Austin/Central Texas Opportunities?

[Preston Ganey Jr]

Hey y'all, hope my first post isn't too obnoxious. I'm following the wife (and her job) to Austin, Tx, and I've been actively searching for gigs in the Central Texas area. As best as I can tell, the market is dominated by Team Health (with St David's) and USACS (Seton Hospitals). Baylor Scott and White has a small presence in the outskirts. San Antonio's an hour away but its independent group and USACS there also seem full.

Does anyone know of any independent groups in Austin/San Antonio that might be staffing? I'm reticent to give up too much acuity by doing only freestandings, and I'm even looking at locums or sort-of-regional-locums by blocking shifts somewhere in driving distance of central texas. Heck, I'd even consider doing a fellowship spot, if I thought it'd be a ticket to steady employment in the area. Appreciate any advice and happy to receive any contacts by PM.

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[DeadCactus]

Really rough job market based on a few people I know in the area. Best bet is going to be rural moonlighting clumped into blocks away from home. If you're going to be there long-term and want a job you can commute to daily, probably going to have to play the "do PRN shifts for a few years until something opens up" game. Hopefully someone with direct experience can weigh in.

 

[zurned]

PM'ed you

 

[Preston Ganey Jr]

Thank you!

 

[Brigade4Radiant]

Has anything changed in the Austin market?

 

[DeadCactus]

Has anything changed in the Austin market?

Housing prices went up.

 

[emergentmd]

There are lots of opportunities in Austin. It used to be impossible to get into one of the major Hospital systems but now I hear they are begging for docs to stay.

 

[EctopicFetus]

There are lots of opportunities in Austin. It used to be impossible to get into one of the major Hospital systems but now I hear they are begging for docs to stay.

Cause usacs and team abused the crap out of them not any other reason.

 

[RustedFox]

Hipsters moved in and made it insufferable for anyone without a mustache and at least 2 Apple devices.

 

[GonnaBeADoc2222]

I realize this post was resurrected, but to address the original post, I'll never understand why a high earner would relocate for their spouses job to work for USACS/team or (LOL) do a fellowship

 

[Rekt]

I realize this post was resurrected, but to address the original post, I'll never understand why a high earner would relocate for their spouses job to work for USACS/team or (LOL) do a fellowship

Divorce is much more expensive than downgrading your job.

 

[BoardingDoc]

I'll never understand why a high earner would relocate for their spouses job to work for USACS/team or (LOL) do a fellowship

1: Because your spouse is also a high earner
2: Because their job is part of their core identity and this would be their dream job
3: Because this is the job that allows you to be close to family/friends/whatever
Those are off the top of the dome. I'm sure there are a plethora of others.

To be clear, I'm not saying I'd want to do that either. I AM saying that I would do that for my wife if the situation warranted it. Family >>>>>>>>> Job/$$$.

 

[Brigade4Radiant]

I was thinking of relocating because of my girlfriend but I'm starting to realize that would be a bad idea. I already do a lot but it doesn't make since to leave family and a high paying job when we are talking about me loosing 100k to USACS

 

[GonnaBeADoc2222]

Please please please...don't ever leave family and a good job for another person.

 

[GonnaBeADoc2222]

1: Because your spouse is also a high earner
2: Because their job is part of their core identity and this would be their dream job
3: Because this is the job that allows you to be close to family/friends/whatever
Those are off the top of the dome. I'm sure there are a plethora of others.

To be clear, I'm not saying I'd want to do that either. I AM saying that I would do that for my wife if the situation warranted it. Family >>>>>>>>> Job/$$$.

Happy wife, happy life, I suppose!

They can enjoy working for Dom while he sips tequila on his yacht....that their wives are probably on too.

 

[miacomet]

There are lots of opportunities in Austin. It used to be impossible to get into one of the major Hospital systems but now I hear they are begging for docs to stay.Lol

I bet, with TeamHealth and USACS!!!

 

[emergentmd]

TH and USACS are the major players in town. There are smaller ones that essentially are CMGs too. S&W employs their docs and I hear decent things about them.

Bottom line is Austin was almost impossible to break into. Our SDG never advertised and was always a friend of a friend hire with alot of say from the ER director. I called both SDGs back in the day and each had 1 spot each opened. I was lucky to get one spot, my fellow residence from a "High powered residency " got the other group. The ER director eventually told me they hired me b/c he liked me, and where I trained didn't really matter.

Even when Austin became full CMG, it was hard to break into Austin and most new hires were ferried out to all the crappy small town ERs with lower rates and promise of shifts at one of the mother ships.

I just talked to an old SDG partner who finally got tired of the CMG screwing her around and sent in her resignation. No less than a hr later, the Regional medical director called her begging her to stay until they find a replacement which essentially means til fall when a new batch gets hatched.

This is completely foreign to the Austin Market.

 

[hoot504]

I'm in Phoenix and there's a locums doc who travels from Austin to work here at our group. They also work in Austin but stated the jobs there are uniformly terrible. They cited the CMG takeover as the main reason why.

 

[miacomet]

I'm in Phoenix and there's a locums doc who travels from Austin to work here at our group. They also work in Austin but stated the jobs there are uniformly terrible. They cited the CMG takeover as the main reason why.

Phoenix isn't all CMG?

 

[hoot504]

Phoenix isn't all CMG?

‘Tis. Envision and TH have mostly carved everything up.

 

[Fox800]

There are no independent groups in Austin. They sold out to TEAMHealth and USACS.

The "independent" groups in San Antonio are a farce. GSEP is "independent" but the they are subcontracted by Envision who actually owns the contracts for the hospitals that they staff at...at least that's how it was 3-4 years ago. It might be "democratic" but you are literally sucking from Envision's teat. They neglected to tell me this until I paid to fly all the way down to do an interview (as a resident).

VEA is "independent" but the practice is owned by one doctor. Not democratic. Everyone else is an employee or 1099. You are NOT a practice owner/partner.

Outside of GSEP and VEA, San Antonio is run by CMGs.

 

[EctopicFetus]

Dom probably can’t get a woody. So no fear.

 

[EctopicFetus]

‘Tis. Envision and TH have mostly carved everything up.

A little APP also.

Empower at st joes is an sdg but don’t think it’s ever been a decent job.

Banner thunderbird is a sdg I believe and Vituity has a tiny presence.

 

[The Knife & Gun Club]

I realize this post was resurrected, but to address the original post, I'll never understand why a high earner would relocate for their spouses job to work for USACS/team or (LOL) do a fellowship

Sometimes you’ve gotta do what’s best for the relationship and the family. My wife’s a surgeon and the market for her line of work is not nearly as flexible as EM or other “plug and play” types of docs.

Positions doing what she’s trained for don’t come along that often, and once you have that job it’s incredibly challenging to move because you’ve got a whole patient panel and referral base that takes years to build up.

If the job she gets is in Denver, we’re going to Denver. Some USACS scumbag will get their second yacht off my hard work, but I like my wife and don’t really want to be divorced lol.

 

[ZX10R]

I work in the area. 1099 is the way to go. Its a great system; you'll have a 1099 guy next to you making >100 more an hour while seeing half as many patients. Burnout is very high among the W-2s. Im also here for my spouse (we are both EM). If something doesn't change, we'll both be gone in a year.

I will say tho, the overall work environment isn't that bad. Nurses are good, consulting specialists isnt met with immediate hate (except urology like every other place I worked). I imagine it was an amazing gig 2009-2014 where average pay was >500 a year from what I hear.