Anesthetix

[foxtrot]

Does anyone know anything or anyone who has ever worked for anesthetix? I know they are an anesthesia and pain amc. Not as large as Sheridan or NAPA. Any input would be appreciated.

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[paradoxone]

Does anyone know anything or anyone who has ever worked for anesthetix? I know they are an anesthesia and pain amc. Not as large as Sheridan or NAPA. Any input would be appreciated.

Be careful to get the full story before you sign up with Anesthetix Management (AKA Anthem Associates or what other names they are using.)

Anesthetix, recruits under different names and no longer calls all their new groups Anesthetix. Their main Recruiter is Anthem Associates which has the same owners but they use many other recruiters, to advertise their jobs.

See lawsuit below for a real world example of how you can expect to be treated by Anesthetix.

Ok ... I was looking into what looked like a great job opportunity on gasworks in which I recognized the name anesthetix. I remember reading that name on SDN and while I was returning a call to the recruiter, I did a quick google search:
Anesthetix court document
Hung up the phone before they could pick up. Can't believe what that poor guy went through. Don't know the details of course, but in addition to trying to rip him off, seems like they really worked hard to tarnish his name when he tried to get them to pay him. I can see why alot of folks just walk away quietly in these situations.

SDN may have potentially saved me from a nightmare situation.

TheSandMan,

Did you read the whole docket? It was a pretty fascinating read.

Anesthetix tried the "smear campaign" tactic on this dude. They tried to impugn his character, made allegations that he was an incompetent practitioner, and tried to even question his hygiene. Pretty pathetic.

He tried to sue under Title VII, in part, alleging that there was discrimination based on the fact that he is a U.S. citizen (that they only hire J-1 and H-1B visa docs), but that was summarily dismissed by the court. That would've been a federal lawsuit.

What was (or will be) litigated was the possibility that Anesthetix misrepresented the contract to him, and that they didn't pay him.

Interesting read, full of caselaw, for anyone willing to take the time. Thanks for posting!

-copro

 

[paradoxone]

Does anyone know anything or anyone who has ever worked for anesthetix? I know they are an anesthesia and pain amc. Not as large as Sheridan or NAPA. Any input would be appreciated.

Where are these locations and what are the names of these practices?

Can someone in the know please post the names and locations of Anesthetix practices?

from;

http://www.prweb.com/releases/Anesthetix/growingplatform/prweb2361314.htm

Anesthetix Grows Practice Operations to 10 States

Leading national provider of anesthesiology and pain management services, Anesthetix Management, LLC ("Anesthetix"), recently marked a new milestone, expanding operations into its 10th state. This is proof that more hospitals are learning about and embracing Anesthetix' unique value proposition. It also further demonstrates the success of its national platform and local delivery model over a wide geographic footprint. It's gratifying to see Anesthetix selected as the

for so many highly regarded institutions

Our leadership team of accomplished industry veterans works tirelessly to support our local physician groups in the delivery of clinical and business 'best practices' for our surgeons and hospital partners.

Growing into our 10th state is proof that more hospitals are learning about Anesthetix and embracing our methods and results. It also further demonstrates the success of our national platform and local delivery model over a wide geographic footprint. We look to continue scaling the delivery of our customer-focused services into the future.

In addition to starting and managing a new anesthesia group customized for a facility's surgeons and patient base, what sets Anesthetix apart is our commitment to becoming a 'perioperative partner' to our facilities

By being involved in the satisfaction of their customers, by helping their OR's run in a time- and cost-efficient manner, and by developing new service volumes, through pain management or anesthesia for diagnostic procedures, for example, Anesthetix achieves a phenomenal value proposition for our facility partners.
Palm Beach Gardens, FL (PRWEB) April 28, 2009 -- Leading national provider of anesthesiology and pain management services, Anesthetix Management, LLC ("Anesthetix"), recently marked a new milestone, expanding operations into its 10th state.
With practice locations throughout the Midwest-, Northeast-, and Southeastern United States, Anesthetix is expanding its reputation for delivering quality-focused, service-oriented anesthesiology and pain management services.
Its facility partners vary from small community hospitals, to larger tertiary-care facilities and anesthesiology residency programs. These include some of the best hospitals and health care systems in the United States, with many of them earning the highest rankings in various national publications.
"It's gratifying to see Anesthetix selected as the "anesthesia partner of choice" for so many highly regarded institutions," said Steven Gottlieb, MD, President and CEO of Anesthetix. "Our leadership team of accomplished industry veterans works tirelessly to support our local physician groups in the delivery of clinical and business 'best practices' for our surgeons and hospital partners."
"Growing into our 10th state is proof that more hospitals are learning about Anesthetix and embracing our methods and results. It also further demonstrates the success of our national platform and local delivery model over a wide geographic footprint. We look to continue scaling the delivery of our customer-focused services into the future."
"In addition to starting and managing a new anesthesia group customized for a facility's surgeons and patient base, what sets Anesthetix apart is our commitment to becoming a 'perioperative partner' to our facilities," said Tushar Ramani, MD, Chief Operating Officer. "By being involved in the satisfaction of their customers, by helping their OR's run in a time- and cost-efficient manner, and by developing new service volumes, through pain management or anesthesia for diagnostic procedures, for example, Anesthetix achieves a phenomenal value proposition for our facility partners."
CONTACT
Steven Gottlieb, MD
President and CEO
Telephone: 561.799.3552
Email: smg (at) anesthetix (dot) com

 

[foxtrot]

Does anyone know of people who currently work for the organization or have worked with them personally?

 

[deleted126335]

.

 

[Planktonmd]

The future of anesthesiology practice in this country is going to be Hospital employment or AMC's.
The private practice small group model is going to disappear because it simply can not compete with the big companies and it is too inefficient to keep up with the changing conditions.
So, if you are going to private practice I strongly suggest that you consider working for AMC's as long as you are able to negotiate a fair contract.

 

[foxtrot]

The future of anesthesiology practice in this country is going to be Hospital employment or AMC's.
The private practice small group model is going to disappear because it simply can not compete with the big companies and it is too inefficient to keep up with the changing conditions.
So, if you are going to private practice I strongly suggest that you consider working for AMC's as long as you are able to negotiate a fair contract.

It certainly seems that way when you look at the job posting sites (which is unfortunate).

 

[deleted126335]

.

 

[foxtrot]

I would advise new grads to try real hard to avoid being a hospital employee or an employee of an AMC. Been there done that. I realize that this will be harder in the future. But if you can find a high quality egalitarian private practice group that has had an exclusive contract for decades, it is worth "paying up" for it in terms of a longer buy in. Or living in a second or third choice metro area.

I completely agree. The problem with this is that many of these groups are not hiring because of the economy. If anyone knows of any stable groups in the midwest please pm me.

 

[kirk002]

What's so bad about being a hospital employee?

 

[godfather]

For all new grads do not ever be suckered into working for anesthetix, this is the worse job you can get. i have seen them ruin 2 hospitals anesthesia departments and their recruiters are snakes oilmen. this is perhaps the most incompetent, unjust, management company around and they re MO is always the same. they sucker a hospital with a great presentation into how inefficient they re current setup is and than sucker the hospital into giving them the contract. they're next step is always to advertise a job for 350k to 400k with 12 wks of vacation(which u will never get because they're reputation is so bad that no body wants to work for them and usually they only can get new grads or other providers with serious promblems on their resumes(drug users, bad records, etc) . anyways they piss everybody of so badly that their contract is almost never renewed, and they re always kicked. they will never take your side in any disagreement between the anesthesiologist and either the hospital admin, surgeons or crnas. please people you guys will save yourself some trouble by calling their hospitals where they have the contract talking to some of the anesthesiologists, you will get a clear picture how miserable all of their workers are. whatever you do do not blindly sign with these people they will screw your career up.

 

[sevoflurane]

For all new grads do not ever be suckered into working for anesthetix, this is the worse job you can get. i have seen them ruin 2 hospitals anesthesia departments and their recruiters are snakes oilmen. this is perhaps the most incompetent, unjust, management company around and they re MO is always the same. they sucker a hospital with a great presentation into how inefficient they re current setup is and than sucker the hospital into giving them the contract. they're next step is always to advertise a job for 350k to 400k with 12 wks of vacation(which u will never get because they're reputation is so bad that no body wants to work for them and usually they only can get new grads or other providers with serious promblems on their resumes(drug users, bad records, etc) . anyways they piss everybody of so badly that their contract is almost never renewed, and they re always kicked. they will never take your side in any disagreement between the anesthesiologist and either the hospital admin, surgeons or crnas. please people you guys will save yourself some trouble by calling their hospitals where they have the contract talking to some of the anesthesiologists, you will get a clear picture how miserable all of their workers are. whatever you do do not blindly sign with these people they will screw your career up.

 

[USAnesthesiaDoc]

Does anyone know if Sheridan has the same bad kind of reputation that Anesthetix has?

 

[IN2B8R]

Does anyone know if Sheridan has the same bad kind of reputation that Anesthetix has?

Yes.

 

[foxtrot]

Does anyone know if Sheridan has the same bad kind of reputation that Anesthetix has?

Double Yes

 

[fakin' the funk]

For all new grads do not ever be suckered into working for anesthetix, this is the worse job you can get. i have seen them ruin 2 hospitals anesthesia departments and their recruiters are snakes oilmen.

Sounds slippery.

 

[AmericanMD]

What's so bad about being a hospital employee?

Ditto. What is so bad about being a hospital employee? I'm just an M3 trying to figure things out.

 

[IlDestriero]

Ditto. What is so bad about being a hospital employee? I'm just an M3 trying to figure things out.

A hospital employee will be at the mercy of their hospital administration employer. Limited/no opportunity for negotiating with the hospital for hours/workload/compensation, fixed salary, etc. That's a bad arrangement. Anything you make over your salary goes to the hospital. Even if there is an incentive compensation component, they're still making money on your back.
You can substitute anesthesia management company for hospital above, it's the same, but worse because your boss isn't even part of the system. If they lose your hospital/ASC, they don't care, they have 50 more. They also don't care if you have to relocate to some other managed hospital when you're fired suddenly.
In private practice your group keeps all the money made and they distribute the excess to the partners. Some are not partner track, ie employees of the practice, but they usually get some other benefit over partner track people, like making more money, no call, etc. There are a lot of different arrangements for PP compensation, but the point is you keep your earnings.
Traditional academic practices have faculty employees with a "dean's tax" paid back to the medical school. Any profits will not normally be paid back to you as a bonus. I've been in this arrangement as well, it's not the best. You bust your hump for a pat on the back and a thumbs up at the end of the year. Some academic practices have incentive compensation strategies, but I don't get the impression that it is the norm. Some also pay for extra time or days worked, very variable as well.
I'm in a hybrid private-academic practice. It's an unusual arrangement, but it works, and is, IMHO, fair, though my work is supporting the salaries of researchers and over paid managers.
A fair and equal PP is the best arrangement. Hospital employee is really only a little better than AMC stooge.
One PP caveat is that while you are "buying into" your partnership, and the partners are splitting your 1-200k+/ yr earnings over your salary, the group may be falling apart, losing hospital subsidies, about to be taken over, etc. 2-3 years down the line they might be selling out or being forced out. No pot of gold at the end of the rainbow for you.
What is my father in law's PP radiology practice worth after 20 years of high quality service to a profitable hospital? What should the buy in to partnership be to earn a share of his stable long term practice. Answer... Nothing. The groups contract was not renewed. A few upstarts came in and they're outsourcing to India. It happens. Maybe he should have thought of that instead of hiring a couple new guys. They tried to make them hospital employees as well, but they didn't have their act together to make it happen. The new group may be on borrowed time as well.

 

[ProRealDoc]

A hospital employee will be at the mercy of their hospital administration employer. Limited/no opportunity for negotiating with the hospital for hours/workload/compensation, fixed salary, etc. That's a bad arrangement. Anything you make over your salary goes to the hospital. Even if there is an incentive compensation component, they're still making money on your back.
You can substitute anesthesia management company for hospital above, it's the same, but worse because your boss isn't even part of the system. If they lose your hospital/ASC, they don't care, they have 50 more. They also don't care if you have to relocate to some other managed hospital when you're fired suddenly.
In private practice your group keeps all the money made and they distribute the excess to the partners. Some are not partner track, ie employees of the practice, but they usually get some other benefit over partner track people, like making more money, no call, etc. There are a lot of different arrangements for PP compensation, but the point is you keep your earnings.
Traditional academic practices have faculty employees with a "dean's tax" paid back to the medical school. Any profits will not normally be paid back to you as a bonus. I've been in this arrangement as well, it's not the best. You bust your hump for a pat on the back and a thumbs up at the end of the year. Some academic practices have incentive compensation strategies, but I don't get the impression that it is the norm. Some also pay for extra time or days worked, very variable as well.
I'm in a hybrid private-academic practice. It's an unusual arrangement, but it works, and is, IMHO, fair, though my work is supporting the salaries of researchers and over paid managers.
A fair and equal PP is the best arrangement. Hospital employee is really only a little better than AMC stooge.
One PP caveat is that while you are "buying into" your partnership, and the partners are splitting your 1-200k+/ yr earnings over your salary, the group may be falling apart, losing hospital subsidies, about to be taken over, etc. 2-3 years down the line they might be selling out or being forced out. No pot of gold at the end of the rainbow for you.
What is my father in law's PP radiology practice worth after 20 years of high quality service to a profitable hospital? What should the buy in to partnership be to earn a share of his stable long term practice. Answer... Nothing. The groups contract was not renewed. A few upstarts came in and they're outsourcing to India. It happens. Maybe he should have thought of that instead of hiring a couple new guys. They tried to make them hospital employees as well, but they didn't have their act together to make it happen. The new group may be on borrowed time as well.

My perspective on this job issue was that there are many ways to go and it all depends on what you want. Like Ildestriero explained, you can work for an AMC, be a hospital employee, go into PP, etc.

I'll be honest and say my #1 priority was to maximize earnings in my first five years as an attending. I want to be debt free in two years time and build that FU account quickly. This was important for me because I am concerned about how healthcare reform will affect everyone's salaries.

I looked at partnership track jobs, employed positions, academic positions, etc. While they all had their pluses and minuses, I went with a hospital employee position.

So why an employed position for me? Because it takes time to become partner and time is short before healthcare reform kicks in. Once 2014 rolls around, there will be plenty of uncertainty and salaries may actually decrease.

The partnership salaries (2-yr track) quoted to me during many interviews (low -to-mid 400s), were the same or less than what I will be making as an employee. So why wait 2-3 years to make that partner salary when I can make it from day one? You can argue about the benefits of being your own boss, more control over your time, etc. and this will depend on what you want out of your career.

In the end, I realized that I would have been bitter going to work for a group, taking a lower salary and finding out that there was no pot of gold at the end for whatever reason. If things don't work out at my new job after a few years, then I will walk away knowing that I put myself in good financial footing.

Since I have board certification and fellowship training, I should be able to find my way back to academia should the private sector jobs dry up. For now however, it's time to make hay while the sun shines.

While an employee, I am planning to pursue either an MBA or Masters in Healthcare administration and become involved at an administrative level. I've always felt that we need to be part of the decision-making process in a hospital in order to protect ourselves and our friends in this competitive game.

 

[sevoflurane]

Great point of view and very smart.

The last option is to get into PP as self employed/1099. Eat what you kill. In the right location, it can give you competitive PP wages without partnership/buy in. Certain set ups will give you the flexibility to work hard and put a few extra coins in the piggy bank OR have a better lifestyle for family and fun.

Payer mix is important no matter where you go.

 

[Apollyon]

The Anesthetix/Sheridan thing about proffering the same thing time and again, just going to another area after being run out of town on a rail for being snake oil salesmen (which is not unique to anesthesia - we've seen EmCare do the same with EM), makes me think of Sparky Pilastri in the classic, vaunted, cherished piece of cinematica entitled "Bring It On". All I can say is "Those aren't spirit fingers - These Are Spirit Fingers!"

 

[AmericanMD]

A hospital employee will be at the mercy of their hospital administration employer. Limited/no opportunity for negotiating with the hospital for hours/workload/compensation, fixed salary, etc. That's a bad arrangement. Anything you make over your salary goes to the hospital. Even if there is an incentive compensation component, they're still making money on your back.
You can substitute anesthesia management company for hospital above, it's the same, but worse because your boss isn't even part of the system. If they lose your hospital/ASC, they don't care, they have 50 more. They also don't care if you have to relocate to some other managed hospital when you're fired suddenly.
In private practice your group keeps all the money made and they distribute the excess to the partners. Some are not partner track, ie employees of the practice, but they usually get some other benefit over partner track people, like making more money, no call, etc. There are a lot of different arrangements for PP compensation, but the point is you keep your earnings.
Traditional academic practices have faculty employees with a "dean's tax" paid back to the medical school. Any profits will not normally be paid back to you as a bonus. I've been in this arrangement as well, it's not the best. You bust your hump for a pat on the back and a thumbs up at the end of the year. Some academic practices have incentive compensation strategies, but I don't get the impression that it is the norm. Some also pay for extra time or days worked, very variable as well.
I'm in a hybrid private-academic practice. It's an unusual arrangement, but it works, and is, IMHO, fair, though my work is supporting the salaries of researchers and over paid managers.
A fair and equal PP is the best arrangement. Hospital employee is really only a little better than AMC stooge.
One PP caveat is that while you are "buying into" your partnership, and the partners are splitting your 1-200k+/ yr earnings over your salary, the group may be falling apart, losing hospital subsidies, about to be taken over, etc. 2-3 years down the line they might be selling out or being forced out. No pot of gold at the end of the rainbow for you.
What is my father in law's PP radiology practice worth after 20 years of high quality service to a profitable hospital? What should the buy in to partnership be to earn a share of his stable long term practice. Answer... Nothing. The groups contract was not renewed. A few upstarts came in and they're outsourcing to India. It happens. Maybe he should have thought of that instead of hiring a couple new guys. They tried to make them hospital employees as well, but they didn't have their act together to make it happen. The new group may be on borrowed time as well.

Thanks. That was helpful.

 

[gandhi]

dealing with a job with anesthetix, people always leave with in less than a year, they never show how much you make, they prey on new grads, they never help you in conflicts with surgeon or adm, they are run by bunch or ******ed high schools grads and one nanny in florida, technically/functionally they are bunch of losers who are money driven and they think we new grads are desperate ,they make money out of you and you dont even know till it is late, they have made millions from your ignorance and visa issues, poor FMG are the biggest game for them , unethical, who regulates these GUYS , theres got to be some authority, they beg you take the job once you do they leave you to wolfs and dont care how you deal with sick high school administrators and dont help you in your professional growth, they are sharks, with thirst for money


very good thread

http://forums.studentdoctor.net/showthread.php?t=826578

 

[Apollyon]

So, I go on a tour of a new hospital where I shall be going to work. I'm out at lunch with the recruiter and a handler from the group I am joining (hot!) - I'm EM, so they showed me the whole hospital.

Well, at lunch, my back is to the door (Wild Bill Hickok notwithstanding). The recruiter sees someone and smiles and waves someone over. Have you ever thought you saw a ghost?

This guy walks up, and I look, and am aghast. I recognize this guy immediately - and I haven't seen him in 14 years.

When we were in med school, there were several guys with the same name, so we had to differentiate. Say the name was "Bill" - there was "old Bill" and "Bill with the beautiful wife". This guy was "crazy Bill" - seriously.

After med school, a guy I knew was a resident with him. He said - back then - that this guy was doing all sorts of "not kosher" stuff, and it was only a matter of time until he got caught.

So, I look to my left - and there he is. He didn't remember me at first. We had been suitemates. This guy was the best suitemate, if, by best, you mean "stealing food, screwing up the air conditioning (freezing the condenser), getting drunk A LOT, disrupting other people studying, lying all the time, and bringing your equally degenerate friends over".

He then took off. His current wife was antithetical to his first wife (whom he divorced in med school), except she, like the first, wasn't fat.

The recruiter then said how Anesthetix came on board, and he with them, and I thought that he was emblematic of that company.

 

[UTSouthwestern]

So, I go on a tour of a new hospital where I shall be going to work. I'm out at lunch with the recruiter and a handler from the group I am joining (hot!) - I'm EM, so they showed me the whole hospital.

Well, at lunch, my back is to the door (Wild Bill Hickok notwithstanding). The recruiter sees someone and smiles and waves someone over. Have you ever thought you saw a ghost?

This guy walks up, and I look, and am aghast. I recognize this guy immediately - and I haven't seen him in 14 years.

When we were in med school, there were several guys with the same name, so we had to differentiate. Say the name was "Bill" - there was "old Bill" and "Bill with the beautiful wife". This guy was "crazy Bill" - seriously.

After med school, a guy I knew was a resident with him. He said - back then - that this guy was doing all sorts of "not kosher" stuff, and it was only a matter of time until he got caught.

So, I look to my left - and there he is. He didn't remember me at first. We had been suitemates. This guy was the best suitemate, if, by best, you mean "stealing food, screwing up the air conditioning (freezing the condenser), getting drunk A LOT, disrupting other people studying, lying all the time, and bringing your equally degenerate friends over".

He then took off. His current wife was antithetical to his first wife (whom he divorced in med school), except she, like the first, wasn't fat.

The recruiter then said how Anesthetix came on board, and he with them, and I thought that he was emblematic of that company.

One of my former partners started an AMC and while he started it out with actually good intentions and to do it the "right way," the greed finally caught up with him. Now he's looking to sell and retire but to get to this point, how may people did he have to screw and was it worth it all for the few million extra dollars padding his bank account? His own business person attended a meeting of mine on a deal and told me he couldn't wait to quit once all of contract stipulations had been met.

Again, I have a perspective that is certainly affected by my health status, but I can truthfully say that if I die today, tomorrow, next year, or not for another 10 years, I am happy to go my grave knowing I have never knowingly screwed anyone, stabbed someone in the back intentionally, and have given my best to make the world around me a better place to live in and the people in it a chance to do the same.

Look at each situation you may possibly get involved with as objectively as possible and NEVER COMPROMISE YOUR PRINCIPLES. Once you do, you slide down that slippery pathway with little if any chance to change course.

 

[UTSouthwestern]

Oh and for John Q. Public that might be perusing this BBS: Welcome to health care government style. You don't get to choose, you don't get necessarily the best, you get what's cheapest. Think about who is now your provider because you may not get the chance to do so afterward with Crazy Bill taking care of you.

 

[Mac4]

You just have to look out for yourself. Yes, no sane person would join Anesthesiatix/anthem/somnia or whatever. However, it is not like some PP would screw you less.

 

[deleted126335]

The profession is in the process of being broken. The same way that perfusionists were broken in the 80s-90s. At that time many had their own corporations (private perfusion groups) that contracted with hospitals and surgeons for their professional services. What followed was hospitals employing them as well as big corporations- Psicor/Baxter. Also the market became flooded with training programs. They are virtually now all employed and their inflation adjusted income doesn't come close to what they were making 20-30 years ago. Does this sound familiar? Options are going down. No sight of this trend reversing anytime soon.

 

[Monty Python]

Does anyone know anything or anyone who has ever worked for anesthetix? I know they are an anesthesia and pain amc. Not as large as Sheridan or NAPA. Any input would be appreciated.

This is one thing I'm glad I don't have to put up with by working at a military hospital, employed by Uncle Sam.

Is my employment setting perfect, all things considered? Of course not.

Does my employer have ugly warts and moles? Of course. What employer doesn't?

But ... we are there for the patient, not for turning a profit, not for quarterly dividend payments to stockholders living several states away. And everyone is straight salary.

My setting is not for everyone. But if you like diversity, moving (yes, you will), serving your country, taking care of the best patients in the world, and not answering to stockholders then consider the military. It's far from perfect but still has a lot to offer, at least IMHO. And you don't need to worry about Sheridan/Anthem-like treatment.

 

[KungPOWChicken]

This is one thing I'm glad I don't have to put up with by working at a military hospital, employed by Uncle Sam.

Is my employment setting perfect, all things considered? Of course not.

Does my employer have ugly warts and moles? Of course. What employer doesn't?

But ... we are there for the patient, not for turning a profit, not for quarterly dividend payments to stockholders living several states away. And everyone is straight salary.

My setting is not for everyone. But if you like diversity, moving (yes, you will), serving your country, taking care of the best patients in the world, and not answering to stockholders then consider the military. It's far from perfect but still has a lot to offer, at least IMHO. And you don't need to worry about Sheridan/Anthem-like treatment.

Ha Ha are you a recruiter? You forgot to mention the huge pay cut 50%+, the endless amount of bull**** adm. stuff, all the uniform crap you get to buy and pay for yourself, the bull**** bonus paperwork you have to fill out and the constant delays and screw ups in getting paid. You are hardly salaried. The clueless administrative support staff. I could write a book on the crap that I had to deal with on deployment. I would take an anesthetix job in a heartbeat compared to the military. At least you aren't a slave and can resign without being thrown in prison. The absolute worst part of the military is the surgeons are terrible and downright dangerous. I had a surgeon spending an hour trying to get in the abdomen for a lap chole. She kept saying I've never seen adhesions this bad. Are you kidding you're still not in. I had to tell her that she wasn't in and her patient had crepitus. WTF. The only good surgeons where I work are trained outside the military

 

[dhb]

And you don't need to worry about Sheridan/Anthem-like treatment.

YET...

Isn't uncle sam hiring private contractors to fight wars / ensure "security" in Ascrackingstan & Irak?

 

[x26bac]

Again, I have a perspective that is certainly affected by my health status, but I can truthfully say that if I die today, tomorrow, next year, or not for another 10 years, I am happy to go my grave knowing I have never knowingly screwed anyone, stabbed someone in the back intentionally, and have given my best to make the world around me a better place to live in and the people in it a chance to do the same.
.

Right on! i agree 100 percent!


People (in business and certainly in medicine) that if you win I lose. That is NOT the case. If you win SO DO I. thats the mentality to have.

This forum is a cesspool of everything that is wrong with this profession and specialty. Look at all the stupid bickering about stuff that absolutely DONT MATTER. Its idiotic and embarassing.

 

[Monty Python]

Ha Ha are you a recruiter? You forgot to mention the huge pay cut 50%+, the endless amount of bull**** adm. stuff, all the uniform crap you get to buy and pay for yourself, the bull**** bonus paperwork you have to fill out and the constant delays and screw ups in getting paid. You are hardly salaried. The clueless administrative support staff. I could write a book on the crap that I had to deal with on deployment. I would take an anesthetix job in a heartbeat compared to the military. At least you aren't a slave and can resign without being thrown in prison. The absolute worst part of the military is the surgeons are terrible and downright dangerous. I had a surgeon spending an hour trying to get in the abdomen for a lap chole. She kept saying I've never seen adhesions this bad. Are you kidding you're still not in. I had to tell her that she wasn't in and her patient had crepitus. WTF. The only good surgeons where I work are trained outside the military

No, I'm not a recruiter. And as stated in my previous post the military is certainly not problem-free nor irritant-free. It is what it is, warts, moles, and all. I focus on treating the best, most-deserving patients in the world in a practice environment where profit is a non-issue. Yes, the environment has it's fair share of crap, as do most other types of work settings elsewhere to one degree or another. I just personally think the formula of [military positives minus military negatives] > [civilian positives minus civilian negatives]. Your mileage may vary.

 

[foxtrot]

One of my former partners started an AMC and while he started it out with actually good intentions and to do it the "right way," the greed finally caught up with him. Now he's looking to sell and retire but to get to this point, how may people did he have to screw and was it worth it all for the few million extra dollars padding his bank account? His own business person attended a meeting of mine on a deal and told me he couldn't wait to quit once all of contract stipulations had been met.

Again, I have a perspective that is certainly affected by my health status, but I can truthfully say that if I die today, tomorrow, next year, or not for another 10 years, I am happy to go my grave knowing I have never knowingly screwed anyone, stabbed someone in the back intentionally, and have given my best to make the world around me a better place to live in and the people in it a chance to do the same.

Look at each situation you may possibly get involved with as objectively as possible and NEVER COMPROMISE YOUR PRINCIPLES. Once you do, you slide down that slippery pathway with little if any chance to change course.

I completely agree with you. It is too bad that money has become the number one priority in most people's lives. I value honesty, hard work, fairness and ethics. It is becoming harder and harder to find a place to work that values these same principles, which is a shame. But I refuse to give up. There have to be a few others out there who still care about these things (just have to find them).

Good to hear from you UT.

 

[pgg]

Ha Ha are you a recruiter? You forgot to mention the huge pay cut 50%+, the endless amount of bull**** adm. stuff, all the uniform crap you get to buy and pay for yourself, the bull**** bonus paperwork you have to fill out and the constant delays and screw ups in getting paid. You are hardly salaried. The clueless administrative support staff. I could write a book on the crap that I had to deal with on deployment. I would take an anesthetix job in a heartbeat compared to the military. At least you aren't a slave and can resign without being thrown in prison. The absolute worst part of the military is the surgeons are terrible and downright dangerous. I had a surgeon spending an hour trying to get in the abdomen for a lap chole. She kept saying I've never seen adhesions this bad. Are you kidding you're still not in. I had to tell her that she wasn't in and her patient had crepitus. WTF. The only good surgeons where I work are trained outside the military

It wasn't too long ago that I had an app on my iPhone counting down the days until I could get out. When I went below 1000 days I felt like a milestone had been passed. But ...

The civilian hospital where I moonlight has totally gone bonkers with CMS. I don't even know where to begin griping about it, but the Navy joint is a far better work environment now. I never thought I'd see the day when the .mil bureaucracy was preferable to a supposedly "sane" doctor-oriented doctor-run hospital. But CMS with their beard nets and paper long sleeves and mandatory 10 minute "sit wet times" when cleaning ORs between cases are ruining it. And this is just a taste of what's coming with more government influence in healthcare. To an extent, the .mil is paradoxically immune to that.

The pay gap is also narrowing. $250-270K with solid benefits and a government pension, a healthy and deserving patient population, the best (by far) malpractice environment ... You can do a lot better $-wise in PP, but you'll also work a lot harder for it. With the small amount of moonlighting on the side I do, my total income last year was comparable to many entry level academic jobs. If I sign the line to stay in until retirement eligibility, I'll wind up with a reasonably competitive income, given the hours involved.

As for the grass being greener re: quality of care ... at times I've been surprised by what goes on out in BFE. This morning at 4:30 I got called to take an ICU patient back to the OR. Among the issues were a hefty Levophed infusion treating a kinked a-line (NIBP 180/100 ... HR was 120), and NS being poured into a patient with a chloride of 119. Par for the course out here in .civ paradise.

The young physicians in the .mil are generally solid. There are a few O6 types who are hiding from the real world that you have to watch out for. I'll take them over the civilian FMGs who speak broken english, unless the S is H'ing TF and they revert to their native tongues to swear or pray.

Deployments suck. Skill rot can be a problem. The military invented the independent CRNA. There are problems with working in the military.



tldr version - In the last few years I've been watching the civilian side of medicine go straight to hell in a handbasket. The good anesthesia jobs are getting scarcer, and there's no reason to think that trend will reverse. AMCs are winning contracts left and right. Medicare is in trouble. Healthcare reform is a slow motion train wreck. Getting out at my first opportunity isn't the no-brainer decision it used to be.

 

[pgg]

I just personally think the formula of [military positives minus military negatives] > [civilian positives minus civilian negatives].

The balance has tipped a lot in the last few years. The get-out choice isn't so obvious any more, at least for those of us who had more than the typical 4-year HPSP service debt.

 

[aneftp]

It's a business world. Business wants to maximize profits while W2 want to do as little work as possible.

Private practice groups screw young grads all the time. My sister was in 5 year partnership track. They basically screwed her over $1 million over that time as the "buy in".

Did the same to guy who started a pain practice for them. He ended committing suicide a couple years later.

It's just a cut throat world.

Hospital employee sometimes has excellent benefits. Don't know what the family demographics here. But being self employed and a family of 4. Health care costs are soaring. You pay for your own disability and malpractice (I pay occurrence). These "benefits" a hospital can offer u can add up to close to $50k when it's all added up.

Private practice eat what u kill. Depends on what u are killing. Many peeps I know we're easily making mid $550s up till a couple years ago. No benefits. Thats ok when u are making that much.

Now payer mix changes. They are making in mid 300s still working 60 hours no benefits. You end up waiting 2 hours for next eat what you kill case not making any money. That guaranteed $325k with benefits starts looking better and better.

There is no easy answer. I agree with the OP. Some AMCs you need to know what you are getting yourself into. If you don't like what they are offering try to get them to put you on a 1099 cause their W2 benefits are usually no where as good as a full hospital employee position. Hospital based usually has excellent health for you and family as well as occurrence malpractice. AMCs (outside of Sheridan) do not offer occurrence and your tail could run 10-30k when it's all said and done. Sheridan is self insured so their malpractice is actually good compared to others.

But if you get into bed with these amc, it's usually better to negotiate a 1099 so u get more tax write offs since their benefits are no good. At least it makes it more bare able.

 

[cincincyreds]

So which AMC is worse, NAPA or Sheridon? People ask me this all the time and I really don't have any idea.

 

[nycitygas]

So which AMC is worse, NAPA or Sheridon? People ask me this all the time and I really don't have any idea.

I've heard NAPA outside of new york city (Erie, Poconos) can you give a good deal. In the city, beggars can't be choosers. I don't think they even offer partnership to anybody anymore.

Sheridan is big in the south east it looks like? I've never heard of it in my area.

 

[nycitygas]

It's a business world. Business wants to maximize profits while W2 want to do as little work as possible.

Private practice groups screw young grads all the time. My sister was in 5 year partnership track. They basically screwed her over $1 million over that time as the "buy in".

Did the same to guy who started a pain practice for them. He ended committing suicide a couple years later.

It's just a cut throat world.

Hospital employee sometimes has excellent benefits. Don't know what the family demographics here. But being self employed and a family of 4. Health care costs are soaring. You pay for your own disability and malpractice (I pay occurrence). These "benefits" a hospital can offer u can add up to close to $50k when it's all added up.

Private practice eat what u kill. Depends on what u are killing. Many peeps I know we're easily making mid $550s up till a couple years ago. No benefits. Thats ok when u are making that much.

Now payer mix changes. They are making in mid 300s still working 60 hours no benefits. You end up waiting 2 hours for next eat what you kill case not making any money. That guaranteed $325k with benefits starts looking better and better.

There is no easy answer. I agree with the OP. Some AMCs you need to know what you are getting yourself into. If you don't like what they are offering try to get them to put you on a 1099 cause their W2 benefits are usually no where as good as a full hospital employee position. Hospital based usually has excellent health for you and family as well as occurrence malpractice. AMCs (outside of Sheridan) do not offer occurrence and your tail could run 10-30k when it's all said and done. Sheridan is self insured so their malpractice is actually good compared to others.

But if you get into bed with these amc, it's usually better to negotiate a 1099 so u get more tax write offs since their benefits are no good. At least it makes it more bare able.

Did your sister put in 5 years and not get partnership? Ouch.

 

[deleted126335]

It's a business world. Business wants to maximize profits while W2 want to do as little work as possible.

Private practice groups screw young grads all the time. My sister was in 5 year partnership track. They basically screwed her over $1 million over that time as the "buy in".

Did the same to guy who started a pain practice for them. He ended committing suicide a couple years later.

It's just a cut throat world.

Hospital employee sometimes has excellent benefits. Don't know what the family demographics here. But being self employed and a family of 4. Health care costs are soaring. You pay for your own disability and malpractice (I pay occurrence). These "benefits" a hospital can offer u can add up to close to $50k when it's all added up.

Private practice eat what u kill. Depends on what u are killing. Many peeps I know we're easily making mid $550s up till a couple years ago. No benefits. Thats ok when u are making that much.

Now payer mix changes. They are making in mid 300s still working 60 hours no benefits. You end up waiting 2 hours for next eat what you kill case not making any money. That guaranteed $325k with benefits starts looking better and better.

There is no easy answer. I agree with the OP. Some AMCs you need to know what you are getting yourself into. If you don't like what they are offering try to get them to put you on a 1099 cause their W2 benefits are usually no where as good as a full hospital employee position. Hospital based usually has excellent health for you and family as well as occurrence malpractice. AMCs (outside of Sheridan) do not offer occurrence and your tail could run 10-30k when it's all said and done. Sheridan is self insured so their malpractice is actually good compared to others.

But if you get into bed with these amc, it's usually better to negotiate a 1099 so u get more tax write offs since their benefits are no good. At least it makes it more bare able.

Accurate post.

Is it even possible to negotiate 1099 or anythig above standard offer with AMCs?

 

[deleted126335]

Did your sister put in 5 years and not get partnership? Ouch.

Not uncommon. It is incredible the behavior that people can rationalize.

 

[Metalblade]

Foxtrot, in response to your original question, I know someone who worked for Anesthetix. From what I remember, they promised an yearly bonus and never paid it. He along with one or two colleagues resigned. Not only did they not get their bonus which they were due by contract, but Anesthetix tried to get out of paying their last months salary, citing some sort of breach of contract or something, although they had violated the contract first. Eventually enough people left that they had to hire a large number of locums and basically run a transitory anesthesia department. There was a lot of political upheaval and eventually they lost the contract.