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Panacea Financial Contract Review
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Zendo said:
Are nights-only positions similar to nighthawks in radiology (some even 1 week on, 2 weeks off) common in anesthesia? If so, do they compensate more?
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I’m aware of some in academics (where rooms chronically run until midnight or later). Typically you work a few less hours than a typical day shift but get paid the same total, so the per hour compensation is higher. Most people are not interested in jobs like these for more than a couple years after training.
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nimbus said:
We have a couple guys who used to take 14-15 nights/month of OB call in addition to their regular job. But that was before we implemented rules against overworking.
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How would this work? Would they be off before and after the shift? Were there only 2 people doing ob at night if you had 2 people doing 15 each? How often are you working the whole night?
 
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dabears505 said:
How would this work? Would they be off before and after the shift? Were there only 2 people doing ob at night if you had 2 people doing 15 each? How often are you working the whole night?
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No they were working before and after. Even though it was a unit where you could sleep through the night or get up only once or twice, it became seen as a problem.


It was a strange arrangement that happened over time. For a long time the the OB work was undesirable due to low volume and poor payor mix. It was originally covered by 4-5people. Most of them gave away the night work. The 2 I mentioned voluntarily picked up most of the night work even though their primary jobs were at other places. They are classic workaholics, each doing this for about 20 years. There was a stipend that made it worthwhile to them, but not to the rest of us. Gradually the original 4-5 people doing the OB work dwindled down to basically 1 person who covered every weekday. The others moved to other sites within our practice. Most of the nights and weekends were covered primarily by 2 people. Plus a small group of 3-4 others who would pitch in when they could. More recently, the payor mix and the volume have improved so more people are interested in doing it now.
 
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dabears505 said:
Were they single? What kind of stipend was it? 1500?
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Neither single. One is one house/one wife type. The other guy got married late in life but only one wife. Very nice guy with an idiosyncratic personality, world traveler, trekker, ran marathons on every continent including Antarctica. He voluntarily covered every Christmas Eve and every New Year’s Eve for 20 years.
 
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nimbus said:
Neither single. One is one house/one wife type. The other guy got married late in life but only one wife. Very nice guy with an idiosyncratic personality, world traveler, trekker, ran marathons on every continent including Antarctica. He voluntarily covered every Christmas Eve and every New Year’s Eve for 20 years.
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Hey nimbus I’m right here, just call me by my name!
 
As employees our group still ties our salaries to MGMA regional data and, living in the South, it has worked out pretty well, overall. I will have to find the most recent MGMA to see the 50/75/90 Southern data (there was a Reddit thread that had it posted and then blocked by Dr. Google for violation of terms), but the numbers I have seen on Gaswork aren't the highest or best. When we recruit, we have to remind admin and ourselves that Gaswork is often the lowest common denominator as the better jobs often fill via word of mouth recruitment. I am constantly inundated with job postings listing >$500k, 12-17 wks vacation. Some are $450k with 2 wks on/2 wks off. I also have a friend in an academic practice doing peds while running 2 peds rooms at 1:1 or 1:2 supervision with 5 MDs, 3 CRNAs, and 2 residents for $425k and 12 wks vacation.

Location and practice set up are everything.
 
pmichaelmd said:
As employees our group still ties our salaries to MGMA regional data and, living in the South, it has worked out pretty well, overall. I will have to find the most recent MGMA to see the 50/75/90 Southern data (there was a Reddit thread that had it posted and then blocked by Dr. Google for violation of terms), but the numbers I have seen on Gaswork aren't the highest or best. When we recruit, we have to remind admin and ourselves that Gaswork is often the lowest common denominator as the better jobs often fill via word of mouth recruitment. I am constantly inundated with job postings listing >$500k, 12-17 wks vacation. Some are $450k with 2 wks on/2 wks off. I also have a friend in an academic practice doing peds while running 2 peds rooms at 1:1 or 1:2 supervision with 5 MDs, 3 CRNAs, and 2 residents for $425k and 12 wks vacation.

Location and practice set up are everything.
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I am not inundated with these job postings
 
pmichaelmd said:
As employees our group still ties our salaries to MGMA regional data and, living in the South, it has worked out pretty well, overall. I will have to find the most recent MGMA to see the 50/75/90 Southern data (there was a Reddit thread that had it posted and then blocked by Dr. Google for violation of terms), but the numbers I have seen on Gaswork aren't the highest or best. When we recruit, we have to remind admin and ourselves that Gaswork is often the lowest common denominator as the better jobs often fill via word of mouth recruitment. I am constantly inundated with job postings listing >$500k, 12-17 wks vacation. Some are $450k with 2 wks on/2 wks off. I also have a friend in an academic practice doing peds while running 2 peds rooms at 1:1 or 1:2 supervision with 5 MDs, 3 CRNAs, and 2 residents for $425k and 12 wks vacation.

Location and practice set up are everything.
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Lol will you please PM me some of these >500k 12-17w off gigs ???
 
ASA posts a nice summary of all different salary data from surveys in their almanac. I think you can find it on google
 
In terms of looking at listings on Gaswork, I really only look at the postings for Georgia. Correlating that with Southern MGMA data, median/75%/90% numbers are roughly $492k/$575k/$692k. Most of what I see listed approximates median. In terms of benefits, etc, total compensation might make certain offers better. Median with 12 wks vacation might be better than 75% with only 8 wks. I have seen listings in GA for $400k with 2 wks on/ 2 wks off. Imagine the locums work you could do during some of those off weeks.
Additionally, we have locums docs filling the gaps and their recruiters are telling us they have seen offers at $500/hr. I imagine that means $325/hr to the locums doc and $175/hr to the middle man. Eventually this bubble will burst and we will see what happens with normalization.
 
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pmichaelmd said:
In terms of looking at listings on Gaswork, I really only look at the postings for Georgia. Correlating that with Southern MGMA data, median/75%/90% numbers are roughly $492k/$575k/$692k. Most of what I see listed approximates median. In terms of benefits, etc, total compensation might make certain offers better. Median with 12 wks vacation might be better than 75% with only 8 wks. I have seen listings in GA for $400k with 2 wks on/ 2 wks off. Imagine the locums work you could do during some of those off weeks.
Additionally, we have locums docs filling the gaps and their recruiters are telling us they have seen offers at $500/hr. I imagine that means $325/hr to the locums doc and $175/hr to the middle man. Eventually this bubble will burst and we will see what happens with normalization.
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This is what was going on in EM right before the job market blew up
 
We have to tie everything together

Workload
Workpace (the speed of cases)
Work acuity
Pay
Total compensation including health retirement

I don’t think the data fully accounts for true working conditions. 500k/45 asa 4 hours is not the same as 500k/45 hours asa 1/2

To get to the 600k it may take 60 hours

It does not account for after hours work or weekend work.
 
GassYous said:
This is what was going on in EM right before the job market blew up
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Are you expressing genuine concern or just some humor (this is a serious question as a rising M4). What happened to EM is pretty scary tbh, but from what I've heard anesthesia market is super undersaturated.

But would be glad to be enlightened if somehow this was a bad omen as I see the EM threads from 5-7 years ago where people are saying "I don't even get out of bed for less than $250 /hr"
 
amyl said:
What happened to the em job market? I thought it was still a great market for them?
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EM market got overfilled with new grads combined with the fact that many ERs can be run by 1-2 MDs plus a bunch of NPs.

A hospital with 8 ORs still needs 8 anesthesiologists...but they can staff the ED with 2. And CRNAs make substantially more than NPs so they aren't nearly as cost effective.

Anesthesiologists can also work in ASCs so the number of job opportunities is much higher so it's a better supply demand ratio
 
UscGhost said:
EM market got overfilled with new grads combined with the fact that many ERs can be run by 1-2 MDs plus a bunch of NPs.
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Do physicians on admitting floors not get annoyed at medical ancillaries having free rein with very little MD supervision?

I mean, I've seen how other physicians already get annoyed enough at EM physicians as it is.
 
UscGhost said:
EM market got overfilled with new grads combined with the fact that many ERs can be run by 1-2 MDs plus a bunch of NPs.

A hospital with 8 ORs still needs 8 anesthesiologists...but they can staff the ED with 2. And CRNAs make substantially more than NPs so they aren't nearly as cost effective.

Anesthesiologists can also work in ASCs so the number of job opportunities is much higher so it's a better supply demand ratio
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Hospitals opened tons of new EM residencies for the obvious reason of cheap labor. Now, a flood of grads, mid level creep, and management companies like team health and envision have created the current job market for them.

Looking at anesthesia we have the management companies, we have mid level creep (although ours is fairly static, theirs dynamic.) The only thing we don't have is a flood of new grads. If there were to be big increases in residency slots we would see anesthesia take the same fate.

We may have a slight buffer due to ASCs and some specialty specific work, but a hospital with 8 ORs needs 2 anesthesiologists.
 
aneftp said:
We have to tie everything together

Workload
Workpace (the speed of cases)
Work acuity
Pay
Total compensation including health retirement

I don’t think the data fully accounts for true working conditions. 500k/45 asa 4 hours is not the same as 500k/45 hours asa 1/2

To get to the 600k it may take 60 hours

It does not account for after hours work or weekend work.
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Southern region has always been more highly compensated but also had the greatest number of units per capita. At one point years ago we asked our billing company and our group was somewhere in the 18000 U / MD (or DO) range, putting us around the 86% nationally and between median and 75% Southern.
As we are salaried W2 employees, our weekend call and call in general are included. We do get extra $$ if we have to work PC or late at our remote hospital to offset the workload or at least make it somewhat more palatable.
 
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aneftp said:
We have to tie everything together

Workload
Workpace (the speed of cases)
Work acuity
Pay
Total compensation including health retirement

I don’t think the data fully accounts for true working conditions. 500k/45 asa 4 hours is not the same as 500k/45 hours asa 1/2

To get to the 600k it may take 60 hours

It does not account for after hours work or weekend work.
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I’m confused. Are there places or people who don’t count night work and weekend work in their weekly work hours?
 
nimbus said:
I’m confused. Are there places or people who don’t count night work and weekend work in their weekly work hours?
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I think aneftp means “overtime,” like I was describing. If we pick up an extra weekend or work late at our ASC due to shortage we get “extra” compensation, but this is all rolled into our reportable work hours.
Base salary + extra hours + bonus = our MGMA salary metric, then add our bennies (401k match, malpractice, 9 weeks vacay, LTD, life and AD&D insurance, etc) for our total compensation package.
 
Does anyone know the yearly average amount of units billed for a person doing medical direction? Curious what is considered super busy.
 
ERRES2288 said:
Lol will you please PM me some of these >500k 12-17w off gigs ???
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Stuff like this. Many from recruitment firms but maybe you would want to check them out.
 

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leapfrog top hospital award? You gotta be ****ting me. Do they 401k match? What's the call schedule? Give me real info
 
GassYous said:
leapfrog top hospital award? You gotta be ****ting me. Do they 401k match? What's the call schedule? Give me real info
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You mean that you really don't care about Leap frog, Baldridge award, US News and World report rankings, center of excellence, Press Gainey Guardian of excellence awards, Forbes, Fortune and Glassdoor "Best Employers", etc.?

You have a bad attitude.
 
Dr. Rude said:
You mean that you really don't care about Leap frog, Baldridge award, US News and World report rankings, center of excellence, Press Gainey Guardian of excellence awards, Forbes, Fortune and Glassdoor "Best Employers", etc.?

You have a bad attitude.
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I only work at hospital with nursing Magnet designation, since that’s a really prestigious reward….. that can be bought by throwing money at it and pick your “best” staff for three day interviews with good lunch spread.
 
Anakinmemer said:
I was browsing gasworks instead of studying for my obgyn shelf and decided to check out jobs in the northeast. I see things posted like this: GasWork.com - Reference #356284

Seemingly a 5 day week for 625k in Connecticut with no call, obviously this looks too good to be true, so is it? How do you tell what's real vs a scam
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Alot of gaswork offers seem questionable.
 
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