Grass greener syndrome?

[Chloroform4Life]

Not everywhere. There are many, many quality jobs still out there. The number of good, fair, quality jobs seems to vary dramatically depending on which region we're talking about.

What do you think about the Southeast region?

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[bashwell]

So maybe you are for real. So you need to figure out how the business (not the practice) of medicine works real fast. So here are a few lessons:

Other anesthesiologists are not your friends. Rather they are the people with whom you share a workload. They will dump the worst reimbursing, most difficult cases on you and try to take as much of the money you generate as possible, either in the form of a buy in, expenses, or both.

Surgeons are not your friends. The thing they want most from you is for your not to cancel the case and they will do/say anything to make that happen. They also want to cut at their convenience, and really don't care about your schedule, whether the patient is optimized, or post op pain management.

Nurses are not your friends: they will dump whatever menial tasks on you that they can, and don't care about your supplies, your machine, your lines, or if you need assistance with a procedure. They just want to go home at the end of their shift having done as little work as possible. They especially love it when you transport the patient to the OR.

Hospital administrators are not your friends: they just want you to be available to the surgeons at all times, without compensation. Like RN's, also love it when you transport the patient to the OR. That way you get blamed for all the delays.

Regarding anesthesia billing and management, residency programs don't teach this because most professors don't know anything about it. Like most important things in life, it is self taught. I would google some keywords and spend a few hours every day figuring it out. Once you figure out which way the money is flowing, it becomes a lot easier to figure out the practice. Good luck.

Frenemies without benefits!

 

[projectpat]

Chloroform4Life - to educate us younger folks.. in hindsight, do you recall any red flags or fishy feelings when considering this offer during residency? whether it was lack of a partnership track or lack of transparency regarding the group's finances? Or were there no suspicions?

 

[Man o War]

My wife watches that show Survivor. Every time I watch it with her it reminds me of my old PP group. My new group has a much better dynamic. This is sometimes difficult for a resident to discern even if you have a few interviews with a group. It does get easier to spot red flags as you move forward in your career and know what to look for IMO.

 

[Chloroform4Life]

Chloroform4Life - to educate us younger folks.. in hindsight, do you recall any red flags or fishy feelings when considering this offer during residency? whether it was lack of a partnership track or lack of transparency regarding the group's finances? Or were there no suspicions?

No. I accepted the offer as it was written in my contract and the group has been treating me fairly (other than the low compensation obviously). I only interviewed at a couple places and neither offer was that great. I think I was too focused on this being a great location that I didn't explore other opportunities. As a resident and never really making any money before, 280k did not seem like it was bad. Hell that's 5 times more than I'd seen before in a year. The group did try to sell me how great 1099 was and how I can deduct everything but in retrospect W2 would have been a lot better. I probably should've gone on more interviews and search for better opportunities. The excitement of having the first job offer in my life being >200k blinded me. I reasoned that the difference between 300 and 400k isn't that much, especially after tax. But that extra 60k or so after tax can add up to a nice retirement fund.

 

[deleted162650]

Chloroform4Life - to educate us younger folks.. in hindsight, do you recall any red flags or fishy feelings when considering this offer during residency? whether it was lack of a partnership track or lack of transparency regarding the group's finances? Or were there no suspicions?

I've said it before and I'll say it again: Connections, Connections, Connections. It's damn hard to tell a good group from a bad one on interview day alone (unless it's really a disaster). Every group will make it sound like hey have the best gig on earth. You need to talk to your attendings and former residents in the classes ahead of you. Where did they go, are they happy, etc? Since you've been outta residency for a lil bit, where did your co-residents go? That is how you get the real intel, and how you find the good jobs cuz those will never be on Gaswork unless they're BFE. Now if your network connections come up dry, then take that as a sign that the force is not strong with you, and be happy that at least you're employed.

What do you think about the Southeast region?

Well, that's probably not totally fair. There are some very nice places to live in the Coastal SE, and I have no personal knowledge of the Anesthesia market there, but in general the proportion of malcontents is directly related to the number of CRNA's and AMC's in the area. Both have a pretty strong foothold in the SE. On top of that, you have to deal with 200% humidity and bugs bigger than the average size dog here in SoCal.

 

[caligas]

What do you think about the Southeast region?

I've said it before and I'll say it again: Connections, Connections, Connections. It's damn hard to tell a good group from a bad one on interview day alone (unless it's really a disaster). Every group will make it sound like hey have the best gig on earth. You need to talk to your attendings and former residents in the classes ahead of you. Where did they go, are they happy, etc? Since you've been outta residency for a lil bit, where did your co-residents go? That is how you get the real intel, and how you find the good jobs cuz those will never be on Gaswork unless they're BFE. Now if your network connections come up dry, then take that as a sign that the force is not strong with you, and be happy that at least you're employed.






Well, that's probably not totally fair. There are some very nice places to live in the Coastal SE, and I have no personal knowledge of the Anesthesia market there, but in general the proportion of malcontents is directly related to the number of CRNA's and AMC's in the area. Both have a pretty strong foothold in the SE. On top of that, you have to deal with 200% humidity and bugs bigger than the average size dog here in SoCal.

Connections are very helpful, but I've had 2 jobs and both are very good gigs that I found on my own with time and effort.

And to the OP, don't feel bad, we all make these kind of mistakes early on. It's way better than killing a patient or marrying a bitch (or a cheating dick, for the ladies).

 

[PainDrain]

While I will say connections do matter, a lot also depends on where you are located in the country. My area of the east coast is locked down by AMCs and academic centers; a lot of the jobs suck. I have heard of jobs making 250k for 60 hour weeks and 6 weeks vacation, no bonus, no profit sharing, nothing. Cardiac guys making 330 and being on call every other weekend. There are some rare gems but getting into them is insanely hard and the partnership track may be 5 years. F-that. There are also several places where you are working for a handful of partners who are making 500-600K. I am sticking around a few more years for family reasons and then I will likely move.

 

[criticalelement]

While I will say connections do matter, a lot also depends on where you are located in the country. My area of the east coast is locked down by AMCs and academic centers; a lot of the jobs suck. I have heard of jobs making 250k for 60 hour weeks and 6 weeks vacation, no bonus, no profit sharing, nothing. Cardiac guys making 330 and being on call every other weekend. There are some rare gems but getting into them is insanely hard and the partnership track may be 5 years. F-that. There are also several places where you are working for a handful of partners who are making 500-600K. I am sticking around a few more years for family reasons and then I will likely move.

This is unfortunately the reality in most major markets. Until people start saying F you and walking and nobody taking these jobs this will continue. This is a major reason (in my mind at least) why going into anesthesia residency is not the greatest idea..

 

[scootad.]

This is not unique to gas. There are shady jobs in all specialties. I'm a radiologist and know of many places more than willing to work the new associate for 3-4 years, promise partnership, then nothing. All the while skimming 200k on your back. It's always best to try to know people on the inside before joining any group, but this is sometimes not possible. The good news is many docs don't stay at their first job. Chalk it up to a learning experience and move on. You will be more marketable for the next one.

 

[Planktonmd]

Call the senior partner into the room. Ask him if he could sit in the room while you go to lunch. Except after lunch, you aint coming back. Ever. Just dont come back. If he gives you a problem call the medical board on him and make up some bull sh t on him.

Although this sounds great but you are likely going to need a letter of recommendation from these guys even if they are crooks.
It all starts by making a decision that you will no longer accept the status quo, then you start looking for jobs. Don't initially inform your current employer of your decision until you have some solid offers, but if they find out so be it, you had already decided.
Once you have good offers you sit with the partners and have a frank and open discussion, and see if they are willing to sweeten your deal to retain you, although from what you described it sounds unlikely that they will do that.

 

[Chloroform4Life]

Although this sounds great but you are likely going to need a letter of recommendation from these guys even if they are crooks.
It all starts by making a decision that you will no longer accept the status quo, then you start looking for jobs. Don't initially inform your current employer of your decision until you have some solid offers, but if they find out so be it, you had already decided.
Once you have good offers you sit with the partners and have a frank and open discussion, and see if they are willing to sweeten your deal to retain you, although from what you described it sounds unlikely that they will do that.

Thanks Plankton, that's exactly what I am doing right now. I don't want to burn any bridges and I've gotten along well with all the partners. You're right, I don't think they will be willing to sweeten the deal. Since I've been here, there's already been one employee anesthesiologist who has left after about a year as well. They keep hiring new employee anesthesiologists with the same deal I got. Maybe with me leaving, they will start figuring out that what they are doing is not working.

 

[Planktonmd]

Thanks Plankton, that's exactly what I am doing right now. I don't want to burn any bridges and I've gotten along well with all the partners. You're right, I don't think they will be willing to sweeten the deal. Since I've been here, there's already been one employee anesthesiologist who has left after about a year as well. They keep hiring new employee anesthesiologists with the same deal I got. Maybe with me leaving, they will start figuring out that what they are doing is not working.

They will not change what they are doing! The current job market provides an abundance of cheap labor and potential victims to these predators and I bet you they will have no trouble finding your replacement, especially if you are in a desirable area.
Don't take it personal , it's supply and demand.
They will eventually sell out to an AMC. Actually I bet you they are already considering it and that's why they are not interested in adding more partners who would split their buy out money.