Why I may kiss a partnership track goodbye..

[deleted126335]

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[BuzzPhreed]

This is a 6-yr bump and some thread necromancy. But people should read it. And see how the times have changed. The malignant "false partnership" tracks started in Atlanta have spread like a cancer throughout the southeast. People here were talking about this crap six years ago! And it's only getting worse!

 

[ketosisevangelist]

This is a 6-yr bump and some thread necromancy. But people should read it. And see how the times have changed. The malignant "false partnership" tracks started in Atlanta have spread like a cancer throughout the southeast. People here were talking about this crap six years ago! And it's only getting worse!

What are you talking about.

 

[BuzzPhreed]

Usually questions on internet forums end with a "?"

 

[Mman]

This is a 6-yr bump and some thread necromancy. But people should read it. And see how the times have changed. The malignant "false partnership" tracks started in Atlanta have spread like a cancer throughout the southeast. People here were talking about this crap six years ago! And it's only getting worse!

Huh?

Variations of partnership tracks have been around for decades and in all parts of the country. Most of the big groups nationally 20 years ago were some variety of pyramid shape. The system has almost always been stacked against new hires with exceptions here and there.

 

[BuzzPhreed]

The practice I just left (in the southeast) stopped offering partnership tracks for new hires 2 years ago. I was told that this was becoming the "norm" for new hires. Prior to that everyone was offered a 2-yr buy in. No more.

That's the point. If you re-read the whole thread, the bigger point is that this was observed by some posters in "desirable" regions back as far as six years ago. The OP was debating whether or not to go locums and how to work making a decent wage without being put in a bad position by the groups holding the exclusive hospital contract(s) in a region. Mega practices without real fair market competition.

A lot of the discussion we've had (and points I've made recently) echo a lot of what was said in this thread six years ago. There are themes there. Re-read it again. It's interesting that it's only getting worse and, in my opinion, may be soon reaching a breaking point. In that time AMCs have expanded their control and PP groups are not really offering partnership tracks anymore - period - in these regions.

That was the point.

 

[Mman]

That was the point.

Been going on for decades. The only thing that changed is that AMCs are taking over more practices.

 

[BuzzPhreed]

Been going on for decades. The only thing that changed is that AMCs are taking over more practices.

Yes and no.

I know back in the 90's a similar situation occurred. When the bottom fell out then practices offered partnerships to hires to keep/retain them. Now flash forward almost twenty years everyone is back in "defensive" mode with the AMCs looming take-over. That, and the expansion of services and the increase in the ACT model. It's a recipe for disaster.

I talked candidly to one of the partners when I left that practice and told him that I thought they were being very short-sighted. He basically told me the same thing you have: that the treatment I was getting was the "norm" back when he was hired. I asked him if he liked it and thought it was fair back then. What do you think his answer was? I believe his exact words were, "F*ck no, I didn't!" Nonetheless, he was made a partner after a short time and when people realized that there was going to be ongoing turn over if they didn't make it worthwhile for folks to stay. So, I left him with a somewhat rhetorical question about how my situation now was different than his? I don't think he gave two ****s honestly. Suck it up, or leave. I left.

Flash-forward to now. These greedy bastards have it all figured out. There's no goodwill anymore. There's not even a remote interest in the future of the specialty. That's what's changed. The difference is ludicrous hand-cuffs in the employment contracts that make you pay-out if you want to leave. There's no "gold" anymore. The situation has gotten far worse than the "decades" of this that you describe. Again, to beat the dead horse, until the exclusive contract is completely murdered and buried it's going to be impossible for any reasonable group to challenge with an new RFP. The already-present groups have gotten too big and entrenched. The AMCs have too much ability to promise and ability to deliver... even if that means a coterie of rotating faces at a particular hospital. That's whose competing against each other now, and the little guy loses. In my opinion, everyone loses in that scenario, including the surgeons and the patients.

We are f*cking this specialty out of existence. Mark my words. It's gotten that bad in some geographical regions. No one seems to care. Including you with your "oh, well" and devil-may-care attitude reflected in most of your posts. How gray is your hair?

 

[Mman]

We are f*cking this specialty out of existence. Mark my words. It's gotten that bad in some geographical regions. No one seems to care. Including you with your "oh, well" and devil-may-care attitude reflected in most of your posts. How gray is your hair?

I care quite a bit about our specialty. I just realize this is the same thing people have been saying and doing forever. It never changes. I have a recently retired partner in his 70s and it's interesting to hear him talk about how things have changed and stayed the same for the last 40 years. The job market waxes and wanes but the basics haven't changed.

How gray is my hair? Really? Doesn't seem terribly relevant to anything you are trying to say.

 

[Baller MD]

I care quite a bit about our specialty. I just realize this is the same thing people have been saying and doing forever. It never changes. I have a recently retired partner in his 70s and it's interesting to hear him talk about how things have changed and stayed the same for the last 40 years. The job market waxes and wanes but the basics haven't changed.

How gray is my hair? Really? Doesn't seem terribly relevant to anything you are trying to say.

Uhhh...

 

[Mman]

Uhhh...

So in your opinion, what has changed? I mean other than the fact it's now AMCs looking to screw people over instead of private groups.

 

[Doctor4Life1769]

So in your opinion, what has changed? I mean other than the fact it's now AMCs looking to screw people over instead of private groups.

More CRNAs and SRNAs to flood the market. The ACA and falling reimbursements. More folks turning to hospital-based employment.

 

[anbuitachi]

First time seeing SRNA in hospital today.. i didn't even know we trained SRNAs, but b/c he was in same case as us ms4s... we didn't get to do anything...

 

[IlDestriero]

First time seeing SRNA in hospital today.. i didn't even know we trained SRNAs, but b/c he was in same case as us ms4s... we didn't get to do anything...

We try to pair med students with residents, fellows or solo MDs. That sucks. Was there more than one med student in the case? That's lame as well.
Poor rotations lead to disinterest in the field. They should fix that.

 

[dmk5n]

The book "The Rape of Emergency Medicine" is the writing on the wall. Read with a healthy dose of Maalox

 

[deleted171991]

I've only read the first 10%, but I already like it.

 

[Consigliere]

This brings up an interesting topic. From what I've been "told" (by our school's PD director), they're expecting a good job market through approximately 2014 or so. Now, granted, who the hell can predict that entirely, but assuming this is true, that's when I'd be getting out of residency.

The point is, while it may be a viable strategy to do locums etc. NOW, when the market tightens up on demand versus supply, might us "med student era" dudes be thinking more along the lines of JOINING a partnership for safety related concerns.

In other words, I remember MilMD and some others having posted about the early 90's (I think that's when it was) where there was a glut of anes docs and hard to secure any stability in the market. Few were hiring.

THUS, during a transition period where demand is leveling off, I could see some advantage in securing a partnership in order to secure employment in a potentially changing job market.

Thoughts? (other than, dude just get through rotations....lol)

Bwahahahahaha! This post was from 2008 and boy did that prediction NOT come true.

 

[deleted171991]

The book "The Rape of Emergency Medicine" is the writing on the wall. Read with a healthy dose of Maalox

It's worth reading even for the part where the author points out that most truly wealthy American families tend to send their offspring to law school, not to medical school. Eye-opener.

 

[anbuitachi]

It's worth reading even for the part where the author points out that most truly wealthy American families tend to send their offspring to law school, not to medical school. Eye-opener.

that is because most truly wealthy american families are not doctors

 

[urge]

that is because most truly wealthy american families are not doctors

Medicine as a career is for poor people. Rich people are in business.

 

[pgg]

It's worth reading even for the part where the author points out that most truly wealthy American families tend to send their offspring to law school, not to medical school. Eye-opener.

1) The offspring of truly wealthy American families don't have to work for a living, so it doesn't matter that the lawyer job market is as shockingly horrific as it is. You think the new-grad anesthesia job market is sub-optimal? Check out what a new-grad lawyer who isn't top 10 in his class at a top 10 law school has to deal with.

2) Medicine is hard work. Why is it eye-opening that people who don't have to work, choose careers (ie, trophy degrees) that are comparatively easy?

 

[gasdoc77]

that is because most truly wealthy american families are not doctors

They go to law school so that they can pursue politics. They can spend years perfecting the art of lying so that they can stand in front of the public and sway people with empty rhetoric and vague non-committal promises, knowing all along that their entire pursuit serves no other purpose than to feed their narcissistic ego. Funny how they all of a sudden "care" about us little guys when they know that the needs of themselves and their offspring will be met for many generations to come (as a result of their back-door dealings).

 

[anbuitachi]

1) The offspring of truly wealthy American families don't have to work for a living, so it doesn't matter that the lawyer job market is as shockingly horrific as it is. You think the new-grad anesthesia job market is sub-optimal? Check out what a new-grad lawyer who isn't top 10 in his class at a top 10 law school has to deal with.

2) Medicine is hard work. Why is it eye-opening that people who don't have to work, choose careers (ie, trophy degrees) that are comparatively easy?

really? i only know 2 ppl who just graduated from non top 10 law schools and not top 10 in class.. they have less loans than med students (since their summer internship is very well paid, plus only 3 yrs). one starts at 170k base (NYC), the other 150k (DC).. not bad.

Meanwhile person i know who just finished pain fellowship from one of the best programs in NYC, was getting pain offers in high 100s to low 200s in nyc

 

[urge]

Meanwhile person i know who just finished pain fellowship from one of the best programs in NYC, was getting pain offers in high 100s to low 200s in nyc

No way.

 

[Mman]

really? i only know 2 ppl who just graduated from non top 10 law schools and not top 10 in class.. they have less loans than med students (since their summer internship is very well paid, plus only 3 yrs). one starts at 170k base (NYC), the other 150k (DC).. not bad.

Meanwhile person i know who just finished pain fellowship from one of the best programs in NYC, was getting pain offers in high 100s to low 200s in nyc

New grad anesthesia salary >>>>>>>>>>> new grad lawyer salary.

My starting salary was higher than my friends that went to elite law schools are making 5 years out at major firms.


If you want to make real money, you need to be in business. It's just that most people in business don't make that money. Only a few.

 

[anbuitachi]

New grad anesthesia salary >>>>>>>>>>> new grad lawyer salary.

My starting salary was higher than my friends that went to elite law schools are making 5 years out at major firms.


If you want to make real money, you need to be in business. It's just that most people in business don't make that money. Only a few.

its hard to compare cause ppl who get into medicine are already selected out of a large group of ppl. its easy to get into law school. its easy to go into business. but therefore a smaller % of lawyer and business will be making med money or more, since theres more of them in total

 

[risnwb]

really? i only know 2 ppl who just graduated from non top 10 law schools and not top 10 in class.. they have less loans than med students (since their summer internship is very well paid, plus only 3 yrs). one starts at 170k base (NYC), the other 150k (DC).. not bad.

Meanwhile person i know who just finished pain fellowship from one of the best programs in NYC, was getting pain offers in high 100s to low 200s in nyc

Maybe for base, with the ability to make twice that as incentive pay... The bad offers in NY area for new grads without fellowship at non academic places are more like mid to high two's. It's bad but it ain't THAT bad...


Posted using SDN Mobile

 

[Mman]

its hard to compare cause ppl who get into medicine are already selected out of a large group of ppl. its easy to get into law school. its easy to go into business. but therefore a smaller % of lawyer and business will be making med money or more, since theres more of them in total

that's why they also have low (relative) starting salaries. Too much competition for the jobs. The market is oversaturated with potential employees so employers can lower the salary.

 

[womp]

really? i only know 2 ppl who just graduated from non top 10 law schools and not top 10 in class.. they have less loans than med students (since their summer internship is very well paid, plus only 3 yrs). one starts at 170k base (NYC), the other 150k (DC).. not bad.

$170k in NYC and 150k in DC is like making $90k in most of the country. You can't get a tiny 2 bedroom condo for $500k in Manhattan or any livable parts of Brooklyn.

Medicine is still a great deal if you live in a smaller city or suburb with reasonable cost of living.

 

[nimbus]

$170k in NYC and 150k in DC is like making $90k in most of the country. You can't get a 2 bedroom condo for $500k in Manhattan or any livable parts of Brooklyn.

But they're working so much they don't need a condo.

 

[projectpat]

This is a 6-yr bump and some thread necromancy. But people should read it. And see how the times have changed. The malignant "false partnership" tracks started in Atlanta have spread like a cancer throughout the southeast. People here were talking about this crap six years ago! And it's only getting worse!

Just to be clear on what these "false partnership" tracks actually are... i.e. during the employment process, the interviewer will tell you about a 4-6 year partnership track, blah blah, sign here and you accept. 4-6 years pass and then what? Nothing happens? You bring up what you were promised and they ignore you or tell you that it's coming but it never comes? I'm just trying to comprehend how these groups aren't publicly labeled as unprofessional, deceitful, dishonest, etc.

Or does a false partnership track = sign here and join us and maybe you can make partner one day but in reality, you're never going to make partner?

 

[BuzzPhreed]

Just to be clear on what these "false partnership" tracks actually are... i.e. during the employment process, the interviewer will tell you about a 4-6 year partnership track, blah blah, sign here and you accept. 4-6 years pass and then what? Nothing happens? You bring up what you were promised and they ignore you or tell you that it's coming but it never comes? I'm just trying to comprehend how these groups aren't publicly labeled as unprofessional, deceitful, dishonest, etc

Not this. If they commit to a partnership track in an offer letter, then you have legal recourse if they don't deliver. The key is to get it in writing (however you can). And 4-6 years?? Eff that. They should offer it to you in two.

Or does a false partnership track = sign here and join us and maybe you can make partner one day but in reality, you're never going to make partner?

This. This is becoming "the norm".

 

[nycitygas]

I have a few friends that work in Big Law who graduated my year from college.

My first year out, I make more than all of them and work much much less. I also have almost 100% job security while they have none. I can also pack up and move to pretty much any part of the country confident that I will be able to find employment.

The only benefit law has over medicine is that you make bank right out of school while we make peanuts during residency. Finance is better than medicine if you end up in that top 10% of bankers and traders but I don't have the personality to succeed in that type of environment.

Medicine as a career is also much more fulfilling and satisfying as a career. My dad is 70 years old and is still working full time because he loves it. Anesthesia is also a great field because it's very easy to "slow down" and go part-time rather than retire which seems boring and awful to me. I have never heard of a part time I banker or law partner.

NYC salaries for anesthesia and pain are not that low. They are actually higher than many other parts of the country (although not high enough to account for the COL). NAPA starts off at at 250K a year for its mommy track jobs. Full time make 300. Plenty of pain jobs that start off close to 3. Tell your friend to keep looking.

 

[Mman]

I have a few friends that work in Big Law who graduated my year from college.

My first year out, I make more than all of them and work much much less. I also have almost 100% job security while they have none. I can also pack up and move to pretty much any part of the country confident that I will be able to find employment.

I forgot to mention the hours as well. Most young lawyers making 150K a year are working 80 hours a week to do so. They definitely get to earn money immediately out of school. But they work crazy hours to do so and the money isn't anything special for what they do to earn it.

 

[deleted171991]

The book "The Rape of Emergency Medicine" is the writing on the wall. Read with a healthy dose of Maalox

I've read about 60% of it already, and the more I read the more I like it. It's a masterpiece. Reading it should be compulsory for graduating residency.

 

[BuzzPhreed]

It's not even remotely logical to compare the medical profession to law. Apples and oranges. It's a totally different job. There are about 252:1 people to lawyers out there. There are about 369:1 doctors. That's a factor of almost 1.5 times the number of lawyers to doctors. Who do you think society needs more of?

 

[BuzzPhreed]

I've read about 60% of it already, and the more I read the more I like it. It's a masterpiece. Reading it should be compulsory for graduating residency.

Maybe it's high time that someone writes "The Rape of Anesthesiology". I could fill it with stories. Trust me.