Teamhealth vs EMcare/Envision vs Schumacher vs USACS vs Vituity

[TooMuchResearch]

Avoid USACS at all cost.

In the last 2 years they have done the following:
- Cut hours significantly. Staffing physician hours around 2.25-2.4 pt/hr.
- Cut 401k contributions from 34k to 27k. Rate from 13% to 10%.
- Eliminated the 401k max over pay. (Once you maxed out the 401k contribution they provided, you got a small chuck of extra pay)
- Suddenly and without notification dropped the employer provided life insurance from 750k to 500k.
- Cut the business expenses account from 8k to 4k. Starting this year, they will no longer pay you out the difference you didn't use.
- No profit sharing since 2016.

Ah, now that the CMG residencies are coming into their own, the downward slide is reaching an inflection point?

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[NYEMMED]

Avoid USACS at all cost.

In the last 2 years they have done the following:
- Cut hours significantly. Staffing physician hours around 2.25-2.4 pt/hr.
- Cut 401k contributions from 34k to 27k. Rate from 13% to 10%.
- Eliminated the 401k max over pay. (Once you maxed out the 401k contribution they provided, you got a small chuck of extra pay)
- Suddenly and without notification dropped the employer provided life insurance from 750k to 500k.
- Cut the business expenses account from 8k to 4k. Starting this year, they will no longer pay you out the difference you didn't use.
- No profit sharing since 2016.

USACS originally marketed their salaries as slightly lower, but the BENEFITS are so much higher.

But they got people to sign on and are slowly cutting the benefits so all that is left is a low paying job

There is no predictability with USACS as far as pay and hours.

You may be scheduled 130 hours, but everyday you may be told to come in late or leave early without pay, because the “volume” was low that day, meanwhile your buddy actually working at that time feels like they are drowning.

USACS staffing model, 4 PAs supervised by one attending. The Attending sees critical level 1s,2s all day, and takes the midlevels liability for all the other patients.

 

[GonnaBeADoc2222]

USACS originally marketed their salaries as slightly lower, but the BENEFITS are so much higher.

But they got people to sign on and are slowly cutting the benefits so all that is left is a low paying job

There is no predictability with USACS as far as pay and hours.

You may be scheduled 130 hours, but everyday you may be told to come in late or leave early without pay, because the “volume” was low that day, meanwhile your buddy actually working at that time feels like they are drowning.

USACS staffing model, 4 PAs supervised by one attending. The Attending sees critical level 1s,2s all day, and takes the midlevels liability for all the other patients.

There's a reason they're called "USUCK"

 

[RustedFox]

There's a reason they're called "USUCK"

What they did in Ohio is unforgivable.

Death to them.

 

[BoardingDoc]

What they did in Ohio is unforgivable.

Death to them.

Not that I disagree with your sentiment, but didn't you just get an SDN sanction for wishing death on people?

Again, that said, USACS can eat a bag of dicks.

 

[RustedFox]

Its okay to wish death to a corporation.

 

[GeneralVeers]

What they did in Ohio is unforgivable.

Death to them.

A little extreme. I'd rather the execs in the company who don't actually work clinical shifts be forced to work full time in their hellhole EDs.

 

[TooMuchResearch]

Its okay to wish death to a corporation.

Didn't the government decide that corporations are people? Something about political donations, maybe it was 5-10 years ago? Just kidding around, I am not a USACS well wisher.

 

[GeneralVeers]

Didn't the government decide that corporations are people? Something about political donations, maybe it was 5-10 years ago? Just kidding around, I am not a USACS well wisher.

I've often wondered if the executives and corporate have read any of the SDN posts and realize that USACS is the most hated CMG in our community. To snatch the crown from Envision was a difficult accomplishment indeed.

 

[Rekt]

I've often wondered if the executives and corporate have read any of the SDN posts and realize that USACS is the most hated CMG in our community. To snatch the crown from Envision was a difficult accomplishment indeed.

I'm sure the yachts full of hookers and blow make up for it.

 

[deleted109597]

How do they sleep at night?
Naked, on piles of money with the fan on.


I'm ok with wanting the corporation (or all CMGs) to die.

 

[Not Pudding]

USACS originally marketed their salaries as slightly lower, but the BENEFITS are so much higher.

But they got people to sign on and are slowly cutting the benefits so all that is left is a low paying job

There is no predictability with USACS as far as pay and hours.

You may be scheduled 130 hours, but everyday you may be told to come in late or leave early without pay, because the “volume” was low that day, meanwhile your buddy actually working at that time feels like they are drowning.

USACS staffing model, 4 PAs supervised by one attending. The Attending sees critical level 1s,2s all day, and takes the midlevels liability for all the other patients.

Sounds about right.

About 9 months ago the cutting seemed to stop. However before that there was tons of pressure to leave early or come in late if the volume was low. Sometimes we would get called and told to sign out our pts and go home. We were also getting constant schedule changes, almost bi-weekly based on the last couple of week's volume. As you could have guessed, the results didn't match reality. I assume there was company wide outcry, as this all stopped after an internal survey.

I've often wondered if the executives and corporate have read any of the SDN posts and realize that USACS is the most hated CMG in our community. To snatch the crown from Envision was a difficult accomplishment indeed.

I assume they do. I know they follow what goes on in the facebook group EMDocs. I know some people who work for USACS who had been called about their facebook posts about USACS in that group.

 

[doctalaughs]

The ones that follow these blogs or facebook are midlevel admins making far less than the "greedy doctors" and have to answer to the executives about the bottom line.... so making ridiculous changes and getting doctors mad doesn't really matter to them much. The top executives already are super-rich and don't read this stuff so only take notice if there is a major exodus that impacts their bottom line.

 

[TooMuchResearch]

Our SDG is hiring to cover a couple retirements, people scaling back shifts, expanding our physician hour coverage (we like to staff heavy), etc.

There are other options available. Same problem as always though: you might have to move.

 

[Rekt]

Our SDG is hiring to cover a couple retirements, people scaling back shifts, expanding our physician hour coverage (we like to staff heavy), etc.

There are other options available. Same problem as always though: you might have to move.

Save a spot for me 3 years from now.

 

[TooMuchResearch]

Save a spot for me 3 years from now.

We need people every year. Retirements and people scaling back are routine occurrences.

 

[deleted109597]

Yeah, but where?

 

[namethatsmell]

Avoid USACS at all cost.

In the last 2 years they have done the following:
- Cut hours significantly. Staffing physician hours around 2.25-2.4 pt/hr.
- Cut 401k contributions from 34k to 27k. Rate from 13% to 10%.
- Eliminated the 401k max over pay. (Once you maxed out the 401k contribution they provided, you got a small chuck of extra pay)
- Suddenly and without notification dropped the employer provided life insurance from 750k to 500k.
- Cut the business expenses account from 8k to 4k. Starting this year, they will no longer pay you out the difference you didn't use.
- No profit sharing since 2016.

I've heard about a recent whistle-blower case by a director against the higher ups in his CMG for poor staffing (I think Envision?).

This needs to go further.

When is there gonna be a big patient suit against a CMG for poor physician staffing directly contributing to a bad outcome? The individuals who decide on staffing levels in EDs but don't actually work in them need to be named in suits. If this is a such a "team sport" as these leeches proclaim from one side of their face while counting their bonuses with the other, let them put on some pads and spend their time in depos and trials.

 

[Groove]

I'll never work for USACS. They sound like complete tools. We need a non profit...union. Though I'm sure a nationwide union organized EM physician strike would be...just terrible PR.

 

[MechEDoc]

When is there gonna be a big patient suit against a CMG for poor physician staffing directly contributing to a bad outcome? The individuals who decide on staffing levels in EDs but don't actually work in them need to be named in suits. If this is a such a "team sport" as these leeches proclaim from one side of their face while counting their bonuses with the other, let them put on some pads and spend their time in depos and trials.

I think the problem is that our failings are usually well hidden. The reason why airlines are so safe is that it is a terrible business model to publicly and graphically kill a group of health people. The commercial aviation industry has had a 16x reduction in fatality rates from 1970 to today.

Healthcare usually inflicts incremental penalties at the individual level on already unhealthy people who have made poor choices. We have all likely seen sloppy work that have lead to likely harm, but rarely see gross negligence that leads to harm (e.g. wrong site surgeries). It is additionally hard for the lay public to tease out harm from the myriad interventions and inflections in someones clinical trajectory.

Aviation
The plane crashed! Everyone burned to death! That isn't supposed to happen!

Where does the fault lie? Probably somewhere with the airline/airplane manufacturer/air traffic control. People won't fly if too many accidents are happening.

Medicine
Drunk uncle Larry got ejected from a rollover, someone didn't detect the subtle findings indicating that a blunt cerebrovascular injury should be worked up. Larry strokes, lives for a few years in a lousy medicaid funded nursing home before he is noted to suddenly decompensate at nursing shift change from pristine vitals to sepsis due to his decubitus ulcer and Larry dies.

Where does the fault lie with Larry?

1. Larry: Larry should have been sober and worn his seat belt. Larry has the primary responsibility.
2. The hospital: A non-physician provider saw Larry in the trauma bay and then transferred care to an inpatient non-physician provider. Neither had heard of the Denver Criteria. Does the fault lie with them? Does it rest with the physicians that didn't adequately check their work? But these physicians were overworked by their CMG and couldn't supervise adequately. Does the fault lie with the CMG? Or the hospital that hired a low quality staffing firm and subsequently credentialed these noctors to work critically ill patients? What about the radiology / trauma group that didn't automatically perform angiography on major traumas? The fault lies with everyone. Larry's lawyers will aim their ire at the emergency medicine and trauma physicians, they have the deepest pockets and the most visible role. The PAs/NPs will skate by, the radiologists will do pretty well because the ED physician didn't order a CTA of the head and neck! One simple test ladies and gentlemen of the jury and Larry would still be walking!
3. Larry's nursing home? They have lots of responsibility for the coup d'grace. But the government also has a role, they pay peanuts and get corresponding care. Larry has little financial worth at this point, no economic future, and few next of kin with the stomach to fight. No lawsuit, no visible tragedy, no change.

I think cases trying to assign liability to a CMG are going to be very rare. It would be better for a physicians group or union to fight publicly against CMGs, perhaps in conjunction with insurers (who have outcomes, cost and billing data). Isn't ironic that Walmart appears to have the clearest picture of healthcare costs and outcomes due to its massive work force and the ability to compare interventions across multiple health systems?

More subtly, lets take a typical "low acuity" PA/NP patient. A sore throat with a cough. The NP doesn't apply evidence based medicine, but instead orders a rapid strep and culture and then reaches for their handy antibiogram (below), writes for Azithromycin, and then adds on codeine cough syrup, Prednisone, an albuterol neb and IM toradol, and discharges with an albuterol inhaler.

The patient likes all this, but forget the patient.

The insurer should hate this. If they have someone with half a brain on their staff they would know the following:

1. For most patients, the only indicated medication would be ibuprofen and an OTC cough medication or honey.
2. The NP's chart will cost more due to the labs and medications. The after visit costs will be higher too.
   • EBM - Low Centor score, no testing, clincal dx, no wheezing / no RAD, tonsils with erythema but without significant exudate or swelling, therefore no steroid indication. Patient gets OTC (self pay) ibuprofen and watchful waiting.
   • NP - $Azithromycin, $codeine, $prednisone, $albuterol.
     • CMG - awesome! More money! Higher billing, higher likelihood of a repeat "customer", fewer complaints, and lower labor costs.
     • Patient - I got meds! Awesome.
     • Insurance company. WTF? None of this was indicated. We paid a fortune for what? How come these folks aren't hiring experts to audit these charts and deny payment? What am I missing? It would be easy. "Your note does not support these interventions, payment denied."

Walmart has no shelf space for hospitals' shoddy healthcare

If you want to witness one of the most compelling examples of healthcare 'disruption' today, gather hospital and health system leaders in a room and hand a microphone to Lisa Woods, senior director of U. S. Health Care at Walmart.

www.beckershospitalreview.com

 

[Bigeminy]

I wanted to poke my head in here and ask about Team Health. The group of ED docs i am a part of recently got taken over by Team Health. We were previously hospital employees. Found out in an email without any warning signs. Our new Team Health contract will start next month. They say nothing will change, just administrative stuff like benefits packages, retirement funds, etc. I'm skeptical that it will actually remain that way, and am curious how a Team Health takeover generally goes.

Do they start changing staffing? Do they tend to micromanage ED docs once they have been running a group for a while?

 

[thegenius]

I wanted to poke my head in here and ask about Team Health. The group of ED docs i am a part of recently got taken over by Team Health. We were previously hospital employees. Found out in an email without any warning signs. Our new Team Health contract will start next month. They say nothing will change, just administrative stuff like benefits packages, retirement funds, etc. I'm skeptical that it will actually remain that way, and am curious how a Team Health takeover generally goes.

Do they start changing staffing? Do they tend to micromanage ED docs once they have been running a group for a while?

Run man....run to the hills!
Run fast and long!!!
They are coming for ya.
They will slowly take your money, your time, your happiness.

Run!!!

 

[Rekt]

I wanted to poke my head in here and ask about Team Health. The group of ED docs i am a part of recently got taken over by Team Health. We were previously hospital employees. Found out in an email without any warning signs. Our new Team Health contract will start next month. They say nothing will change, just administrative stuff like benefits packages, retirement funds, etc. I'm skeptical that it will actually remain that way, and am curious how a Team Health takeover generally goes.

Do they start changing staffing? Do they tend to micromanage ED docs once they have been running a group for a while?

"Just". These are pretty important in my opinion.

 

[Dr Mantis Toboggan]

How many visits do you have per year, average patients per hour, what is typical physician/midlevel staffing?

I wanted to poke my head in here and ask about Team Health. The group of ED docs i am a part of recently got taken over by Team Health. We were previously hospital employees. Found out in an email without any warning signs. Our new Team Health contract will start next month. They say nothing will change, just administrative stuff like benefits packages, retirement funds, etc. I'm skeptical that it will actually remain that way, and am curious how a Team Health takeover generally goes.

Do they start changing staffing? Do they tend to micromanage ED docs once they have been running a group for a while?

 

[GonnaBeADoc2222]

In my experience, their health insurance offering is not good and they contribute nothing to retirement. Your hourly wage might go up a but but they're gonna cut staffing hardcore. I wouldn't work for any CMG unless you have a specific reason why your situation would benefit from it.

 

[NYEMMED]

In my experience, their health insurance offering is not good and they contribute nothing to retirement. Your hourly wage might go up a but but they're gonna cut staffing hardcore. I wouldn't work for any CMG unless you have a specific reason why your situation would benefit from it.

Many people live in areas with only CMGs. Even worse when it’s all one CMG, no competition, leads to low wages. Unfortunately it’s the way our field is these days...

 

[Backpack234]

We need people every year. Retirements and people scaling back are routine occurrences.

Where?

 

[MechEDoc]

TH Pros: they usually don't bother you much.

TH Cons: they don't bother you much because you don't matter much to them.

Things I've seen:
* Calling people off one hour before their shift to save money.
* Reneging on contractual agreements to cover lodging and travel expenses.
* Changing RVU formulas without any transparency that leads to a significant loss of income.
* Changing the physician schedule on a week by week basis tailored to the prior 1-2 weeks of patient census while increasing mid-level hours.
* Sending physicians home early, part way through a previously scheduled shift, when an extra PA was unexpectedly available.
* Forgetting to pay signing bonuses.
* Accidentally overpaying.
* Forgetting to make final payments at the end of contract.
* Providing fewer than contracted hours and then refusing to pay for contracted hours.
* Will virtually never backup of physician as the contract is priority number 1, 2, and 3.
* Providing a schedule 7-10 days before the month starts.
* Scheduling a significantly greater portion of nights than contracted for.
* Scheduling the "new guy" for every single federal holiday (contract stipulated an equal proportion to be off).
* Aggressively (perhaps unethically) up coding charts.
* Hiring underqualified PAs and NPs and forcing you to sign their charts.

Best of luck!

There is no I in team.

 

[namethatsmell]

TH Pros: they usually don't bother you much.

TH Cons: they don't bother you much because you don't matter much to them.

Things I've seen:
* Calling people off one hour before their shift to save money.
* Reneging on contractual agreements to cover lodging and travel expenses.
* Changing RVU formulas without any transparency that leads to a significant loss of income.
* Changing the physician schedule on a week by week basis tailored to the prior 1-2 weeks of patient census while increasing mid-level hours.
* Sending physicians home early, part way through a previously scheduled shift, when an extra PA was unexpectedly available.
* Forgetting to pay signing bonuses.
* Accidentally overpaying.
* Forgetting to make final payments at the end of contract.
* Providing fewer than contracted hours and then refusing to pay for contracted hours.
* Will virtually never backup of physician as the contract is priority number 1, 2, and 3.
* Providing a schedule 7-10 days before the month starts.
* Scheduling a significantly greater portion of nights than contracted for.
* Scheduling the "new guy" for every single federal holiday (contract stipulated an equal proportion to be off).
* Aggressively (perhaps unethically) up coding charts.
* Hiring underqualified PAs and NPs and forcing you to sign their charts.

Best of luck!

An excellent compilation of the CMG classic hits.

 

[EctopicFetus]

Team health likely will save the hospital money cause hospitals are terrible at pricing and negotiating ED contracts. It is sort of their total view of the ED. They dont appreciate it is the front door to their hospital and system. They dont appreciate that there is money there so they dont staff nurses appropriately.

The CMG has to make money. Some will be from their better contracts the rest from their experience in squeezing docs. Good luck and god bless. Best news is that it isnt USACS. Team and Emcare are on par. APP is trying to become a trash heap like the others. Success is coming for them I am sure. they have a ton of non EM doc regional directors who dont understand EM or EM docs.

 

[RustedFox]

Team health likely will save the hospital money cause hospitals are terrible at pricing and negotiating ED contracts. It is sort of their total view of the ED. They dont appreciate it is the front door to their hospital and system. They dont appreciate that there is money there so they dont staff nurses appropriately.

The CMG has to make money. Some will be from their better contracts the rest from their experience in squeezing docs. Good luck and god bless. Best news is that it isnt USACS. Team and Emcare are on par. APP is trying to become a trash heap like the others. Success is coming for them I am sure. they have a ton of non EM doc regional directors who dont understand EM or EM docs.

Why have I not heard of this APP group?
I admit; I may be just dog-tired and be wrong at this precise time, but it doesn't ring a bell.

My main gig was a TeamHealth shop, and TH recently lost the contract.
Lots of bad blood for more reasons (beyond the ER) from my understanding.
New Group takes over in a few months.
We will see whether it is better or worse.
Meet the new boss.
Same as the old boss.

RustedFox Rants:

I'm so freaking fickle when it comes down to whether or not to leave "EM" altogether.
I'll have days (and strings of days) where I say to myself: "I'm soo out from under the thumbs of the corporate d!ckwads when I'm out of debt."
Now I'm out of debt. I could walk away and do something else entirely.

I looked into chart review. Could make 150K or so doing that a year working 40 hours a week from my office and not have to deal with abusive patients and mouthbreathing managers. I imagine myself working at home, enjoying good coffee, with my favorite radio show on, and saying to myself: "Ahh! This is the life. No nightshifts, no soul-sucking patients. UNSUBSCRIBED."

You guys hear me say things all the time on here like; "Godddamned muggles! Its okay to hate them!"

...

I looked into a few other things that I can make 100-150 bucks an hour doing that are totally unrelated to medicine. "Nine-to-five" gigs.

Unless something RADICAL happens; I'm in this game for life.

A good, crisp STEMI on an EKG.
The satisfying "clunk" of a reduction.
An ultrasound-guided central line.
A slam-dunk gallbladder and a bedside US.

I'm hooked.

Those who know me in real-life know that I'm the type to wear my heart on my sleeve. When my patients cry, I am sad. When they are elated, I am pumped. If you prick us, we all bleed.

There's a few phrases that I find myself using every shift that really "make it better."

"I"m glad you came tonight. I can help you. I will help you."

"I understand your feelings. [Chest/abdominal/leg] pain is scary; but it's rarely dangerous. I can help you tell the difference."

"Good thinking. I like the way you think. Together, we can think our way thru this."

"You're doing it right, mommy; I'm proud of you."

"I can tell that you love [this person] very much. I promise you; I will give you my best."

"I can tell that you want to help; but you didn't come to work tonight. I came to work tonight. Let me do the heavy lifting." (or)

"All you have to do is sit back and leave the chemistry to me. I'll keep you up to date."

"I'm sorry to keep you waiting on the results, but I bring you good news!"

"I understand your fear. Every day at work for me is the worst day of someone else's life. I promise you; this is not your day."

...


I see myself as the robe-clad "Obi-Wan Kenobi" (the old one, not the young one) when I say these things. With the right phrase and a hand wave, you can really work "magic".

 

[thegenius]

TeamHealth is terrible. Never expect to understand where the money comes from or your paycheck.

 

[hundreddaysoff]

TH Pros: they usually don't bother you much.

TH Cons: they don't bother you much because you don't matter much to them.

Things I've seen:
* Calling people off one hour before their shift to save money.
* Reneging on contractual agreements to cover lodging and travel expenses.
* Changing RVU formulas without any transparency that leads to a significant loss of income.
* Changing the physician schedule on a week by week basis tailored to the prior 1-2 weeks of patient census while increasing mid-level hours.
* Sending physicians home early, part way through a previously scheduled shift, when an extra PA was unexpectedly available.
* Forgetting to pay signing bonuses.
* Accidentally overpaying.
* Forgetting to make final payments at the end of contract.
* Providing fewer than contracted hours and then refusing to pay for contracted hours.
* Will virtually never backup of physician as the contract is priority number 1, 2, and 3.
* Providing a schedule 7-10 days before the month starts.
* Scheduling a significantly greater portion of nights than contracted for.
* Scheduling the "new guy" for every single federal holiday (contract stipulated an equal proportion to be off).
* Aggressively (perhaps unethically) up coding charts.
* Hiring underqualified PAs and NPs and forcing you to sign their charts.

Best of luck!

There is no I in team.

Been with a TH/HCA shop fulltime for a year.

Things in the above list I have also seen: changing RVU formulas w/o transparency, accidentally overpaying, providing fewer than contracted hours, HCA contract >>> feelings of individual physicians, aggressively upcoding charts, hiring underqualified midlevels (although in fairness most ER midlevels I've seen everywhere are underqualified).

Re the scheduling stuff, around here the individual medical directors make the schedules, so it's probably luck of the draw re how good yours is. My director is pretty good at the scheduling part of his job so we usually get schedules 1--2mo in advance and I always get all my requests.

The main thing about TH that I dislike is they're spineless and prioritize keeping their contracts over advocating the good commonsense medicine that I learned in residency. Eg, they have not fought HCA's protocols about stupid sepsis and stroke over-workups that I have no control over and that likely cost my patients $hundreds--thousands more than they would be paying us if I were king.

As I've said before, the source of most of the evil at my shop is HCA, not TH.

 

[GonnaBeADoc2222]

Biggest issue with them is understaffing to unsafe levels and hiring of grossly unqualified midlevels. Like I would trust a MS4 on their sub-I more.

 

[dchristismi]

So I was the asst director at a shop RustedFox worked at when we lost our contract and were taken over by TH. (Different than the one he referenced above)
Ultimately, not much changed right away. It was actually quite gradual... you know, they slowly heat up the water so you don't realize they're boiling you alive.

I stuck around for a couple of years, but made it clear that I wasn't going to do any admin for them, and only wanted 10 shifts a month (ie not quite full time.) Since they set up the new "group" as IC, it made sense, and was a lot easier saying no to things. I bowed out gracefully a few years later when my hospice gig landed in my lap, but I was starting to see enough deal-breakers that the scales tipped for me.

Overall, I wasn't really in a position to leave when they first took over, but gradually initiated my exit strategy. I hear the place continues to go downhill and the majority of the docs I'd recruited have left. So, basically, I'd recommend you keep your eyes wide open and don't put all your eggs in one basket. Although honestly, that's pretty good advice regardless.

 

[namethatsmell]

So, basically, I'd recommend you keep your eyes wide open and don't put all your eggs in one basket. Although honestly, that's pretty good advice regardless.

This is extremely good advice.

Not having all my eggs in one basket has been huge and has prevented me from getting royally screwed by various employers.

We typically have so little control over our work environment that being able to trade one set of problems for a different set now and again rejuvenates the soul.

 

[alphaholic06]

Team health likely will save the hospital money cause hospitals are terrible at pricing and negotiating ED contracts. It is sort of their total view of the ED. They dont appreciate it is the front door to their hospital and system. They dont appreciate that there is money there so they dont staff nurses appropriately.

The CMG has to make money. Some will be from their better contracts the rest from their experience in squeezing docs. Good luck and god bless. Best news is that it isnt USACS. Team and Emcare are on par. APP is trying to become a trash heap like the others. Success is coming for them I am sure. they have a ton of non EM doc regional directors who dont understand EM or EM docs.

Trying to. They already are. Your last statement proves it.

 

[EctopicFetus]

For those who don’t know app. Google American physician partners. Look at the credentials of their medical directors. Sad state of affairs when FP docs who literally know nothing of em admin are running 10-12 hospitals.

 

[bravotwozero]

Our group in houston got taken over by them, we're all board certified ABEM docs. They were asking our owner how to setup a RVU based payment system for ED compensation.

 

[Groove]

For those who don’t know app. Google American physician partners. Look at the credentials of their medical directors. Sad state of affairs when FP docs who literally know nothing of em admin are running 10-12 hospitals.

Woodard used to be the CEO for NETEP in E TN. Wellmont system. I worked locums for them in the past. I guess he got awarded a regional dir position when they sold out to APP. I can't believe that went over well in their SDG. Too bad, it seemed like a pretty nice operation they had going up there.

 

[Hamhock]

For those who don’t know app. Google American physician partners. Look at the credentials of their medical directors. Sad state of affairs when FP docs who literally know nothing of em admin are running 10-12 hospitals.

Agreed. This is sad.

That said, this is something that EM docs could be doing; but aren't. There is clearly an opportunity to scam some money in EM (ie CMGs) and clearly an opportunity to manage the non-clinical direction of EM. We are failing to take advantage of these opportunities. Instead, we just complain when others do.

Of course, I'll admit, that I am probably one of the biggest wimps -- because I just flee from community EM (to academics or my other specialty).

HH

 

[EctopicFetus]

Our group in houston got taken over by them, we're all board certified ABEM docs. They were asking our owner how to setup a RVU based payment system for ED compensation.

Surprised the question wasn’t more like whats the difference between a 99282 and a 99291.

 

[EctopicFetus]

Woodard used to be the CEO for NETEP in E TN. Wellmont system. I worked locums for them in the past. I guess he got awarded a regional dir position when they sold out to APP. I can't believe that went over well in their SDG. Too bad, it seemed like a pretty nice operation they had going up there.

Yeah. That group is now starting to have their guys look elsewhere. Money talks. The are buying up their EM trained folks. Will be interesting if they have much success. I say that because they are growing rapidly but there isnt a single thing they do that seems good. Many of their docs and MLPs dislike them and they seem disorganized and clueless.

 

[RustedFox]

So I was the asst director at a shop RustedFox worked at when we lost our contract and were taken over by TH. (Different than the one he referenced above)
Ultimately, not much changed right away. It was actually quite gradual... you know, they slowly heat up the water so you don't realize they're boiling you alive.

I stuck around for a couple of years, but made it clear that I wasn't going to do any admin for them, and only wanted 10 shifts a month (ie not quite full time.) Since they set up the new "group" as IC, it made sense, and was a lot easier saying no to things. I bowed out gracefully a few years later when my hospice gig landed in my lap, but I was starting to see enough deal-breakers that the scales tipped for me.

Overall, I wasn't really in a position to leave when they first took over, but gradually initiated my exit strategy. I hear the place continues to go downhill and the majority of the docs I'd recruited have left. So, basically, I'd recommend you keep your eyes wide open and don't put all your eggs in one basket. Although honestly, that's pretty good advice regardless.

I can honestly say that I had so much fun working at that shop doing critical care, but the volume was so overwhelming for the staffing that we had.
I used to go out to the ambulance bay and look across the lake, and someone had a cross illuminated on the opposite shore.
I prayed with that thing in my sight every night shift.

...

It really was a "Level-1 tragedy shop". If Steinbeck were alive, he would have written a sequel to the Grapes of Wrath based on that ER.

I remember Gibby had that "thousand-yard-stare" every shift.

I hope he's okay. He was divorced what... three times?

That, and the cafeteria was freaking amazing. That crew knew that I wanted a "FoxSandwich" and how to make it fast.