Any Mednax employees out there?

[nimbus]

I’ve also been in both situations. W2 vs 1099 - all things being equal 1099 is better (more tax shelter opportunities). That being said, W2 varies widely. If you have a w2 with amazing benefits (such as 100% paid health benefits for a family, huge 401k match, paid disability insurance and a pension - ie like Kaiser) in those rare cases the W2 can be worth way more than 1099. Situation dependant.

My current practice is a 100% productivity based PP and get paid on a W2. I get $x/unit as my gross revenues. Out of that, I pay practice expenses (billing and admin), contribute to my 401k and CBP, pay for malpractice, health insurance, employer portion of FICA, all out of pocket medical expenses, all business expenses(phones, computers, work dinners, hospital donations), CME, etc. What is left over is my W2.

The number on a 1099 would have to be much higher (150-200k) for it to be equivalent to my W2 since none of that stuff except maybe billing and admin would be deducted.

---

Members don't see this ad.

 

[caligas]

I work at a Mednax PICU

My mother is a contract lawyer for a Fortune 500 company, she couldn't even get them to make punctuation changes to large swaths of their standard contract. Talking things that made it clearer and followed standard contract language conventions well established in the legal world according to her and they wouldn't budge, stating a) that they didn't like having everyone's contracts be different, and b) no other lawyers brought these concerns up so they're clearly not a big deal.

Based off the response to what happened the anesthesia guys in Charlotte, Mednax has insinuated that non-competes are the lifeline of their business model to the degree they can be enforced and if they gave in on non-competes, it would be an existential threat to the company.

So I’m assuming other aspects of the job were so desirable that you were willing to overlook this seemingly glaring red flag?

 

[Mikkel]

So I’m assuming other aspects of the job were so desirable that you were willing to overlook this seemingly glaring red flag?

Insert excuse here:

"because my family/geography/interests/hobbies required it."

 

[IMGASMD]

Insert excuse here:

"because my family/geography/interests/hobbies required it."

My SO hates the boonies.

 

[caligas]

My SO hates the boonies.

how has the company been to work for?

 

[Mikkel]

My SO hates the boonies.

I'd file that under "family", but what is the definition of "boonies"? Urban center of 100k? 250k? 500k? 1000k?

 

[Mikkel]

I'd file that under "family", but what is the definition of "boonies"? Urban center of 100k? 250k? 500k? 1000k?

List of metropolitan statistical areas - Wikipedia


Like anything beyond the top 20?

 

[IMGASMD]

List of metropolitan statistical areas - Wikipedia


Like anything beyond the top 20?

I can probably do top 50..... but then you have some places with extreme cold weather, some states I just cannot stand...... so yes out of the top 50, I can do maybe 20.....

 

[BLADEMDA]

I can probably do top 50..... but then you have some places with extreme cold weather, some states I just cannot stand...... so yes out of the top 50, I can do maybe 20.....

Cold weather can pay extremely well with lots of vacation. I do appreciate my warm weather but if I was a new grad I would go where the money is.

 

[Mikkel]

I can probably do top 50..... but then you have some places with extreme cold weather, some states I just cannot stand...... so yes out of the top 50, I can do maybe 20.....

So you mostly associate size of population with whether a location is in the boonies.

There are a ton of awesome places to live lower on that list that you wouldn't think about since they're smaller than the major metros, but they're definitely worth a look for lifestyle and culture and outdoors opportunities.

Cross reference desirable smaller locations with economic prosperity, and you'll find hospitals with good payor mixes, but still low cost of living.

Doctors are very fortunate in that we don't have to be in major metros for job availability. In fact, the better jobs are not in the major metros, so you're better served by staying away from them.

 

[dchz]

In fact, the better jobs are not in the major metros, so you're better served by staying away from them.

You keep saying this over and over again. But through my job search this is very far from the truth.

Sure, most jobs in the boonies are better than the 250/year offered in Manhattan. But the highest paying jobs (>90%ile MGMA) that i've found are actually with in the top 20 of that list of metro locations. With all due respect, when was the last time you did any job searching?

Jobs out in BFE are usually subsidized by the hospital in terms of stipends. That brings their average up higher than the ****ty jobs in the major metros.

But the truth is that >90%ile MGMA groups don't rely on stipends, their average units are high because majority of their population are well insured. You only find that kind of well-insured population in major metro areas. Those insured people also don't want to live in BFE.

Out of the 3 >90%ile groups that i sent my CV to, all 3 of them are in major metro areas, top 20 on that list. My highest offer (even though i didn't take it) was also in a top 25* major metro area according to that list with a pretty freaking low cost of living.

Yeah, if you hate the city, don't look for a job there. But if you simply want the best job possible, all of them are in major metro areas.

 

[Mikkel]

You keep saying this over and over again. But through my job search this is very far from the truth.

Sure, most jobs in the boonies are better than the 250/year offered in Manhattan. But the highest paying jobs (>90%ile MGMA) that i've found are actually with in the top 20 of that list of metro locations. With all due respect, when was the last time you did any job searching?

Jobs out in BFE are usually subsidized by the hospital in terms of stipends. That brings their average up higher than the ****ty jobs in the major metros.

But the truth is that >90%ile MGMA groups don't rely on stipends, their average units are high because majority of their population are well insured. You only find that kind of well-insured population in major metro areas. Those insured people also don't want to live in BFE.

Out of the 3 >90%ile groups that i sent my CV to, all 3 of them are in major metro areas, top 20 on that list. My highest offer (even though i didn't take it) was also in a top 10 major metro area according to that list with a pretty freaking low cost of living.

Yeah, if you hate the city, don't look for a job there. But if you simply want the best job possible, all of them are in major metro areas.

What are the actual annual compensation numbers for those high MGMA places you got offers from?

Actual numbers, not vague percentiles.

Are we talking $800k/year, short partnership tracks, 100% guarantee to get partnership? Surgery center ownership interest?

 

[Leinie]

What are the actual annual compensation numbers for those high MGMA places you got offers from?

Actual numbers, not vague percentiles.

Are we talking $800k/year, short partnership tracks, 100% guarantee to get partnership? Surgery center ownership interest?

MGMA 90th percentile varies by region, with the numbers being $550k (West), $570k (East), $600k (Midwest), and $715k (South). That is on a W-2, so add $35k or so for a 1099 equivalent. National median across regions is $460k. So when you're a new grad and you're excited Mednax (or anyone else) are offering you $400k keep this in mind.

Leinie

 

[Mikkel]

MGMA 90th percentile varies by region, with the numbers being $550k (West), $570k (East), $600k (Midwest), and $715k (South). That is on a W-2, so add $35k or so for a 1099 equivalent. National median across regions is $460k. So when you're a new grad and you're excited Mednax (or anyone else) are offering you $400k keep this in mind.

Leinie

Ok, so I'm well over 90% MGMA for my region, with partnership in a surgery center. But I'm nowhere near the top 20 in metro area population, and my cost of living is relatively low.

So I don't know why anecdotes are being used to justify focusing employment search in the major metros, especially when my major urban center search showed most jobs paying less than 50th percentile MGMA.

 

[dchz]

What are the actual annual compensation numbers for those high MGMA places you got offers from?

Actual numbers, not vague percentiles.

Are we talking $800k/year, short partnership tracks, 100% guarantee to get partnership? Surgery center ownership interest?

I didn't get offers from all the ones I applied to. One of the offers I got is around (W-2) those numbers, but the partnership track is longer (3 years). No surgery center ownership. Major metro area.

Are you saying your job is those exact numbers and you're hiring?

Unless the job is actually open then it doesn't exist at all. Are any new hires in your practice getting the surgical center ownership?

Ok, so I'm well over 90% MGMA for my region, with partnership in a surgery center. But I'm nowhere near the top 20 in metro area population, and my cost of living is relatively low.

So I don't know why anecdotes are being used to justify focusing employment search in the major metros, especially when my major urban center search showed most jobs paying less than 50th percentile MGMA.

Is the surgery center partnership part of the offer to the new hires in your group?

 

[victor le cube]

Mednax in Austin offered 225k for mon-fri no call (7a-5p), 6 weeks vacay. Couldn’t stomach that and turned it down even though I wanted to live there pretty bad.

 

[marr65]

Mednax in Austin offered 225k for mon-fri no call (7a-5p), 6 weeks vacay. Couldn’t stomach that and turned it down even though I wanted to live there pretty bad.

Bravo!! 50 hours per week with probably 4:1 supervision ratio, and probably sick patients as well! No one should take that job...no one. Who am I kidding, some joker probably took that position since it’s in Austin.

 

[okayplayer]

Mednax in Austin offered 225k for mon-fri no call (7a-5p), 6 weeks vacay. Couldn’t stomach that and turned it down even though I wanted to live there pretty bad.

Edit: Tried to post the vomit emoji but was unsuccessful.

 

[chocomorsel]

700-800K supervising 4:1 all the time except and or even on call, not my idea of an ideal job and I am sure there are some who agree.
I would rather take the 550K doing my own cases and not running around like a chicken with my head cut off putting out fires.
So, really, it depends on the person's preference.
There are plenty jobs in the boonies paying 450+ doing own cases, good vacation time and benefits that's worth it to a lot of people. It ain't just about the money. I personally, like the boonies of BFE.

 

[nimbus]

“A larger, longer-living population provides tailwinds to long-term demand for this healthcare company's services, but expense control could remain a problem. Practice salaries and benefits increased to 71.4% of revenue in 2019 from 70.2% in 2018 and uncertainty associated with UnitedHealth's decision led to management acknowledging it's "not able to forecast the outcome of this matter, nor estimate the potential impact to its results."

“Expense control”

If you work for one of these outfits, you are the “expense” and the “problem” that needs to be controlled.

Redirect Notice

 

[nimbus]

Mednax in Austin offered 225k for mon-fri no call (7a-5p), 6 weeks vacay. Couldn’t stomach that and turned it down even though I wanted to live there pretty bad.

That’s $4891/week. Less than $1k/day or less than $100/hr. Mednax is taking more than 50%.

 

[dchz]

Bravo!! 50 hours per week with probably 4:1 supervision ratio, and probably sick patients as well! No one should take that job...no one. Who am I kidding, some joker probably took that position since it’s in Austin.

Yep, I knew someone who took it.

700-800K supervising 4:1 all the time except and or even on call, not my idea of an ideal job and I am sure there are some who agree.
I would rather take the 550K doing my own cases and not running around like a chicken with my head cut off putting out fires.
So, really, it depends on the person's preference.
There are plenty jobs in the boonies paying 450+ doing own cases, good vacation time and benefits that's worth it to a lot of people. It ain't just about the money. I personally, like the boonies of BFE.

There are plenty of jobs paying $450 doing own cases in the metroplex. But I'm glad i taught you about the use of the term "BFE"! (but you don't have to use boonies and BFE, they are the same thing).

 

[chocomorsel]

Yep, I knew someone who took it.



There are plenty of jobs paying $450 doing own cases in the metroplex. But I'm glad i taught you about the use of the term "BFE"! (but you don't have to use boonies and BFE, they are the same thing).

I hate big cities. Too many damn people and traffic.
Totally happy in smaller cities and in BFE.

 

[caligas]

People will do anything, think about choosing to do something like pediatric medicine for $170k. Salaries are what they are become someone is willing to do the thing for that price.

 

[marr65]

People will do anything, think about choosing to do something like pediatric medicine for $170k. Salaries are what they are become someone is willing to do the thing for that price.

An anesthesiologist should expect to start at 350k for a full time job. Frankly, people who take this job depress salary for everyone else. I am glad this is out in the open, so we all know what is a good paying job versus a bad paying job. To be honest, the person who took that Austin is 100% miserable right now. When you work those kind of hours, you aren’t going to live it up, more likely you are sleeping through the whole weekend. Lets be real, that person will be kept supervising all the way till 5pm.

 

[dannyboy1]

Mednax in Austin offered 225k for mon-fri no call (7a-5p), 6 weeks vacay. Couldn’t stomach that and turned it down even though I wanted to live there pretty bad.

That’s significantly worse than a CRNA salary. Hope there is no sucker out there that is actually considering taking this job....

 

[AdmiralChz]

That’s significantly worse than a CRNA salary. Hope there is no sucker out there that is actually considering taking this job....

I saw job offers in Tampa, FL which were even worse. Sheridan/Envision country.

 

[chocomorsel]

People will do anything, think about choosing to do something like pediatric medicine for $170k. Salaries are what they are become someone is willing to do the thing for that price.

Ehh, I think they are what they are due to the insurance companies deciding our worth. Not really our doing. When dealing with kids there’s a lot of Medicaid.
Even some middle class people have been known to put their kids on Medicaid.

 

[pmichaelmd]

I enjoy being in pseudo-BFE and hanging between median and 90% MGMA Southern. Am not sure what 75% is for Southern this most recent survey, but I think we are close. I would never consider that ridiculous Mednax offer.

 

[deleted941485]

Mednax is next on UHCs hitlist to re-evaluate contracts. They’ll go the way TH and envision are going.

The only people making money in this will be the shortsellers.

 

[BigRedBeta]

So I’m assuming other aspects of the job were so desirable that you were willing to overlook this seemingly glaring red flag?

It was worrisome, but overall it was pretty easy actually. 95%+ of PICU jobs are academic, and research/academic output demands remain the only thing that consistently cause me to have anxiety. Joining a private practice PICU out of fellowship is often not the best choice as they are typically small and lack appropriate acuity to continue clinical growth as a new attending. My mednax job is 100% clinical, in a top 20 metropolitan area, and with a volume of admissions that probably puts it in the top 10% of PICUs nationwide. Since I'm really only competing against academic jobs, the compensation package after the first two years exceeds pretty much everything else out there, and after further sweat equity, is more in the ballpark of decent adult anesthesia money.

The company doesn't really matter that much in my day to day existence. There are issues but not to the same level as what is important for anesthesiologists, in terms of day to day stuff. They haven't really dictated our staffing which may be because we are running lean anyways. The HR/benefits stuff isn't anything to write home about. But all told, I like my partners, my unit, my hospital, my city, and the work I'm doing.

 

[aneftp]

Everyone needs to take into account workload vs salary.

I think a “good” salary is mid 400s with 2 1/2 months off working average 45 hours a week plus perks (retirement 20-30k employer matching) With 5-6 calls a month beeper rare call backs after 9pm. Guarantee post day off next day or compensation if working

a “bad” salary is making 550k working 55-60 hours a week What amounts to 4-5 weeks unpaid off and no other benefits. Similar 5-6 calls a month. Super high health care premiums etc. frequent post call working ( with compensation). Cough cough usap “fake full partner giving up 20% to private equity”

Even some VA hospitals vary in workload. Some VA do nothing and get paid. I’m talking about 1:1 supervision 50% of the time and signing off on 2-3 charts each day for 300k. Vs some Va hospitals where the docs cover 1:3 running around like chickens pre op like private 15-20 patients a day for 300k and having overnight emergency cases for same 300k. While it’s true most VA work around 40 hours. The workload is not the same.

Workoad. That’s something many of you young guys never fully understand till you been out in practice for a few years.

 

[chocomorsel]

Everyone needs to take into account workload vs salary.

I think a “good” salary is mid 400s with 2 1/2 months off working average 45 hours a week plus perks (retirement 20-30k employer matching) With 5-6 calls a month beeper rare call backs after 9pm. Guarantee post day off next day or compensation if working

a “bad” salary is making 550k working 55-60 hours a week What amounts to 4-5 weeks unpaid off and no other benefits. Similar 5-6 calls a month. Super high health care premiums etc. frequent post call working ( with compensation). Cough cough usap “fake full partner giving up 20% to private equity”

Even some VA hospitals vary in workload. Some VA do nothing and get paid. I’m talking about 1:1 supervision 50% of the time and signing off on 2-3 charts each day for 300k. Vs some Va hospitals where the docs cover 1:3 running around like chickens pre op like private 15-20 patients a day for 300k and having overnight emergency cases for same 300k. While it’s true most VA work around 40 hours. The workload is not the same.

Workoad. That’s something many of you young guys never fully understand till you been out in practice for a few years.

Agree wholeheartedly. I am all about a reasonable lifestyle job. I don’t need 500k. Especially if I am working like a damn sled dog to get it.
No thank you.