NAPA in trouble in NJ

[IMGASMD]

Do you realize the vast majority of private practices no longer have partnership track? (almost none in the northeast that I know of) Thus there is no EQUAL split amongst the MDs...as an employed anesthesiologist of a PP group you are almost certainly making less than those who have been there since the 'old days.' So indeed, there are AMC jobs where you can make more, for the same work, than a pure PP job especially for the first 3, 5 or 7 years and because corporate rules actually exist, you are treated better.

I’ve looked thrice within the last five years. I know a few still exist in NJ. Maybe MA. Maybe PA. (Not NE). Some of them advertise on gasworks. (I know, most here think they’re bottom of the barrel type places….) I found them generally to be “okay.” They obviously don’t make the top 10% MGMA, but usually at least 50% for the region. If you actively seek them out, they do exist. Whether you will make partner or not in time, maybe that’s a different question. (I did with a $20 buy in… . We had a “hostile” take over, by a national AMC. No buy out, most of the partners just left, including me.)

I’ve focused my searches for PP and MD solo heavy places. I don’t need to clear 700+ to be content with life.

If you’re goal is to make lots while it shines, I’d look into Livingston, as locum, as perm. It may worth you a while. I think you’d have to work for the money, but…..

You interview with GHA/Houston? I’ve been told by some folks pretty in the know it was >30%. Was told Orlando also around 30%. Austin/central 25%. Yes several at around only 20% but I’m pretty confident several at 30% or more.

Again only those in the group/part of sale know for sure but similar numbers been talked about for years.

Again though as bad as I think USAP is, Napa much worse as their is no split. Napa takes all and tries to get by paying as low as possible to take as much as possible.

It’s hard to say who is in a worse position-probably USAP. I say that as Napa has more room to increase salaries. CRNAs and new employees demanding more money. For USAP some of that money has to come out of existing partners pay as the revenues/expenses are split. At Napa, since they take more and no split they can raise without it coming out of existing employees pockets.

Neither in a great situation, but USAP in a cycle where senior MDs either have to work more or the money to increase pay comes out of their salaries-higher dissatisfaction

When you say revenue split, is that true all year round? That would make sense to me then.

The ones that I know of, there’s a bottom line number from the mothership. Our expected profit from this practice is $3 million.

If hit that number, then the rest is paid out as bonus. THAT bonus is 60:40. Us/AMC.

If not…. No bonus for you!

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[agammaglobulin]

You assume that a local private practice as the same bargaining power as a large AMC with rate negotiation.... which is blatantly not true.

Assumptions: Group is 50% private and 50% public insured. If AMC takes 25% off the top, it would need to negotiate 50% higher private rates to make up for the SAME amount the AMC is taking out in order to keep partner income the same. For 75% private insured, would still need 30% higher rates just to break even. This is unlikely and why AMCs often increase hours, increase supervision, etc to make up for the difference.

edit: Maybe AMCs get better rates on health insurance, malpractice and other benefits that help in savings for the group. Perhaps that's why AMCs often bundle everything together for a "compensation package" instead of simply telling you what you make hourly/yearly prior to benefits.

 

[Mman]

True, but it is more complicated than that. Not having to answer to someone else, the perceived security of ownership is as important as not having to send taxes to Rome. For many of us, It is better to Rule in Hell than to serve in Heaven.

I don't disagree, but it personally irks me when people go on and out about somebody "stealing their billing" or whatever simply because 100% of the revenue doesn't end up in their pocket. As an individual physician, I have almost no ability to get a good rate from an insurance company. Like none. I can join a group that can collect infinitely more money for the same work. Would be silly of me to imply they are stealing it from me if it doesn't all go to me.

When we have docs on partnership track, they are literally making more money than they could in any other fashion despite the fact some of their collections are going to partners.



I'm as anti AMC as anybody.

 

[Mman]

Assumptions: Group is 50% private and 50% public insured. If AMC takes 25% off the top, it would need to negotiate 50% higher private rates to make up for the SAME amount the AMC is taking out in order to keep partner income the same. For 75% private insured, would still need 30% higher rates just to break even. This is unlikely and why AMCs often increase hours, increase supervision, etc to make up for the difference.

edit: Maybe AMCs get better rates on health insurance, malpractice and other benefits that help in savings for the group. Perhaps that's why AMCs often bundle everything together for a "compensation package" instead of simply telling you what you make hourly/yearly prior to benefits.

AMCs are getting near $200/unit (or even beyond) in some places at this point. They can easily double or triple the private rate compared to some practices.

 

[2Fast2Des]

AMCs are getting near $200/unit (or even beyond) in some places at this point. They can easily double or triple the private rate compared to some practices.

Damn that's a wild unit value... That's how they are profitable

 

[jwk]

Damn that's a wild unit value... That's how they are profitable

Remember though that it's all about payor mix. Unless you're cherry-picking, half or more of just about anyone's business is government paid. CMS conversion factor nationwide is in the low-mid $20s per unit.

 

[Fpg1245]

Remember though that it's all about payor mix. Unless you're cherry-picking, half or more of just about anyone's business is government paid. CMS conversion factor nationwide is in the low-mid $20s per unit.

It still baffles me how the field continues to live despite govt asinine reimbursement for anesthesia services. They can’t possibly think they are accurately valuing the service…oh wait.

 

[amyl]

Does anyone know what the result of the NAPA drama in Reno was?

I believe the courts sided w patient care and let the drs stay and form their old group again. They would not enforce the non compete

 

[aneftp]

Remember though that it's all about payor mix. Unless you're cherry-picking, half or more of just about anyone's business is government paid. CMS conversion factor nationwide is in the low-mid $20s per unit.

Does any medical specialist/speciality have such a wide descepency in Medicare Vs commercial insurance.

My general surgeon friends get reimbursed approx 60% Medicare Vs commercial. Meaning if commercial insurance pays him $500 for procedure. Medicare will pay him $300. Enough to live.

But with anesthesia commercial that pays $100/unit for a 5 unit egd that takes 15 min max from preop to recovery. That’s $500 for anesthesia for commercial. But u be lucky to get $17/unit x 5 units for Medicare egd. That’s $85.

Think about it kids on these forms who demand $300/hr. That may work well if payor mix is over 50% commercial. But I’ve been in hospitals 70-80% Medicare and 10% Medicaid. And only 10% commercial. No subsidy. M

An anesthesiologist would need to do a min of 3 egd solo (No crna’s cause u can’t have that overhead with 80-90% govt healthcare). U would need to do a min of 3 egd per hour non stop for 8 hours. To pay for. A locums doc $300/hr x 8 hours. ($2400).

So kids. Who has done 20-24 gi procedures solo per day PLUS preop ur own patients

That’s a ton of work. And yes. Some gi docs book that many. They bounce from room to room and u are the one bouncing as well. No other crna or doc in the second room.

 

[Zekchar]

Think about it kids on these forms who demand $300/hr. That may work well if payor mix is over 50% commercial. But I’ve been in hospitals 70-80% Medicare and 10% Medicaid. And only 10% commercial. No subsidy. M

I think the use of the term kids is demeaning. It is meant to imply some bullcrap immaturity or misunderstanding of "how it works" and that is simply not true. We "kids" are merely asking the market rate.

In the end, I don't care about the hard numbers behind the scenes. We never get to see them anyways and there is no room to negotiate those things. All I can negotiate, for the sake of my husband and family, is my hourly rate. Thus I want top dollar in exchange for my free time.

I don't care if there isn't a hospital subsidy.
I don't care if the billing comes from the proceduralist's cut.
I don't care if they're in the red in order to afford me.

The market's supply and demand forces say that my rate is $300/hr currently and that's what I'm going to insist on. They can cut corners and hire inferior practitioners like CRNAs, or go out of compliance, or have the surgeon/proceduralist "supervise" the nurses. One bad outcome and one multimillion dollar lawsuit later, all their MD(a) savings have suddenly evaporated. Preventing that back outcome is where my value lies and that is why I want my $300/hr.

 

[vector2]

I think the use of the term kids is demeaning. It is meant to imply some bullcrap immaturity or misunderstanding of "how it works" and that is simply not true. We "kids" are merely asking the market rate.

In the end, I don't care about the hard numbers behind the scenes. We never get to see them anyways and there is no room to negotiate those things. All I can negotiate, for the sake of my husband and family, is my hourly rate. Thus I want top dollar in exchange for my free time.

I don't care if there isn't a hospital subsidy.
I don't care if the billing comes from the proceduralist's cut.
I don't care if they're in the red in order to afford me.

The market's supply and demand forces say that my rate is $300/hr currently and that's what I'm going to insist on. They can cut corners and hire inferior practitioners like CRNAs, or go out of compliance, or have the surgeon/proceduralist "supervise" the nurses. One bad outcome and one multimillion dollar lawsuit later, all their MD(a) savings have suddenly evaporated. Preventing that back outcome is where my value lies and that is why I want my $300/hr.

 

[Mman]

The market's supply and demand forces say that my rate is $300/hr currently and that's what I'm going to insist on.

which market is that in? Because there are docs lining up to work for far less than that around me

 

[Status Sciaticus]

Does any medical specialist/speciality have such a wide descepency in Medicare Vs commercial insurance.

My general surgeon friends get reimbursed approx 60% Medicare Vs commercial. Meaning if commercial insurance pays him $500 for procedure. Medicare will pay him $300. Enough to live.

But with anesthesia commercial that pays $100/unit for a 5 unit egd that takes 15 min max from preop to recovery. That’s $500 for anesthesia for commercial. But u be lucky to get $17/unit x 5 units for Medicare egd. That’s $85.

Think about it kids on these forms who demand $300/hr. That may work well if payor mix is over 50% commercial. But I’ve been in hospitals 70-80% Medicare and 10% Medicaid. And only 10% commercial. No subsidy. M

An anesthesiologist would need to do a min of 3 egd solo (No crna’s cause u can’t have that overhead with 80-90% govt healthcare). U would need to do a min of 3 egd per hour non stop for 8 hours. To pay for. A locums doc $300/hr x 8 hours. ($2400).

So kids. Who has done 20-24 gi procedures solo per day PLUS preop ur own patients

That’s a ton of work. And yes. Some gi docs book that many. They bounce from room to room and u are the one bouncing as well. No other crna or doc in the second room.

300/hr? Guess they gotta dig into those DRGs or facility fees to make up for it.
Also, kids? Im sure back in your day, this was a lot of money, but it aint now, boomer.

 

[Status Sciaticus]

which market is that in? Because there are docs lining up to work for far less than that around me

Oregon, Washington, Texas, Arkansas, NJ, NY, PA, IA. One needs to only look at Gasworks.

 

[narcotics999]

which market is that in? Because there are docs lining up to work for far less than that around me

Everywhere. Your place must have other nice perks.

 

[GravelRider]

Does any medical specialist/speciality have such a wide descepency in Medicare Vs commercial insurance.

My general surgeon friends get reimbursed approx 60% Medicare Vs commercial. Meaning if commercial insurance pays him $500 for procedure. Medicare will pay him $300. Enough to live.

But with anesthesia commercial that pays $100/unit for a 5 unit egd that takes 15 min max from preop to recovery. That’s $500 for anesthesia for commercial. But u be lucky to get $17/unit x 5 units for Medicare egd. That’s $85.

Think about it kids on these forms who demand $300/hr. That may work well if payor mix is over 50% commercial. But I’ve been in hospitals 70-80% Medicare and 10% Medicaid. And only 10% commercial. No subsidy. M

An anesthesiologist would need to do a min of 3 egd solo (No crna’s cause u can’t have that overhead with 80-90% govt healthcare). U would need to do a min of 3 egd per hour non stop for 8 hours. To pay for. A locums doc $300/hr x 8 hours. ($2400).

So kids. Who has done 20-24 gi procedures solo per day PLUS preop ur own patients

That’s a ton of work. And yes. Some gi docs book that many. They bounce from room to room and u are the one bouncing as well. No other crna or doc in the second room.

That practice you describe is not long for this world without a subsidy. Unless it’s in some isolated niche location with some other perks, there is no way that practice will be able to recruit “the kids.” Without the ability to recruit “kids,” how do you expand or grow the practice?

 

[nimbus]

which market is that in? Because there are docs lining up to work for far less than that around me

I wish I got $300/hr. But I’m entrenched and don’t like moving.

 

[GravelRider]

Oregon, Washington, Texas, Arkansas, NJ, NY, PA, IA. One needs to only look at Gasworks.

Add Michigan…right on the first page.

$300/hr is $528k before benefits working 40 hours per week and taking 8 weeks vacation. After benefits its like $450-475ish? I would say that’s pretty much the going rate for an employed position with a reasonable workload right now.

 

[Status Sciaticus]

Add Michigan…right on the first page.

$300/hr is $528k before benefits working 40 hours per week and taking 8 weeks vacation. After benefits its like $450-475ish? I would say that’s pretty much the going rate for an employed position with a reasonable workload right now.

Yeah but no call.....
.....and 40 hours per week instead of 50-60 like most places.
Also you dictate your own hours, and elect your own cash distribution.

 

[GravelRider]

Yeah but no call.....
.....and 40 hours per week instead of 50-60 like most places.
Also you dictate your own hours, and elect your own cash distribution.

Right. I think $300/hr is a good starting point in evaluating a job. 40 hours per week could be taking call, but having early and short days on those non-call days. My point is that the incredulous reactions to $300/hr jobs is not in line with what is happening in the market right now. Obviously details matter, but that number is a good place to start.

 

[Status Sciaticus]

Right. I think $300/hr is a good starting point in evaluating a job. 40 hours per week could be taking call, but having early and short days on those non-call days. My point is that the incredulous reactions to $300/hr jobs is not in line with what is happening in the market right now. Obviously details matter, but that number is a good place to start.

Lol those same people arent going to like it when rates go upto 400/hr, even though we have seen them posted.

 

[GravelRider]

Lol those same people arent going to like it when rates go upto 400/hr, even though we have seen them posted.

Yeah. Just saw one for $400/hr (6hr guarantee) in California. I know nothing about the job, but those rates are out there and becoming more common.

 

[chocomorsel]

which market is that in? Because there are docs lining up to work for far less than that around me

Well they need to wise up then.
The market is hot for Anesthesia right now.
And I know you make a killing so don’t act like you guys can’t afford locums at $300 an hour. I don’t know if you mean your group.

 

[Dr. Rude]

Well they need to wise up then.
The market is hot for Anesthesia right now.
And I know you make a killing so don’t act like you guys can’t afford locums at $300 an hour. I don’t know if you mean your group.

The local market is what the local market is. Why pay above market rates or work for below local market rates?

Just like real estate. LOCATION, LOCATION, LOCATION.

 

[chocomorsel]

The local market is what the local market is. Why pay above market rates or work for below local market rates?

Just like real estate. LOCATION, LOCATION, LOCATION.

If NJ and NYC are offering $300 an hour then I don’t see why anyone in the country would take less.
It’s just dumb.
That being said, my local locums market pays about 200 an hour if you are lucky. I just pass on it. People start saying no, demand will increase.

 

[Mman]

Well they need to wise up then.
The market is hot for Anesthesia right now.
And I know you make a killing so don’t act like you guys can’t afford locums at $300 an hour. I don’t know if you mean your group.

we've never used locums. I'm saying the hospitals in my general area have no problem hiring locums for less. I get emails from recruiters offering me less than that to work.

The ones putting up ads are the desperate ones, aka top of the market. There are plenty of places filling their slots for less than that.

 

[chocomorsel]

we've never used locums. I'm saying the hospitals in my general area have no problem hiring locums for less. I get emails from recruiters offering me less than that to work.

The ones putting up ads are the desperate ones, aka top of the market. There are plenty of places filling their slots for less than that.

What they offer and what you negotiate are usually two different things.
I don’t locums much anymore so I must say that the few offers I have had have been in the $300 range. I do remember one that was $240 or so and I told them no, those are PreCovid and CRNA rates.
Just say no.

 

[Dr. Rude]

Yeah. Just saw one for $400/hr (6hr guarantee) in California. I know nothing about the job, but those rates are out there and becoming more common.

Right now the sun is shining especially for those with flexibility and will trade a high hourly rate for low security.
Healthcare is an especially fragile place at this time. Lowering high priced locum tenens usage is on every practice manager’s mind.

 

[IMGASMD]

we've never used locums. I'm saying the hospitals in my general area have no problem hiring locums for less. I get emails from recruiters offering me less than that to work.

The ones putting up ads are the desperate ones, aka top of the market. There are plenty of places filling their slots for less than that.

Or they have multiple agencies blasting emails.
Didn’t someone get an email about this particular job for $400/hr. On top of that I think they will have some trouble to convert the locum to perm. If I was making north of 700K “on paper” 400/hr * 40hr * 46 weeks. To something that may “only” be 500+ with calls.
Unless you’re locum full time, I think it’s hard to get into some of these jobs with the availability they’re looking for.

I agreed and “they” agreed to let me cover some weekends and during my vacation week at 300/hr. (Not this particular job). It took a lot, I mean absurd amount, of time to get me even started. The agencies, as soon as they hear I can only cover a weekend or two a month, and possibly one week during the summer, automatically shut down. Even at making 150hr/hr off me, they need me to work at least 100hrs to even make malpractice to worth it. ($15000). Then there’s lodging and travel. I digress.

 

[chocomorsel]

Or they have multiple agencies blasting emails.
Didn’t someone get an email about this particular job for $400/hr. On top of that I think they will have some trouble to convert the locum to perm. If I was making north of 700K “on paper” 400/hr * 40hr * 46 weeks. To something that may “only” be 500+ with calls.
Unless you’re locum full time, I think it’s hard to get into some of these jobs with the availability they’re looking for.

I agreed and “they” agreed to let me cover some weekends and during my vacation week at 300/hr. (Not this particular job). It took a lot, I mean absurd amount, of time to get me even started. The agencies, as soon as they hear I can only cover a weekend or two a month, and possibly one week during the summer, automatically shut down. Even at making 150hr/hr off me, they need me to work at least 100hrs to even make malpractice to worth it. ($15000). Then there’s lodging and travel. I digress.

What kind of offers are you getting? I am about to quit and live internationally but need a transitional period. I am about the money right now.

 

[chocomorsel]

Please go to the private forum and post locums jobs so we can help each other out.
Thank you.

 

[narcotics999]

Well they need to wise up then.
The market is hot for Anesthesia right now.
And I know you make a killing so don’t act like you guys can’t afford locums at $300 an hour. I don’t know if you mean your group.

Based on my limited experiences, Locums for AMC is better than locums for PP. For the later, each minute you are not working is like stealing $ from the group.

AMC usually is not efficient (downtime), pays on time (weekly or biweekly), follows through the scheduled shifts. On a light day, I can leave before the shift ends; just tell the OR nurse in charge to call me back if i am needed. PP, on the other hand, will ask if I want the day off the night before (no work no $).

 

[sevoflurane]

Or they have multiple agencies blasting emails.
Didn’t someone get an email about this particular job for $400/hr. On top of that I think they will have some trouble to convert the locum to perm. If I was making north of 700K “on paper” 400/hr * 40hr * 46 weeks. To something that may “only” be 500+ with calls.
Unless you’re locum full time, I think it’s hard to get into some of these jobs with the availability they’re looking for.

I agreed and “they” agreed to let me cover some weekends and during my vacation week at 300/hr. (Not this particular job). It took a lot, I mean absurd amount, of time to get me even started. The agencies, as soon as they hear I can only cover a weekend or two a month, and possibly one week during the summer, automatically shut down. Even at making 150hr/hr off me, they need me to work at least 100hrs to even make malpractice to worth it. ($15000). Then there’s lodging and travel. I digress.

when i did locums, my malpractice carrier provided me with 2 weeks per year of “locums” coverage for free.

 

[sevoflurane]

was surprised to say the least

 

[chocomorsel]

was surprised to say the least

Trying to see what about my suggestions to help each other out was so funny.

 

[Hoya11]

If NJ and NYC are offering $300 an hour then I don’t see why anyone in the country would take less.
It’s just dumb.
That being said, my local locums market pays about 200 an hour if you are lucky. I just pass on it. People start saying no, demand will increase.

Just as another data point:

I was at an anesthesia gathering last night. Multiple outside attendings coming up to me asking to work for my group for 200/hr. Highest paid of our per diems is 220/hr. We do not have difficulty filling and we are outside NYC suburb. But we have an ASC group and the work is really easy..

 

[chocomorsel]

Just as another data point:

I was at an anesthesia gathering last night. Multiple outside attendings coming up to me asking to work for my group for 200/hr. Highest paid of our per diems is 220/hr. We do not have difficulty filling and we are outside NYC suburb. But we have an ASC group and the work is really easy..

They are academics and have no clue what the market is. And to them who are used to making about $150 an hour that’s a good deal. Goes with the program.
Like I said, they are offering that in my town too. I just say no cuz I know better and also willing to travel.

 

[BLADEMDA]

I wish I got $300/hr. But I’m entrenched and don’t like moving.

Wow. With your cost of living and you aren't getting $300 per hour? About 1/2 my state is asking for and getting $275 per hour at a minimum with the max rate around $375 per hour. This is the physicians getting that rate not the locums companies which are charging much more in the $450 per hour range. CRNAs are getting $170-$180 per hour with extra stipends for living expenses with some groups paying as much as $200 per hour (1099) for a CRNA.

 

[GravelRider]

Right now the sun is shining especially for those with flexibility and will trade a high hourly rate for low security.
Healthcare is an especially fragile place at this time. Lowering high priced locum tenens usage is on every practice manager’s mind.

I wonder if they’ll write an op-Ed (from their multi-million dollar waterfront mansions) hinting that the government needs to step in and save them from these greedy doctors like they did for the traveling nurses?

 

[IMGASMD]

I wonder if they’ll write an op-Ed (from their multi-million dollar waterfront mansions) hinting that the government needs to step in and save them from these greedy doctors like they did for the traveling nurses?

Then I hope someone will be smart enough to hit back with what insurance company are actually paying physicians, surgery, supplies , and facility fees.

Isn’t that one of the things that’s coming? Hospital show transparency and insurance company show transparency….. everyone shows…. their hands.

 

[IMGASMD]

when i did locums, my malpractice carrier provided me with 2 weeks per year of “locums” coverage for free.

I asked our malpractice carrier, they don’t offer anything.
I was also told, some carriers have a “moonlighting” rate.

 

[aneftp]

Wow. With your cost of living and you aren't getting $300 per hour? About 1/2 my state is asking for and getting $275 per hour at a minimum with the max rate around $375 per hour. This is the physicians getting that rate not the locums companies which are charging much more in the $450 per hour range. CRNAs are getting $170-$180 per hour with extra stipends for living expenses with some groups paying as much as $200 per hour (1099) for a CRNA.

Agree. Full time locums docs pulling easily 1 million a year. One dude I know is gonna to be close to 1.5 million for the year. He’s already surprise $700k for the first 6 months. Yes he works like 70-80 hours a week. But he’s a work hard, plays hard type of guy. Takes 8 full weeks off and actually home for his kids events.

$275/hr is the bare minimum 1099 these days. $300 seems like the norm. Even The large AMCs is paying $300/hr. They will see if you will accept $250/hr first. You counter at $350. They will settle at $300.

Some places on the west side of florida are giving $350/hr (usually with a 8-10 week commitment)

If you are gonna to take a w2 job. Estimate the benefits/job stability/commute/calls.

A state university job benefits are generally valued at 40-50k (retirement/healthcare etc) over AMC w2 that offers little in terms of retirement and crappy healthcare. And just do your calculations from there.

The USAP/Envison. jobs with w2 I know all vary in terms of pay/hours and compensation. There is no one size fits all because all jobs are managed locally.

I do agree Napa is probably the worst of the AMCs these days. My buddy in upstate New York says Napa can retain anyone. It’s a revolving door. Napa biggest ploy is to try to enforce non competes. That’s what they tried in the mid Atlantic region.

 

[IMGASMD]

Napa biggest ploy is to try to enforce non competes. That’s what they tried in the mid Atlantic region.

it would be very interesting what’s going to happen in nj. How the noncompete will be decided.

 

[dannyboy1]

it would be very interesting what’s going to happen in nj. How the noncompete will be decided.

Enforcing the non compete will pretty much shut down one of the largest medical centers in the region. Safe to say it’s not gonna happen.

 

[Mman]

Yes he works like 70-80 hours a week. But he’s a work hard, plays hard type of guy. Takes 8 full weeks off and actually home for his kids events.

if you work 80 hours a week 44 weeks a year, you aren't going to be there for almost anything for your kids those 44 weeks of the year even if your kids live and go to school across the street from the hospital. As a locums that has to bounce around to any degree?????

 

[sevo00]

if you work 80 hours a week 44 weeks a year, you aren't going to be there for almost anything for your kids those 44 weeks of the year even if your kids live and go to school across the street from the hospital. As a locums that has to bounce around to any degree?????

Agree. 80 hours a week I don’t know how that translates to ample family time, unless you yourself aren’t sleeping at all. Sounds miserable.

 

[narcotics999]

True academic places have min 25 annual leave days off. That’s 5 weeks. 1-2 weeks of cme. Add another 10-13 days paid sick leave. Plus holiday pay (if state). That’s 8-9 weeks off.

Curiously, do people really take so many sick leave days? Say you are in your 30s, 40s, healthy. What are the excuses? I am not talking about maternity/paternity leave, Covid leave etc.

 

[Gern Blansten]

Curiously, do people really take so many sick leave days? Say you are in your 30s, 40s, healthy. What are the excuses? I am not talking about maternity/paternity leave, Covid leave etc.

In my experience, most take very few. However, if a family member has surgery or something of that nature, it’s nice to have them. I rarely take more than one or two days a year and it’s almost always because of the health need of an immediate family member. There are some places where it is the culture to treat them as vacation days. Notably, I’m speaking of the VA.

 

[anbuitachi]

In my experience, most take very few. However, if a family member has surgery or something of that nature, it’s nice to have them. I rarely take more than one or two days a year and it’s almost always because of the health need of an immediate family member. There are some places where it is the culture to treat them as vacation days. Notably, I’m speaking of the VA.

im in academic and here we cant take our sick days for family member having surgery i believe. no problem if its your own surgery.

crnas are telling me there are bunch of places paying 200 a hr per diem, and highest ive heard was 250/hr for crna. the crnas here make more than docs (but they do also work 12 hr shifts so they are guaranteed 12 hrs per day)

 

[IMGASMD]

Enforcing the non compete will pretty much shut down one of the largest medical centers in the region. Safe to say it’s not gonna happen.

So then what kind of leverage do any of the AMCs have? Pick off the smaller groups? Stop expansion?
Isn’t this the biggest protection they have from people reform after a buy out?