San Antonio EM Market - PRN

[ShockIndex]

I haven't seen an EM contract in Texas with a noncompete clause. They may exist, but I haven't seen one in the dozens of contracts I've looked at.
With the market tightening it may be more common now, but I've signed a couple contracts in the last 3 months that didn't have them.

I had one at my last academic job that said I could not work in any county in which my employer had an ED for 1 year. I didn’t think too much about it at the time I took the job, but it certainly was in the back of my mind heading off to fellowship in case things didn’t work out (we are keeping our house). The more I think about it, the more I agree with AAEM that non-competes have no role in EM except perhaps senior department leadership.

Atrium Health in Charlotte (formerly CHS that owns Carolinas Medical Center) vigorously enforces non-competes with its physicians. There were several very public disputes with primary care groups over the Atrium non-compete resulting in docs suing to get out or traveling 90 miles up to my hospital to practice.

Parents in limbo as south Charlotte pediatricians leave Atrium Health over proposed pay cut

South Charlotte parents are scrambling to line up new pediatricians after a string of abrupt departures from clinics affiliated with Atrium Health. Doctors have been unable to give their patients’ families much information about why they’re leaving. But the hospital group, formerly known as...

www.charlotteagenda.com

https://www.google.com/amp/s/amp.charlotteobserver.com/news/business/article209797689.html

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[cyanide12345678]

So Dallas, Houston, Austin and now San Antonio are no longer options.

Are Lubbock, Amarillo, el paso still high paying options? Right now i make $265/hr IC for 1.7 PPH.

I've been waiting for my wife to finish residency before we moved back to Texas. We're going to be actively job hunting in 6 months. Are there any good options left? Or am i looking at a massive paycut?

 

[deleted109597]

Lubbock is tight, they are opening a new residency and have done a big hiring thing and pushing out the nonboarded people to the other hospitals. Amarillo slightly less so. El Paso has openings.
The Valley has a million, but they're all HCA/Emcare or Schumacher.

 

[cyanide12345678]

Lubbock is tight, they are opening a new residency and have done a big hiring thing and pushing out the nonboarded people to the other hospitals. Amarillo slightly less so. El Paso has openings.
The Valley has a million, but they're all HCA/Emcare or Schumacher.

Yeah i don't think i can ever convince my wife on moving to the valley. Amarillo/el paso has been our compromise where i can get my tort reform, no state income tax, and cheap living and she can get a no humidity environment with summers that aren't Houston miserable.

 

[Zebra Hunter]

Yeah i don't think i can ever convince my wife on moving to the valley. Amarillo/el paso has been our compromise where i can get my tort reform, no state income tax, and cheap living and she can get a no humidity environment with summers that aren't Houston miserable.

From what my buddy in Amarillo says, his group is no longer hiring. So market might have dried up there, as well.

 

[cyanide12345678]

From what my buddy in Amarillo says, his group is no longer hiring. So market might have dried up there, as well.

That's just great -_-

What happened to our field?!?!?!? In 5 years we're on the brink of saturation and massive paycuts -_- this was a hot field a few years ago!!!

 

[Apollyon]

Lubbock is tight, they are opening a new residency and have done a big hiring thing and pushing out the nonboarded people to the other hospitals. Amarillo slightly less so. El Paso has openings.
The Valley has a million, but they're all HCA/Emcare or Schumacher.

4 years ago, at ACEP, Lubbock was recruiting. Damn, but I missed it! Hell, I could have been halfway to FIRE right now! And they were paying twice (literally) as much as I was making then!

 

[Dr Mantis Toboggan]

Although some feel this board is “too negative”. I think it’s a great way to get the pulse of the specialty/job market.

That's just great -_-

What happened to our field?!?!?!? In 5 years we're on the brink of saturation and massive paycuts -_- this was a hot field a few years ago!!!

 

[TheComebacKid]

No. The hospitals generally don't pay anything to the group, with a few exceptions where they pay stipends to staff low-volume EDs. Hospitals only care about metrics, and CMGS have slick sales pitches about how they will improve patient satisfaction, LWBS, and length of stay. They make a compelling argument to hospital CEOS to switch. Generally if metrics improve then hospital admins get a bigger bonus which is all they care about.

Just out of curiosity, on the whole, how do SDGs perform compared to CMGs on things like metrics, patient satisfaction, etc.?

I get the sales/marketing pitch put forth by the CMGs, but nothing they do IMO from a metrics standpoint is "better" than what a SDG can provide. I'm not sure why SDGs can't market the same things.

 

[EctopicFetus]

Just out of curiosity, on the whole, how do SDGs perform compared to CMGs on things like metrics, patient satisfaction, etc.?

I get the sales/marketing pitch put forth by the CMGs, but nothing they do IMO from a metrics standpoint is "better" than what a SDG can provide. I'm not sure why SDGs can't market the same things.

Many SDGs have no incentive or plan to grow. Why would they need to. I know of groups making 800k+ per doc. Why would they want to grow? WHats the benefit. This is the issue. The docs need to fight for themselves. There is no benefit for me and my group to take on local contracts. We are structured in a super fair manner so there is no money to be made by growing ourselves.

A CMG on the other hand.... all growth is profit for them.

 

[GeneralVeers]

Just out of curiosity, on the whole, how do SDGs perform compared to CMGs on things like metrics, patient satisfaction, etc.?

I get the sales/marketing pitch put forth by the CMGs, but nothing they do IMO from a metrics standpoint is "better" than what a SDG can provide. I'm not sure why SDGs can't market the same things.

The CMGs have a slick powerpoint presentation, where they advertise economy of scale, and dedicated VP of Patient Satisfaction or some such nonsense. They will also trumpet their Doctor in Triage program as a way to improve front-end metrics. It's convincing, and I don't think an SDG can compete with this, when a hospital admin's only goal is maintain his metric-based bonuses.