Would you make this job move?

[ghastly75]

Hey all,

This is a truly personal journey but I hope that since "others" have been there before they can shed light on my situation.
I am felloship trained, board certified, several years out working in academic practice. Scope is 100% pedi anesthesia and I love that.
my current job: Clinically I frequently do very challenging pedi cases solo and with residents/fellows/CRNA's/AA's. Clinically I'm strong. I'm just a spoke in the wheel though from a hierarchy perspective in the academic department. Easily replaced. Probably not going to be forever job , however, would love a 100% pedi job in Private practice where my skills are valued.
Wife not happy in her job, and family on other coast.
She has offer for old job (more pay, better hours)
I have offer for new job (generalist, only healthy peds)
Money is similar for me actually less vacation. More call (home call)
Practice structure is care team model, where they call it collegial…
The whole anesthesia practice is in transition at this new place and is yet to be fully staffed. They went from primarily MD, to now care team model, with 6 MD and 7 CRNA. I've talked to everyone who works at "new" job, they're normal, nice people, but I feel that not all has been relayed to me. Last week I saw an ad on Gaswork for CRNA of new job, that said CRNA can do own spinals, blocks, regional etc. , if want to and trained but don't have to…
that statement concerns me because it puts the ball in the CRNA court and makes a DOC who denies them that option to look like the bad guy.. In my current practice some colleagues allow CRNA to do blocks, Central lines, epidurals , but many do not. I don't. I like to do them myself.
My concerns with new job, CRNA's rule roost and I'm just pre-op junkie, except I take first call and they are back up. But we are close to family. And wife likely much happier.
I'd be losing opportunity to find my best gig, (100%) pedi in private practice if in general anesthesia for too long as I'd lose skills.
New contract is for two years and 180 day notice.
Any wisdom? What questions to ask current members to tease out truth of practice?
Thanks all.

---

Members don't see this ad.

 

[urge]

Happy wife, happy life.

 

[deleted171991]

180 day-notice seems too long. That's 180 days to get crappy cases when you decide to leave "AMA".

I don't like the part where CRNAs can do stuff either. It's great for the partners, but it makes you a preop monkey. It's also obvious that they are switching to an ACT model. It's 6:7 now, expect 5:10-15 soon.

But a happy wife...

 

[ghastly75]

Two years and 180 notice is stiff. More than anywhere I've looked. I've seen 5 months, but most places have been 90 days. I offered 90 days and 1 year but they declined.
Would you be concerned about scope of CRNA practice? CRNA and Doc's employed by same group, essentially hospital.

 

[deleted171991]

Same private group is good. Same hospital employer - not so good (independent anesthesia groups tend to be less understanding toward militant CRNAs than hospitals, although nowadays it's all about profit).

The fact that they are switching away from solo is pretty concerning for me. Where do they plan to stop? I would treat the job as if it were a de facto 1:3 coverage job (or worse).

If I were you, I would keep looking for a 100% Pedi job, maybe in an academic center that is much closer to your family. But it depends how happy you are when you do (adult) cases with CRNAs.

P.S. I am the kind of guy who would be happier taking a pay cut for working solo, than be the CRNAs' monkey. I could put up with the middle road, if it were 1:2 coverage (or 1:3 on long cases) and some other conditions that would make me enjoy work.

 

[IanMcGalt]

It might be a good move for you but keep in mind that in 3 years or so you won't be able to get a job in a children's hospital.

 

[BobBarker]

I dont think this is the right job. I would keep looking somewhere for another place close to home. I do know of a place to look that would meet many of your dream job specifications but it is located in the city that Chandler Bing thought it was the end of the world to move to.

 

[Substance]

I would be reluctant to sign a contract with a 180 day cancellation clause. I would be even more reluctant to continue negotiations after making a reasonable request (a 90 day cancellation clause, which is the industry norm) and having it rebuked. They are clearly not negotiating on good faith.

If you think they're uncompromising now, wait until you start working there.

 

[BuzzPhreed]

My concerns with new job, CRNA's rule roost and I'm just pre-op junkie, except I take first call and they are back up. But we are close to family. And wife likely much happier.
I'd be losing opportunity to find my best gig, (100%) pedi in private practice if in general anesthesia for too long as I'd lose skills.
New contract is for two years and 180 day notice.

Holy crap! This sounds almost exactly like a horrible situation I just extricated myself from.

Here's what I suggest as your deal breakers:

1) You cut the notice down to 90 days.
2) They guarantee in writing to make you a partner after two years. Ask to see the books.
3) With your experience the starting salary (east coast depending where) should be at least in the $375-400k range if your gonna be a non-partner track guy (see item 2). I would not take anything less unless you get it in writing a guarantee where you're gonna be in two years. Make them show you the books.
4) Make certain you know what the arrangements are regarding their supervision model. Just because they only have 7 CRNAs now doesn't mean they aren't going to hire more or that the hospital doesn't have CRNA employees and you're walking into a 4:1 routine practice. In that case you will only be doing pre-ops and putting out CRNA created fires.
5) They pay tail. Period. No questions asked. 100%. Whether you leave after 1 week or they excuse you after 1 year (etc.). From day 1 on.
6) Your wife (like mine) will be much happier if you're happier. Happy wife = happy life. Miserable husband = divorce.
7) You will have to draw your own line on what you allow the CRNAs to do. A good friend of mine whom I've discussed my situation with extensively says that he thinks spinals, lumbar epidurals, and a-lines are okay. Everything else absolutely not. And he does not allow them to do it. Make sure this is clear and consistent within your practice or, yes, you will be the bad guy.

If it smells rotten trust me it probably is.

 

[BuzzPhreed]

You know let me expound on this point.

The HR idiot at the place I just left told me in so many ways that this kind of b.s. is the "new industry norm" for private practices. WTF? Not offering a partnership and making me kowtow to the militant CRNAs who want to do everything with little supervision is the new "industry norm"? Who the **** are you to tell me that's the case? Why not just call yourself an AMC and stop lying to people?!?!!

People, please do not sign these ******* contracts!! Refuse to do it. The only way these greedy ******** are going to learn to not screw people over is if we all stand up and refuse to sign these contracts. There are plenty of locums jobs in the meantime until you find what you want. Or if you find yourself in a bad situation just get out of it as quickly as possible like I did. Yeah it's gonna be tough but your integrity and personal sense of job satisfaction is far more important in the long run.

It seems to swing in waves. The current wave is the greedy ******* who know there are a lot of residency grads coming out looking for jobs in good places. And they are trying to **** you.

 

[nap$ter]

hell no.

that must not be the only job in town (east coast). find a gig close enough to your wife's parents to keep her happy. what's the rush?

if you take that job, you'll be throwing your fellowship/peds experience out the window if you work it for more than a year or two.

happy wife, unhappy husband = divorce = unhappy wife, happy husband.

happyish wife, happyish husband = good compromise.

keep looking (and mebbe the wife should seek out other opportunities as well)

 

[nap$ter]

7) You will have to draw your own line on what you allow the CRNAs to do. A good friend of mine whom I've discussed my situation with extensively says that he thinks spinals, lumbar epidurals, and a-lines are okay. Everything else absolutely not. And he does not allow them to do it. Make sure this is clear and consistent within your practice or, yes, you will be the bad guy.

this.

 

[ghastly75]

Holy crap! This sounds almost exactly like a horrible situation I just extricated myself from.

Here's what I suggest as your deal breakers:

1) You cut the notice down to 90 days.
2) They guarantee in writing to make you a partner after two years. Ask to see the books.
3) With your experience the starting salary (east coast depending where) should be at least in the $375-400k range if your gonna be a non-partner track guy (see item 2). I would not take anything less unless you get it in writing a guarantee where you're gonna be in two years. Make them show you the books.
4) Make certain you know what the arrangements are regarding their supervision model. Just because they only have 7 CRNAs now doesn't mean they aren't going to hire more or that the hospital doesn't have CRNA employees and you're walking into a 4:1 routine practice. In that case you will only be doing pre-ops and putting out CRNA created fires.
5) They pay tail. Period. No questions asked. 100%. Whether you leave after 1 week or they excuse you after 1 year (etc.). From day 1 on.
6) Your wife (like mine) will be much happier if you're happier. Happy wife = happy life. Miserable husband = divorce.
7) You will have to draw your own line on what you allow the CRNAs to do. A good friend of mine whom I've discussed my situation with extensively says that he thinks spinals, lumbar epidurals, and a-lines are okay. Everything else absolutely not. And he does not allow them to do it. Make sure this is clear and consistent within your practice or, yes, you will be the bad guy.

If it smells rotten trust me it probably is.

Thanks for the insight:
1. There is no partner track, all employees. Everyone equal from day one. I will make exactly the same as the guy who has been there 12 years. I would be an employee of a multispecialty physician group. Pay is around 400K
They say supervision is no more than 3:1 except in dire emergencies and sometimes 2:1
They do pay tail but only if you complete the contract terms. 2years up front 180 notice., I asked for 1 year and 90 days, they declined. The only wiggle room was after two years, contract goes to 1 year…they wanted to continue to reup for two years
I don't want to burn bridges though and for my wife (highly specialized professional) and I to obtain jobs in area close to family its very challenging to near impossible to get all we want.
thanks for insight folks!

 

[ghastly75]

I dont think this is the right job. I would keep looking somewhere for another place close to home. I do know of a place to look that would meet many of your dream job specifications but it is located in the city that Chandler Bing thought it was the end of the world to move to.

Hah, Tulsa? I couldn;t do that, but thanks!

 

[BLADEMDA]

Keep looking. That job is not the right one for you.

 

[BuzzPhreed]

What Blade said.

 

[Spinach Dip]

You know let me expound on this point.

The HR idiot at the place I just left told me in so many ways that this kind of b.s. is the "new industry norm" for private practices. WTF? Not offering a partnership and making me kowtow to the militant CRNAs who want to do everything with little supervision is the new "industry norm"? Who the **** are you to tell me that's the case? Why not just call yourself an AMC and stop lying to people?!?!!

People, please do not sign these ******* contracts!! Refuse to do it. The only way these greedy ******** are going to learn to not screw people over is if we all stand up and refuse to sign these contracts. There are plenty of locums jobs in the meantime until you find what you want. Or if you find yourself in a bad situation just get out of it as quickly as possible like I did. Yeah it's gonna be tough but your integrity and personal sense of job satisfaction is far more important in the long run.

It seems to swing in waves. The current wave is the greedy ******* who know there are a lot of residency grads coming out looking for jobs in good places. And they are trying to **** you.

It's this new operating strategy called MMFM.

 

[IlDestriero]

Doesn't sound so great to me. You need to decide what you want to do with your career. If you want complex peds, don't accept less. After a few years you will find it very difficult to go back, especially in a desirable area.

 

[shopsteward]

You've done a peds fellowship that you won't be using, and which you are less likely to be able to use after your two years in this salt mine are up? If so, then reduce your proposed salary over the next two years by the opportunity cost of your fellowship. Starts not to look so well paid, doesn't it?

 

[ProRealDoc]

I've talked to all docs in group and interim Chief mentioned we should be proctoring CRNA on central line, nerve blocks…I fundamentally disagree there.

If I heard that at a job interview, I'd get up and walk out. Not interested in proctoring anyone.

 

[BuzzPhreed]

If I heard that at a job interview, I'd get up and walk out. Not interested in proctoring anyone.

That would take some serious stones but I like it. The difference is that you can work on changing that perception in a small group with a few docs and CRNAs. In a group that has over 40 anesthesiologists and 60 CRNAs it'd be like urinating into a strong wind.

 

[BuzzPhreed]

I don't want to burn bridges though and for my wife (highly specialized professional) and I to obtain jobs in area close to family its very challenging to near impossible to get all we want.

It sounds like you're gonna take it. Let us know how that works out for you. Seriously.

 

[IlDestriero]

I've talked to all docs in group and interim Chief mentioned we should be proctoring CRNA on central line, nerve blocks…I fundamentally disagree there.

If I heard that at a job interview, I'd get up and walk out. Not interested in proctoring anyone.

You don't walk out! Wait till after they wine you and dine you at the 5star restaurant. Come on man.

 

[ghastly75]

Its a difficult choice because for us to both find jobs in the same geographical locale is hard. We are looking to have children in the next few years and having family near by will be very helpful in so many ways.
When I looked at this job, I understood that I'd be leaving the pediatric world as I knew it…I was ok with that because of the location to family.
As I've inquired further; I've yet to hear someone at this "new" job say they love it…perhaps the CRNA's do…which the ad on Gaswork declares lifestyle position, signing bonus, do your own blocks, spinals, etc… work day ends for them at 3:30 or they get overtime…if they're not interested in OT then the DOCs take over the rooms until 5:30 even if pre call… It seems that this group is very much orientated toward CRNA lifestyle, but not necessarily DOC, and one doc stated that clearly.
Could I change the perception in a small group, perhaps.
Money is fair/good for area, especially no buy in, so for short term its really good, considering I'd make the same as everyone else.
As stated I asked for 1 year/90 day terms, they declined.
I asked to be .95FTE to free up about 12-13 days per year so I could do OP smile and keep pediatric connection with clinical work/community, they denied.
The town is great, awesome schools, close to ocean, could bike to work…
Am I being stubborn about the catering to CRNA's?

 

[ghastly75]

It's this new operating strategy called MMFM.

What is MMFM?

 

[deleted171991]

As I've inquired further; I've yet to hear someone at this "new" job say they love it…perhaps the CRNA's do…which the ad on Gaswork declares lifestyle position, signing bonus, do your own blocks, spinals, etc… work day ends for them at 3:30 or they get overtime…if they're not interested in OT then the DOCs take over the rooms until 5:30 even if pre call… It seems that this group is very much orientated toward CRNA lifestyle, but not necessarily DOC, and one doc stated that clearly.
Could I change the perception in a small group, perhaps, but the interim chief (soon to be chief) has clearly stated their belief: proctor the CRNA for Central lines, blocks, " because we're collegial care team model." I think going into a new situation where you butt heads with a chief is bad news.
As stated I asked for 1 year/90 day terms, they declined. Its two year, 180 terms, or your penalized value of previous 12 month salary!
I asked to be .95FTE to free up about 12-13 days per year so I could do OP smile and keep pediatric connection with clinical work/community, they denied.

There is a new book coming out in 2016: "Two years a slave".

WTH are you in doubt about? Don't just walk away, run!

 

[BobBarker]

Who makes more money, you or your wife? I wouldn't let my wife's professional concerns factor into this. She will probably permanently retire once the baby is born anyways.

 

[BuzzPhreed]

Could I change the perception in a small group, perhaps, but the interim chief (soon to be chief) has clearly stated their belief: proctor the CRNA for Central lines, blocks, " because we're collegial care team model." I think going into a new situation where you butt heads with a chief is bad news.

I just don't understand this way of thinking. You will be the one responsible for a bad outcome if that CRNA drops a lung, lines the artery, etc. I don't care what they say. Your tookus will be in court defending why you let them do it. Laws of deep pockets prevail. So why not just put it in yourself anyway? This "collegial" stuff is horse****. It's a sign of the "nice guy" mentality who doesn't want to tell the sweet nurse or ball-buster militant grey-hair CRNA they can't do it. These types of anesthesiologists are the ones who's kids get whatever they want. You know the type. CRNAs are not our colleagues in the truest sense of the word. They are nurses. They have no idea what we went through to become what we are. Completely different training pathway. And most insulting many of them will tell you our extra training is irrelevant until they find themselves in the **** and don't know how to get out. I can't tell you the number of times I've run into that. Completely different level of responsibility.

I had similar alarm flags when I decided to jump ship and move late last summer. When I finally got to the job it was far worse than I had imagined. I should've listened to my gut. My wife also wanted a change to a better geographic area. After seeing how miserable I was she was quite content to move back to where we had come from.

Don't underestimate the ability of a lousy job to completely ****-up your otherwise good life. No matter even if that ****-job you want is in Fiji and comes with a Mai Tai in your hand.

 

[Spinach Dip]

What is MMFM?

LOL

More
Money
For
Me

 

[IanMcGalt]

Where I am, there are enough blocks and lines for the docs to maintain our skills. If we trained nurses to do it not only would we have a bunch of nurses doing it not that well, we'd get worse at the procedures too.

Plus, training nurses is digging your own grave before they stab you in the back and push you in.

 

[michigangirl]

CRNA stuff aside, as you've gotten a lot of advice on that front-- I'd like to go back to IlDestriero's point:

Doesn't sound so great to me. You need to decide what you want to do with your career. If you want complex peds, don't accept less. After a few years you will find it very difficult to go back, especially in a desirable area.

This would be the dealbreaker for me. It seems you really enjoy doing the complex peds cases-- a big reason some pedi-trained folks stay in academic jobs despite lower salary. Are you cool with the transition to all healthy, all bread and butter?

 

[ghastly75]

Holy crap! This sounds almost exactly like a horrible situation I just extricated myself from.

Here's what I suggest as your deal breakers:

1) You cut the notice down to 90 days.
2) They guarantee in writing to make you a partner after two years. Ask to see the books.
3) With your experience the starting salary (east coast depending where) should be at least in the $375-400k range if your gonna be a non-partner track guy (see item 2). I would not take anything less unless you get it in writing a guarantee where you're gonna be in two years. Make them show you the books.
4) Make certain you know what the arrangements are regarding their supervision model. Just because they only have 7 CRNAs now doesn't mean they aren't going to hire more or that the hospital doesn't have CRNA employees and you're walking into a 4:1 routine practice. In that case you will only be doing pre-ops and putting out CRNA created fires.
5) They pay tail. Period. No questions asked. 100%. Whether you leave after 1 week or they excuse you after 1 year (etc.). From day 1 on.
6) Your wife (like mine) will be much happier if you're happier. Happy wife = happy life. Miserable husband = divorce.
7) You will have to draw your own line on what you allow the CRNAs to do. A good friend of mine whom I've discussed my situation with extensively says that he thinks spinals, lumbar epidurals, and a-lines are okay. Everything else absolutely not. And he does not allow them to do it. Make sure this is clear and consistent within your practice or, yes, you will be the bad guy.

If it smells rotten trust me it probably is.

The new CRNA's are getting a signing bonus. I don't know how much, just stated in advertisement . I was not offered one. Is it petty to ask for a signing bonus?

 

[Spinach Dip]

The new CRNA's are getting a signing bonus. I don't know how much, just stated in advertisement . I was not offered one.

What in the actual f#ck is going on here?

 

[Psai]

The new CRNA's are getting a signing bonus. I don't know how much, just stated in advertisement . I was not offered one. Is it petty to ask for a signing bonus?

...what the hell? CRNAs get signing bonuses but not a board certified, fellowship trained doctor?

 

[nap$ter]

...what the hell? CRNAs get signing bonuses but not a board certified, fellowship trained doctor?

i've counted no less than 7 huge red flags in this thread. Black and white, hell no, i'd rather dip my tender bits in lye, DEALBREAKER RED FLAGS in this thread. the kind of red flags that would make me unabashedly stand up, thank them for their time, and walk out kind of deal breakers (unless you want that 5 star dinner, but i'm guessing this interview came with a cafeteria salad and a snapple).

if you value your everlasting soul, if your wife values your soul, for the sake of dear baby jesus do not take this job. it makes me sick to think of any MDA (haha) working in this coal mine.

you asked for advice here, i think you've received it. let us know what you choose, and how it turns out.

 

[ghastly75]

I just don't understand this way of thinking. You will be the one responsible for a bad outcome if that CRNA drops a lung, lines the artery, etc. I don't care what they say. Your tookus will be in court defending why you let them do it. Laws of deep pockets prevail. So why not just put it in yourself anyway? This "collegial" stuff is horse****. It's a sign of the "nice guy" mentality who doesn't want to tell the sweet nurse or ball-buster militant grey-hair CRNA they can't do it. These types of anesthesiologists are the ones who's kids get whatever they want. You know the type. CRNAs are not our colleagues in the truest sense of the word. They are nurses. They have no idea what we went through to become what we are. Completely different training pathway. And most insulting many of them will tell you our extra training is irrelevant until they find themselves in the **** and don't know how to get out. I can't tell you the number of times I've run into that. Completely different level of responsibility.

I had similar alarm flags when I decided to jump ship and move late last summer. When I finally got to the job it was far worse than I had imagined. I should've listened to my gut. My wife also wanted a change to a better geographic area. After seeing how miserable I was she was quite content to move back to where we had come from.

Don't underestimate the ability of a lousy job to completely ****-up your otherwise good life. No matter even if that ****-job you want is in Fiji and comes with a Mai Tai in your hand.

Believe me, I don't get it either. There are only so many blocks and central lines for this hospital, to dilute the experience is mind blowing. I watched a colleague today let a CRNA attempt an a-line on a healthy teenager and I threw on some gloves because my buddy (attending ) was supervising the fellow place an epidural. I was horrified to see the CRNA botch the A-line and I had to jump in and place it (after CRNA hematoma from trying to ram a catheter in a vein…) Lord knows that can happen to anybody, but I don't want to be in that position everyday.

 

[Substance]

i've counted no less than 7 huge red flags in this thread. Black and white, hell no, i'd rather dip my tender bits in lye, DEALBREAKER RED FLAGS in this thread. the kind of red flags that would make me unabashedly stand up, thank them for their time, and walk out kind of deal breakers (unless you want that 5 star dinner, but i'm guessing this interview came with a cafeteria salad and a snapple).

if you value your everlasting soul, if your wife values your soul, for the sake of dear baby jesus do not take this job. it makes me sick to think of any MDA (haha) working in this coal mine.

you asked for advice here, i think you've received it. let us know what you choose, and how it turns out.

Mind sharing what you think those are? I totally agree with you by the way.

Here are mine ( I could only come up with three):
1. Nurses are getting bonuses while docs aren't. Tells you what the group values.
2. They won't budge on the unreasonable termination clause. That right there is enough to make me pass on it. Inflexible administration.
3. No peds, even though you want to do it. You'll waste away there.

It seems like they're trying to turn it into a CRNA mill for the purposes of profits.

 

[BuzzPhreed]

the fact that its being supported by the chief is especially dismaying and will probably keep me from joining.

 

[Yo GabbaPentin]

Believe me, I don't get it either. There are only so many blocks and central lines for this 100 bed hospital, to dilute the experience is mind blowing. the fact that its being supported by the chief is especially dismaying and will probably keep me from joining. I watched a colleague today let a CRNA attempt an a-line on a healthy teenager and I threw on some gloves because my buddy (attending ) was supervising the fellow place an epidural. I was horrified to see the CRNA botch the A-line and I had to jump in and place it (after CRNA hematoma from trying to ram a catheter in a vein…) Lord knows that can happen to anybody, but I don't want to be in that position everyday.

You are asking questions which you already know the answers to. You are hoping for someone to post about their similar job which is pretty good. You want someone to give you the advice to take this job which will help you to ignore the other 12 people telling you to run. You KNOW this is a **** job and you have a gut feeling that you will spend two years with you hands grasped firmly around your ankles.

I've posted similar questions about my previous job and I also knew the answers to them. I'm not gonna be the one to advise you to take this job. The best scenario you can hope for out of this is that they use Vaseline that is not sprinkled with sand.

 

[ProRealDoc]

That would take some serious stones but I like it. The difference is that you can work on changing that perception in a small group with a few docs and CRNAs. In a group that has over 40 anesthesiologists and 60 CRNAs it'd be like urinating into a strong wind.

I'd walk out, come back in, and walk out again so all 60+ in attendance take notice.

 

[ProRealDoc]

The new CRNA's are getting a signing bonus. I don't know how much, just stated in advertisement . I was not offered one. Is it petty to ask for a signing bonus?
HHS
]

It'd be petty if you didn't ask for one. In fact, ask for two.

 

[ProRealDoc]

All jokes aside, what this job is looking for, is a sucker who will train the CRNAs and then boot you out once they're done with you.

The joke of a chief they currently have is probable married to a CrNA or has a financial interest of some sort. He could also be the typical spineless anesthesiologist who fears losing his job and is bowing down to pressure from administration.

Either way, don't be that sucker.

 

[ghastly75]

You are asking questions which you already know the answers to. You are hoping for someone to post about their similar job which is pretty good. You want someone to give you the advice to take this job which will help you to ignore the other 12 people telling you to run. You KNOW this is a **** job and you have a gut feeling that you will spend two years with you hands grasped firmly around your ankles.

I've posted similar questions about my previous job and I also knew the answers to them. I'm not gonna be the one to advise you to take this job. The best scenario you can hope for out of this is that they use Vaseline that is not sprinkled with sand.

Thanks for the advice and candid statements, they are at times brash but humorous .
Let me say I will not be going to this job.
The red flags for me were:
1. Practice in transition to more CRNA's
2. CRNA's signing bonus, none to MD
3.Chief Doc seemed intent on towing company line (proctor CRNA's for central lines etc.)
4. Imbalance in service work, after 40 hours CRNA's out door and Doc's finish up.
5. Terms: 2 years, 180 notice. Then resign for 2 years/180 day notice or leave.
6. Employee of multi specialty physician group/hospital partnership , no chance at partner, everybody an employee.

Lets just say it was an excellent lesson in negotiations, and trusting one's gut feeling.
Don't ignore the red flags folks.

 

[deleted126335]

Based on the data that you provided it sounds like the right choice. One thought: Hit up all the institutions that do a decent amount of complex peds with a job situation that you find desirable in your preferred geographic area. Keep sending letters, when in town to visit your wife's family, schedule informational interviews just so they can see your face and genuine interest. If your credentials and skills are as described and your communication skills are strong you should get a hit within a year or two. The key will be how wide and desirable is your geographic target area.

 

[BuzzPhreed]

Lets just say it was an excellent lesson in negotiations, and trusting one's gut feeling.
Don't ignore the red flags folks.

I sincerely wish I had almost the last year of my life back and had listened to my gut, because I had many of the same reservations that you did yet I still jumped. It was a horrible mistake that I was able to undo through some tough negotiating at the back end and a lot of good lawyering.

To all the freshly trained anesthesiologists out there, there are a lot of greedy groups who are going to try to **** you over. Even as I was leaving this latest fiasco, I was told that they have a stack of resumes of qualified people to replace me. They don't care. Groups like this just one someone to sign the chart and have you take all the risks with your license. Remember that: it's your medical license that you put eight years of blood sweat and tears into getting. If you leave, they will just replace you. That's how they think. They don't care.

The answer is to stand up to them and refuse to sign a crappy contract that ties your hands. Either negotiate until you get exactly what you want or walk away. Don't be blinded by intangibles like desirable location or other things. It won't be worth your loss of integrity to our profession. If you cave in during the contract phase, they will feel like they have you by the short hairs.

They don't teach this stuff in residency. Get a good lawyer up front. That person can also act like your agent. Learn to negotiate. You are (or will be) a highly paid and highly trained professional and you should be willing to pay a little extra to someone to help you navigate this process. There are people at these groups who just don't care about your risk, and I mean professional risk, so long as they can collect what you bill. They will put you with newbie CRNAs and four rooms and in risky situations. You will have little or no say in the cookie-cutter anesthesia that goes on everyday. Hell, they probably won't even call you when there's a problem either because they don't recognize it or they don't want your help in the first place. You will exist just to do pre-ops and sign consents and write post-op orders. Trust me. I lived this for a short time. And the people around you who allow this and accept this are either collecting a ton of revenue on the back of your hard work or have just had their spirit broken.

Recognize a **** job when it smacks you in the olfactory bulb. Trust your gut. And don't be afraid to say no. If you make a mistake and say yes, don't be afraid to walk away.

 

[Jay K]

Thanks for the advice and candid statements, they are at times brash but humorous .
Let me say I will not be going to this job.

cheese and rice, finally…