OC/LA Groups (Sanitized Version)

[GassYous]

Long time reader, first time caller, posting under a pseudonym for obvious reasons

Now that the job search is done, I feel comfortable writing this up. I want to acknowledge everyone who has posted as the free exchange of information here has been an invaluable resource and allows everyone to know what is out there and have a basis for comparison. For disclosure and liability purposes, this may just be a dream and the information is worth to you as much as you paid for it.

I'm a CA-3 at a top (1-10) program on the east coast. Strong resident with strong CV (D1 athlete, full ride to top med school, AOA,>20 1st author pubs in Anesthesiology, A&A, RAAPM, JCVA etc, recs from names you've heard of who vouch for skillset that is quick, efficient and personable and matched to a very competitive fellowship program). Decided wanted to do general, partner pushing for So Cal since we have a strong connection to the area so I did my due diligence and interviewed with the following groups. Phone calls were made to get my foot in the door. Here's my experience:

Hoag (NHAC)- many consider it the "best" job out there in So Cal, extremely in-bred with in-house referral system from the top LA and SD program (notice no plural there). They considered it was "lucky" for me to have someone I knew and strongly referred me. 3 year partner track, production based. Non lucrative and easy cases at ortho institute until later in your career (why?) despite my strong connection to the surgeons and them requesting it. They wavered with possibly having to be per-diem for first 6 months. Pre-partner income is skimmed with a unit value that is above average. Total package before partner is less than starting CRNA pay at my current institution with much more hours than our CRNAs. Imagine busting your ass and striving to be nothing but the best all so you can make less than a nurse anesthetist. And that is a best case scenario for socal. This group also prides themselves on only hiring cardiac or chief residents though they have not stuck to that lately.

MV - Chill group, seemingly fair, have a line of people working as per-diem waiting for a full time position. Per diem hourly rate (why not ASA unit based?!) made me have to mute the phone so they couldn't hear me laugh. There was someone whose been there almost 12 months as per diem, bless their heart. ICU RNs in covid units make more (this isn't a knock on them, they deserve it). 2 or 3 years to partner IIRC. Associate pay is production based, claimed fair scheduling but who knows. Benefits are standard, can't believe paid vacation is rare in CA. Partner comp package isn't anything to write home about but seemed to be great people to be around.

Kaiser SD - wanted people to work per-diem, they're "expanding" with new facility that will need 10 additional providers. Per diem rate is laughable if you're a reasonable person. Then consider that you have to fund your own benefits until you get the privelege of being full time. 5 year track IIRC. Pension is sweet though if you're not an idiot, could outpace those dividends saving up your own money over 30 years. Standard kaiser package, lifestyle seems great once partner compared to other CA gigs. Very nice to have integrated EMR and patients actually set up well for surgery. Before I even got the chance to tell them I'm not interested, they had called references and texted around asking people who knew me. This would be a long term option if you have the patience and a trust fund to live off.

Allied Anesthesia - Did this as a courtesy interview. Did my best to not hang up mid-call. They also wanted to do a mock oral boards as part of the interview. Three regional branches - 1 is extremely malignant, 1 is malignant and 1 is semi-malignant. 5 year track, production based, lowest unit value that I saw on the trail. Did not want to discuss numbers and kept defaulting to "you'll be compensated well". Apparently well is pediatrician salary working neurosurgeon hours for 5 years.

ASMG - just quick call, seemingly fair, 1 year of "match" which means driving around everywhere and them assigning you somewhere people liked you. Heavy collections and skimming. Huge group and huge geographic area. Lots of driving. Probably most lucrative and best benefits package as well as least malignant track.

So Cal seems like a race to the bottom. Good luck negotiating because if you don't really want what they offer you, there's someone who is willing to work for less. It sucks to be replaceable but that's the market here. Combine this with a litigous population, huge patient entitlement, a liberal environment (nothing wrong with the politics but when a nurse reports a doctor or a bad patient outcome occurs, good luck facing the jury or judge), high medicare+medi-cal population (read lower reimbursements) along with a seemingly endless supply of people who want to live/work in So Cal. This is one of the rare places where it seems like the academic gigs are a better value than playing these silly games and racing to the bottom of the reimbursement scale in private practice. Money may not be everything but financial security for your investment in yourself is a long way off. We have cRNAs who make more than some of the partner gigs here while working 40 hours and never taking call and not assuming the liability.

Lol yeah I wanted to go to socal but the jobs are just so bad. It's amazing how different it is from northern california. I don't know why anyone labors in those terrible conditions when the job market is pretty decent around the country. Allied anesthesia is crappy; I can't believe someone who went through all the bs of medical school and residency would be willing to take jobs there as nonpartners. Shady ass people.

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[LifeofGas]

Long time reader, first time caller, posting under a pseudonym for obvious reasons

Now that the job search is done, I feel comfortable writing this up. I want to acknowledge everyone who has posted as the free exchange of information here has been an invaluable resource and allows everyone to know what is out there and have a basis for comparison. For disclosure and liability purposes, this may just be a dream and the information is worth to you as much as you paid for it.

I'm a CA-3 at a top (1-10) program on the east coast. Strong resident with strong CV (D1 athlete, full ride to top med school, AOA,>20 1st author pubs in Anesthesiology, A&A, RAAPM, JCVA etc, recs from names you've heard of who vouch for skillset that is quick, efficient and personable and matched to a very competitive fellowship program). Decided wanted to do general, partner pushing for So Cal since we have a strong connection to the area so I did my due diligence and interviewed with the following groups. Phone calls were made to get my foot in the door. Here's my experience:

Hoag (NHAC)- many consider it the "best" job out there in So Cal, extremely in-bred with in-house referral system from the top LA and SD program (notice no plural there). They considered it was "lucky" for me to have someone I knew and strongly referred me. 3 year partner track, production based. Non lucrative and easy cases at ortho institute until later in your career (why?) despite my strong connection to the surgeons and them requesting it. They wavered with possibly having to be per-diem for first 6 months. Pre-partner income is skimmed with a unit value that is above average. Total package before partner is less than starting CRNA pay at my current institution with much more hours than our CRNAs. Imagine busting your ass and striving to be nothing but the best all so you can make less than a nurse anesthetist. And that is a best case scenario for socal. This group also prides themselves on only hiring cardiac or chief residents though they have not stuck to that lately.

MV - Chill group, seemingly fair, have a line of people working as per-diem waiting for a full time position. Per diem hourly rate (why not ASA unit based?!) made me have to mute the phone so they couldn't hear me laugh. There was someone whose been there almost 12 months as per diem, bless their heart. ICU RNs in covid units make more (this isn't a knock on them, they deserve it). 2 or 3 years to partner IIRC. Associate pay is production based, claimed fair scheduling but who knows. Benefits are standard, can't believe paid vacation is rare in CA. Partner comp package isn't anything to write home about but seemed to be great people to be around.

Kaiser SD - wanted people to work per-diem, they're "expanding" with new facility that will need 10 additional providers. Per diem rate is laughable if you're a reasonable person. Then consider that you have to fund your own benefits until you get the privelege of being full time. 5 year track IIRC. Pension is sweet though if you're not an idiot, could outpace those dividends saving up your own money over 30 years. Standard kaiser package, lifestyle seems great once partner compared to other CA gigs. Very nice to have integrated EMR and patients actually set up well for surgery. Before I even got the chance to tell them I'm not interested, they had called references and texted around asking people who knew me. This would be a long term option if you have the patience and a trust fund to live off.

Allied Anesthesia - Did this as a courtesy interview. Did my best to not hang up mid-call. They also wanted to do a mock oral boards as part of the interview. Three regional branches - 1 is extremely malignant, 1 is malignant and 1 is semi-malignant. 5 year track, production based, lowest unit value that I saw on the trail. Did not want to discuss numbers and kept defaulting to "you'll be compensated well". Apparently well is pediatrician salary working neurosurgeon hours for 5 years.

ASMG - just quick call, seemingly fair, 1 year of "match" which means driving around everywhere and them assigning you somewhere people liked you. Heavy collections and skimming. Huge group and huge geographic area. Lots of driving. Probably most lucrative and best benefits package as well as least malignant track.

So Cal seems like a race to the bottom. Good luck negotiating because if you don't really want what they offer you, there's someone who is willing to work for less. It sucks to be replaceable but that's the market here. Combine this with a litigous population, huge patient entitlement, a liberal environment (nothing wrong with the politics but when a nurse reports a doctor or a bad patient outcome occurs, good luck facing the jury or judge), high medicare+medi-cal population (read lower reimbursements) along with a seemingly endless supply of people who want to live/work in So Cal. This is one of the rare places where it seems like the academic gigs are a better value than playing these silly games and racing to the bottom of the reimbursement scale in private practice. Money may not be everything but financial security for your investment in yourself is a long way off. We have cRNAs who make more than some of the partner gigs here while working 40 hours and never taking call and not assuming the liability.

I know a few of my co-residents went to ASMG. I personally interviewed there too. I was impressed with how organize they are and the unit value they presented to me was above average. I ended up taking another job (which was not that great). Anyhow, 2 people I know left ASMG not even a year after. Apparently ASMG skimmed so much that the take home income is low.

One of my friend went to Hoag. I think its the best group as when I asked them how much they make...it's significantly more. However...they also get worked hard.

Yeah, SoCal is not that great for jobs. Sure, the idea of finding a job close to the glitz and glamour of LA City is nice, but you never get to really enjoy it because you are always working. What is worse is that the money you make...you probably have to spend it on rent. I don't personally think it's sustainable long term.

Perhaps work somewhere else where you make the big bucks...get financially stable, pay off loans, make some good investments such that you don't have to worry about money. Then...maybe move to back to Socal.

I wish I did that...but I'm stuck in SoCal for now.

 

[GassYous]

I know a few of my co-residents went to ASMG. I personally interviewed there too. I was impressed with how organize they are and the unit value they presented to me was above average. I ended up taking another job (which was not that great). Anyhow, 2 people I know left ASMG not even a year after. Apparently ASMG skimmed so much that the take home income is low.

One of my friend went to Hoag. I think its the best group as when I asked them how much they make...it's significantly more. However...they also get worked hard.

Yeah, SoCal is not that great for jobs. Sure, the idea of finding a job close to the glitz and glamour of LA City is nice, but you never get to really enjoy it because you are always working. What is worse is that the money you make...you probably have to spend it on rent. I don't personally think it's sustainable long term.

Perhaps work somewhere else where you make the big bucks...get financially stable, pay off loans, make some good investments such that you don't have to worry about money. Then...maybe move to back to Socal.

I wish I did that...but I'm stuck in SoCal for now.

I actually visited one of my wife's friends in LA recently. When they first got there, they did this and that because it was new and fresh. But now they just basically work and stay home. One of them works at home. I mean yeah I guess the weather is nice and all that but I probably did more in LA by visiting those few days than they have all year. I'd rather live somewhere cheaper that's still decent and visit the expensive places.

 

[deleted162650]

Well, (not all, but) a good chunk of the info above is either misconstrued, or outright false. You’d think such a bright candidate woulda paid better attention on interview day.

 

[Peterluger]

I know a few of my co-residents went to ASMG. I personally interviewed there too. I was impressed with how organize they are and the unit value they presented to me was above average. I ended up taking another job (which was not that great). Anyhow, 2 people I know left ASMG not even a year after. Apparently ASMG skimmed so much that the take home income is low.

One of my friend went to Hoag. I think its the best group as when I asked them how much they make...it's significantly more. However...they also get worked hard.

Yeah, SoCal is not that great for jobs. Sure, the idea of finding a job close to the glitz and glamour of LA City is nice, but you never get to really enjoy it because you are always working. What is worse is that the money you make...you probably have to spend it on rent. I don't personally think it's sustainable long term.

Perhaps work somewhere else where you make the big bucks...get financially stable, pay off loans, make some good investments such that you don't have to worry about money. Then...maybe move to back to Socal.

I wish I did that...but I'm stuck in SoCal for now.

How much money academic make? Like at ucla. And how hard u work there?

 

[chocomorsel]

Long time reader, first time caller, posting under a pseudonym for obvious reasons

Now that the job search is done, I feel comfortable writing this up. I want to acknowledge everyone who has posted as the free exchange of information here has been an invaluable resource and allows everyone to know what is out there and have a basis for comparison. For disclosure and liability purposes, this may just be a dream and the information is worth to you as much as you paid for it.

I'm a CA-3 at a top (1-10) program on the east coast. Strong resident with strong CV (D1 athlete, full ride to top med school, AOA,>20 1st author pubs in Anesthesiology, A&A, RAAPM, JCVA etc, recs from names you've heard of who vouch for skillset that is quick, efficient and personable and matched to a very competitive fellowship program). Decided wanted to do general, partner pushing for So Cal since we have a strong connection to the area so I did my due diligence and interviewed with the following groups. Phone calls were made to get my foot in the door. Here's my experience:

Hoag (NHAC)- many consider it the "best" job out there in So Cal, extremely in-bred with in-house referral system from the top LA and SD program (notice no plural there). They considered it was "lucky" for me to have someone I knew and strongly referred me. 3 year partner track, production based. Non lucrative and easy cases at ortho institute until later in your career (why?) despite my strong connection to the surgeons and them requesting it. They wavered with possibly having to be per-diem for first 6 months. Pre-partner income is skimmed with a unit value that is above average. Total package before partner is less than starting CRNA pay at my current institution with much more hours than our CRNAs. Imagine busting your ass and striving to be nothing but the best all so you can make less than a nurse anesthetist. And that is a best case scenario for socal. This group also prides themselves on only hiring cardiac or chief residents though they have not stuck to that lately.

MV - Chill group, seemingly fair, have a line of people working as per-diem waiting for a full time position. Per diem hourly rate (why not ASA unit based?!) made me have to mute the phone so they couldn't hear me laugh. There was someone whose been there almost 12 months as per diem, bless their heart. ICU RNs in covid units make more (this isn't a knock on them, they deserve it). 2 or 3 years to partner IIRC. Associate pay is production based, claimed fair scheduling but who knows. Benefits are standard, can't believe paid vacation is rare in CA. Partner comp package isn't anything to write home about but seemed to be great people to be around.

Kaiser SD - wanted people to work per-diem, they're "expanding" with new facility that will need 10 additional providers. Per diem rate is laughable if you're a reasonable person. Then consider that you have to fund your own benefits until you get the privelege of being full time. 5 year track IIRC. Pension is sweet though if you're not an idiot, could outpace those dividends saving up your own money over 30 years. Standard kaiser package, lifestyle seems great once partner compared to other CA gigs. Very nice to have integrated EMR and patients actually set up well for surgery. Before I even got the chance to tell them I'm not interested, they had called references and texted around asking people who knew me. This would be a long term option if you have the patience and a trust fund to live off.

Allied Anesthesia - Did this as a courtesy interview. Did my best to not hang up mid-call. They also wanted to do a mock oral boards as part of the interview. Three regional branches - 1 is extremely malignant, 1 is malignant and 1 is semi-malignant. 5 year track, production based, lowest unit value that I saw on the trail. Did not want to discuss numbers and kept defaulting to "you'll be compensated well". Apparently well is pediatrician salary working neurosurgeon hours for 5 years.

ASMG - just quick call, seemingly fair, 1 year of "match" which means driving around everywhere and them assigning you somewhere people liked you. Heavy collections and skimming. Huge group and huge geographic area. Lots of driving. Probably most lucrative and best benefits package as well as least malignant track.

So Cal seems like a race to the bottom. Good luck negotiating because if you don't really want what they offer you, there's someone who is willing to work for less. It sucks to be replaceable but that's the market here. Combine this with a litigous population, huge patient entitlement, a liberal environment (nothing wrong with the politics but when a nurse reports a doctor or a bad patient outcome occurs, good luck facing the jury or judge), high medicare+medi-cal population (read lower reimbursements) along with a seemingly endless supply of people who want to live/work in So Cal. This is one of the rare places where it seems like the academic gigs are a better value than playing these silly games and racing to the bottom of the reimbursement scale in private practice. Money may not be everything but financial security for your investment in yourself is a long way off. We have cRNAs who make more than some of the partner gigs here while working 40 hours and never taking call and not assuming the liability.

Wonder which of the above Salty belongs to? Because he says his practice if fair and at MGMA median plus. Doesn't sound like any of the above.
Why don't you put some real numbers down? What are you afraid of if you are anonymous with a throw away account? It would help people as the vague references above don't really tell much. How terrible is terrible?

 

[chocomorsel]

How much money academic make? Like at ucla. And how hard u work there?

You know, these horrible sentences you construct together thinking you are being funny, but in actuality making fun of a stereotypical Asian person's English, are horribly racist. You need to stop!!!
I notice you only do this occasionally when speaking of California or anything that is Asian related. So...stop it. You clearly know proper English.

 

[chocomorsel]

Which kaiser u work for? How many call u take per month?

but how many dollar kaiser pay for first year of attending

Where can we get these practice aba stems, or are you just referring to the pdf on the ABA website?

Next time she bark, ask animal control to come take care of wild dog loose in hospital

It’s because anesthesiology is full of weak people. That’s why Pain, which is a subspecialty of Anesthesiology, opened up to applicants from other specialties.

I am putting your a ss on BLAST!!! JERK.

 

[deleted162650]

How much money academic make? Like at ucla. And how hard u work there?

UC salary is public info. You can look up the compensation of all UC employees online.

 

[Dawkter]

How much money academic make? Like at ucla. And how hard u work there?

Don't know the specifics. I would venture to guess 350-400k + benefits as is the norm for most SoCal academic jobs.

 

[spacegun]

Speaking of academic jobs in SoCal, anyone with any recent experience interviewing for SoCal academic jobs? If so I think it'd be helpful for people here to hear your experience. Thanks!

 

[thinkorswim]

Long time reader, first time caller, posting under a pseudonym for obvious reasons

Now that the job search is done, I feel comfortable writing this up. I want to acknowledge everyone who has posted as the free exchange of information here has been an invaluable resource and allows everyone to know what is out there and have a basis for comparison. For disclosure and liability purposes, this may just be a dream and the information is worth to you as much as you paid for it.

I'm a CA-3 at a top (1-10) program on the east coast. Strong resident with strong CV (D1 athlete, full ride to top med school, AOA,>20 1st author pubs in Anesthesiology, A&A, RAAPM, JCVA etc, recs from names you've heard of who vouch for skillset that is quick, efficient and personable and matched to a very competitive fellowship program). Decided wanted to do general, partner pushing for So Cal since we have a strong connection to the area so I did my due diligence and interviewed with the following groups. Phone calls were made to get my foot in the door. Here's my experience:

Hoag (NHAC)- many consider it the "best" job out there in So Cal, extremely in-bred with in-house referral system from the top LA and SD program (notice no plural there). They considered it was "lucky" for me to have someone I knew and strongly referred me. 3 year partner track, production based. Non lucrative and easy cases at ortho institute until later in your career (why?) despite my strong connection to the surgeons and them requesting it. They wavered with possibly having to be per-diem for first 6 months. Pre-partner income is skimmed with a unit value that is above average. Total package before partner is less than starting CRNA pay at my current institution with much more hours than our CRNAs. Imagine busting your ass and striving to be nothing but the best all so you can make less than a nurse anesthetist. And that is a best case scenario for socal. This group also prides themselves on only hiring cardiac or chief residents though they have not stuck to that lately.

MV - Chill group, seemingly fair, have a line of people working as per-diem waiting for a full time position. Per diem hourly rate (why not ASA unit based?!) made me have to mute the phone so they couldn't hear me laugh. There was someone whose been there almost 12 months as per diem, bless their heart. ICU RNs in covid units make more (this isn't a knock on them, they deserve it). 2 or 3 years to partner IIRC. Associate pay is production based, claimed fair scheduling but who knows. Benefits are standard, can't believe paid vacation is rare in CA. Partner comp package isn't anything to write home about but seemed to be great people to be around.

Kaiser SD - wanted people to work per-diem, they're "expanding" with new facility that will need 10 additional providers. Per diem rate is laughable if you're a reasonable person. Then consider that you have to fund your own benefits until you get the privelege of being full time. 5 year track IIRC. Pension is sweet though if you're not an idiot, could outpace those dividends saving up your own money over 30 years. Standard kaiser package, lifestyle seems great once partner compared to other CA gigs. Very nice to have integrated EMR and patients actually set up well for surgery. Before I even got the chance to tell them I'm not interested, they had called references and texted around asking people who knew me. This would be a long term option if you have the patience and a trust fund to live off.

Allied Anesthesia - Did this as a courtesy interview. Did my best to not hang up mid-call. They also wanted to do a mock oral boards as part of the interview. Three regional branches - 1 is extremely malignant, 1 is malignant and 1 is semi-malignant. 5 year track, production based, lowest unit value that I saw on the trail. Did not want to discuss numbers and kept defaulting to "you'll be compensated well". Apparently well is pediatrician salary working neurosurgeon hours for 5 years.

ASMG - just quick call, seemingly fair, 1 year of "match" which means driving around everywhere and them assigning you somewhere people liked you. Heavy collections and skimming. Huge group and huge geographic area. Lots of driving. Probably most lucrative and best benefits package as well as least malignant track.

So Cal seems like a race to the bottom. Good luck negotiating because if you don't really want what they offer you, there's someone who is willing to work for less. It sucks to be replaceable but that's the market here. Combine this with a litigous population, huge patient entitlement, a liberal environment (nothing wrong with the politics but when a nurse reports a doctor or a bad patient outcome occurs, good luck facing the jury or judge), high medicare+medi-cal population (read lower reimbursements) along with a seemingly endless supply of people who want to live/work in So Cal. This is one of the rare places where it seems like the academic gigs are a better value than playing these silly games and racing to the bottom of the reimbursement scale in private practice. Money may not be everything but financial security for your investment in yourself is a long way off. We have cRNAs who make more than some of the partner gigs here while working 40 hours and never taking call and not assuming the liability.

With all due respect, you really don’t have much of a clue of what you’re talking about. I would expect more from a rockstar anesthesiology graduate such as yourself.

It’s clear that you just don’t seem to understand that at some of the above groups, you’re the employer and not just an employee. There’s a difference between paying overhead costs associated with running your group and someone else skimming your earnings off the top. There’s a difference between not getting paid when you take vacation and having a certain amount of paid time off granted to you as a benefit.

 

[Tony C anesthesia]

Well, (not all, but) a good chunk of the info above is either misconstrued, or outright false. You’d think such a bright candidate woulda paid better attention on interview day.

The matter of fact is nobody really cares about your credentials. All they care is who's coming to work for $28-$30/unit, work 12 hours/day and take 7-8 calls/month. That's what makes you a good fit not what you did in residency or fellowship. It sucks but that's true in SoCal.

 

[chocomorsel]

The matter of fact is nobody really cares about your credentials. All they care is who's coming to work for $28-$30/unit, work 12 hours/day and take 7-8 calls/month. That's what makes you a good fit not what you did in residency or fellowship. It sucks but that's true in SoCal.

Preach! Speak the truth! Hahaha. This is funny.
Been there, done that out in Vegas. Left within three years thankfully.

 

[throwawaythesevo]

With all due respect, you really don’t have much of a clue of what you’re talking about. I would expect more from a rockstar anesthesiology graduate such as yourself.

It’s clear that you just don’t seem to understand that at some of the above groups, you’re the employer and not just an employee. There’s a difference between paying overhead costs associated with running your group and someone else skimming your earnings off the top. There’s a difference between not getting paid when you take vacation and having a certain amount of paid time off granted to you as a benefit.

I get that they want you to feel empowered but how exactly are you "the employer"? Sure there's some autonomy over when you work and how much call you take, what cases etc. but it's not that different from an academic place that is well staffed. And it is semantics, you can call it whatever you want but the bottom line is they are making money off you, especially when a "pre-partner" or "pre-participating" or "associate" or whatever name they want to dress it up with. If you leave the cult of So Cal, you'll realize that you can live quite comfortable and retire realistically at 50 elsewhere.

And it is publicly available information with a google search but there are at-least 3 northeast CRNA jobs that have an annual package worth more than the first year salaries at all of the groups described above except ASMG. After tax and adjusted COL, they're more comfortable than you are while bearing none of the same responsibilities. Oh yeah, they're unionized too so they work a 48h+32h q 2 wk schedule.

Just painting a picture of how dire this situation is so my fellow new grads can make an informed decision. It seems the members of some of these groups are taking exception to this. The truth is they think their group is the greatest thing in So Cal because their unit value may be mid 30s to low 40s. That's a low bar compared to the non-mentioned shady groups that are in the low to mid 20s. In the midwest, you'll see mid-50s to 60.

An example to consider:

I know a guy who is very clearly at the bottom of his class, <10th percentile everything, Carribean school, been held back 1.5 years in residency, multiple attempts for basic exam who will be making a base of $260k next year with a production based comp of $37/unit (on top of the base salary) for all services performed after 3pm, on weekends and holidays with standard bennies and 8.5 wks vacation in a no-tax state. Meanwhile, these so-cal new grads may be the top of their class but working per-diem at 150-195/hr in a competition for a full time associate track that may be followed by a 2-5 year partner track only to end up with about 80% of what my bottom-feeder buddy is making his 1st year. Adjust for COL and state tax, and now you tell me who the clear winner is. Money isn't everything but when it's nearly double the money and less COL, it's a big deal.

 

[DrOwnage]

It seems pretty much all of your decisions come down to compensation. I would also never call a colleague a "bottom feeder," unless he was a douche, then I would call him a douche. There's a lot more that comes into play in the real world. You're welcome to move to Alaska with a huge sign on bonus and make 700k a year and get mauled by a grizzly bear on your way to work. Or you could go to the northeast where your aqueous humor in your eyeball freezes when you walk outside in the winter. The market is what it is. I happen to be a new graduate in socal making those crap units and yes I do work extra to make what I consider a decent salary. But I was born and raised in SD, have ties here, and my fiance works here. Nice draw is I do all my own cases. Sounds like you're pretty independent with a mercenary for hire attitude to the highest bidder. Props to you but that's not how everyone works.

 

[throwawaythesevo]

The matter of fact is nobody really cares about your credentials. All they care is who's coming to work for $28-$30/unit, work 12 hours/day and take 7-8 calls/month. That's what makes you a good fit not what you did in residency or fellowship. It sucks but that's true in SoCal.

Truth, it's a race to the bottom. The groups that aren't even mentioned don't care about hiring the MGH rockstar who can do a pedi cardiac case with one hand. They care about who is a warm body that's willing to work for scraps. Even if the rockstar costs only $50k a year more, you can't prove to corporate there's a $50k benefit of hiring that guy over the class bottom feeder. If the bottom feeder messes up, they're replaceable. Stability, efficiency and safety aren't valued in this market, just the bottom line.

The combo of a bunch fo residency programs that are just a shell for free labor along with seemingly everyone's need to be in SoCal have created these abominable conditions.

 

[throwawaythesevo]

It seems pretty much all of your decisions come down to compensation. I would also never call a colleague a "bottom feeder," unless he was a douche, then I would call him a douche. There's a lot more that comes into play in the real world. You're welcome to move to Alaska with a huge sign on bonus and make 700k a year and get mauled by a grizzly bear on your way to work. Or you could go to the northeast where your aqueous humor in your eyeball freezes when you walk outside in the winter. The market is what it is. I happen to be a new graduate in socal making those crap units and yes I do work extra to make what I consider a decent salary. But I was born and raised in SD, have ties here, and my fiance works here. Nice draw is I do all my own cases. Sounds like you're pretty independent with a mercenary for hire attitude to the highest bidder. Props to you but that's not how everyone works.

Actually compensation was 1 consideration but can be a deal breaker when it's literally half of what's offered elsewhere. If you want to get into the hours, call, paid vacation, retirement matching, cme etc - packages are still much better than what I've seen here. Hell, Nor Cal Kaiser had one of the best benefits package I've seen and it was 360 to start 1st year without this per diem audition non-sense.

Props to you for choosing the grind but this post was made to inform others what is out there when you leave the cult of So Cal. No one is disputing some people have to stay in CA or your personal situation. It's simply to inform others so spare us the airing of your personal justifications for why.

I know you were trying to sound intelligent but review a bit of anatomy before making a comment about how eyes freeze.

 

[nimbus]

Truth, it's a race to the bottom. The groups that aren't even mentioned don't care about hiring the MGH rockstar who can do a pedi cardiac case with one hand. They care about who is a warm body that's willing to work for scraps. Even if the rockstar costs only $50k a year more, you can't prove to corporate there's a $50k benefit of hiring that guy over the class bottom feeder. If the bottom feeder messes up, they're replaceable. Stability, efficiency and safety aren't valued in this market, just the bottom line.

The combo of a bunch fo residency programs that are just a shell for free labor along with seemingly everyone's need to be in SoCal have created these abominable conditions.

Most southern Ca practices are production based. Nobody knows how busy things will be in the future. $50k is just a volume variation.

 

[secretasianman]

Truth, it's a race to the bottom. The groups that aren't even mentioned don't care about hiring the MGH rockstar who can do a pedi cardiac case with one hand. They care about who is a warm body that's willing to work for scraps. Even if the rockstar costs only $50k a year more, you can't prove to corporate there's a $50k benefit of hiring that guy over the class bottom feeder. If the bottom feeder messes up, they're replaceable. Stability, efficiency and safety aren't valued in this market, just the bottom line.

The combo of a bunch fo residency programs that are just a shell for free labor along with seemingly everyone's need to be in SoCal have created these abominable conditions.

I had heard about the hoag thing a while back. Imagine being so blinded by your own pride that you are willing to work for scraps because “its hoag.” Sure they get paid more overall, but at what cost? What these groups all get away with with their lack of transparency and nebulously long buy ins is so astounding, not even the stupidest nurse would sign up.

 

[nimbus]

An example to consider:

I know a guy who is very clearly at the bottom of his class, <10th percentile everything, Carribean school, been held back 1.5 years in residency, multiple attempts for basic exam who will be making a base of $260k next year with a production based comp of $37/unit (on top of the base salary) for all services performed after 3pm, on weekends and holidays with standard bennies and 8.5 wks vacation in a no-tax state.

Check your math. You can do better than that in southern Ca. 260k base for 7-3 hours assumes very low productivity. At $37/unit, it would just be 585units/month during those hours.

Which region did you decide to settle? I wouldn’t blame you if accepted an offer in the Midwest for $60/unit.

 

[GaseousClay]

Actually compensation was 1 consideration but can be a deal breaker when it's literally half of what's offered elsewhere. If you want to get into the hours, call, paid vacation, retirement matching, cme etc - packages are still much better than what I've seen here. Hell, Nor Cal Kaiser had one of the best benefits package I've seen and it was 360 to start 1st year without this per diem audition non-sense.

Props to you for choosing the grind but this post was made to inform others what is out there when you leave the cult of So Cal. No one is disputing some people have to stay in CA or your personal situation. It's simply to inform others so spare us the airing of your personal justifications for why.

I know you were trying to sound intelligent but review a bit of anatomy before making a comment about how eyes freeze.

Sounds like our guy here did NOT get offers at Kaiser so cal or Hoag or any of the other good places the TOP candidates are flocking to

 

[DrOwnage]

Sounds like our guy here did NOT get offers at Kaiser so cal or Hoag or any of the other good places the TOP candidates are flocking to

Possibly. He doesn't realize his humble brag stats are relatively average in comparison to most of the people responding to him on this forum. 400k and you're not going hungry. That's around 20k a month after taxes. Our profession does not have large negotiation potential, sometimes you gotta settle.

 

[throwawaythesevo]

Check your math. You can do better than that in southern Ca. 260k base for 7-3 hours assumes very low productivity. At $37/unit, it would just be 585units/month during those hours.

Which region did you decide to settle? I wouldn’t blame you if accepted an offer in the Midwest for $60/unit.

Check your reading comprehension

$260k Base salary + 37/unit for anything after 3pm, a weekday or on-call. Not to mention an average call stipend of 1000-2000 depending on the call. Most in the group average 450-500k immediately without playing the games of auditioning or some partner track

 

[nimbus]

Check your reading comprehension

$260k Base salary + 37/unit for anything after 3pm, a weekday or on-call. Not to mention an average call stipend of 1000-2000 depending on the call. Most in the group average 450-500k immediately without playing the games of auditioning or some partner track

I understand what you wrote. The most efficient hours are between 7-3 and 7-3 is already 40hrs/week. $260k for 40 hours of work is VERY low. That’s about $150/hr which assuming average efficiency is $20-25/unit. If they just offered $37/unit for everything, the pay would be much higher. Due to COVID slowdown, I averaged less than 40hrs/week for most of last year and made much more. What’s their average work week?

 

[throwawaythesevo]

Possibly. He doesn't realize his humble brag stats are relatively average in comparison to most of the people responding to him on this forum. 400k and you're not going hungry. That's around 20k a month after taxes. Our profession does not have large negotiation potential, sometimes you gotta settle.

Lol it is SDN but I would still stake a large sum of money that these are not "average" stats. I didn't even post my stats, just my background. I don't think full rides are given out like candy now.

There's nothing wrong with "settling" but it's important to know and acknowledge how much of a compromise is made to live and work in So Cal. You're not going hungry but you're also not paying off your modest 4 bed 3 bath in Irvine until your 50s and don't even dream about buying in Newport coast. Now imagine if you don't make partner...

 

[thinkorswim]

I get that they want you to feel empowered but how exactly are you "the employer"? Sure there's some autonomy over when you work and how much call you take, what cases etc. but it's not that different from an academic place that is well staffed. And it is semantics, you can call it whatever you want but the bottom line is they are making money off you, especially when a "pre-partner" or "pre-participating" or "associate" or whatever name they want to dress it up with. If you leave the cult of So Cal, you'll realize that you can live quite comfortable and retire realistically at 50 elsewhere.

It’s much more than semantics, it's like night and day from academics or any other employed position. Sure, some practices may have “buy-ins” with a lower unit value, but you will eventually become a partner and owner of the group, at which point no one is “skimming” your earnings. Are you seriously comparing being a employee for a few years to being one for your entire career? Do you really think those senior faculty members working fewer hours and getting paid more aren’t doing so at your expense?

Just painting a picture of how dire this situation is so my fellow new grads can make an informed decision. It seems the members of some of these groups are taking exception to this. The truth is they think their group is the greatest thing in So Cal because their unit value may be mid 30s to low 40s. That's a low bar compared to the non-mentioned shady groups that are in the low to mid 20s. In the midwest, you'll see mid-50s to 60.

An example to consider:

I know a guy who is very clearly at the bottom of his class, <10th percentile everything, Carribean school, been held back 1.5 years in residency, multiple attempts for basic exam who will be making a base of $260k next year with a production based comp of $37/unit (on top of the base salary) for all services performed after 3pm, on weekends and holidays with standard bennies and 8.5 wks vacation in a no-tax state. Meanwhile, these so-cal new grads may be the top of their class but working per-diem at 150-195/hr in a competition for a full time associate track that may be followed by a 2-5 year partner track only to end up with about 80% of what my bottom-feeder buddy is making his 1st year. Adjust for COL and state tax, and now you tell me who the clear winner is. Money isn't everything but when it's nearly double the money and less COL, it's a big deal.

No one is arguing that there are more lucrative jobs elsewhere. This entire thread basically highlights how underwhelming the Southern California job market is as a whole. Most of us working and living here are doing so for other reasons aside from the money. But while we’re tossing around useless anecdotes, let me give you one. I know a few guys in Southern California that pull over $800k doing only OB. There’s always a story somewhere.

 

[throwawaythesevo]

It’s much more than semantics, it's like night and day from academics or any other employed position. Sure, some practices may have “buy-ins” with a lower unit value, but you will eventually become a partner and owner of the group, at which point no one is “skimming” your earnings. Are you seriously comparing being a employee for a few years to being one for your entire career? Do you really think those senior faculty members working fewer hours and getting paid more aren’t doing so at your expense?



No one is arguing that there are more lucrative jobs elsewhere. This entire thread basically highlights how underwhelming the Southern California job market is as a whole. Most of us working and living here are doing so for other reasons aside from the money. But while we’re tossing around useless anecdotes, let me give you one. I know a few guys in Southern California that pull over $800k doing only OB. There’s always a story somewhere.

You tell realistically how rewarding it is to be an owner (1/30th or less) in a group whose revenues are suppressed due to an overall low unit reimbursement from private insurance in CA compared to other states along with a non-negligible portion of cases medicaid (18-22 per unit). Have you been a partner elsewhere to even compare? Sure, you're an owner, but you own essentially a blockbuster while the Netflix employees out there make more with a better lifestyle, benefits and vacation.

Imagine paid vacation, guaranteed relief at a certain time, a cap of 1:2 supervision or choice to down own cases, long turnover times so you can sit and enjoy lunch and enough staff so you can take academic days or personal days with just an email the day before. For about 100k less and 4-6 more weeks off, I'd take the academic gig any day if I had to stay in CA.

The difference in my anecdote is an opportunity available to pretty much anybody with a pulse. Yeah that OB group has people clearing over 1 mil, so what? You and I are as likely to get hired at that group as we are to **** out bricks of gold next time you sit on the johnny.

It's not so much that there are more lucrative jobs out there, it's that nearly every respectable job out there competes with or beats the best jobs in So Cal without playing the games required.

 

[Peterluger]

UC salary is public info. You can look up the compensation of all UC employees online.

Thats the point im trying to make. These people are all talking about “top applicants” (i dont even know what that means in anesthesiology for fresh grads, who dont have any clinical experience to speak of in the real world) going to certain places, but it seems like academics in CA pays more than all these no-name hospitals like hoag etc. What kind of units are these private people making anyways, are there even units to be billed for during covid, except for intubations? LOL

Even in the nyc area, as a new grad you can easily make $500k plus benefits, including but not limited to 4-6 weeks vacation, 1 week CME, 401k etc.

My impression is that in CA academics seems to be not just the best way by a mile, but the only way.

 

[ucladoc2b]

I interviewed at several of these groups mentioned above (including the groups of some members on this forum).

I am not coming from a top tier residency.

All of mine were for partnership level tracks.

Most of the posting is inaccurate (at least in my experience).

 

[GaseousClay]

You tell realistically how rewarding it is to be an owner (1/30th or less) in a group whose revenues are suppressed due to an overall low unit reimbursement from private insurance in CA compared to other states along with a non-negligible portion of cases medicaid (18-22 per unit). Have you been a partner elsewhere to even compare? Sure, you're an owner, but you own essentially a blockbuster while the Netflix employees out there make more with a better lifestyle, benefits and vacation.

Imagine paid vacation, guaranteed relief at a certain time, a cap of 1:2 supervision or choice to down own cases, long turnover times so you can sit and enjoy lunch and enough staff so you can take academic days or personal days with just an email the day before. For about 100k less and 4-6 more weeks off, I'd take the academic gig any day if I had to stay in CA.

The difference in my anecdote is an opportunity available to pretty much anybody with a pulse. Yeah that OB group has people clearing over 1 mil, so what? You and I are as likely to get hired at that group as we are to **** out bricks of gold next time you sit on the johnny.

It's not so much that there are more lucrative jobs out there, it's that nearly every respectable job out there competes with or beats the best jobs in So Cal without playing the games required.

Let me venture another guess... did not match into Ortho so went into anesthesia as a backup?

 

[chocomorsel]

I interviewed at several of these groups mentioned above (including the groups of some members on this forum).

I am not coming from a top tier residency.

All of mine were for partnership level tracks.

Most of the posting is inaccurate (at least in my experience).

So maybe they offer different offers to different candidates?
Or maybe it is a “cult” where people are afraid to speak the truth. We all know the more desirable the place, the less it pays. No matter your stats.
I for one believe throwaways account and am immensely enjoying this tea.

 

[nimbus]

Thats the point im trying to make. These people are all talking about “top applicants” (i dont even know what that means in anesthesiology for fresh grads, who dont have any clinical experience to speak of in the real world) going to certain places, but it seems like academics in CA pays more than all these no-name hospitals like hoag etc. What kind of units are these private people making anyways, are there even units to be billed for during covid, except for intubations? LOL

Even in the nyc area, as a new grad you can easily make $500k plus benefits, including but not limited to 4-6 weeks vacation, 1 week CME, 401k etc.

My impression is that in CA academics seems to be not just the best way by a mile, but the only way.

1. Southern Ca is not filled with “top applicants.” By definition most of us are average.

2. On average, academics pays less than PP in southern Ca but there are exceptions.

3. MGMA data is very accurate for the region. Anyone is free to look it up.

 

[GassYous]

I interviewed at several of these groups mentioned above (including the groups of some members on this forum).

I am not coming from a top tier residency.

All of mine were for partnership level tracks.

Most of the posting is inaccurate (at least in my experience).

Details?

 

[<(^_^)>]

Coming at this from a financial standpoint I think some may be underestimating the impact of a long buy-in with substantial sweat equity. Every dollar saved at the start of a 30 year career is worth ~8x as much as a dollar saved at the end of a 30 year career (loosely speaking, due to compounded gains in the market). So if you do end up losing out on 150k savings for 3 years that ends up being ~3-4M at the end of your career, and it’s not a guarantee you’ll make partner either.

On the flip side it’s not clear to me how you wouldn’t be able to afford a ~1.3M house in Irvine with current mortgage rates on 350k a year and pay it off within 15 years, if you were determined to do so. I’m seeing about ~97k total cost (assuming 20% down 2.625% 15 year jumbo and 1% property tax). Post tax income would be 230k, after maxing 19k 401k assuming typical nuclear family (SO + 2 kids).

So yes, you can live a reasonably nice life off 130k post taxes and post housing expenses in Irvine, and pay your house off by ~47 (assuming 2 years saving for down payment) if that’s important to you but it is true that especially new grads outside of California that think they’re going to be able to afford an ocean view are in for a rude awakening based on 2021 real estate prices.

 

[nimbus]

Coming at this from a financial standpoint I think some may be underestimating the impact of a long buy-in with substantial sweat equity. Every dollar saved at the start of a 30 year career is worth ~8x as much as a dollar saved at the end of a 30 year career (loosely speaking, due to compounded gains in the market). So if you do end up losing out on 150k savings for 3 years that ends up being ~3-4M at the end of your career, and it’s not a guarantee you’ll make partner either.

On the flip side it’s not clear to me how you wouldn’t be able to afford a ~1.3M house in Irvine with current mortgage rates on 350k a year and pay it off within 15 years, if you were determined to do so. I’m seeing about ~97k total cost (assuming 20% down 2.625% 15 year jumbo and 1% property tax). Post tax income would be 230k, after maxing 19k 401k assuming typical nuclear family (SO + 2 kids).

So yes, you can live a reasonably nice life off 130k post taxes and post housing expenses in Irvine, and pay your house off by ~47 (assuming 2 years saving for down payment) if that’s important to you but it is true that especially new grads outside of California that think they’re going to be able to afford an ocean view are in for a rude awakening based on 2021 real estate prices.

In my experience, everybody makes partner at every place I’ve ever worked unless there are glaring issues. In my group, everyone gets paid the same whether they are partner or not.

Also remember that Irvine tract house will be worth a lot more than $1.3mil by the time it’s paid off. If history is any indication, it can easily be 4x. It’s true oceanfront is impossible these days without a windfall.

 

[ucladoc2b]

Details?

I thought the groups named there were fair. People seemed pretty happy. 2-3 year pretty fair buy ins. Income was pretty similar amongst all the groups . People seemed to stick around for a while at all of them. I wasn’t asked to be per diem at any of them.

I really felt I couldn’t go wrong with any of them.

Also note I interviewed in person at them as well.

 

[Twiggidy]

Thats the point im trying to make. These people are all talking about “top applicants” (i dont even know what that means in anesthesiology for fresh grads, who dont have any clinical experience to speak of in the real world) going to certain places, but it seems like academics in CA pays more than all these no-name hospitals like hoag etc. What kind of units are these private people making anyways, are there even units to be billed for during covid, except for intubations? LOL

Even in the nyc area, as a new grad you can easily make $500k plus benefits, including but not limited to 4-6 weeks vacation, 1 week CME, 401k etc.

My impression is that in CA academics seems to be not just the best way by a mile, but the only way.

It’s the reason why academic gigs can be harder to get than the private gigs. Many do no return the calls of people with CA licenses and work experience. I also agree with what does a top candidate even mean. New grads will go in to many practices and be truly uncomfortable working solo for the first time

 

[Twiggidy]

We also need to remember that the top notch private practices aren’t going to be advertising with a billboard on the 5 when they’re hiring

(No disrespect to those practices advertising on Gasworks)

 

[ucladoc2b]

We also need to remember that the top notch private practices aren’t going to be advertising with a billboard on the 5 when they’re hiring

(No disrespect to those practices advertising on Gasworks)

I just emailed/called them. Got a pretty solid response. And I really am not connected at any place.

 

[thinkorswim]

You tell realistically how rewarding it is to be an owner (1/30th or less) in a group whose revenues are suppressed due to an overall low unit reimbursement from private insurance in CA compared to other states along with a non-negligible portion of cases medicaid (18-22 per unit). Have you been a partner elsewhere to even compare? Sure, you're an owner, but you own essentially a blockbuster while the Netflix employees out there make more with a better lifestyle, benefits and vacation.

Imagine paid vacation, guaranteed relief at a certain time, a cap of 1:2 supervision or choice to down own cases, long turnover times so you can sit and enjoy lunch and enough staff so you can take academic days or personal days with just an email the day before. For about 100k less and 4-6 more weeks off, I'd take the academic gig any day if I had to stay in CA.

The difference in my anecdote is an opportunity available to pretty much anybody with a pulse. Yeah that OB group has people clearing over 1 mil, so what? You and I are as likely to get hired at that group as we are to **** out bricks of gold next time you sit on the johnny.

It's not so much that there are more lucrative jobs out there, it's that nearly every respectable job out there competes with or beats the best jobs in So Cal without playing the games required.

I really don't understand what you're trying to accomplish here by arguing apples and oranges. No one disagrees that you can make more elsewhere, but as I mentioned earlier, many of us are in California for other reasons aside from money. I have a number of good friends who are partners at highly desirable groups around the country, and while they may more than I do, it's not nearly enough for me to uproot my family. Plus those places have four seasons, which I don't want to deal with either.

What some posters are taking exception to here is the mischaracterization of the practices you have described. There are some here who are partners at these groups and you're arguing about the details of their job after interviewing as a CA-3? You haven't even held a real job as an attending yet and you're lecturing us about the structure and benefits of partnership in a group?

By all means, be free to take your "paid" vacation, guaranteed relief, and long lunch breaks. I can tell you that where I live, this type of job will make about half of what I currently do. If you choose to ignore the fact that someone is taking advantage of you in that situation, then that is your choice. We will just have to disagree on what an ideal job is, and that's fine.

 

[deleted162650]

Here’s the deal, If you’re looking for that 750K with 12wks off job - you’re not gonna find it in SoCal. If you’re looking for a 400-500k job with 6-8wks off doing your own cases 45-50hrs/wk, you can find that here in the good PPs. Unit values are significantly better in the good groups than those quoted above. Is there going to be some kind of buy-in? Yes. The structure of that buy-in varies greatly between practices. Keep in mind that both Kaiser and academics will also have a tiered compensation model.

Newsflash: CA also has high taxes and high COL. If you’re on the FIRE tip, best to look elsewhere.

 

[GassYous]

We also need to remember that the top notch private practices aren’t going to be advertising with a billboard on the 5 when they’re hiring

(No disrespect to those practices advertising on Gasworks)

If your top notch group is hiring drop me a line

 

[USCTrojan11]

Has anyone interviewed after COVID started? Imagine offers are different now compared to before? Thx in advance

 

[deleted162650]

Has anyone interviewed after COVID started? Imagine offers are different now compared to before? Thx in advance

We have been interviewing. Our offer is the same as it ever was.

 

[ucladoc2b]

Has anyone interviewed after COVID started? Imagine offers are different now compared to before? Thx in advance

All of my interviews were in December-January.

 

[propofabulous]

All of my interviews were in December-January.

Any chance I can PM you with a question? Your settings don’t let me

 

[ucladoc2b]

Any chance I can PM you with a question? Your settings don’t let me

Sure!

 

[noclaw]

Well, (not all, but) a good chunk of the info above is either misconstrued, or outright false. You’d think such a bright candidate woulda paid better attention on interview day.

I'm reminded of one of the speakers at our med school graduation, who said something to the effect of "Half of what we taught you these last four years is wrong. Problem is, we don't know which half."

Rather than report that there are errors in the original post, why not correct them?

I thank throwaythesevo for taking time to publish his impressions. I would like to hear from partners inside these premier groups to hear where exactly throwaway misspoke. Insiders should have zero compunction about providing the real numbers in their recruiting pitch if they are, indeed, proud of those numbers. All this tiptoeing around the numbers makes me think even (maybe especially) the partners know the numbers ain't all that great.

 

[nimbus]

I'm reminded of one of the speakers at our med school graduation, who said something to the effect of "Half of what we taught you these last four years is wrong. Problem is, we don't know which half."

Rather than report that there are errors in the original post, why not correct them?

I thank throwaythesevo for taking time to publish his impressions. I would like to hear from partners inside these premier groups to hear where exactly throwaway misspoke. Insiders should have zero compunction about providing the real numbers in their recruiting pitch if they are, indeed, proud of those numbers. All this tiptoeing around the numbers makes me think even (maybe especially) the partners know the numbers ain't all that great.

Do you seriously expect people to broadcast their income on a public forum? Would you?