Stuck in between rock and hard place

[ScepticSkeksis]

Health inusurance, $2500 401K contribution, Business Expense acccount. You are talking about rounding errors when considering a salary of $300-$500K.

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[EctopicFetus]

Sorry all… have not been on here and I see you all have been very busy here. All good.

Major - I’m happy to chat offline. And I’m sure the site director can help go over what the comp model change at their site means to their team both hourly and annually. I don’t know if there is a way to DM on here, but feel free to reach out.

As for CMS changes - they go up and down annually. We have not typically adjusted our paid RVU rates with these changes. We also don’t adjust pay rates down when IRS 401K contribution limits and payroll taxes go up. In 2023, our docs will get a pretax $2500 increase in company contribution to their 401K because IRS limits are going up - no change in pay the company is absorbing the cost. We also haven’t seen an increase in our health insurance rates for the last 3-4 years when the overall cost of the plans have gone up. Next year we actually have better options with lower deductibles without a cost increase.

I know some will jump in with the fact that I have not responded to every comment - there were A LOT. Many weren’t exactly kind. Happy to have a collegial discussion - I’m happy with my group and wish everyone well.

Def sounds like dom. Lol. Talk offline cause you don’t want to let people see the truth? Why are your docs universally miserable (except your “leaders”)?

 

[EM_Disney_Doc]

Try answering the questions, amigo.
You have a captive audience.
Use it.

I did answer the questions the OP posed. I don’t know where they are interviewing so cannot answer the specific question of how the comp changes were determined. There are 2 pages of posts since last weekend.

Specific snippets I saw in comments - loan program allows you to use any bank you want. We have a negotiated rate reduction with Laurel Road but you can bring federal consolidation if that is better for you or any lender of your choice.

Malpractice - we fight frivolous crap and are self insured. If you fight frivolous cases long enough you get a reputation with attorneys and the lawyers don’t bring the BS. We have a National Clinical Governance Board (all physicians) that works to bring best practices from all of our legacy groups together and reduce practice variation. We have a 24/7 Failsafe doc on call for a second opinion and a process to document these calls for high risk cases. We have never had a suit brought on these cases that are by definition high risk. By self insuring we all have a vested interest in managing our risk. And yes, if a doc is sued we fight for them and work hard to get them dropped.

And its Amiga. No mustache to twirl or cajones.

 

[turkeyjerky]

Lol. What a joke.

Of course he's happy with his group, he's at the top of the pyramid (scheme). I'm sure Yertle the Turtle was happy too.

I'm sure they fight frivolous crap when you adhere to their ridiculous policies, like a CT and Tap for every.single.headache.

 

[JacobMcCandles]

In 2023, our docs will get a pretax $2500 increase in company contribution to their 401K because IRS limits are going up - no change in pay the company is absorbing the cost.

The company isn't absorbing s**t. There's only 1 main way CMGs make money and that's by seeing patients. The pit docs are the ones seeing patients and bringing revenue in. Unless you have a bunch of sites where you're getting subsidies and you're paying the docs more than you'd actually collect from the patient (which is very unlikely to be the case) then you're just FOS saying the company is absorbing this cost. Or do you really mean that the pit docs are absorbing a little less admin fluff? Just say exactly what it is...the pit docs are getting just slightly more of the money that THEY bring in.

Malpractice - we fight frivolous crap and are self insured. If you fight frivolous cases long enough you get a reputation with attorneys and the lawyers don’t bring the BS. We have a National Clinical Governance Board (all physicians) that works to bring best practices from all of our legacy groups together and reduce practice variation. We have a 24/7 Failsafe doc on call for a second opinion and a process to document these calls for high risk cases. We have never had a suit brought on these cases that are by definition high risk. By self insuring we all have a vested interest in managing our risk. And yes, if a doc is sued we fight for them and work hard to get them dropped.

Would you like to share data that USACS physicians are actually sued at a rate that is less than the national average for EM? Or would you like to say that your statement was intentionally misleading or that you misspoke? Or that you actually believe the snake oil that you sell?

 

[HemorrhagicShock]

I am enjoying how hard some of you are trying to get a USACS shill to actually come out and say "yep, you got me, we're terrible and completely guilty of everything you hear from our non-admin pit docs"

Somebody said it above - while it's exhausting to some extent to read, it serves as a great warning for those who are uninitiated to the EM attending life (residents, med students etc)

 

[sylvanthus]

I hope the USACS discussion continues. Its important for new grads to see how they BS you and for experienced docs to call out the BS so the new guys know. Keep it up USACS admin dude/dudette. Keep chatting so everyones eyes can be opened. Or run away cuz thatll speak volumes also. Either way winner winner chicken dinner

 

[EctopicFetus]

My gut doesn’t feel right with usacs at all. The guys at the top are making all the filet mignon while the pit docs are getting crumbs.

Crumbs and working in understaffed EDs with a bunch of midlevels who cant spell. Of course those midlevels may be more of an owner of USACS than the docs. I find it comical how Dom and other USACS leaders claim everyone wants to buy their BS stock. then on the other hand they have to sell to MLPs to find buyers of their trash.

An idiot is born every minute.......