separate note on SCP. I work for them now, but have worked for envision (full time), teamhealth (prn, but for years now), and did quite a bit of locums work at a vituity run place. The culture of SCP is very dependent on who is your direct leadership. The original schumacher (before it was SCP) was a small contract management group, but it was at least doctors all the way up and down. The old-timers at my current job talk very fondly of the culture and ability to actually communicate concerns with anyone up the food chain. And even now, I've been able to talk to the CMO (technically one of two) of all of SCP about concerns we had at our site, and they get addressed. As long as your complaint isnt "I don't want to make the company money", they're extremely open to the idea that happy staff members are productive staff members and want to do what keeps you happy enough to keep producing. A few different "money saving" initiatives have been called off because we asked for a chance to prove we dont need x policy or y scheduling in order to accomplish z goal. In our case it was RVU per shift. we said we can document better if thats what they need, and we dodged a pay cut completely - ended up with a pay RAISE instead a few months later after they saw our results. Can only imagine how much money we made them if they were like "you did so good, you get a permanent pay raise" months after suggesting a pay cut.
I say it matters who is above you because they went from Schumacher to SCP after acquiring two other small groups and those small groups are also represented in the leadership hierarchy. Lets say one was known for being a bit malignant before being acquired and remains a bit malignant (I hear) with how they run their prior, and new, sites since then. Having access to the highest echelon of leadership doesn't matter as much when 'middle management' is lacking and they make more month-to-month decisions that matter to you. But that's true everywhere, just good to know that the top of the pyramid cares enough to listen and you stand a decent chance of being in a linear hierarchy where everyone cares enough to listen (and that if you're in a hierarchy where the people above you don't care to listen, there is actually options to legitimately plead your site's case to a level or two levels above).
Like anything, there are obviously places to improve. I'm not a multi-multi millionaire, which means someone is stealing money I should be making given the RVU beast I pride myself on being. But thats the nature of the whole contract management business.
