Any pay cuts from covid?

[Aether2000]

Base pay initially cut 30%, all bonuses for work last year cancelled. Now we are working at 85% pay (full schedule) until July, then possibly back to 100%. Bonus pay from last year is being negotiated. CRNAs are leaving in significant numbers.

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[nimbus]

Now we are working at 85% pay (full schedule) until July, then possibly back to 100%.

Are you back up to full schedule? Which region? We are only about 50% on the west coast. Our bottleneck is supplies (gowns, masks) and testing.

 

[Mman]

The profit margins are so high for almost any practice in anesthesia with at least 30% private insurance.

Unless your commercial rates are really good, 30% commercial insurance is not a hugely profitable place to be IMHO. I mean that's probably going to end up being something like collecting $25-$30 per unit depending on the amount of self pay patients.

 

[d9sccr]

Not anesthesia related, but one of the derm private equity groups here fired all non-physician providers and is now renegotiating physician contract/salaries. I can’t understand why they don’t all leave en masse

 

[aneftp]

Unless your commercial rates are really good, 30% commercial insurance is not a hugely profitable place to be IMHO. I mean that's probably going to end up being something like collecting $25-$30 per unit depending on the amount of self pay patients.

If you can average $35-40/unit including Medicare/Medicaid and commercial. You can still pull $450k billing 12k units. Which is the average case load working roughing 45-48 hours in private practice per week

But let’s just say you have 12k units. 4000 of those units are averaging around $70/unit (which is average for a small anesthesia practice). That $280k

say the rest of the $8000 units are lowly Medicare/Medicaid/self pay. Say combine that averages to be $15/unit That’s 120k.
You still making around 400k

bigger practice average much more commercial insurance.

just wanted to show the young guys on these forms how much money there is in anesthesia doing average work.

the harder working docs work up to 20k billing units in private world. I suspect most amc practice docs work 15k units. Assuming solo MD practice in western states.

 

[abolt18]

We are around 85% of normal volume. All scheduled and urgent cases get a COVID test prior. Positive => cancel unless the operation can't wait.

People are being quite lax with PPE here (not me) and it's alarming to me. On the other hand, they just sent us the statistics on the PCR testing we're doing in house and they're reportedly demonstrating a sensitivity and specificity of both >95%. In our low prevalence area, that certainly makes the negative predictive value of the test quite high. This obviously doesn't account for someone who tests negative on day 2 after infection and comes for surgery on day 5 with a higher viral load (but still asymptomatic).

Are you back up to full schedule? Which region? We are only about 50% on the west coast. Our bottleneck is supplies (gowns, masks) and testing.

 

[aneftp]

Not anesthesia related, but one of the derm private equity groups here fired all non-physician providers and is now renegotiating physician contract/salaries. I can’t understand why they don’t all leave en masse

1. Non competes
2. covid-19

so where will these dermatologists go?

for the first time in a long long long time. unless you are single and no kids. Or kids fully grown. It hard to leave a job without a game plan for the next job.

it’s one thing being new grad age 30 for me and my buds just to work anytime we wanted per diem at the trauma hospital. And than take off to Spain and live it up for a week. Work a couple more weeks. Than buy last minute plane tickets to South Americans and live it up. Renting a cheap apartment

people have families and kids to feed and support. They can’t leave and walk out of a job immediately if they don’t like the contract being changed. They got to plan ahead for the next step. And right now. There aren’t any jobs.

 

[d9sccr]

1. Non competes
2. covid-19

so where will these dermatologists go?

for the first time in a long long long time. unless you are single and no kids. Or kids fully grown. It hard to leave a job without a game plan for the next job.

it’s one thing being new grad age 30 for me and my buds just to work anytime we wanted per diem at the trauma hospital. And than take off to Spain and live it up for a week. Work a couple more weeks. Than buy last minute plane tickets to South Americans and live it up. Renting a cheap apartment

people have families and kids to feed and support. They can’t leave and walk out of a job immediately if they don’t like the contract being changed. They got to plan ahead for the next step. And right now. There aren’t any jobs.

While there’s no way of determining what’s in their contracts, presumably they can’t just cut compensation—hence the new contracts. What happens if you refuse to resign? I would assume their non competes would expire. Either way, their non competes are <10 miles in Indianapolis. I drive further than that for some of our off site stuff. Dermatologists can open new practices. I have more than a few friends here that are seeing patients in office again and running 80-90% capacity. They’re also fully reimbursed for tele-health still. They’ve become as comfortable being a cog in a wheel as much as a lot of our field

 

[chocomorsel]

Base pay initially cut 30%, all bonuses for work last year cancelled. Now we are working at 85% pay (full schedule) until July, then possibly back to 100%. Bonus pay from last year is being negotiated. CRNAs are leaving in significant numbers.

Let them leave. Replace them with physicians.

 

[Aether2000]

We are Florida- all of our hospitals we staff surgery schedules are full and the ASCs are over 100%. Boom! This is 1.5 weeks after reopening.

 

[chocomorsel]

We are Florida- all of our hospitals we staff surgery schedules are full and the ASCs are over 100%. Boom! This is 1.5 weeks after reopening.

And your Covid numbers are getting fudged and people getting fired. Get your money while you still can, before they close shop again. And don't take chances with PPE.

 

[aneftp]

And your Covid numbers are getting fudged and people getting fired. Get your money while you still can, before they close shop again. And don't take chances with PPE.

Florida is a big state. 60-65% of the cases are down in Miami-palm beach area. Other parts of state aren’t hit as hard. Sure. They have cases but it’s not as bad as south florida.

its like New York. New York is a big state. But upstate New York didn’t get hit hard (my friend up there).

similar in florida. The central and eastern side up to Jacksonville didn’t get a lot of cases. Had the spikes in early April. But cases not over loading system.

 

[Ronin786]

These pay cuts are frustrating to hear. Outside of PP, it's not like you get a bonus when the hospital is making money but you eat **** when they don't.

 

[chocomorsel]

Florida is a big state. 60-65% of the cases are down in Miami-palm beach area. Other parts of state aren’t hit as hard. Sure. They have cases but it’s not as bad as south florida.

its like New York. New York is a big state. But upstate New York didn’t get hit hard (my friend up there).

similar in florida. The central and eastern side up to Jacksonville didn’t get a lot of cases. Had the spikes in early April. But cases not over loading system.

Yeah, but when it shuts down, the whole state shuts down. Not just certain parts. At least most state orders that is.

 

[Mman]

If you can average $35-40/unit including Medicare/Medicaid and commercial. You can still pull $450k billing 12k units. Which is the average case load working roughing 45-48 hours in private practice per week

But let’s just say you have 12k units. 4000 of those units are averaging around $70/unit (which is average for a small anesthesia practice). That $280k

say the rest of the $8000 units are lowly Medicare/Medicaid/self pay. Say combine that averages to be $15/unit That’s 120k.
You still making around 400k

bigger practice average much more commercial insurance.

just wanted to show the young guys on these forms how much money there is in anesthesia doing average work.

the harder working docs work up to 20k billing units in private world. I suspect most amc practice docs work 15k units. Assuming solo MD practice in western states.

Sure, but you also gotta subtract a lot from that theoretical $400K per year they are taking in.

--billing and collections probably chops out 6% or so
--small amount of overhead probably takes another 1-2%

So now they are making about $375K or so. But that isn't including benefits. Start taking out money for health insurance, malpractice insurance, employer contributions for 401K, etc. Now their paycheck reflects more like $300K per year in salary. Most people (physicians included) tend to ignore the value/cost of the benefits they are receiving and focus more on the paycheck. Then take out some taxes on that paycheck and the $400K per year they are "collecting" is a lot smaller when it hits their bank account.

 

[aneftp]

Sure, but you also gotta subtract a lot from that theoretical $400K per year they are taking in.

--billing and collections probably chops out 6% or so
--small amount of overhead probably takes another 1-2%

So now they are making about $375K or so. But that isn't including benefits. Start taking out money for health insurance, malpractice insurance, employer contributions for 401K, etc. Now their paycheck reflects more like $300K per year in salary. Most people (physicians included) tend to ignore the value/cost of the benefits they are receiving and focus more on the paycheck. Then take out some taxes on that paycheck and the $400K per year they are "collecting" is a lot smaller when it hits their bank account.

Agree. There are tons of variable being self employed. That’s why having a working spouse with state or federal (or private large employers )health care benefits can often determine what is a good private physician fee for service practice or not.

if I had a working spouse With generous healthcare w2 benefits. I’d take A 400k 1099 jobs with major tax deductions over a 400k w2 AMC job with no retirement match

A 400k self employed job. You can give urself 50-100k pre tax deduction for retirement. You can have major section 179 deduction. Basically pay urself 130k salary. Malpractice will cost between $10-20k in most states. That’s max I ever paid was 25k and that was for a 3/5 million policy but most hospitals require only 500k-1mil these days.

best of both worlds

 

[Arch Guillotti]

Base pay initially cut 30%, all bonuses for work last year cancelled. Now we are working at 85% pay (full schedule) until July, then possibly back to 100%. Bonus pay from last year is being negotiated. CRNAs are leaving in significant numbers.

How are bonuses for last year cancelled? Were they not paid out in the first place?

 

[Aether2000]

They were to be paid this Spring- apparently a different fiscal year. When COVID shut down the hospitals, physicians were told the bonuses were not going to be paid on the date due, and would be "negotiated" when enough funds became available later....

 

[anbuitachi]

anyone in nyc hospitals getting pay structure changes?

 

[abolt18]

But those admins probably got their own bonuses right before telling that to all the physicians...

They were to be paid this Spring- apparently a different fiscal year. When COVID shut down the hospitals, physicians were told the bonuses were not going to be paid on the date due, and would be "negotiated" when enough funds became available later....

 

[skypilot]

If you can average $35-40/unit including Medicare/Medicaid and commercial. You can still pull $450k billing 12k units. Which is the average case load working roughing 45-48 hours in private practice per week

But let’s just say you have 12k units. 4000 of those units are averaging around $70/unit (which is average for a small anesthesia practice). That $280k

say the rest of the $8000 units are lowly Medicare/Medicaid/self pay. Say combine that averages to be $15/unit That’s 120k.
You still making around 400k

bigger practice average much more commercial insurance.

just wanted to show the young guys on these forms how much money there is in anesthesia doing average work.

the harder working docs work up to 20k billing units in private world. I suspect most amc practice docs work 15k units. Assuming solo MD practice in western states.

Nice. So you are saying we can still make an excellent living as Anesthesiologists doing our own cases as long as there is no management company skimming off the top.

 

[Mman]

Nice. So you are saying we can still make an excellent living as Anesthesiologists doing our own cases as long as there is no management company skimming off the top.

you can find plenty of jobs with "management companies skimming off the top" that will pay you that same amount. People just complain that $350K or $400K isn't an excellent living because someone else is making money off you.

 

[skypilot]

you can find plenty of jobs with "management companies skimming off the top" that will pay you that same amount. People just complain that $350K or $400K isn't an excellent living because someone else is making money off you.

But only supervision jobs where there is lots of pressure to increase the ratio and work your tail off till you burn out and are replaced.

 

[Mman]

But only supervision jobs where there is lots of pressure to increase the ratio and work your tail off till you burn out and are replaced.

nah, you can find plenty of normal supervision jobs for that rate that are not insane. Hell you can find mommy track jobs that will pay you $300K. If you want to have a lot of busy work supervising you can starting getting mid $400s and up.

 

[Modstopizdy]

it’s one thing being new grad age 30 for me and my buds just to work anytime we wanted per diem at the trauma hospital. And than take off to Spain and live it up for a week. Work a couple more weeks. Than buy last minute plane tickets to South Americans and live it up. Renting a cheap apartment

people have families and kids to feed and support. They can’t leave and walk out of a job immediately if they don’t like the contract being changed. They got to plan ahead for the next step. And right now. There aren’t any jobs.

That first paragraph up there is what keeps me going though this grind. The Life. Then the second paragraph makes me shudder at the prospect of waking up to a nagging wife and crying children. I do wonder why any red blooded male with money and flexibility would want to settle down and give it up before getting to the age where the sex drive and energy levels naturally go down the ****ter.

 

[deleted126335]

That first paragraph up there is what keeps me going though this grind. The Life. Then the second paragraph makes me shudder at the prospect of waking up to a nagging wife and crying children. I do wonder why any red blooded male with money and flexibility would want to settle down and give it up before getting to the age where the sex drive and energy levels naturally go down the ****ter.

The person most of us are at age 18-30 or so is not the person we are after that period.

 

[Modstopizdy]

The person most of us are at age 18-30 or so is not the person we are after that period.

I don't know, I'm not far from 30 but I've firmly had my eye on the prize since I was a poor teenager. The only thing that's changed as I've invested more and more years and got closer to the end of training is increasing desperation to reach that payoff and enjoy the hell out of it. Physically and mentally I've noticed no changes, and long may it continue.

 

[deleted126335]

I don't know, I'm not far from 30 but I've firmly had my eye on the prize since I was a poor teenager. The only thing that's changed as I've invested more and more years and got closer to the end of training is increasing desperation to reach that payoff and enjoy the hell out of it. Physically and mentally I've noticed no changes, and long may it continue.

Whatever makes you happy as long as you are honest.

 

[abolt18]

That first paragraph up there is what keeps me going though this grind. The Life. Then the second paragraph makes me shudder at the prospect of waking up to a nagging wife and crying children. I do wonder why any red blooded male with money and flexibility would want to settle down and give it up before getting to the age where the sex drive and energy levels naturally go down the ****ter.

Or you could wake up to a supportive wife you call a companion with awesome kids with whom you love sharing your hobbies and doing fun things. That's what I've chosen

 

[deleted162650]

Or you could wake up to a supportive wife you call a companion with awesome kids you love sharing your hobbies and doing fun things with.

 

[bobow98]

Or you could wake up to a supportive wife you call a companion with awesome kids with whom you love sharing your hobbies and doing fun things. That's what I've chosen

When I walked in this morning and saw that the flag was half-mast, I thought ‘All right, another bureaucrat ate it!'

Nah I prefer to yell upstairs to my mom for more tendies instead.
Forgive the intrusion from the IM forum

 

[abolt18]

Intrusions welcome. I think people here love additional perspective!

Nah I prefer to yell upstairs to my mom for more tendies instead.
Forgive the intrusion from the IM forum

 

[2Fast2Des]

Or you could wake up to a supportive wife you call a companion with awesome kids with whom you love sharing your hobbies and doing fun things. That's what I've chosen

When I walked in this morning and saw that the flag was half-mast, I thought ‘All right, another bureaucrat ate it!'

Honestly I have no idea how parents have successful careers, hobbies, maintain relationships, and take care of kids. We just have a dog and a small townhouse and I somehow feel like I don't have the time to do everything we would like. How the hell can you be able to do all and have a kid or kid(s)?? It scares me that I will have no time for myself or my SO and just become servants to the little ones when we get to that point in our lives, or forbid, like our friends who all of a sudden can't stay out past 730pm because of the kids.

 

[chocomorsel]

Honestly I have no idea how parents have successful careers, hobbies, maintain relationships, and take care of kids. We just have a dog and a small townhouse and I somehow feel like I don't have the time to do everything we would like. How the hell can you be able to do all and have a kid or kid(s)?? It scares me that I will have no time for myself or my SO and just become servants to the little ones when we get to that point in our lives, or forbid, like our friends who all of a sudden can't stay out past 730pm because of the kids.

Get a nanny. You can afford it.
Yeah, I enjoy being lazy but if I ever feel the urge, I plan on getting live in help.

 

[abolt18]

Honestly I have no idea how parents have successful careers, hobbies, maintain relationships, and take care of kids. We just have a dog and a small townhouse and I somehow feel like I don't have the time to do everything we would like. How the hell can you be able to do all and have a kid or kid(s)?? It scares me that I will have no time for myself or my SO and just become servants to the little ones when we get to that point in our lives, or forbid, like our friends who all of a sudden can't stay out past 730pm because of the kids.

You definitely make sacrifices. My hobbies have all been on the back-burner through most of med school and residency (with occasional guys trips to go climbing/camping/hiking with brothers or friends).

You are not wrong that you sort of become a servant to the kids. Your life revolves around them and their needs much if not most of the time. And once you have them, you can't very well give them back, so enjoy the married-without-kids period. I loved the time with my wife before we had kids. I love my life currently even more.

A nice thing is that they're getting bigger now so I can take them "mountain biking" on some easy trails, we can do a lot of hiking, we can enjoy some good movies together and build Lego together, and I honestly enjoy being with them, teaching them, and spending time with them.

 

[pgg]

Honestly I have no idea how parents have successful careers, hobbies, maintain relationships, and take care of kids. We just have a dog and a small townhouse and I somehow feel like I don't have the time to do everything we would like. How the hell can you be able to do all and have a kid or kid(s)?? It scares me that I will have no time for myself or my SO and just become servants to the little ones when we get to that point in our lives, or forbid, like our friends who all of a sudden can't stay out past 730pm because of the kids.

The answer is that you just start caring about different stuff. Having kids is like diverting sufentanil ... no, not in a "bad life choice" kind of way ... more in the sense that it chemically changes your brain and reward center pathways.

When I was 10, I couldn't comprehend why adults didn't have massive Lego collections. They had jobs and cash. WTF was wrong with them? They could just go buy like 8 of the yellow brick castle sets and make an amazing huge yellow castle.

 

[chocomorsel]

J

The answer is that you just start caring about different stuff. Having kids is like diverting sufentanil ... no, not in a "bad life choice" kind of way ... more in the sense that it chemically changes your brain and reward center pathways.

When I was 10, I couldn't comprehend why adults didn't have massive Lego collections. They had jobs and cash. WTF was wrong with them? They could just go buy like 8 of the yellow brick castle sets and make an amazing huge yellow castle.

I bet there are some parents out there who after having kids think it’s a “bad life choice”.
You hear it occasionally but not too often. Because it’s taboo to not want or “love” to be a parent after the fact. And heresy to speak about it loudly.
Plenty of parents become parents accidentally. I would bet like half the parents.

 

[pgg]

I bet there are some parents out there who after having kids think it’s a “bad life choice”.
You hear it occasionally but not too often. Because it’s taboo to not want or “love” to be a parent after the fact. And heresy to speak about it loudly.
Plenty of parents become parents accidentally. I would bet like half the parents.

If it's accidental then it wasn't a choice.

 

[chocomorsel]

If it's accidental then it wasn't a choice.

But you aren’t allowed to say that you hate being a parent.
Accident or not. Rather, it’s considered taboo to say so.

 

[2Fast2Des]

But you aren’t allowed to say that you hate being a parent.
Accident or not. Rather, it’s considered taboo to say so.

I chatted with a few of my colleagues who do admit children ain't all that. One guy who said he has a single brother who traverses the world on a whim, while he watches in jealousy where everything about a child filled life is planned. He isn't unhappy about his kid, but feels like life could have been better without. Others would say how 1 kid is enough, no more headache needed with more. I know everyone has different goals in life, heck one of my friends spouse wants to be a professional house wife and pump out babies. I just hope the day we "settle" down, we have the ability to turn the switch to become mature boring parents. I can't imagine living a life where I would look at my kid as a burden and be unhappy. And hope to god they are born without any health problems.

 

[deleted162650]

I always thought I wanted to be a father. Now that I have kids, I realize what I really wanted to be is an uncle.

 

[chocomorsel]

I immensely enjoy my nieces and nephews. I got plenty of them.

 

[2Fast2Des]

I immensely enjoy my nieces and nephews. I got plenty of them.

All play and no pay, best of both worlds!

 

[gasdoc77]

MOM.....THE MEATLOAF......F

 

[Dawkter]

anyone in nyc hospitals getting pay structure changes?

Same question, especially curious about the academic institutions....