Anesthesia Group Merger

[Pharmado]

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I am a CA-3 looking for a good PP group to join next July. I don't really have any specific geographical needs so I've looked in a lot of places, mostly in the Midwest . I recently spoke with a small group that covers a single hospital in a small town. The company that owns the hospital also controls 3 other hospitals and has asked that each of the 4 anesthesia groups covering their hospitals merge into 1. They were very open about this and indicated that they are in talks to make this move in the coming year, but no specific details have been worked out. I'm early in talks with the group, but it sounds like an area I'd be happy living in with a group that I think I'd be happy being a part of if the current salary/benefit structure stays in place. They have a 2 year partnership track, so I'd be entering a situation where I am not a partner and I'm joining likely the smallest group in the merger. That being said, does anyone have experience with this type of situation? It seems that I'd be taking a job with no specific details on what the future holds and no guarantees that the situation is to my liking in the future. On the other side, these are hospitals that aren't close enough together for any of the groups to easily take over the positions of the others without a significant investment of resources. Is this a situation I should avoid, or simply one that I should get as many guarantees as possible placed in any potential contract? Any help would be appreciated.

 

[Hoya11]

I am a CA-3 looking for a good PP group to join next July. I don't really have any specific geographical needs so I've looked in a lot of places, mostly in the Midwest . I recently spoke with a small group that covers a single hospital in a small town. The company that owns the hospital also controls 3 other hospitals and has asked that each of the 4 anesthesia groups covering their hospitals merge into 1. They were very open about this and indicated that they are in talks to make this move in the coming year, but no specific details have been worked out. I'm early in talks with the group, but it sounds like an area I'd be happy living in with a group that I think I'd be happy being a part of if the current salary/benefit structure stays in place. They have a 2 year partnership track, so I'd be entering a situation where I am not a partner and I'm joining likely the smallest group in the merger. That being said, does anyone have experience with this type of situation? It seems that I'd be taking a job with no specific details on what the future holds and no guarantees that the situation is to my liking in the future. On the other side, these are hospitals that aren't close enough together for any of the groups to easily take over the positions of the others without a significant investment of resources. Is this a situation I should avoid, or simply one that I should get as many guarantees as possible placed in any potential contract? Any help would be appreciated.

I would say avoid. You do not know what the situation will be like after the merger. It will likely be VERY different. You may have to drive long distances, your salary may suddenly change, partnership agreement seems meaningless with a big merger openly in the works. Are they merging to increase their insurance negotiated reimbursements and then sell to an AMC based on the new figure/new size? Not worth the risk. Sure it could work out, but they are openly telling you that a merger is happening...that is like them saying look we cant tell you what your getting into.. NOT the time to join.

When I was looking I got an offer from a group that a year after the offer went on to merge with multiple small independent hospitals. Its been a huge shakeup with lots of people leaving and contracts changing hands still going on as a ripple effect. The group is seen as unstable. Im very glad I did not join.

If you like the area look for some other options in the same area. The fact that they are interested in merging probably suggests poor financial prospects and/or looking to sell out.. I would absolutely avoid. After its all said an done re-evalute your decision after the merger and you can always try to join then when you know what your getting

 

[sevoflurane]

It's all in the contract. Just like the oral boards...

If this, then that.

Mergers can be a consolidating sign of potential acquisition and if your foot is in the door and you are willing to accept terms, then you may get a parachute now rather than never.

Just presenting another side.

Good luck.

 

[Mman]

there is nothing wrong with groups merging. That can be a good thing. Gives them better negotiating power, etc.

The red flag in this to me is that the hospital system is demanding these separate groups merge. I'm assuming if they don't they will just be dropped and the hospital will go with an AMC or just hire the docs themselves. That doesn't seem like a hospital system I'd be terribly anxious to be a part of.

 

[psychbender]

Something similar happened with a classmate of mine from med school. One of the hospital systems back home went through a rebranding phase, demanded more interoperability between their previously rather independent hospitals, and insisted that the anesthesiology group from the larger hospital take on the contract from the smaller one 40 minutes down the interstate. They did, but in order to keep both running, had to hire on several new partners (which is when my classmate left a good job halfway across country to come home), and change from physician only to supervising CRNAs maybe 50-70% of the time. Per him, there was a lot of internal grumbling at first, but things have settled down, and the partners are mostly content with their situation.

Point being, it might "work out," but the final working conditions may change from what they are now.

 

[aneftp]

This is all the result of Obamacare and pushing for "efficiency"

And please don't use the Bs excuse "mergers have been happening pre ACA"

It's not secret the ACA has pushed more hospitals to merge to fight for dollars. Stronger in numbers theory and negotiationing power. Same with medicine.

The flip side is insurers expected something like the ACA exchanges (aka the individual market which was and still only 5% of the market). Insurers expected the ACA exchanges to grow to 25% of the entire USA population so insurers can have the upper hand in the individual market. That obviously hasn't happened.

 

[Shimmy8]

I have an offer for a group in Midwest that previously covered 3 hospitals (one large hospital, two small community) and this past year merged with another group in same area for negotiating power, per the president I interviewed with. Also, he felt it gave them even more stability to *not* be taken over by an AMC. They still have their own board and are a division of the larger group, but the long term plan is for interchangeability for personnel.

Anyway, just another perspective.

 

[dmk5n]

Another perspective...

4 groups?
Take the job.
It'll take 2 years to complete talks and finalize the merger.
You'll be a partner by the time lawyers finish their paperwork. (hopefully)
In 4-6 years, sell to AMC.
$$$

 

[DrCommonSense]

Another perspective...

4 groups?
Take the job.
It'll take 2 years to complete talks and finalize the merger.
You'll be a partner by the time lawyers finish their paperwork. (hopefully)
In 4-6 years, sell to AMC.
$$$

Yeah good luck with that lol