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Just like EM docs, private practice pediatricians can also do well. Self-employment > employment (especially CMGs) for any specialty. Also, that’s your friend’s fault.
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Another good SDG bites the dust
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Reminder that it was the ACEP leaders own CMGs who started the whole lets bill level five for all charts upcoding shenanigans.
Not surprisingly the payors noticed and started to reduce their reimbursements with their own downcoding shenanigans.
It's a war of attrition. You really think if there weren't 99285s being billed and mostly 99284s they wouldn't downcode the 4s?
We play the game, they adapt, we adept, they adapt, etc etc.
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This is literally perhaps the worst take. Do explain your logic.
I also know lots of senior acep leadership. Some are good some are not. The current ACEP president thinks em docs are too stupid to run a practice. It is literally easier to run single or truly small ED practice than it is to run a Dunkin’ Donuts. Most of the acep leadership is interested in nothing more than a giant circle jerk. They over inflate their importance and what they have accomplished to blind em docs to how they re too scared to do anything meaningful.
You say that like most doctors could run a Dunkin' Donuts...
Maybe EM is different, but in FM we get very little training in the business of medicine. Not saying we (physicians in general) can't learn how, but we don't come out of training with much knowledge of experience in that area.
Definitely zero
I'm in the process of opening a UM consulting firm as a side gig and I'm overwhelmed at the amount of filings necessary just to operate a business
Basic business/investing should be a mandatory part of ANY residency IMO
would rather see questions on my boards related to proper filing order of a tax ID for a small business than some of the social medicine stuff.
But do I think 1 in 10 could? Yep.. thats all it takes. To run an EM group first off there are resources that generally just want you to use their services if you are completely lost. 2nd, you just need 1-2 business savvy people and by business savvy I mean have a minimal competence / interest. Running a DnD requires oh so much more. PLus as a group of docs you can afford to pay a lawyer, CPA etc. That makes it much easier.
perhaps I have just always been around more entrepreneurial docs so it seems like any non ***** could do it. I think again, you need 1-2 people out of a group to have a minimal amount of business acumen as well as interest. Thats all.. Its not a high bar..
Actually it has been mandated for many years in EM. Still, just a financial person lecturing on conference day didn't do much for me. The single thing I recall is the guy saying, "Do NOT invest in the things you like, such as, wineries, horse farms, or shipyards and marinas".
I mean sounds like good advice. I have sat through some of these and I agree that residencies should not outsource this and allow advisors to advertise theri servcies. I have been so incredibly underwhelmed. every residency should have a few people who understand investing and personal finance.
Yeah, same.
FinanceGuy: "Let me, a snively corporate type lecture you on financial things right now."
Me: "Bro, I just worked eleventeen hours off-service and had to deal with all that nonsense. I'm tuning you out immediately."
@Apollyon
It doesn't help that these people are the most punchable types at baseline.
"Hi, I'm financial pantywaist. About the markets right now. The CBSDG index is stable, which means that the KHIPL sector is poised for...."
BRO, I HAVE NO IDEA WHAT YOU'RE TALKING ABOUT. TAKE YOUR NECKTIE AND HANG YOURSELF IN THE TRAUMA BAY, THEN I'LL BE INTERESTED.
I think wci has done a great job of providing financial education- for free. Most residents should either check out his website or get his book. Plus it’s from the viewpoint of a physician.
No, I’m not getting paid to say this.
No, I’m not getting paid to say this.
I don't disagree, but you have to go out of your way to find that info. Financial literacy needs to be a foundational topic of residency, that's the point, and it definitely isn't. Entire generations of people going off and making 400k-ish with zero knowledge of what to do with it
I completely agree that finances in the 4th yr of med school and throughout residency should be core but with all the info avail now, it has become a choice not wanting to learn.
Most docs just don't care and happy to just make 400K/yr
Most docs just don't care and happy to just make 400K/yr
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I bought and read WCI's book 3rd year of residence and am glad I did. Stopped following the site a few years ago when he started w/ the clickbait. It was so nice to be armed with some background knowledge and be able to immediately sniff out snake oil salesmen pushing whole life insurance or other scams.
With regard to education, you need to make a distinction between financial literacy, eg personal finance and the business of healthcare. Frankly, teaching the former is nice and all, but really not the responsibility of programs. Whereas the latter should really be taught, but isn't in my experience--partly b/c few understand it, and those that do, treat it like a trade secret. The most we got was an annual lame lecture from some snail in the coding department who gave a few "pearls" on maximizing our charts.
With regard to education, you need to make a distinction between financial literacy, eg personal finance and the business of healthcare. Frankly, teaching the former is nice and all, but really not the responsibility of programs. Whereas the latter should really be taught, but isn't in my experience--partly b/c few understand it, and those that do, treat it like a trade secret. The most we got was an annual lame lecture from some snail in the coding department who gave a few "pearls" on maximizing our charts.
Yeah he saved me millions. I liked it when he used to interact on here and on his forums. A northwest mutual snakeoil salesman came to our medical school and I met with him but then read the book and dodged a huge bullet. I still listen to his podcast and it's helpful. I appreciate everything he has done for me.
Any Oregon EPs in here can go to this to help out
An Evening with Dr. Glaucomflecken to Support Physician Autonomy
📅 May 1
⏰ Doors open 5:30 PM | Show starts 6:30 PM
📍 Venue 252 | 252 Lawrence Street, Eugene, OR 97401
🎟 $25 suggested donation
Come for the comedy, stay for the cause, and support the future of patient-centered care.
Dr. Glaucomflecken brings sharp humor to the realities of modern medicine, but behind the laughs is a real concern: Healthcare is changing, and decisions are increasingly driven by business pressures instead of what’s best for patients. This fundraiser helps support local physicians working to keep care patient-focused and free of corporate influence. Proceeds will go toward legal and advocacy efforts to protect independent medicine and ensure patients come first.
Tickets available at the door or online. Limited seating available.
An Evening with Dr. Glaucomflecken to Support Physician Autonomy
📅 May 1
⏰ Doors open 5:30 PM | Show starts 6:30 PM
📍 Venue 252 | 252 Lawrence Street, Eugene, OR 97401
🎟 $25 suggested donation
Come for the comedy, stay for the cause, and support the future of patient-centered care.
Dr. Glaucomflecken brings sharp humor to the realities of modern medicine, but behind the laughs is a real concern: Healthcare is changing, and decisions are increasingly driven by business pressures instead of what’s best for patients. This fundraiser helps support local physicians working to keep care patient-focused and free of corporate influence. Proceeds will go toward legal and advocacy efforts to protect independent medicine and ensure patients come first.
Tickets available at the door or online. Limited seating available.
Latest is the CEO of ApolloMD is saying he is gonna work clinical shifts in Oregon. A total PR disaster. Anyone with 2 functioning neurons can see what this is and what a horrible look for ApolloMD.. all for a pretty tiny contract and a health system that seems to be terrible. Its watching a train wreck right before my eyes.
HAHAHAHAHAHA
omg
too funny
so, they're admitting it was a horrible idea now without saying it
The best part is that he's not working for Lane Emergency Physicians INC but as an employee of Independent Physicians Resource INC which is yet another a staffing group that is a part of ApolloMD. Despite the fact that PeaceHealth's ED contract is with LEP not IPR and everything is supposed to be run under LEP control not IPR control according to state law in Oregon. Also Dr. Chapman the appointed owner of Lane Emergency Physicians apparently is staying in Chicago and not planning on moving to Eugene this summer to run his "locally managed independent group."
The first step when you start digging yourself a hole is to stop digging. I’m pleased to see that ApolloMD just continues to dig.
They moved from shovels to heavy machinery.
Check out this video, "highlights from Apollo MD peacehealth Oregon trail"
https://share.google/LrPAAM9RnJm86ueSh
https://share.google/LrPAAM9RnJm86ueSh
So it seems that Lane Emergency Physicians has zero official documentation that it exists and furthermore does not have a contract with PeaceHealth for hiring physicians.
Dr. Chapman’s testimony:
kval.com
Dr. Chapman’s testimony:
Testimony continues in Eugene Emergency Physicians lawsuit against PeaceHealth & ApolloMD
Testimony continues today (Wed.) in the lawsuit filed by Eugene Emergency Physicians against PeaceHealth and Apollo MD.The lawsuit seeks to pause the hospital’s
kval.com
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Hopefully Judge Kasubhai can see how FOS ApolloMD is.So it seems that Lane Emergency Physicians has zero official documentation that it exists and furthermore does not have a contract with PeaceHealth for hiring physicians.
Dr. Chapman’s testimony:
Testimony continues in Eugene Emergency Physicians lawsuit against PeaceHealth & ApolloMD
Testimony continues today (Wed.) in the lawsuit filed by Eugene Emergency Physicians against PeaceHealth and Apollo MD.The lawsuit seeks to pause the hospital’s
Good summary of court today
Looks like PeaceHealth may have seen the writing on the table as their court case did not seem to be going well. Perhaps EEP will stay after all? It would be great to see a local group beat back corporate medicine, if only in one small way.
www.peacehealth.org
lookouteugene-springfield.com
Moving forward together on emergency care in Lane County
PeaceHealth and Eugene Emergency Physicians (EEP) recognize that the past several months have been challenging for physicians, caregivers and the communities we serve.Together, PeaceHealth and EEP have agreed to reset the approach to Emergency Department physician services in Oregon. We have...
PeaceHealth reverses course, plans to renew ER contract with Eugene Emergency Physicians
PeaceHealth plans to renew its contract with Eugene Emergency Physicians after nearly three months of conflict with the local doctors group.
lookouteugene-springfield.com
I wish them the best of luck at EEP. Although they will get along great with the medical staff and nurses, I feel like there is going to be a target on their group by the C suite.
That's great news. I would love to see more states adopt similar legislative protections against the corporate practice of medicine and then actually enforce them.Looks like PeaceHealth may have seen the writing on the table as their court case did not seem to be going well. Perhaps EEP will stay after all? It would be great to see a local group beat back corporate medicine, if only in one small way.
Moving forward together on emergency care in Lane County
PeaceHealth and Eugene Emergency Physicians (EEP) recognize that the past several months have been challenging for physicians, caregivers and the communities we serve.Together, PeaceHealth and EEP have agreed to reset the approach to Emergency Department physician services in Oregon. We have...
PeaceHealth reverses course, plans to renew ER contract with Eugene Emergency Physicians
PeaceHealth plans to renew its contract with Eugene Emergency Physicians after nearly three months of conflict with the local doctors group.
If three things happened the EM outlook would be so much better:
1) More anti-corporate practice of medicine rules
2) Require a physician at all times in any place that wants to call itself an ER
3) Revisit the ACGME rules proposal and even if not the 4 year rules, increase the requirements for a hospital to have EM trainees so these recent garbage sites shutter or at least stop opening up.
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The c suite will turn over before it matters.
Yeah, that was my immediate thought. We're cogs, but, we have a black letter thing we do (we're not there, no pts seen). They are cogs, too, but with ill defined parameters, and, thus, more cleanly culled.
Great job to this group for putting up a fight and winning. Hope it sets an example. Awesome
@southerndoc, I know you advocated for Apollo as not a true CMG and I take to heart what you say. But from what the "media" has put out, it seems pretty clear they are a CMG. The appeared to subvert state regulations by created a new "local" group as a puppet just to get a contract that they were going to manage remotely. Even the "owner" of said group was not going to live in the state.
Man, there are no winners in this. Peace got a black eye, but in time, this will fade. EEP appears to have won, but prob spent a bunch of money getting a job where they were not wanted. EEP appears to have some protection now and would be difficult to fire, but Peace can make their lives miserable without actually firing them.
Truthfully, I think EEP eventually will break up or ask to be bought out eventually. If I were a EEP doc and if I were not geographically locked, I would be looking for a new job. I could not imagine working for someone where I have a target on my back.
Man, there are no winners in this. Peace got a black eye, but in time, this will fade. EEP appears to have won, but prob spent a bunch of money getting a job where they were not wanted. EEP appears to have some protection now and would be difficult to fire, but Peace can make their lives miserable without actually firing them.
Truthfully, I think EEP eventually will break up or ask to be bought out eventually. If I were a EEP doc and if I were not geographically locked, I would be looking for a new job. I could not imagine working for someone where I have a target on my back.
To the bolded, this was not the first time in the very recent past that they've pissed off the community, the governor and the State medical association...and that's just for that location, forget the other hospitals they have in the region. You're probably right that the memory of this will fade over time, but PeaceHealth is racking up bad PR at an alarming pace.
What do you think the odds are that something like this happening and everyone retains their job? I figure it's pretty close to 0%. It sounds like the entire hospital with the exception of a few administrators were very happy with EEP. Since it appears that EEP is going to be staying, my guess is that they're going to see some turnover in the c-suite. I think it's inevitable. You can't have something like this happen and then continue on with the same exact players. I would also think that EEP is going to be pretty stable for a long time because if the hospital gets rid of the contract then the likelihood for a lawsuit or fallout is going to be even higher now.
You missed out on the black eye ApolloMD got too.. I think EEP will actually be fine.. they probably bought 5 years at a minimum. I also think realistically this will fade and the group will get a redo with some new C suite leaders soon.
Everything fades over time.
Look at SummaHealth. It's a distant memory.
Regarding ApolloMD as a CMG, I never said they weren't a CMG. I said they weren't private equity owned or backed. I stand by that. If the news media has portrayed it elsewhere, what can I say? News is never wrong, is it? The only people who clearly understand the structure of ApolloMD and ValorBridge are those of us involved in it.
I am speaking for myself with this and someone who was not involved in the RFP process at PeaceHealth (therefore, I am not knowledgeable of the contract specifics). I am sure ApolloMD could not have backed out of this deal if we wanted to as I bet there were stipulations in place that involved monetary compensation if one party did not fulfill its obligations. It looks worse to back out of a contract to a health system than it does to continue it even despite the negative publicity. Backing out of a contract has worse implications to future contract negotiations than displacing a local group who lost the RFP process.
Come on man. CMG but not PE? We play that game in eyes where yeah, it’s still corporate and it’s still PE, no matter how you want to manipulate the terminology. “But there’s physician ownership” blah blah blah. Some of our leadership who got their payouts are really good at parroting that, and there’s (I’ll repeat it) enough Stockholm Syndrome in our about to retire docs and trainees to make it work.
Your overlords boned this one up incredibly badly and I commend EEP for having the goshdarn backbones and cojones to stand up to the suits. I hope more states go as nuclear as Oregon legally to close loopholes and keep PE out of medicine. It’s the absolute scourge of my field. Why do you think Dr. G popped up?
As an outsider with a different practice model, I still couldn’t give less of a F about “oh, but the numbers/contract.” It was a stupid money play by people who only care about spreadsheets, and it damaged patient care for a region. I hope that C suite takes their golden parachutes nowhere else and somehow the system can rebuild.
Your overlords boned this one up incredibly badly and I commend EEP for having the goshdarn backbones and cojones to stand up to the suits. I hope more states go as nuclear as Oregon legally to close loopholes and keep PE out of medicine. It’s the absolute scourge of my field. Why do you think Dr. G popped up?
As an outsider with a different practice model, I still couldn’t give less of a F about “oh, but the numbers/contract.” It was a stupid money play by people who only care about spreadsheets, and it damaged patient care for a region. I hope that C suite takes their golden parachutes nowhere else and somehow the system can rebuild.
That's impossible, unless there is a continued growth of EM residencies producing an overabundance of EM physicians who are then willing to work in the thousands of rural hospitals for $100/hr.
Oh, wait....
Apologies, but what does this even mean?
He’s an ApolloMD apologist as he works for them but for some reason continues to post in the Apollo threads. Personally, I’d take my L, quit posting in the ApolloMD threads, and continue being a valued contributor.
From my experience, I would peg EEP to keep their contract at close to 0%. Our SDG was in a similar situation and TH/HCA decided to pay us off to prevent rocking the boat. TH/HCA made the right calculations and decided a decent 8 figure pay out would be better. Peace/Apollo chose the other road which created more potholes than they could navigate.
Regardless, as a SDG, I would rather be paid out then go on with my life.
Just like a marriage. Would you rather just take a payout and divorce or be stuck in an unhappy marriage with mistrust/animosity?
If you know me, you know I care about truth and do not care about public perception of me as a person. I could care less about how people think of me.
You are correct that I should quit posting. The internet is full of people who think they know things they do not. Arguing with someone on the internet is about as productive as trying to reason with a bear.
Except bear rips you to literal pieces, and eats you!
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I sometimes feel like people are the same on the internet. 😀
Your SDG was in a nationally covered court case against TH with medical influencers making TikToks garnering millions of views while the hospital CEO was cast in a horrible light? This is well past what your group went through.
THIS is the contract that got EM all up in arms over?!
EM is so ****ing cooked. This contract is garbage for a new hire. Piss poor pay, especially in Oregon with their income tax. Paying new grad BE docs less than BCEM AND no benefits? F off with that noise. I'm sure the partners make a lot of profit off of their new hires but this is so gross. Glad to work for a shop that gives equal pay for your work from day 1. This **** makes my blood boil.
EM is so ****ing cooked. This contract is garbage for a new hire. Piss poor pay, especially in Oregon with their income tax. Paying new grad BE docs less than BCEM AND no benefits? F off with that noise. I'm sure the partners make a lot of profit off of their new hires but this is so gross. Glad to work for a shop that gives equal pay for your work from day 1. This **** makes my blood boil.
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Well, it’s pretty unusual to get ownership in a business in any industry without some kind of buy-in or sweat equity.
