american anesthesiology/mednax

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Surgeons are starting to join management companies. Especially at hospitals where none of the practitioners are officially affiliated with the hospital (for litigation purposes). Some of these surgeons are joining companies and still getting their similar salaries (because they bring the patients with them to the company). I think that's the reason why anesthesia gets the shaft in these situations. We don't bring patients so they just pay us whatevers.

But good points have been made. I think this is the trend and eventually every practice will be affiliated with a management company and we'll all have to be thankful for a employee position. Instead of the 1 million dollar home, anesthesiologist may have to be happy with the 500K condo

Members don't see this ad.
 
I would take a partnership track, but only if the contract had a provision that, in case I am not made partner within 2 years, I will receive the difference in salaries as a bonus. They can't have it both ways. ;)

For those of you in private groups, if a new grad asked for this in a contract would you do it? Reasonable? Seems only fair to me.
 
No one can tell for sure which groups will make it or not. Out of the 3 groups I interviewed with as a new grad, only 1 stands today. Chances are I would have been screwed.

Do you have anything In your contract to protect agains this?
 
Members don't see this ad :)
This is exactly what AMCs tell physicians when they are about to screw them: "You take care of the patients and we worry about the silly details like money and work hours"
Are you now an AMC executive? :)

What are the downsides of taking an amc job as a new grad ? What are the hidden secrets to be aware of?
Why not just avoid the situation of making less and taking more call on a partnership track only to find out they are selling to an amc when you r just about partner?
 
I think it would be more reasonable to ask for a piece of the buyout $$ in case the group sells to an AMC before you're made partner. Say the partner track salary is 70% of partner salary. If the group sells out while your still in the track I would want a clause saying you get a 70% share of what each partner takes home.

A group may be more willing to accept this because if they don't sell out, it's no sweat off their backs. If the group says no way then maybe that's a red flag that a sell out is on the horizon.


You should do your homework up front and not take a partner track position with a group that has a Hx of not making people partner at the end of their CLEARLY DEFINED (both financially and timeline) partner track.
 
What are the downsides of taking an amc job as a new grad ? What are the hidden secrets to be aware of?
Why not just avoid the situation of making less and taking more call on a partnership track only to find out they are selling to an amc when you r just about partner?


1) you are an employee
2) other people are profiting off of your license and work and increasing the cost of healthcare by adding middle men
3) you aren't in charge of the work conditions and could be expected to push the limits of safety -- on your license
4) compensation and hours worked can be dramatically changed and you don't have any protection, i.e., a union -- incidentally there should definitely be a union for employed physicians

Probably a lot of other issues too. It may become the norm, but I'd rather pay my dues in a private group and risk that it wouldn't last.
 
For those of you in private groups, if a new grad asked for this in a contract would you do it? Reasonable? Seems only fair to me.
Seems reasonable.

Also ask if group is no longer in its current entity that and terms of partnership track changes (due to buyout) that they pay for ur tail coverage out the door.
 
1) you are an employee
2) other people are profiting off of your license and work and increasing the cost of healthcare by adding middle men
3) you aren't in charge of the work conditions and could be expected to push the limits of safety -- on your license
4) compensation and hours worked can be dramatically changed and you don't have any protection, i.e., a union -- incidentally there should definitely be a union for employed physicians

Probably a lot of other issues too. It may become the norm, but I'd rather pay my dues in a private group and risk that it wouldn't last.
Most management companies that take over (buy out) current group usually let current group run day to day operations.

If increase demand. Than group sits down with management company to determine if increase staffing is needed. This is how my friend group who sold out to mednax years ago has done things. They were one of the first groups to sell out. N
 
Are some AMCs better to work for vs others? Are any more reputable? A friend works for an AMC in the southeast and says he couldn't be happier. Of note, his salary is higher than mine (in PP) and he has a nice benefit package.

This is my opinion but it seems that setup, pay, offer one gets is highly variable on location where AMC takes over. Really desirable area like NY...not gonna be good offer.

If you look at east coast cities and markets more and more are being gobbled up by these AMCs. Look at NC or FL for example.
 
It is reasonable to ask. I don't think you are likely to get it though.
Supply and demand of fools.

If they can get fools to join without the clause, why bother? The moment they cannot recruit they will be more open to it.

I would ask for ALL my buy-in money if they sell before making partner. And a clause saying you are the first to be paid if there is not enough money for all liabilities.
 
Last edited:
  • Like
Reactions: 1 user
Supply and demand of fools.

If they can get fools to join without the clause, why bother? The moment they cannot recruit they will be more open to it.

I would ask for ALL my by in money if they sell before making partner. And a clause saying you are the first to be paid if there is not enough money for all liabilities.

of the new grads you guys interview...how many are aware of this type of stuff? aren't most of us fools (especially if you come from an academic place that pushes most residents into fellowship)? I mean we don't get much education on this type of stuff (at my place at least)...I wonder how many of our current CA-3's know stuff like this
 
  • Like
Reactions: 1 user
I think it would be more reasonable to ask for a piece of the buyout $$ in case the group sells to an AMC before you're made partner. Say the partner track salary is 70% of partner salary. If the group sells out while your still in the track I would want a clause saying you get a 70% share of what each partner takes home.

A group may be more willing to accept this because if they don't sell out, it's no sweat off their backs. If the group says no way then maybe that's a red flag that a sell out is on the horizon.


You should do your homework up front and not take a partner track position with a group that has a Hx of not making people partner at the end of their CLEARLY DEFINED (both financially and timeline) partner track.


What's the best way to find this type of thing out? Ask those in the group? Is this a sensitive question to go around asking those that are partners? Ask people in other groups in the area?
 
Members don't see this ad :)
not an AMC executive. To each there own. Being screwed is a relative term and a risk/benefit equation is always in play. Determining your own destiny is what many feel is the benefit of PP, but in reality when your a partner you get one vote out of many and that vote may not even have equal weight depending on the group. Whats the difference in working for an AMC versus an academic practice. Most often they have less salaries and a single person, the chair, determines most everything.

I run a side business and that gives more angina about costs and revenue then my current employment.
 
not an AMC executive. To each there own. Being screwed is a relative term and a risk/benefit equation is always in play. Determining your own destiny is what many feel is the benefit of PP, but in reality when your a partner you get one vote out of many and that vote may not even have equal weight depending on the group. Whats the difference in working for an AMC versus an academic practice. Most often they have less salaries and a single person, the chair, determines most everything.

I run a side business and that gives more angina about costs and revenue then my current employment.
Gotta agree with you.

Lots of infighting within groups. Lots of headaches. 2-3 people may be responsible for speaking with hospital administrators.

The real issue is administrators are just suits. Most are non clinical. Never have been. Suits like to talk to suits. That's where AMCs have the main advantage. Someone with mba degree and zero clinical medical experience wants to talk to someone one their same level.

Look at mednax executive staff. While there are MDs in the executive group. Most are "regional directors". But Most of the movers and shakers are non clinical. And these are the people who draw up the X's and O's with the same non clinical hospital administrators.
 
  • Like
Reactions: 1 user
Whats the difference in working for an AMC versus an academic practice.

In my area:
4:1 vs 2:1 supervision in OR's
Unsupervised vs supervised CRNA's in GI lab
Spinals and epidurals for OB done by CRNAs, vs MD's
Colleagues who couldn't get anything better vs colleagues who like the academic world (research, tertiary care center cases, etc)

That's it in a nutshell. In my experience, AMC's have been consistently evasive and dishonest about what they promise and what they expect.
 
What's the best way to find this type of thing out? Ask those in the group? Is this a sensitive question to go around asking those that are partners? Ask people in other groups in the area?

The best way is via contacts like former residents and staff at your program that know people with the group. The next best bet is to ask for contacts of former members of the group who have left and ask them why they left. This is pretty standard, and the group shouldn't have a problem giving you some names/numbers. I think it'd be perfectly reasonable to ask if there are any hires who failed to make partner at the completion of the track as well (and why). Again, the track should be very clearly defined from both a financial and time perspective. I talked to a lot of groups as a CA-3 looking at jobs in at least 5 states. It's surprisingly easy to tell which ones are being evasive and a little shady when you're asking questions. Talk to as many people in the group as you can on interview day, especially the junior guys who recently went through the track. You're bound to find at least one or two honest members.
 
In my area

That's it in a nutshell. In my experience, AMC's have been consistently evasive and dishonest about what they promise and what they expect.


How many AMCs have you worked for and which one's?

My bigger picture reason for mentioning the AMC vs Academics is the reality that we all work for somebody (even if your a member of a group you don't get to do whatever you want ) and we all have less control over our lives then we all think we do, unless you don't need the money, have no loans and no need to live in one location.
 
Has anyone ever pondered on why is it that you have to pay to be part of a group? What part of the business you are buying? What is the monetary value of a group?
Excellent question. One that Ive been asking for twelve years and no group could give me an answer. These are excellent discussions and the truth of anesthesia practice is being elucidated in these forums as of late.
 
Excellent question. One that Ive been asking for twelve years and no group could give me an answer. These are excellent discussions and the truth of anesthesia practice is being elucidated in these forums as of late.

Its a business with excellent profit, thus it has monetary value.
 
I am just surprised as most hospital systems consolidate (say orlando basically is a two hospital system). Why not just kick out the management companies and take everything in house.

It's not rocket science. And orlando health pediatric hospital is already in house anesthesia. Just kick team health and Sheridan out of their remaining hospitals and call it a day.

As a side note. That's why those mba business (non clinical people) like to talk to one another. They (orlando health big wigs) probably already play golf or go to same baptist church/synagogue as Sheridan and team health officials.
 
I am just surprised as most hospital systems consolidate (say orlando basically is a two hospital system). Why not just kick out the management companies and take everything in house.

It's not rocket science. And orlando health pediatric hospital is already in house anesthesia. Just kick team health and Sheridan out of their remaining hospitals and call it a day.

As a side note. That's why those mba business (non clinical people) like to talk to one another. They (orlando health big wigs) probably already play golf or go to same baptist church/synagogue as Sheridan and team health officials.


Why exactly kick Team Health out of ORMC? Unless the CEO can do it cheaper (which he can't) then Team Health stays. Since Team Health doesn't get a subsidy why should the CEO take the anesthesia in house?

Sheridan picked up two more hospitals over the past 12 months in the Orlando area.
 
Why exactly kick Team Health out of ORMC? Unless the CEO can do it cheaper (which he can't) then Team Health stays. Since Team Health doesn't get a subsidy why should the CEO take the anesthesia in house?

Sheridan picked up two more hospitals over the past 12 months in the Orlando area.

U don't know what the terms of the ormc/wolverine package is. Especially with trauma one hospital and many non pay/self pay trauma. Than again I know they have srna training program there. So it depends how creative they are with their srna "supervision" by crnas.

The issue becomes bigger in 2016 when Obama (supposedly yanks funding from indigent care/trauma hospitals that was part of the aca) unless stated opted in for Medicaid expansion.
 
Got wind of creative language in contracts with anesthesia. My friend group (trauma center with one of the amc sell outs). This is what he just texted me.

"Subsidy is an ugly word. There are incentives in the contract based upon things like beta blockers, on time starts, and perioperative antibiotics. "

So trauma hospitals (especially in southern opt out states) can deny giving "subsidies" to groups or amc. Amc can deny "taking subsidies". But at end of the day most are still taking "subsidies" only it's worded differently.

So it's all smoke and mirrors by managed so called "business leaders" citing "effiency" and "savings"
 
Got wind of creative language in contracts with anesthesia. My friend group (trauma center with one of the amc sell outs). This is what he just texted me.

"Subsidy is an ugly word. There are incentives in the contract based upon things like beta blockers, on time starts, and perioperative antibiotics. "

So trauma hospitals (especially in southern opt out states) can deny giving "subsidies" to groups or amc. Amc can deny "taking subsidies". But at end of the day most are still taking "subsidies" only it's worded differently.

So it's all smoke and mirrors by managed so called "business leaders" citing "effiency" and "savings"

"Metrics" are the new "subsidies"
 
  • Like
Reactions: 1 user
Its a business with excellent profit, thus it has monetary value.
Do you value a business for its revenue or its profit?

If a business brings a lot in revenue but looses that money in salaries ending with no profit at the end of the year, how much is the business worth?
 
Can anyone out there comment on the process of renegotiating your contract with an AMC once your initial contract is complete. Say your group was bought out and you agreed to a five year employment contract and that is now complete...how did it go? In particular, has anyone done this with Mednax?
 
Can anyone out there comment on the process of renegotiating your contract with an AMC once your initial contract is complete. Say your group was bought out and you agreed to a five year employment contract and that is now complete...how did it go? In particular, has anyone done this with Mednax?

Hard to comment. My close friend was one of first groups to sell out to mednax. So they will be up for negotiations after this year.

Mednax has only been acquiring anesthesia practices for around the past 7 or so years. Some groups have between a 5-10 years (yes 10 years, just won't tell u which one) structure.
Can anyone out there comment on the process of renegotiating your contract with an AMC once your initial contract is complete. Say your group was bought out and you agreed to a five year employment contract and that is now complete...how did it go? In particular, has anyone done this with Mednax?

u ain't going to get many answers on these boards. Cause my buddy was first group to sell out and they won't renegotiate until next year.

So mednax does pretty long lock in periods. U are talking 7 plus years. The older partners were free to leave after the initial 5 year period and some did leave/retire. But the compensation structure still remains in effect since the first buyout.
 
Do you value a business for its revenue or its profit?

If a business brings a lot in revenue but looses that money in salaries ending with no profit at the end of the year, how much is the business worth?

In my group shareholders take profit via s corp and profit sharing in addition to nice salaries.
 
Last edited:
  • Like
Reactions: 1 user
In my group shareholders take profit via s corp and profit sharing in addition to nice salaries.
You can pay yourselves however you choose. The fact that you cannot predict your full salary when you are cutting the monthly checks does not make the difference between your under estimated salary and your real salary a profit.

At the end of the year the bank account of the S corp is zero.
 
You can pay yourselves however you choose. The fact that you cannot predict your full salary when you are cutting the monthly checks does not make the difference between your under estimated salary and your real salary a profit.

At the end of the year the bank account of the S corp is zero.

Well it seems pretty profitable to us, the amc's that have offered to buy us, the prospective shareholders who wish to own a share, and the ex wives' divorce lawyers.
 
A stick instead of a carrot.
The issue with metrics (in anesthesia) is its almost all BS. These big wigs amc (or even bigger private groups) like to talk the talk how much better they are than everyone else. They point to such things as "on time" performance.

It's just a bunch of Bs. We all know that. At my current practice they had this blue sheet where nursing, surgery, and anesthesia all checked what time they saw patients for first starts. After 6 months they just stopped collecting data. It's like they were trying to find data that pointed finger at anesthesia for reason for delayed first starts.

Same thing at my previous academic hospital job.

We all know anesthesia is rarely the reason for first case starts. Admin knows it's rarely nursing either. It's either surgeon or patient who accounts for the delays. But admin can't point fingers at surgeons or patients. They aren't going to bite the hands that feed them.
 
The issue with metrics (in anesthesia) is its almost all BS. These big wigs amc (or even bigger private groups) like to talk the talk how much better they are than everyone else. They point to such things as "on time" performance.

It's just a bunch of Bs. We all know that. At my current practice they had this blue sheet where nursing, surgery, and anesthesia all checked what time they saw patients for first starts. After 6 months they just stopped collecting data. It's like they were trying to find data that pointed finger at anesthesia for reason for delayed first starts.

Same thing at my previous academic hospital job.

We all know anesthesia is rarely the reason for first case starts. Admin knows it's rarely nursing either. It's either surgeon or patient who accounts for the delays. But admin can't point fingers at surgeons or patients. They aren't going to bite the hands that feed them.
The metrics are unfortunately here to stay and proliferate.
These metrics "PQRS, SCIP, patient satisfaction..." are just the beginning of a new system where the practice of medicine will become a series of protocols and algorithms.
It's like transforming an analog system into a digital system that consists of ones and zeros, this new system is much easier for bureaucrats, accountants, and politicians to understand although it provides no benefit to patients or providers.
They figured that if they can't understand medicine the best solution is to create new medicine they can understand and control.
 
Excellent question. One that Ive been asking for twelve years and no group could give me an answer. These are excellent discussions and the truth of anesthesia practice is being elucidated in these forums as of late.
The anesthesia business is only as valuable as the current contract and the goodwill and history of service the group has generated to help secure a new one, and the unknowable desire of the the administration to grant them one. The dollar amount is based on what the management company thinks they can squeeze out of you over x years, how hard it would be to get your contract, and how much your practice is worth to them (existing higher than average contract rates, foothold in a neighboring city, etc.). How much of your total income is "salary" and "expenses" and "profit" is a game for the CPAs, and apparently divorce lawyers. Would it be different if you just got a straight $600 as a 1099 vs salary, paid benefits, retirement plans, and profit sharing? I don't know and it's an interesting question. How could a judge say your share is worth x when the business could lose 100% of its value in the time it takes the hospital CEO to sign a competitors contract?
How much was my father in law's profitable radiology practice worth after over 20 years of solid service providing 24/7 coverage, etc?
Zero. They lost their contract unexpectedly to another large multi hospital group that wanted to expand into their city after months good faith negotiations. They didn't even know another group was interested nor did the administration try to negotiate more competitive terms, they just dropped the bomb on the day the president was supposed to sign the new contract, the deadline for renewal. The new group didn't even want to keep any of them, and they were all unemployed 90 days later. Fortunately he was considering retiring anyway, and it was probably good for him or he'd still be working there. (Just 3 more years...)
Apparently the other group offered to set up an expanded interventional practice that was supposed to take patients from another hospital and generate more facility fees, which was something that the existing had group looked into and determined was not likely to be profitable based on their estimates (and they wanted my father in law's group to take all the risk/cost in hiring another IR person with no current patient need).
The whole hospital failed a couple years later and was taken over by a large hospital system. Big surprise. I guess the IR scheme didn't save their bottom line...
 
Last edited:
  • Like
Reactions: 1 user
Has anyone ever pondered on why is it that you have to pay to be part of a group? What part of the business you are buying? What is the monetary value of a group?

Don't play dumb. This has been rehashed on this forum dozens of times.

Ownership used to equal security.

The deal was an anesthesia group will trade you the security of ownership in return for working harder for less for a period of time.

Historically, paying up for ownership has been a good deal for many.

Now it is a high risk strategy with only a potential payoff.

For many old-timers it was the best investment that they ever made. For today's young grads it is more of a very expensive lottery ticket. A lottery ticket that they are forced to purchase in order to work. Some private practice groups will still be private practice groups ten or more years from now. How many? Nobody knows. A lot less is a safe bet.

Groups still ask for buyins, despite the sh1tty return because there is no shortage of young grads. In other words, because they can.
 
  • Like
Reactions: 1 users
Has anyone ever pondered on why is it that you have to pay to be part of a group? What part of the business you are buying? What is the monetary value of a group?

In our group (and others I can get first hand info about), a buy in isn't "paying to be part of the group", it's paying into the AR of the group that you will collect out of. You can structure things however you want, but when it comes down to it on day 1 as a partner you are collecting money that was billed while you weren't a partner. Is it fair to the previous partners to have you collect on their efforts? Not really. Then again, when you make partner you'd probably not rather wait 3-6 months for the collections to start coming in before you actually get paid. So we let you collect the payouts on day 1, but your "buy in" is simply your share of that AR which you collect to be paid back to the group over a period of time.

And then on the back side if/when you leave or die, we pay you a "buy out" of your share of the AR that won't be collected til after you are gone. A buy in under those circumstances is essentially an interest free loan to your future self.

If you'd like to argue against the "buy in", I presume you also don't believe in the "buy out" on the back end.
 
Agree with Mman. Our first year salary is basically an estimate of our "lowest realistic salary" for a year, minus 1/n of the groups A/R. Second year is a % of partner salary which is very fair. Meetings every 6 months to discuss progress towards partnership and any concerns.
Leaving the group, a member receives 1/n of the A/R.

So yes, there is a buy in, in the reduced salary year one, but it is redeemed upon exit. The true buy in is the difference between "lowest realistic salary" and the actual salary (and the reduced % second year), but that is there in case we have a below average year to prevent the nonpartner from in effect making more than our partners (treating the actual A/R as a constant), and in case someone bolts with only the 45 day notice required, leaving us understaffed.

If someone chose to not pay into the A/R I suppose we could discuss it, but it would mess with our system, and they would not be paid until their actual billings came through, which are likely to be lower than ours, especially for new grads in the beginning as we train them up.
 
Most of the partnerships that I have been aware of you have to buy your share A/R's + work harder for less for a period of time.
Just buying the A/Rs while working the same hours for the same pay minus the /R buy in would be historically very generous.
 
Most of the partnerships that I have been aware of you have to buy your share A/R's + work harder for less for a period of time.
Just buying the A/Rs while working the same hours for the same pay minus the /R buy in would be historically very generous.

The partnerships I'm aware of don't have anybody "work harder" for a period of time. They do require a term of salaried work to see if you fit the practice and are "worth" them making partner and that time varies from group to group.
 
By the way most of those who are defending the private group model here will be selling to an AMC within a year or so.

Why? I've been defending it for years and I can't see any chance of selling to an AMC. I mean maybe 10 or 20 years from now, but at this point it is so far out there it's hard to make the connection.
 
In our group (and others I can get first hand info about), a buy in isn't "paying to be part of the group", it's paying into the AR of the group that you will collect out of. You can structure things however you want, but when it comes down to it on day 1 as a partner you are collecting money that was billed while you weren't a partner. Is it fair to the previous partners to have you collect on their efforts? Not really. Then again, when you make partner you'd probably not rather wait 3-6 months for the collections to start coming in before you actually get paid. So we let you collect the payouts on day 1, but your "buy in" is simply your share of that AR which you collect to be paid back to the group over a period of time.

And then on the back side if/when you leave or die, we pay you a "buy out" of your share of the AR that won't be collected til after you are gone. A buy in under those circumstances is essentially an interest free loan to your future self.

If you'd like to argue against the "buy in", I presume you also don't believe in the "buy out" on the back end.

1 I never got offered a buy out in any of the groups I interviewed.

2 By the time you are about to be made partner your collections from your hard work have long been part of the AR just a any others, so I don't see why a brand new partner owes anything to the older ones.

That makes sense for new hires. Their collections will take a while to come in and they need money. I can see them borrowing money from the group and paying it back over the year. How much money would a new grad need to borrow? 30, 40, 50 even 100 thousand? Why is joining a group 500K then?
 
Last edited:
Say a hypothetic group of partners typically made 500k, A/R ~125k. They offer 375k, then they only make 400k that year for whatever reason. Now they are upside down on the new hire by 100k.

Is that more fair?



I personally would choose to base all new hire rates on a % of partner, but that is too nebulous for a lot of people to sign up for, and it is not allowed by our groups contracting attorney for year 1.
I think it is a load of crap to make the new person work harder than the partners in addition to lower salary. Except for the "new guy works Christmas first year." :)
 
Agree with Mman. Our first year salary is basically an estimate of our "lowest realistic salary" for a year, minus 1/n of the groups A/R. Second year is a % of partner salary which is very fair. Meetings every 6 months to discuss progress towards partnership and any concerns.
Leaving the group, a member receives 1/n of the A/R.

So yes, there is a buy in, in the reduced salary year one, but it is redeemed upon exit. The true buy in is the difference between "lowest realistic salary" and the actual salary (and the reduced % second year), but that is there in case we have a below average year to prevent the nonpartner from in effect making more than our partners (treating the actual A/R as a constant), and in case someone bolts with only the 45 day notice required, leaving us understaffed.

If someone chose to not pay into the A/R I suppose we could discuss it, but it would mess with our system, and they would not be paid until their actual billings came through, which are likely to be lower than ours, especially for new grads in the beginning as we train them up.
When someone quits your practice, for how long do they get the 1/n of the AR? Some collections might take 2 or 6 months to arrive. Are you going to get paid for 6 months after you leave?

After a 500k buy in, I would expect you get 1/n of AR for a full year more or less.

We both know it is not going to happen. I suspect you guys are getting 1/n of 1 month of AR which is a joke ~50k. So, what happened to my 500k buy in?
 
Last edited:
Say a hypothetic group of partners typically made 500k, A/R ~125k. They offer 375k, then they only make 400k that year for whatever reason. Now they are upside down on the new hire by 100k.

Is that more fair?



I personally would choose to base all new hire rates on a % of partner, but that is too nebulous for a lot of people to sign up for, and it is not allowed by our groups contracting attorney for year 1.
I think it is a load of crap to make the new person work harder than the partners in addition to lower salary. Except for the "new guy works Christmas first year." :)
Very hard to make any sense of the scenario you posted.

How is it that you are upside down because partners are making 400 and employee 375?
 
Because should they leave you give them A/R of 125.
I understand that not all groups do this, but a number of them do. There are actually some fair partnership tracks out there still, just not many, and probably not on gasworks.
In the scenario you assume where you dont get your A/R if you leave, then you are right and group "made" 25k on the new hire.

I still feel like a bunch of young enterprising anesthesiologists should get together and make their own AMC, but with actual partnership tracks for all involved. Highly unlikely given the greed that is commonplace though.
 
Last edited:
I still feel like a bunch of young enterprising anesthesiologists should get together and make their own AMC, but with actual partnership tracks for all involved. Highly unlikely given the greed that is commonplace though.


How do you think the existing AMCs were formed?
 
Top