the hospital is not trying to hire the anesthesiologists back and form their own group to profit off of. The anesthesiologists are forming a group and contracting with the hospital. Why should their non-compete prevent them from doing so in this situation? The employees had no say in whether or not the contract between NAPA and the hospital remained intact.
 
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3 short years ago, Mednax was able to enforce a noncompete for their employed anesthesiologists in North Carolina working at atrium health. I don’t know if Biden’s executive order has anything to do with it but the tide does seem to be turning.

www.lawandtheworkplace.com

FTC and DOJ Hold Workshop On Non-Compete Agreements

As we reported this past summer, President Biden signed an Executive Order titled “Promoting Competition in the American Economy.” At the time, President
www.lawandtheworkplace.com www.lawandtheworkplace.com
 
GravelRider said:
If NAPA has an easy case here then why don’t they seem to be fighting it? They have a lot to lose if a precedent is set where the hospital can terminate the contract and the anesthesiologists can regroup and contract with that same hospital.

It also brings forward a larger question of non-competes in a situation like this. All things considered, the anesthesiologists were just employees/workers for NAPA. If two larger entities (NAPA and the hospital) have a disagreement that cause them to terminate a contract, why should the employees have a non-compete enforced that would prevent them from earning a living? In this situation the hospital is not trying to hire the anesthesiologists back and form their own group to profit off of. The anesthesiologists are forming a group and contracting with the hospital. Why should their non-compete prevent them from doing so in this situation? The employees had no say in whether or not the contract between NAPA and the hospital remained intact.
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Seems they are fighting it (they need to or their whole business model is done). The docs are working at the hospital and will be sued. I imagine the hospital agreed to cover legal costs/awards in the employment deal.
 
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Some of the surprise balance billing legislation seems to really hurt the AMC business model. Plenty of small private groups were also doing this, however.
 
HemeOncHopeful19 said:
I would say it is complicated by the fact that they sold out to a company (Mednax) that then sold them to NAPA. I’m sure their contract allowed for that but I wouldn’t exactly say they were “going back on the deal” any more than Mednax did when they sold them to NAPA.
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Still amazes me that American Anesthesiology in it's entirety was sold for less than the cost of one of it's big group purchases.
 
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I hope Sevo (and the group at Renown) is doing okay. We haven't heard from him in a while. He started a thread that his group was hiring, and now that thread has disappeared.

I hope Renown kicked USAP out March 31. I hope Sevo's partners are able to regroup. It sounds private equity made a proper mess of what was previously a stable private practice. It's too bad that the details of their (Mednax's and USAP's) screwups aren't published far and wide for future hospital administrators, senior partners, and young anesthesiologists to learn from.
 
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C4C said:
I hope Sevo (and the group at Renown) is doing okay. We haven't heard from him in a while. He started a thread that his group was hiring, and now that thread has disappeared.

I hope Renown kicked USAP out March 31. I hope Sevo's partners are able to regroup. It sounds private equity made a proper mess of what was previously a stable private practice. It's too bad that the details of their (Mednax's and USAP's) screwups aren't published far and wide for future hospital administrators, senior partners, and young anesthesiologists to learn from.
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Didn't the private group invite the PE? The original partners collected big buyouts. The newly recruited were the ones screwed most.

I guess the lesson is: Never join a group that was sold out recently. You can probably do locums for them at a crisis/semi-crisis rate.
 
C4C said:
I hope Sevo (and the group at Renown) is doing okay. We haven't heard from him in a while. He started a thread that his group was hiring, and now that thread has disappeared.

I hope Renown kicked USAP out March 31. I hope Sevo's partners are able to regroup. It sounds private equity made a proper mess of what was previously a stable private practice. It's too bad that the details of their (Mednax's and USAP's) screwups aren't published far and wide for future hospital administrators, senior partners, and young anesthesiologists to learn from.
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I think it was NAPA, not USAP.
 
amp.rgj.com

Renown says it will immediately hire anesthesiologists April 1 after they resign from national company

Renown says it will hire anesthesiologists who resign from national group as a legal battle continues with the hospital, doctors and anesthesiology group
amp.rgj.com

It seems as though the hospital is encouraging the anesthesiologists to resign from NAPA and be hired by the hospital…essentially daring the courts to not allow enforcement of the non-compete. The situation sounds like way more of a mess than was led on. I still hope it works out for the anesthesiologists, but I would be very skeptical of taking a permanent position until the dust settles. Locums, on the other hand…
 
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GravelRider said:
amp.rgj.com

Renown says it will immediately hire anesthesiologists April 1 after they resign from national company

Renown says it will hire anesthesiologists who resign from national group as a legal battle continues with the hospital, doctors and anesthesiology group
amp.rgj.com

It seems as though the hospital is encouraging the anesthesiologists to resign from NAPA and be hired by the hospital…essentially daring the courts to not allow enforcement of the non-compete. The situation sounds like way more of a mess than was led on. I still hope it works out for the anesthesiologists, but I would be very skeptical of taking a permanent position until the dust settles. Locums, on the other hand…
Click to expand...

High risk high reward….. you’re starting from the ground up…. When the dust settles, they may not offer a 6 months partnership, no buy in.
 
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IMGASMD said:
High risk high reward….. you’re starting from the ground up…. When the dust settles, they may not offer a 6 months partnership, no buy in.
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Don’t think there is any partnership. It’s just a direct hire form the hospital.
 
IMGASMD said:
High risk high reward….. you’re starting from the ground up…. When the dust settles, they may not offer a 6 months partnership, no buy in.
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I would say high risk, mediocre reward. The job sounds nice but isn’t anything to write home about at the end of the day. Also not sure how much benefit early partnership will be in a hospital-employed system.

Anyone considering a job there should certainly expect all of their questions and concerns to be answered more thoroughly than what has been posted in this forum.
 
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IMGASMD said:
High risk high reward….. you’re starting from the ground up…. When the dust settles, they may not offer a 6 months partnership, no buy in.
Click to expand...

You are also risking an overworked and underpaid type of situation if the courts find in favor of NAPA and the hospital becomes severely understaffed. I would be really hesitant to sign up for anything other than a short term assignment with all of that drama.
 
Did he pull the listing? I thought it’s a MD only private practice… else they 6 months partner is pointless…..
Even if hospital employed, maybe they have some surgery centers, that’s out of hospital system. That can be good money makers.
500K +
MD only
6 months partner
No buy in is what I remember.
I wish I took a picture of the original terms.

The money is probably little above average. I don’t know about COL, likely cheaper than where I am, no tax. It’s near all the outdoor stuff you can ever do….

I don’t think it’s a bad gig for the right person. To uproot from a stable place to make a little more, probably not.
 
GravelRider said:
amp.rgj.com

Renown says it will immediately hire anesthesiologists April 1 after they resign from national company

Renown says it will hire anesthesiologists who resign from national group as a legal battle continues with the hospital, doctors and anesthesiology group
amp.rgj.com

It seems as though the hospital is encouraging the anesthesiologists to resign from NAPA and be hired by the hospital…essentially daring the courts to not allow enforcement of the non-compete. The situation sounds like way more of a mess than was led on. I still hope it works out for the anesthesiologists, but I would be very skeptical of taking a permanent position until the dust settles. Locums, on the other hand…
Click to expand...


However, if you’re a new hire, you wouldn’t have signed the NAPA noncompete agreement. I think it would be okay to work directly for the hospital as long as the terms are good. Hopefully the new position offered by the hospital is not requiring a noncompete. That would be hypocritical.
 
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