Thread for fellows looking for first jobs

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gaspasser127 said:
I’m not quite sure what the ProPublica database and new grads looking for jobs have to do with one another.

FWIW, I’ve met a lot of these KOLs this past year during various courses/conference and most of them seem very down to earth and have a genuine interest in teaching - or so it seems. Sure they get paid $$$ by industry for it - but why shouldn’t they?

I bet working for a KOL is a mixed bag and ultimately probably isn’t much different than any other private practice.
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gaspasser127 said:
I’m not quite sure what the ProPublica database and new grads looking for jobs have to do with one another.

FWIW, I’ve met a lot of these KOLs this past year during various courses/conference and most of them seem very down to earth and have a genuine interest in teaching - or so it seems. Sure they get paid $$$ by industry for it - but why shouldn’t they?

I bet working for a KOL is a mixed bag and ultimately probably isn’t much different than any other private practice.
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when i talk with KOLs, this thought comes to my mind:

show me who a used car salesman is without showing me a used car salesman.
 
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1. How did you know the time was right to bring in another pain physician? (ie market cues, being booked out months, owner planning on cutting back)

2. What kind of oversight is there when I begin? (ie are you in a completely new satellite location that no patient has stepped foot in and the owner monitors you remotely Vs sharing clinic space and patient volume)

3. What is the airspeed velocity of an unladen swallow?

4. How are your billing and collections done (3rd party company that takes a percentage, in house billing, EMR billing and how do you make sure you are collecting what is owed. Also what is the lag time).

5. Is there a firm plan for partnership Vs permanent employment. Do not accept vague hand-waving. Permanent employment is fine if it’s structured fairly.
 
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Agast said:
1. How did you know the time was right to bring in another pain physician? (ie market cues, being booked out months, owner planning on cutting back)

2. What kind of oversight is there when I begin? (ie are you in a completely new satellite location that no patient has stepped foot in and the owner monitors you remotely Vs sharing clinic space and patient volume)

3. What is the airspeed velocity of an unladen swallow?

4. How are your billing and collections done (3rd party company that takes a percentage, in house billing, EMR billing and how do you make sure you are collecting what is owed. Also what is the lag time).

5. Is there a firm plan for partnership Vs permanent employment. Do not accept vague hand-waving. Permanent employment is fine if it’s structured fairly.
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Great questions. Unladen swallow lol.

Should the new grad looking for the first job ask anything about:
1. Expectations with regard to “ancillaries”
2. Expectations with regard to opioid management
3. Future plans to sell the practice
4. Mid level oversight
5. Any recent or current audits
6. Recent or current lawsuits
7. Doctor turnover
 
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Agast said:
1. How did you know the time was right to bring in another pain physician? (ie market cues, being booked out months, owner planning on cutting back)

2. What kind of oversight is there when I begin? (ie are you in a completely new satellite location that no patient has stepped foot in and the owner monitors you remotely Vs sharing clinic space and patient volume)

3. What is the airspeed velocity of an unladen swallow?

4. How are your billing and collections done (3rd party company that takes a percentage, in house billing, EMR billing and how do you make sure you are collecting what is owed. Also what is the lag time).

5. Is there a firm plan for partnership Vs permanent employment. Do not accept vague hand-waving. Permanent employment is fine if it’s structured fairly.
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how does number 4 impact evaluation of jobs? specifically the 3rd party, in house, emr billing part.
 
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gazzer said:
how does number 4 impact evaluation of jobs? specifically the 3rd party, in house, emr billing part.
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3rd party billers take a percentage of your collections as their fee, whereas an in house biller is a fixed cost. That will change your expected overhead. Understanding the cost of your overhead plays a role in how much of a bonus you can expect to see after a full year of work.
 
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A number of practices have in house billing but it’s a separate corp when u become partner the super partner that owns the billing is taking a cut along with the rent you pay for the building he owns thru another corp.

Probably a fair way to get some $ without being too greedy on % collections
 
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I’m a graduating fellow looking for jobs in West - MTN West. Frustrating search so far, open to any potential jobs. PM me.
 
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Czech777 said:
I’m a graduating fellow looking for jobs in West - MTN West. Frustrating search so far, open to any potential jobs. PM me.
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Curious as to what opportunities you are finding in this area?
 
Czech777 said:
I’m a graduating fellow looking for jobs in West - MTN West. Frustrating search so far, open to any potential jobs. PM me.
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Mountain west is very desirable so very few jobs for that reason.
The two places that no recruiter or job board ever has decent pain jobs are Southern California and the mountain west. I see options all over the country except those two places.

There are jobs to be found in Bay Area and Arizona/NM, but SoCal and the mountain west have been extremely tight for a decade. You may need to open up the geographic area of your job search.
 
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What attributes actually set a new grad apart from other new grad peers in the eyes of the employer ?

1. The answer may be as simple as “the most desirable new grad seems most open to being manipulated.” It seems to me that large groups basically view the young doctor (yep, even being 35-40 years old counts as being young in doctor years) as a thing to be molded into whatever vessel the ceo/cmo, nurse administrator vampires believe will collect the most money from insurance companies (legality of secondary importance and morality an after thought).
2. The corollary may be: if you are not agreeable to being endlessly micro managed and manipulated, do not consider joining a large group.
3. Smaller groups are most likely interested in whether or not the fresh grad will break even after a couple years and will not cause too many headaches along the way. Smaller groups seem more interested in reducing overhead and improving efficiency, while larger groups seem intent on increasing overhead, decreasing efficiency, and ripping everyone off to the greatest degree while burning down the specialty by creating nurse practitioner armies and MD needle/knife linkedin bois, selling out to PE, and destroying insurance coverage for all procedures. My feeling about hospitals is that they too will DEFINITELY attempt to rip off the unprepared new grad, but their attempts will seem pedestrian and simplistic compared to the larger “pain groups.” What of the vaunted ortho/neuro groups that appear like a mirage in the scorching wasteland of urban pain groups? From what I have heard, they may be a good deal in that the new grad may avoid opioid management and get fed, but the new pain grad will most likely be something of an underling and needle lemur and in the most egregious cases may be totally controlled by the surgeons (and certainly at risk of being sold to PE demons); and so the new grad will also be most desirable when he shuts his mouth and looks cute.
4. What new grad seems most desirable to an LOP-only shop, dare you ask? Well, this is a very special subset and god only knows how they identify their special little boys to be anointed under their cloth. I have a feeling this new grad needs to give off the air of an unloved orphan child with no one at all in the world. Here, let me take you under my wing, sweet child, and feed you bread and honey.
 
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Your posts are super pithy and entertaining @ateria radicularis magna . As someone recently approached by a PE firm I Definitely have a number. I’m a solo doc. Do u want to buy my practice? I’ll let u match their offer. @Doctodd had a post to purchase a unicorn practice in Miami. Didn’t hear a lot of offers on the forum.
 
nvrsumr said:
Your posts are super pithy and entertaining @ateria radicularis magna . As someone recently approached by a PE firm I Definitely have a number. I’m a solo doc. Do u want to buy my practice? I’ll let u match their offer. @Doctodd had a post to purchase a unicorn practice in Miami. Didn’t hear a lot of offers on the forum.
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I don’t have the money. But I would love to know their offer. Can you give me a range?
 
ateria radicularis magna said:
What attributes actually set a new grad apart from other new grad peers in the eyes of the employer ?

1. The answer may be as simple as “the most desirable new grad seems most open to being manipulated.” It seems to me that large groups basically view the young doctor (yep, even being 35-40 years old counts as being young in doctor years) as a thing to be molded into whatever vessel the ceo/cmo, nurse administrator vampires believe will collect the most money from insurance companies (legality of secondary importance and morality an after thought).
2. The corollary may be: if you are not agreeable to being endlessly micro managed and manipulated, do not consider joining a large group.
3. Smaller groups are most likely interested in whether or not the fresh grad will break even after a couple years and will not cause too many headaches along the way. Smaller groups seem more interested in reducing overhead and improving efficiency, while larger groups seem intent on increasing overhead, decreasing efficiency, and ripping everyone off to the greatest degree while burning down the specialty by creating nurse practitioner armies and MD needle/knife linkedin bois, selling out to PE, and destroying insurance coverage for all procedures. My feeling about hospitals is that they too will DEFINITELY attempt to rip off the unprepared new grad, but their attempts will seem pedestrian and simplistic compared to the larger “pain groups.” What of the vaunted ortho/neuro groups that appear like a mirage in the scorching wasteland of urban pain groups? From what I have heard, they may be a good deal in that the new grad may avoid opioid management and get fed, but the new pain grad will most likely be something of an underling and needle lemur and in the most egregious cases may be totally controlled by the surgeons (and certainly at risk of being sold to PE demons); and so the new grad will also be most desirable when he shuts his mouth and looks cute.
4. What new grad seems most desirable to an LOP-only shop, dare you ask? Well, this is a very special subset and god only knows how they identify their special little boys to be anointed under their cloth. I have a feeling this new grad needs to give off the air of an unloved orphan child with no one at all in the world. Here, let me take you under my wing, sweet child, and feed you bread and honey.
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what's LOP?
 
ateria radicularis magna said:
What attributes actually set a new grad apart from other new grad peers in the eyes of the employer ?

1. The answer may be as simple as “the most desirable new grad seems most open to being manipulated.” It seems to me that large groups basically view the young doctor (yep, even being 35-40 years old counts as being young in doctor years) as a thing to be molded into whatever vessel the ceo/cmo, nurse administrator vampires believe will collect the most money from insurance companies (legality of secondary importance and morality an after thought).
2. The corollary may be: if you are not agreeable to being endlessly micro managed and manipulated, do not consider joining a large group.
3. Smaller groups are most likely interested in whether or not the fresh grad will break even after a couple years and will not cause too many headaches along the way. Smaller groups seem more interested in reducing overhead and improving efficiency, while larger groups seem intent on increasing overhead, decreasing efficiency, and ripping everyone off to the greatest degree while burning down the specialty by creating nurse practitioner armies and MD needle/knife linkedin bois, selling out to PE, and destroying insurance coverage for all procedures. My feeling about hospitals is that they too will DEFINITELY attempt to rip off the unprepared new grad, but their attempts will seem pedestrian and simplistic compared to the larger “pain groups.” What of the vaunted ortho/neuro groups that appear like a mirage in the scorching wasteland of urban pain groups? From what I have heard, they may be a good deal in that the new grad may avoid opioid management and get fed, but the new pain grad will most likely be something of an underling and needle lemur and in the most egregious cases may be totally controlled by the surgeons (and certainly at risk of being sold to PE demons); and so the new grad will also be most desirable when he shuts his mouth and looks cute.
4. What new grad seems most desirable to an LOP-only shop, dare you ask? Well, this is a very special subset and god only knows how they identify their special little boys to be anointed under their cloth. I have a feeling this new grad needs to give off the air of an unloved orphan child with no one at all in the world. Here, let me take you under my wing, sweet child, and feed you bread and honey.
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This is an accurate description. I would love to know which one of these 4 reflects your situation currently. It is an interesting dichotomy. Every employee feels wronged. Justified in some cases, but totally off base in most cases. How do we learn to be content? Those student loans aren't going to pay themselves off.
 
Is PE really all that bad?? There is a very large, very successful multi specialty group in NJ that was acquired by PE a few years ago. All the docs I talk to there seem very happy, are very productive and very satisfied with the management
 
I know there’s a lot of pain hopefuls in this forum so I just want to say, don’t let your job become your life and it’s really not as bad as these guys are kvetching about. I think it’s normal to pause and wonder What does it all Mean in any career…Keep your sense of self separate and you will be fine.
 
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Dr. Ice said:
Is PE really all that bad?? There is a very large, very successful multi specialty group in NJ that was acquired by PE a few years ago. All the docs I talk to there seem very happy, are very productive and very satisfied with the management
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Great question.
Is PE really all that bad? I have heard similar stories of beneficent PE and functional PE managed groups, and the new grads could really use some direction regarding how to tell bad PE from good PE. This may be the most important question for a new grad, in fact.
 
Agast said:
I know there’s a lot of pain hopefuls in this forum so I just want to say, don’t let your job become your life and it’s really not as bad as these guys are kvetching about. I think it’s normal to pause and wonder What does it all Mean in any career…Keep your sense of self separate and you will be fine.
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Great advice. A positive attitude and healthy lifestyle can probably defend against a lot of troubling things going on. If the new grads can get a good sense of what he or she is getting into and also maintain the zen, then I would say that’s the ideal scenario. Definitely some good jobs out there—but the question the new grad asks is, how do I find them? What do I need to know before hand? What do I ask? Who do I trust?
 
Dr. Ice said:
Is PE really all that bad?? There is a very large, very successful multi specialty group in NJ that was acquired by PE a few years ago. All the docs I talk to there seem very happy, are very productive and very satisfied with the management
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They probably got a nice buyout. Talk to the employed docs 5 years from now, and I bet they'll be singing a different tune.
 
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ateria radicularis magna said:
Great advice. A positive attitude and healthy lifestyle can probably defend against a lot of troubling things going on. If the new grads can get a good sense of what he or she is getting into and also maintain the zen, then I would say that’s the ideal scenario. Definitely some good jobs out there—but the question the new grad asks is, how do I find them? What do I need to know before hand? What do I ask? Who do I trust?
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There are fewer jobs than there are applicants. The reality is sometimes you have to find a job that pays the bills while you keep looking - that’s partly why most contracts are two years. My mom refers to this as “Riding a donkey while looking for a horse” (this was about dating advice but I figure it’s more appropriate here because what’s the point of dating a donkey.) My best advice to new grads is don’t buy a house and an expensive car with your Attending money until you’re sure you want to stay put. Educate yourself on the business side of pain as much as possible, even if you are hospital-employed. You have to understand your billing and collections if you want to be able to negotiate your worth. No one is going to teach you how the sausage gets made if you don’t look for those answers yourself.
 
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nvrsumr said:
Your posts are super pithy and entertaining @ateria radicularis magna . As someone recently approached by a PE firm I Definitely have a number. I’m a solo doc. Do u want to buy my practice? I’ll let u match their offer. @Doctodd had a post to purchase a unicorn practice in Miami. Didn’t hear a lot of offers on the forum.
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send them to me....ill listen to their offer. PM or call me cuz im curious. And no there were no public offers on the forum, as you would expect. My practice is not an ebay or bringatrailer auction.
 
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