Another AMG question ?

[Cookie]

Hello all, need your help making a decision. I am considering joining a group that sold to an AMG 2-3 years ago (it was a solid private group, no subsidy, good payer mix). Some of the old partners are planning to cut down or retire over the next couple of years. Currently, the AMG is offering a good salary/vacation package but my concern is that the package will change once the old partners retire (less salary, less vacation , or just not replacing retiring partners)!
How common is it for an AMG to change their agreement with the group after the 5 year mandatory period that's part of the buy-out ?
your help is greatly appreciated!

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[GassYous]

I am partial to the glc43

But if you're not at the table you're on the menu

 

[Cookie]

Sorry meant AMC not AMG!

 

[Peterluger]

Mercedes is a soccer mom and old man grandpa car. Get a BMW

 

[Guillemot]

Hello all, need your help making a decision. I am considering joining a group that sold to an AMG 2-3 years ago (it was a solid private group, no subsidy, good payer mix). Some of the old partners are planning to cut down or retire over the next couple of years. Currently, the AMG is offering a good salary/vacation package but my concern is that the package will change once the old partners retire (less salary, less vacation , or just not replacing retiring partners)!
How common is it for an AMG to change their agreement with the group after the 5 year mandatory period that's part of the buy-out ?
your help is greatly appreciated!

Don't buy a house if you join.

 

[deleted126335]

First contract is always the best.

 

[IMGASMD]

If I was a betting man? I’d bet that it will change for the better, for the AMC.

There are few members here who have advocated for AMCs. There is even a job in FL that was posted recently.... in the club house, that generated some good discussion.

I agree though, if you’re not at the table, whatever they’re selling, all stinks.

There are groups out there will have an “executive board”. Don’t let that shhht fool you. If corporate tell them to jump, they just ask how high. You answer to your corporate lord. They’d rather pay the locum than deal with your grievances.

They’re after all, doing their jobs, which is making corporate money. If you can make peace with that, sure.

 

[dannyboy1]

It’s a job. See what they are offering. Get the calls and hours IN WRITING and the compensation + Overtime rate.

 

[Endee]

How common is it for an AMG to change their agreement with the group after the 5 year mandatory period that's part of the buy-out ?
your help is greatly appreciated!

If it’s Envision I’m pretty sure it always happens.

 

[Beach bum]

The contracts I have seen with AMC are incredibly one sided. That, and the fact that your first contract/conditions are always the best kind of says it all doesn’t it?

 

[Hoya11]

Hello all, need your help making a decision. I am considering joining a group that sold to an AMG 2-3 years ago (it was a solid private group, no subsidy, good payer mix). Some of the old partners are planning to cut down or retire over the next couple of years. Currently, the AMG is offering a good salary/vacation package but my concern is that the package will change once the old partners retire (less salary, less vacation , or just not replacing retiring partners)!
How common is it for an AMG to change their agreement with the group after the 5 year mandatory period that's part of the buy-out ?
your help is greatly appreciated!

Well part of the 5 year mandatory period is to maintain staff while recruiting new people...

The old partners have had a buy out. The AMC makes the 5 year mandatory period mandatory, because the salary and vacation and hours for the old partners who got the buyout, now is significantly reduced from their sweet situation before the sale - and they want them to stay to earn a little bit of the buyout back and to re-staff.

The package has to be around whatever your local market is - or else they couldn't staff the ORs..

Are there other AMCs in your area? What do they pay?

Does this AMC have other hospitals in your area? What do they pay at those sites?

If you like the group or location - give it a try. You can always leave if they make changes. Just don't buy a house.

I mean, every AMC has generally the same package IMO - 350-425k with 6-8weeks weeks vacation.. I would be expecting that

 

[MirrorTodd]

Mercedes is a soccer mom and old man grandpa car. Get a BMW

Dude no way, everyone and their momma has a BMW nowadays and they all don't know how to use a blinker.

 

[fittipaldi1of1]

Well part of the 5 year mandatory period is to maintain staff while recruiting new people...

The old partners have had a buy out. The AMC makes the 5 year mandatory period mandatory, because the salary and vacation and hours for the old partners who got the buyout, now is significantly reduced from their sweet situation before the sale - and they want them to stay to earn a little bit of the buyout back and to re-staff.

The package has to be around whatever your local market is - or else they couldn't staff the ORs..

Are there other AMCs in your area? What do they pay?

Does this AMC have other hospitals in your area? What do they pay at those sites?

If you like the group or location - give it a try. You can always leave if they make changes. Just don't buy a house.

I mean, every AMC has generally the same package IMO - 350-425k with 6-8weeks weeks vacation.. I would be expecting that

You can’t easily leave once you accept the bonuses from the AMC. They give you a relocation stipend and start date bonus that has a retention bonus of 2 years with tax and interest due to them if you leave before the 2 years.

 

[IMGASMD]

You can’t easily leave once you accept the bonuses from the AMC. They give you a relocation stipend and start date bonus that has a retention bonus of 2 years with tax and interest due to them if you leave before the 2 years.

Tax goes to the government....

Like other said before me, if that’s one of your concerns, don’t spend that money, and save up to pay the money back.

Or you try to ask for that money as a retention bonus and pay at end of the year, or ask to spread that money out throughout the year rather than take it as a lump sum.

I agree all the contracts/tactics are the same with the AMCs. Don’t get me started on how they value their crnas more than physicians.

If you treated it like just a job, and you’re just an employee, it will be fine.

 

[IlDestriero]

Mercedes is a soccer mom and old man grandpa car. Get a BMW

Soccer moms all drive BMWs. And Lexi.
And they certainly don’t drive this

 

[aneftp]

With friendly sellout. All AMCs negotiation different set of rules for the selling partners.

some formers partners get preferred calls vacations FOREVER as part of the buyout.
Ask about the equity of the work distribution.

I’ve seen practices that sold out to one of the big AMCs. The partners basically take Monday-Thursday calls (starting at 5pm).

the amc allows the former partners to run the practice without meddling. The new docs end up taking the 24 hour weekend calls more.

as for what happens in 3-5 years. We don’t know. If it’s reasonable offer and market rate. Consider it. If not. Look elsewhere

 

[gasdoc77]

With friendly sellout. All AMCs negotiation different set of rules for the selling partners.

some formers partners get preferred calls vacations FOREVER as part of the buyout.
Ask about the equity of the work distribution.

I’ve seen practices that sold out to one of the big AMCs. The partners basically take Monday-Thursday calls (starting at 5pm).

the amc allows the former partners to run the practice without meddling. The new docs end up taking the 24 hour weekend calls more.

as for what happens in 3-5 years. We don’t know. If it’s reasonable offer and market rate. Consider it. If not. Look elsewhere

Adding to this, seriously consider how resentful you WILL be if the old partners have a favorable package or treatment. Whether or not your offer seems fair, there is no way that dynamic is sustainable. Maybe not tomorrow, or the next day, but it will eat at you and really affect you in time.

 

[IMGASMD]

Adding to this, seriously consider how resentful you WILL be if the old partners have a favorable package or treatment. Whether or not your offer seems fair, there is no way that dynamic is sustainable. Maybe not tomorrow, or the next day, but it will eat at you and really affect you in time.

If we all suffer together then it’s okay. I remember a “study” years ago. Most people will accept being under paid if everyone all being under paid; however, it’s when we perceive someone is being treated more favorably, we get pissed.

 

[Cookie]

Thank you all. The group seems very fair. Everybody shares the call burden equally and takes the same number of weeks of vacation. They claim the pay is the same but there is no way for me to verify that.
The group was well run before they sold it and didn’t take any subsidy from the hospital. The salary the AMC is offering is competitive for the location and the vacation is what makes this job attractive( more than 10 weeks) .
Again, the concern is if all this can/will change once the 5 years are up and old partners retire !
If I learned one thing from SDN, it is that AMCs can’t be trusted!

 

[abolt18]

Thank you all. The group seems very fair. Everybody shares the call burden equally and takes the same number of weeks of vacation. They claim the pay is the same but there is no way for me to verify that.
The group was well run before they sold it and didn’t take any subsidy from the hospital. The salary the AMC is offering is competitive for the location and the vacation is what makes this job attractive( more than 10 weeks) .
Again, the concern is if all this can/will change once the 5 years are up and old partners retire !
If I learned one thing from SDN, it is that AMCs can’t be trusted!

Just don't expand too aggressively into your paycheck, don't buy too big of a house that's hard to sell, get a nice 6-month emergency fund so you can bounce if things change in a bad and intolerable way. Voilà !

 

[midazzoler]

The group was well run before they sold it and didn’t take any subsidy from the hospital.

They didn’t take a subsidy and sold to the AMC. I don’t like this group at all. Especially if they sold and didn’t have to. Sounds like you’re gonna have to make the best of the boomer leftovers. Good luck.

 

[Cookie]

I agree with you, my understanding is that they sold the practice because they wanted to cash out before they retired. I am just not sure about the future of AMCs, has anybody heard that HCA is taking over Anesthesia in 11 hospitals from Teamhealth in Clearwater/Tampa area, all will be HCA employees!

 

[chocomorsel]

I agree with you, my understanding is that they sold the practice because they wanted to cash out before they retired. I am just not sure about the future of AMCs, has anybody heard that HCA is taking over Anesthesia in 11 hospitals from Teamhealth in Clearwater/Tampa area, all will be HCA employees!

WTH is the difference? Team Health, HCA? They are all crap. Which crap tastes better, I don’t know as I have never tried it.

 

[IMGASMD]

WTH is the difference? Team Health, HCA? They are all crap. Which crap tastes better, I don’t know as I have never tried it.

They all operate the same, unfortunately. Also now Mednax is consolidated with NAPA. You don’t even have, ****ty competitions anymore. They all graduated from the same MBA schools, have no good way to make fat cats in c-suites fatter than “trim the fat” from “employees”.

@BLADEMDA did mention he likes usap a little better.... at least usap has a different model.

 

[deleted126335]

 

[Leinie]

I agree with you, my understanding is that they sold the practice because they wanted to cash out before they retired. I am just not sure about the future of AMCs, has anybody heard that HCA is taking over Anesthesia in 11 hospitals from Teamhealth in Clearwater/Tampa area, all will be HCA employees!

The HCA group is headed by the former TeamHealth regional director. While I'm sure there is an interesting story there, at the end of the day it's the same bad job as before.

 

[Drwine]

In the era of zero or near zero interest rates and minimal current avenue to make any investment income is limited, the investment bankers/hedge funds have found a new way to get income. I did enjoy some brief schadenfreude when KKR was ****ting their pants in the beginning of the pandemic and severe curtailment of elective surgeries because MBAs understand that any percentage of zero is still zero.

 

[IMGASMD]

In the era of zero or near zero interest rates and minimal current avenue to make any investment income is limited, the investment bankers/hedge funds have found a new way to get income. I did enjoy some brief schadenfreude when KKR was ****ting their pants in the beginning of the pandemic and severe curtailment of elective surgeries because MBAs understand that any percentage of zero is still zero.

They made their physicians take a pay cut and forced some PTOs? And their executives too?
From my perspective, doing nothing to earn millions.... now still earning hundreds of thousands, doing nothing. Is still too goddamn much.

 

[BLADEMDA]

They made their physicians take a pay cut and forced some PTOs? And their executives too?
From my perspective, doing nothing to earn millions.... now still earning hundreds of thousands, doing nothing. Is still too goddamn much.

Envision cut their employer 401K contribution by half. They also cut year end "bonuses" by a significant amount to some practices. The salaries paid by Envision were already on the low end but the executives didn't care and made more cuts.

 

[Drwine]

The Schadenfreude was short lived. Hedge fund managers and investment bankers made sure that **** flows downhill. Wall St. getting involved in health care whether running insurance companies, hospitals or AMCs is not a good thing. Sort of like business people going into politics and trying to run the city, state or country as they would their business. I should create a poll to see whether we think of them more like cancer or parasites??

 

[BLADEMDA]

I must emphasize that AMCs don't like to give raises. This means each year you get a cost of living CUT while others get a raise or COLA. Do the math on your "income" after 10 years without a raise vs a job that gives annual raises.

AMCs are a dead end for those that can't find a job anywhere else or are riding out the end of their careers. USAP is the sole exception because at least they cut you in on some of the pie.

 

[IMGASMD]

I must emphasize that AMCs don't like to give raises. This means each year you get a cost of living CUT while others get a raise or COLA. Do the math on your "income" after 10 years without a raise vs a job that gives annual raises.

AMCs are a dead end for those that can't find a job anywhere else or are riding out the end of their careers. USAP is the sole exception because at least they cut you in on some of the pie.

We are employees, yet not.
As opposed to crnas wants to be independent, yet want to punch clocks and get paid as employees.

 

[cthrowaway]

Regarding TeamHealth and Envision:

I understand that HCA has gone "in house" with all their anesthesia departments previously staffed by TeamHealth in Florida. I heard (but cannot confirm) that HCA's Florida hospitals with Envision are still Envision. But then I came across this ad:

Anesthesia Opportunity in Riverside, California job with HCA Healthcare - Far West/Mountain Division | 110177447

As a member of the Riverside Community Hospital Anesthesia Team, you will be part of a 13-physician anesthesia team.

careers.jamanetwork.com

It is also available on HCA's own jobs board. It sounds like HCA is bringing anesthesia departments in house, after all. Doing it at Riverside (in California) is interesting, for a couple of reasons.

California is one of two states where hospitals are forbidden from employing physicians directly. (The simple workaround is that every hospital has an attached foundation, which can employ physicians. Kaiser owns the hospitals; Permanente employs the physicians, for instance.)

Envision was only at Riverside for ~two years. They angered, essentially, all of their physicians, and had to turn it into a CRNA department. Now they are rumored to be employing residents, as they are looking for cheaper and cheaper anesthesia staffing solutions.


While it is easy to make fun of HCA and the troubles they are having--and it is absolutely delightful to watch TeamHealth and Envision squirm--it is concerning that the biggest hospital network seems to have so willingly gone through the charade of contracting with anesthesia management companies and believing their impossible promises, knowing that all the while after the AMCs failed, the hospitals could exert control over the physicians by employment.

I will leave to another thread what hospital employment means for the professionals and the profession.

But I would like to invite members from Florida to tell me their experiences, and correct me where I'm wrong.

 

[GassYous]

What did you decide op

 

[Cookie]

What did you decide op

I ended up not taking it, too much uncertainty!

 

[GassYous]

Smart cookie

 

[GravelRider]

I must emphasize that AMCs don't like to give raises. This means each year you get a cost of living CUT while others get a raise or COLA. Do the math on your "income" after 10 years without a raise vs a job that gives annual raises.

AMCs are a dead end for those that can't find a job anywhere else or are riding out the end of their careers. USAP is the sole exception because at least they cut you in on some of the pie.

I will preface this by saying that I am often negative about medicine and anesthesia in general, so to see me say something positive should be worth something. I also don’t necessarily endorse taking a job with an AMC…though it might be your best option in certain circumstances. However, the idea that AMCs don’t give raises is not necessarily true. I keep my eye on the job market through both Gaswork and word of mouth and salaries have definitely increased. When I was finishing residency about 5 years ago, I frequently encountered jobs paying $275-300k with 4-6 weeks vacation. Now a new grad can step into a job making $500k and 6-10 weeks of vacation with ease. Just glancing at Gaswork today and using a well-known anesthesia villain, I am seeing multiple NAPA jobs offering around $500k in the NYC metro region. Now obviously details matter, but that compensation was not the case a few years ago. Whether or not that is fair compensation is another discussion, but the point is, the base level for employed anesthesiologist jobs has increased a fairly significant amount in 5 years.

The point here is also that you should always know your worth and you can’t have the mindset that whatever contract you signed a few years ago is the compensation you are stuck with going forward. You also cannot wait for your employers to give you a raise. You have to reassess your compensation every few years and be ready to ask for adjustments when warranted (preferably as a collective). It is also why it is extremely important to never sign contracts with onerous non-compete clauses. Your ability to take the job down the road offering $100k more and an extra week of vacation is your best negotiation tool.

 

[GassYous]

I will preface this by saying that I am often negative about medicine and anesthesia in general, so to see me say something positive should be worth something. I also don’t necessarily endorse taking a job with an AMC…though it might be your best option in certain circumstances. However, the idea that AMCs don’t give raises is not necessarily true. I keep my eye on the job market through both Gaswork and word of mouth and salaries have definitely increased. When I was finishing residency about 5 years ago, I frequently encountered jobs paying $275-300k with 4-6 weeks vacation. Now a new grad can step into a job making $500k and 6-10 weeks of vacation with ease. Just glancing at Gaswork today and using a well-known anesthesia villain, I am seeing multiple NAPA jobs offering around $500k in the NYC metro region. Now obviously details matter, but that compensation was not the case a few years ago. Whether or not that is fair compensation is another discussion, but the point is, the base level for employed anesthesiologist jobs has increased a fairly significant amount in 5 years.

The point here is also that you should always know your worth and you can’t have the mindset that whatever contract you signed a few years ago is the compensation you are stuck with going forward. You also cannot wait for your employers to give you a raise. You have to reassess your compensation every few years and be ready to ask for adjustments when warranted (preferably as a collective). It is also why it is extremely important to never sign contracts with onerous non-compete clauses. Your ability to take the job down the road offering $100k more and an extra week of vacation is your best negotiation tool.

A lot of that has to do with napa fighting for survival against northwell. But I agree that packages are much better than they were just a few years ago.

 

[narcotics999]

I will preface this by saying that I am often negative about medicine and anesthesia in general, so to see me say something positive should be worth something. I also don’t necessarily endorse taking a job with an AMC…though it might be your best option in certain circumstances. However, the idea that AMCs don’t give raises is not necessarily true. I keep my eye on the job market through both Gaswork and word of mouth and salaries have definitely increased. When I was finishing residency about 5 years ago, I frequently encountered jobs paying $275-300k with 4-6 weeks vacation. Now a new grad can step into a job making $500k and 6-10 weeks of vacation with ease. Just glancing at Gaswork today and using a well-known anesthesia villain, I am seeing multiple NAPA jobs offering around $500k in the NYC metro region. Now obviously details matter, but that compensation was not the case a few years ago. Whether or not that is fair compensation is another discussion, but the point is, the base level for employed anesthesiologist jobs has increased a fairly significant amount in 5 years.

The point here is also that you should always know your worth and you can’t have the mindset that whatever contract you signed a few years ago is the compensation you are stuck with going forward. You also cannot wait for your employers to give you a raise. You have to reassess your compensation every few years and be ready to ask for adjustments when warranted (preferably as a collective). It is also why it is extremely important to never sign contracts with onerous non-compete clauses. Your ability to take the job down the road offering $100k more and an extra week of vacation is your best negotiation tool.

Can you sign up with NAPA without non-compete? I know in CA non-compete is basically nonexistent, but in NY? My N=1 (not me) tells it does enforce it.

 

[BLADEMDA]

I will preface this by saying that I am often negative about medicine and anesthesia in general, so to see me say something positive should be worth something. I also don’t necessarily endorse taking a job with an AMC…though it might be your best option in certain circumstances. However, the idea that AMCs don’t give raises is not necessarily true. I keep my eye on the job market through both Gaswork and word of mouth and salaries have definitely increased. When I was finishing residency about 5 years ago, I frequently encountered jobs paying $275-300k with 4-6 weeks vacation. Now a new grad can step into a job making $500k and 6-10 weeks of vacation with ease. Just glancing at Gaswork today and using a well-known anesthesia villain, I am seeing multiple NAPA jobs offering around $500k in the NYC metro region. Now obviously details matter, but that compensation was not the case a few years ago. Whether or not that is fair compensation is another discussion, but the point is, the base level for employed anesthesiologist jobs has increased a fairly significant amount in 5 years.

The point here is also that you should always know your worth and you can’t have the mindset that whatever contract you signed a few years ago is the compensation you are stuck with going forward. You also cannot wait for your employers to give you a raise. You have to reassess your compensation every few years and be ready to ask for adjustments when warranted (preferably as a collective). It is also why it is extremely important to never sign contracts with onerous non-compete clauses. Your ability to take the job down the road offering $100k more and an extra week of vacation is your best negotiation tool.

Your post is basically my point about AMCs. They force you to sign a non compete or you don't get the job. Then, if you want a small COLA pay increase they again force you to band together with all your colleagues and threaten to quit in order to get it. You won't be treated cordially or like a professional. Instead, the AMC will asses the risk/benefit of letting you go and hiring a new HCA Type grad to replace you.

In a real private practice setting this never happens in terms of pay raises. You should expect higher pay as the revenue increases. Even the dreaded USAP will give you pay raises as the revenue/profits increase due to higher unit rates.

There is no "long term" view when you are working for an AMC. It is day to day or year to year based on the contract. That means there is no job security unless you are willing to accept below market rates for your work.

 

[IMGASMD]

Can you sign up with NAPA without non-compete? I know in CA non-compete is basically nonexistent, but in NY? My N=1 (not me) tells it does enforce it.

Not Enforceable =/ They won’t waste your time by tie you up in court/litigation.

 

[D P356]

Not Enforceable =/ They won’t waste your time by tie you up in court/litigation.

Agree.
They’ve got bigger pockets. Always be willing to walk away, and do your best to minimize the difficulty in doing so.

 

[narcotics999]

Not Enforceable =/ They won’t waste your time by tie you up in court/litigation.

It is against California Business and Professions Code Section 16600. Yes, there is a quasi-law to prevent it.

 

[gasdoc77]

Your post is basically my point about AMCs. They force you to sign a non compete or you don't get the job. Then, if you want a small COLA pay increase they again force you to band together with all your colleagues and threaten to quit in order to get it. You won't be treated cordially or like a professional. Instead, the AMC will asses the risk/benefit of letting you go and hiring a new HCA Type grad to replace you.

In a real private practice setting this never happens in terms of pay raises. You should expect higher pay as the revenue increases. Even the dreaded USAP will give you pay raises as the revenue/profits increase due to higher unit rates.

There is no "long term" view when you are working for an AMC. It is day to day or year to year based on the contract. That means there is no job security unless you are willing to accept below market rates for your work.

Most of the time even if the contract is for one year or more it has a 60-90 day "without cause" termination clause..... basically you are planting your family/buying a house/kids in schools etc for a 2 month rolling contract for your entire working career?!

 

[nimbus]

Most of the time even if the contract is for one year or more it has a 60-90 day "without cause" termination clause..... basically you are planting your family/buying a house/kids in schools etc for a 2 month rolling contract for your entire working career?!

I think that’s standard even with PP groups. I’ve had such a contract for over 20 years.

 

[deleted126335]

Most of the time even if the contract is for one year or more it has a 60-90 day "without cause" termination clause..... basically you are planting your family/buying a house/kids in schools etc for a 2 month rolling contract for your entire working career?!

Sometimes yes. Depends on the local market conditions. I had a contract like this for awhile early in my career. 180 days in that case. Lost some sleep over it every time I challenged a locally prominent surgeon or butted heads with a militant CRNA who was the mistress of somebody in the C-suite.

 

[IMGASMD]

It is against California Business and Professions Code Section 16600. Yes, there is a quasi-law to prevent it.

IANAL, but it’s in the contract that you willingly signed. Even with a law preventing it, unless it has been challenged in court and been eliminated in every contract in CA, I wouldn’t trust it. I’ve heard enough times
“it’s our standard contract...”
“all (insert the name of AMC) contract have the same wording....”
I call bull doodoo


just because you’re right doesn’t mean the time and energy spend fight is worth it.

 

[GravelRider]

Can you sign up with NAPA without non-compete? I know in CA non-compete is basically nonexistent, but in NY? My N=1 (not me) tells it does enforce it.

I don’t know specifics, but my understanding is (once or twice removed) the non-competes have gotten better. I’m pretty sure Northwell has softened their non-compete language and may only be site specific. NAPA has been mirroring whatever Northwell is doing in order to attract personnel.

Your post is basically my point about AMCs. They force you to sign a non compete or you don't get the job. Then, if you want a small COLA pay increase they again force you to band together with all your colleagues and threaten to quit in order to get it. You won't be treated cordially or like a professional. Instead, the AMC will asses the risk/benefit of letting you go and hiring a new HCA Type grad to replace you.

In a real private practice setting this never happens in terms of pay raises. You should expect higher pay as the revenue increases. Even the dreaded USAP will give you pay raises as the revenue/profits increase due to higher unit rates.

There is no "long term" view when you are working for an AMC. It is day to day or year to year based on the contract. That means there is no job security unless you are willing to accept below market rates for your work.

Absolutely. I totally agree. Anything beyond a site-specific non-compete clause is a contract you don’t sign. I would qualify your post by saying there is no “long term” view in anesthesia…full stop. Everything is day to day and year to year, even in private practice. But there is no denying that a NAPA ad from 5 years ago would have advertised a salary of $300k and now they advertise $500k.

My advice is always the same…take the highest paying job in whatever region you want to live with a workload that you are comfortable with and don’t make it difficult to leave. The best job in a region may very well be with an AMC.

 

[dannyboy1]

Sometimes yes. Depends on the local market conditions. I had a contract like this for awhile early in my career. 180 days in that case. Lost some sleep over it every time I challenged a locally prominent surgeon or butted heads with a militant CRNA who was the mistress of somebody in the C-suite.

Why are you doing these things. This is a profession for those with no backbone who don’t like fighting...

 

[deleted126335]

Why are you doing these things. This is a profession for those with no backbone who don’t like fighting...

This was my first job 25+ years ago. Overserved metro area. Bad national market. Very bad local market. Big student loans. Mortgage. Two young children. Needed to be close to elderly, infirm parents and in-laws. That's why I ate **** for a few years. Now I am at the FU point. But I remember quite well.