I enjoyed Apollo with their pure RVU model when I first started working for them but now I tend to hate it. The problem with pure RVU system is that its awesome when there's plenty of patients to go around and sucks when there are few pt's and the ED is overstaffed with providers. We have undergone constant schedule tweaking over the past few months to the point that the ED is majorly overstaffed with MDs and you end up savagely poaching and sniping patients (ambulance bay, triage, etc..) in order to hit "your number" and make a paycheck. You don't have any choice and everyone feels the tension in an environment like that. After I hit my number, I've left early on many occasions just so the other guys would have enough to go around as I genuinely enjoy working with my colleagues. I hate having to think that much about my paycheck while I'm trying to treat sick patients. I hate going into a code calculating my RVUs or doing a direct laryngoscopy on an EMS tubed patient to verify correct placement knowing full well in my head that it's an extra procedure that I can "bill for"... I also don't like the lack of transparency. There are no night differentials though I'm fairly sure people have worked them out under the table. I've heard of people also negotiating "fixed rate" contracts so you never really know how everyone is getting paid. There's no algorithm that I can tell to how PA/NP's assign patients to providers. If they like you, you get to attest their chart. If they don't, you will not get charts assigned to you. They get paid with a productivity component also (not as large as yours) so you have to be careful roaming around on slow days and picking up patients because if you pick up a quick and easy level 4/5 you might be perceived as "stealing their patients" and they will retaliate by not assigning pt's to you knowing that it will impact your salary. If I'm 2.4pph (without MLP) then I have a lower than average MLP component to my overall pph. If I go slower and try not to pick up any 4's, then guess what? Voila... MLP component goes up. It just sucks when there are either 1) too many docs or 2) not enough patients on a slow night, etc.. knowing that you are making 0$/hr when you aren't seeing people.
That being said, Apollo feels less "corporate" than some of the other CMGs such as TH. They have never told me how I should practice medicine and that goes a long way. I was probably happiest with Schumacher and think the best compensation model is 2/3 base salary with 1/3 productivity component and a transparent shift differential for nights. I also received many more transparent metrics at the end of the month with Schumacher. I could see my RVU/hr, PPH, MLP assignment ratio, along with multiple other metrics not only for me but for every other provider.
I honestly don't like going to work having to think so much about getting paid, especially when I'm treating sick patients. It's very "soul sucking" for me of late.
