LA Market

Coffee PRN · Jul 23, 2023

How is the LA market these days? Have a friend getting $300/hr doing easy solo cases. Heard from another person that Henry Mayo is offering $400/hr? But have not personally verified.

medicine2wallstreet · Jul 23, 2023

300 an hour buys you a chicken mcnugget combo in LA. Why anyone wants to live in that godless hell scape is beyond me.

nimbus · Jul 23, 2023

medicine2wallstreet said:
300 an hour buys you a chicken mcnugget combo in LA. Why anyone wants to live in that godless hell scape is beyond me.

One thing that is never brought up in this forum is that if you happen to be a certain ethnicity like Korean, Armenian, or Persian, LA offers community and cultural amenities that cannot be matched anywhere else. Places where elderly parents can gather and feel at home. Even other top 10 cities cannot match it. The pull can be very strong.

aneftp · Jul 23, 2023

nimbus said:
One thing that is never brought up in this forum is that if you happen to be a certain ethnicity like Korean, Armenian, or Persian, LA offers community and cultural amenities that cannot be matched anywhere else. Places where elderly parents can gather and feel at home. Even other top 10 cities cannot match it. The pull can be very strong.

Tons of Koreans in New York.
Tons of Persians in wash dc/new york
(Yes I know southern ca is the Mecca for Persians (half of them live there as I have lots of Persian friends) just like Southern California is also Mecca for Vietnamese and Miami is Cuban land where elderly parents don’t have to relearn a language.

But my point is you don’t necessarily have to live in LA to experience what dc or New York can offer elderly parents who are of Persian decent.

nimbus · Jul 24, 2023

aneftp said:
Tons of Koreans in New York.
Tons of Persians in wash dc/new york
(Yes I know southern ca is the Mecca for Persians (half of them live there as I have lots of Persian friends) just like Southern California is also Mecca for Vietnamese and Miami is Cuban land where elderly parents don’t have to relearn a language.

But my point is you don’t necessarily have to live in LA to experience what dc or New York can offer elderly parents who are of Persian decent.

Very true. My aunts, uncles, and cousins are “New York Koreans”. I was just trying to give one perspective on why someone might want to or need to live in LA. One of our partners moved to LA for a job that paid significantly less because her immediate and extended family are “LA Koreans”.

anonperson · Jul 24, 2023

Most people who grew up in Southern California want to go back. Especially minorities. This is a stereotype to some degree but being closer to family is an important part of life for a lot of East and South Asians.

I'm not anesthesia, but I took a worse lower paying job to be close to my parents and siblings.

It was worth it especially when one parent got fairly sick and needed major surgery. Being able to be close by to help out was priceless.

MirrorTodd · Jul 24, 2023

Man I thought this was about Louisiana and I was like "What? Asians? Persians? What the hell are they doing in the swamp?"

Dr. Rude · Jul 24, 2023

MirrorTodd said:
Man I thought this was about Louisiana and I was like "What? Asians? Persians? What the hell are they doing in the swamp?"

Different swamp.

Remxed · Jul 24, 2023

I'm a graduating fellow who chose a job in LA because my spouse found a job there.

LA groups are primarily production/RVU based. Outside of Kaiser and the academic hospitals, most groups are 1099 rather than w2. Everyone forms their own S-corp to help with tax deductions. The groups that I looked all currently have new hires make 100% partner rates, and the units are insurance blended. Partnership track is anywhere from 1-3 years without any additional buy-in.

Almost all of the people who work in LA all have some sort of connection. They either grew up there or did their training there. Most of the better groups hire by word of mouth. I would not have found the group I signed with without asking my friends who work in the area.

finalpsychyear · Jul 24, 2023

Yeah it took me 6 hrs to get to a 3 hr destination from LA to northern cali recently on a drive cause of that traffic. Yes the weather is great, the girls are pretty but the cost for a doc who is striving for FI or FIRE can be more of a challenge. Sure if your dual MD that's one thing.

ucladoc2b · Jul 24, 2023

Remxed said:
I'm a graduating fellow who chose a job in LA because my spouse found a job there.

LA groups are primarily production/RVU based. Outside of Kaiser and the academic hospitals, most groups are 1099 rather than w2. Everyone forms their own S-corp to help with tax deductions. The groups that I looked all currently have new hires make 100% partner rates, and the units are insurance blended. Partnership track is anywhere from 1-3 years without any additional buy-in.

Almost all of the people who work in LA all have some sort of connection. They either grew up there or did their training there. Most of the better groups hire by word of mouth. I would not have found the group I signed with without asking my friends who work in the area.

Every single group in LA, OC and SD is hiring and short staffed. 100% partner rate for new hires is the norm.

Also, if your hospital is a non profit, you are newly eligible for PSLF. Even in PP.

Guillemot · Jul 24, 2023

ucladoc2b said:
Every single group in LA, OC and SD is hiring and short staffed. 100% partner rate for new hires is the norm.

Also, if your hospital is a non profit, you are newly eligible for PSLF. Even in PP.

Elaborate please

ucladoc2b · Jul 24, 2023

Guillemot said:
Elaborate please

What part?

GassYous · Jul 24, 2023

ucladoc2b said:
What part?

I must have missed the memo on the hiring spree

Ezekiel2517 · Jul 24, 2023

finalpsychyear said:
Yeah it took me 6 hrs to get to a 3 hr destination from LA to northern cali recently on a drive cause of that traffic. Yes the weather is great, the girls are pretty but the cost for a doc who is striving for FI or FIRE can be more of a challenge. Sure if your dual MD that's one thing.

I’m curious, what NorCal destination is normally a 3 hr drive from LA?

MirrorTodd · Jul 24, 2023

Ezekiel2517 said:
I’m curious, what NorCal destination is normally a 3 hr drive from LA?

Pismo Beach. :laugh:

propadex · Jul 24, 2023

Coffee PRN said:
How is the LA market these days? Have a friend getting $300/hr doing easy solo cases. Heard from another person that Henry Mayo is offering $400/hr? But have not personally verified.

Very difficult to know dollars per hour based on typical private practice eat what you kill compensation structure. Anyone in OC or LA proper actually making $300/hr? What are people out there actually making? I think $225-250/hr is more realistic.

dchz · Jul 24, 2023

GassYous said:
I must have missed the memo on the hiring spree

Too late, no take backs!!

aneftp said:
Tons of Koreans in New York.
Tons of Persians in wash dc/new york
(Yes I know southern ca is the Mecca for Persians (half of them live there as I have lots of Persian friends) just like Southern California is also Mecca for Vietnamese and Miami is Cuban land where elderly parents don’t have to relearn a language.

But my point is you don’t necessarily have to live in LA to experience what dc or New York can offer elderly parents who are of Persian decent.

Yeah because NY is so much cheaper than LA... To me, NY is the worst place to practice medicine. At least I have sunshine, good Chinese food, and good weather if I'm gonna be poor in socal.

finalpsychyear · Jul 24, 2023

Ezekiel2517 said:
I’m curious, what NorCal destination is normally a 3 hr drive from LA?

lol well north of lax. cal poly ( san luis obispo) is still technically what central cal then? Gorgeous area though.

Remxed · Jul 24, 2023

ucladoc2b said:
Every single group in LA, OC and SD is hiring and short staffed. 100% partner rate for new hires is the norm.

Also, if your hospital is a non profit, you are newly eligible for PSLF. Even in PP.

Surprisingly the LA academic hospital positions seem be competitive, at least for cardiac. I loosely looked into academic jobs in LA and was shocked to see how low the compensation packages are considering the high COL and taxes. And yet, people still want those positions. I'm coming from a big east coast training program, and it seems like you either need a very well padded CV or have done some amount of training in LA to even get your foot in the door. Most of my emails/faculty introductions were all unanswered.

aneftp · Jul 24, 2023

dchz said:
Too late, no take backs!!

Yeah because NY is so much cheaper than LA... To me, NY is the worst place to practice medicine. At least I have sunshine, good Chinese food, and good weather if I'm gonna be poor in socal.

My buddy who is Korean. We did internship together in nyc. He’s from LA proper. Grew up there.

Eye doc. Did his eye training southwest. Fellowship in south. Moved back to Southern California proper in the city for 10 plus years. Where all the family is.

But moved back to nyc to live the last 4 years and loves the city. He enjoys the city life.

GassYous · Jul 24, 2023

aneftp said:
My buddy who is Korean. We did internship together in nyc. He’s from LA proper. Grew up there.

Eye doc. Did his eye training southwest. Fellowship in south. Moved back to Southern California proper in the city for 10 plus years. Where all the family is.

But moved back to nyc to live the last 4 years and loves the city. He enjoys the city life.

Yeah there's nothing like paying 20 bucks (plus tax and tip) for a margarita and listening to loud cars, loud music and loud sirens all night long

Nyc is dirty smelly and crowded

Ezekiel2517 · Jul 24, 2023

finalpsychyear said:
lol well north of lax. cal poly ( san luis obispo) is still technically what central cal then? Gorgeous area though.

SLO is likely considered central coast. Beautiful spot I agree. But I don’t think a 3 hr drive will even make it to Fresno from LA lol. CA is a massive state

thinkorswim · Jul 24, 2023

propadex said:
Very difficult to know dollars per hour based on typical private practice eat what you kill compensation structure. Anyone in OC or LA proper actually making $300/hr? What are people out there actually making? I think $225-250/hr is more realistic.

It’s not difficult at all if you keep track of your cases.

$250/hour would come out to $518k per year gross income, assuming 45 hours per week and 6 weeks vacation. That’s a bit low, even for LA/OC these days.

tdub878 · Jul 24, 2023

There are many factors to consider when people choose a job. Family, spouse, marital status (custody) friends and general comfort with an area. Many established people already have homes/condos/etc.

Dr. Rude · Jul 24, 2023

GassYous said:
Yeah there's nothing like paying 20 bucks (plus tax and tip) for a margarita and listening to loud cars, loud music and loud sirens all night long

Nyc is dirty smelly and crowded

But it is fookin noo yawk. Ya dum fook.

<(^_^)> · Jul 27, 2023

thinkorswim said:
It’s not difficult at all if you keep track of your cases.

$250/hour would come out to $518k per year gross income, assuming 45 hours per week and 6 weeks vacation. That’s a bit low, even for LA/OC these days.

I think call can make things pretty hard to compare. If you are home call Q5 with a 50% call back rate for average of 2 hours…technically that’s 1 hour worked per call on average….but it better pay better than an hour worked 7-3 M-F.

Overall LA it seems absurdly expensive to live for a new grad (or someone moving to LA) with rates now exceeding 7%. https://cdn.nar.realtor/sites/defau...23-housing-affordability-index-2023-07-14.pdf

Median mortgage payment for median house has roughly doubled nationally since 2020, and LA kept pace or exceeded that depending on the neighborhood.

Hoya11 · Jul 27, 2023

GassYous said:
Yeah there's nothing like paying 20 bucks (plus tax and tip) for a margarita and listening to loud cars, loud music and loud sirens all night long

Nyc is dirty smelly and crowded

plus the physical infrastructures of some of the hospitals (even those with a great reputation) - horrendous! its a tough problem when space is so hard to come by

nimbus · Jul 27, 2023

GassYous said:
Yeah there's nothing like paying 20 bucks (plus tax and tip) for a margarita and listening to loud cars, loud music and loud sirens all night long

Nyc is dirty smelly and crowded

Still, I love NYC. Reminds me of my youthful carefree days.

Dr. Rude · Jul 27, 2023

nimbus said:
Still, I love NYC. Reminds me of my youthful carefree days.

Everywhere (almost) is great when you are young. My uncle was a WW2 submariner and always thought of his submarine as home. His face lit up when he talked about it. I could never understand until I became old (almost).

propadex · Jul 31, 2023

thinkorswim said:
It’s not difficult at all if you keep track of your cases.

$250/hour would come out to $518k per year gross income, assuming 45 hours per week and 6 weeks vacation. That’s a bit low, even for LA/OC these days.

Actually seems pretty good. Others think this is too low?

gasresident1 · Aug 6, 2023

ucladoc2b said:
Every single group in LA, OC and SD is hiring and short staffed. 100% partner rate for new hires is the norm.

Also, if your hospital is a non profit, you are newly eligible for PSLF. Even in PP.

Are we 100% positive about this???? You are telling me that even tho my practice is most definitely not a non profit, if the healthcare system we contract with is a 501c (they are all are) I can be ELIGIBLE for PSLF???

This is honestly a game changer for those of us who were on that COVID pause for years and could actually work out in our favor. I paid nothing, even on my attending salary last year, but am currently 3 years into PSLF because all these monthly counted toward it. Would I ever benefit from PSLF in 10 years on my PP salary? No. Would I benefit in 6.5 years, actually YES!

I'm emailing my loan officer right now. Are we 100% positive about this? If so you are the MAN.

nimbus · Aug 6, 2023

1. Your group must have a contract with a “qualified employer”, ie a “nonprofit” hospital or clinic. This may give more incentive for young debt ridden doctors to work at “nonprofit” facilities. I’m not sure but I don’t think “for profit” hospitals run by Tenet, Prime, and HCA would qualify. However, even if you are directly employed by a for profit entity, eg a PE backed/owned AMC, I believe you still qualify as long as your for profit group is contracted to provide services at a nonprofit hospital and you spend all your time or at least 30hrs/week at the nonprofit hospital. It also gets murky if you spend most of your time at a surgicenter or other for profit facility.

2. At least in Ca and Tx, an official from the nonprofit hospital must attest that you are filling a role that cannot be filled by a direct employee of the hospital because of laws barring direct employment of physicians.

https://www.cmadocs.org/Portals/CMA/files/public/PSLF%202023%20-%20What%20California%20Physicians%20Need%20to%20Know.pdf

ucladoc2b · Aug 6, 2023

gasresident1 said:
Are we 100% positive about this???? You are telling me that even tho my practice is most definitely not a non profit, if the healthcare system we contract with is a 501c (they are all are) I can be ELIGIBLE for PSLF???

This is honestly a game changer for those of us who were on that COVID pause for years and could actually work out in our favor. I paid nothing, even on my attending salary last year, but am currently 3 years into PSLF because all these monthly counted toward it. Would I ever benefit from PSLF in 10 years on my PP salary? No. Would I benefit in 6.5 years, actually YES!

I'm emailing my loan officer right now. Are we 100% positive about this? If so you are the MAN.

Yup.

You shouldn’t have to email your loan officer. This is all handled through the normal PSLF channels.

cchoukal · Aug 6, 2023

I did this working for the VA. The rules changed during COVID, effectively making any repayment plan eligible (historically, it was only the income-based repayment plans that were eligible). The issue will be who is your actual employer, like who will be writing the employment verification letter. What is THEIR status with regard to being non-profit?

EDIT: Just saw Nimbus' post above and it sounds like it's more complicated than I said and maybe there IS a path if your employment isn't directly with the non-profit.

ucladoc2b · Aug 6, 2023

CubsDynasty said:
I would look into specifics on this. My understanding is that Kaiser (a non profit) was legally not allowed to employ the physicians in CA or TX and therefore those docs didn't qualify for PSLF, so this is just addressing the specific loophole of working for a non-profit group at a non-profit hospital in one of those two states that by law excluded you from PSLF. So an AMC or PP wouldn't be included.

This is not factually correct.

A professional corporation cannot be set up as a 501c.

In the state of California (and Texas), there is a legal prohibition against the corporate practice of medicine. Essentially, hospitals cannot hire physicians. They contract with groups to provide services. These groups are mostly structured as a professional corporation. This applies to Kaiser (their physician practice is the Permanete Medical Group), Cedars, and others. All of them have attached medical groups that employ the physicians.

If you work for a private practice or even an AMC that is structured this way because of a legal prohibition, it is covered.

nimbus · Aug 6, 2023

CubsDynasty said:
I would look into specifics on this. My understanding is that Kaiser (a non profit) was legally not allowed to employ the physicians in CA or TX and therefore those docs didn't qualify for PSLF, so this is just addressing the specific loophole of working for a non-profit group at a non-profit hospital in one of those two states that by law excluded you from PSLF. So an AMC or PP wouldn't be included.

Not true. Please read the CMA link I posted above. Our practice manager has already identified the administrators at our contracted hospitals who are willing to sign the necessary attestation.

CubsDynasty · Aug 6, 2023

Already deleted the post above. It doesn’t even apply to me so I have no skin in the game

nimbus · Jan 1, 2024

nimbus said:
1. Your group must have a contract with a “qualified employer”, ie a “nonprofit” hospital or clinic. This may give more incentive for young debt ridden doctors to work at “nonprofit” facilities. I’m not sure but I don’t think “for profit” hospitals run by Tenet, Prime, and HCA would qualify. However, even if you are directly employed by a for profit entity, eg a PE backed/owned AMC, I believe you still qualify as long as your for profit group is contracted to provide services at a nonprofit hospital and you spend all your time or at least 30hrs/week at the nonprofit hospital. It also gets murky if you spend most of your time at a surgicenter or other for profit facility.

2. At least in Ca and Tx, an official from the nonprofit hospital must attest that you are filling a role that cannot be filled by a direct employee of the hospital because of laws barring direct employment of physicians.

https://www.cmadocs.org/Portals/CMA/files/public/PSLF%202023%20-%20What%20California%20Physicians%20Need%20to%20Know.pdf

To update this post, one of my partners had the remaining balance of their loan forgiven in November. They were the first in our group. Others are still in process.

Maz777 · Jan 3, 2024

Remxed said:
Surprisingly the LA academic hospital positions seem be competitive, at least for cardiac. I loosely looked into academic jobs in LA and was shocked to see how low the compensation packages are considering the high COL and taxes. And yet, people still want those positions. I'm coming from a big east coast training program, and it seems like you either need a very well padded CV or have done some amount of training in LA to even get your foot in the door. Most of my emails/faculty introductions were all unanswered.

You dodged a bullet. Stay away from academic jobs.

nimbus · Jan 3, 2024

Current Kaiser listings