Austin, TX-Anesthesia Future?

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Howard888

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So Austin is always in the headlines right now due to the high growth-but also the extreme inflation and rise in cost of living. Is this the next California?

With regards to Anesthesia-looking around you have two groups run by management companies- USAP and NAPA. Boths starting salaries leave a lot to be desired, and for USAP there is the "stock purchase" for "partner".

Most economists dont see inflation going down soon and definitely not in Austin due to the mass influx of californians.
Can an anesthesiologist even afford to work there? Housing is nuts. Is it sustainable? Do you need a spouse with a high income or have to be willing to live 30 minutes outside the city? No state income tax....I guess? Maybe if youre single?

California obviously still has plenty of MDs -but weather is way nicer in California. Is California less management company driven? Do they have higher salaries? Neither of these groups reputation is blowing people away either-so not sure quality of life/job worth the high cost of living and low starting salaries.

If California made it work, so will Austin? City is cool but worth it?

Thinking California folks on here will best be able to answer.
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I don’t know anything about the anesthesia market but I know at least a dozen kids in their 20s (daughter’s friends, partner’s kids, etc) who grew up in Southern California and have now moved to Austin. Despite the rising COL, it’s still more affordable than Ca. I don’t think it would be a bad decision to move there now.
 
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Salary. Location. The work itself.

Choose 2/3

No wrong choices ... just personal choices.
 
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Howard888 said:
So Austin is always in the headlines right now due to the high growth-but also the extreme inflation and rise in cost of living. Is this the next California?

With regards to Anesthesia-looking around you have two groups run by management companies- USAP and NAPA. Boths starting salaries leave a lot to be desired, and for USAP there is the "stock purchase" for "partner".

Most economists dont see inflation going down soon and definitely not in Austin due to the mass influx of californians.
Can an anesthesiologist even afford to work there? Housing is nuts. Is it sustainable? Do you need a spouse with a high income or have to be willing to live 30 minutes outside the city? No state income tax....I guess? Maybe if youre single?

California obviously still has plenty of MDs -but weather is way nicer in California. Is California less management company driven? Do they have higher salaries? Neither of these groups reputation is blowing people away either-so not sure quality of life/job worth the high cost of living and low starting salaries.

If California made it work, so will Austin? City is cool but worth it?

Thinking California folks on here will best be able to answer.
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Did a prelim interview there. 90% supervision (fuk that), 2 year non-guaranteed partnership track, 100-125K "stock" purchase, and salary during the track year is "high 2s low 3s" (fuk that too). Partners apparently 450-500 with 8 weeks off. 45-50 hours.

Dallas pays better, better long term city for sure.
San Antonio is paying the most, but also is shedding partners (I think their vesting period is up) and heard through the grapevine that their quality of care provided has gone downhill significantly (from surgical colleagues who took jobs there). Theres a few small PP groups popping up there now waiting for the implosion to happen.
 
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GandalfTheWhite said:
Did a prelim interview there. 90% supervision (fuk that), 2 year non-guaranteed partnership track, 100-125K "stock" purchase, and salary during the track year is "high 2s low 3s" (fuk that too). Partners apparently 450-500 with 8 weeks off. 45-50 hours.

Dallas pays better, better long term city for sure.
San Antonio is paying the most, but also is shedding partners (I think their vesting period is up) and heard through the grapevine that their quality of care provided has gone downhill significantly (from surgical colleagues who took jobs there). Theres a few small PP groups popping up there now waiting for the implosion to happen.
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Seriously??? 3 max to start? Non guaranteed partner? 100k buy in? Top out 500? A 2000 square foot house there is 7 figures.

Good luck staffing that place-I’ll choose Dallas..or let me know if you have an in with one of those private groups….that sounds like a big win to capitalize on these amc fallouts

That job doesn’t support summers that average 100 degrees for months with cost of living that expensive…cool city, but I’ll visit
 
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Howard888 said:
Seriously??? 3 max to start? Non guaranteed partner? 100k buy in? Top out 500? A 2000 square foot house there is 7 figures.

Good luck staffing that place-I’ll choose Dallas..or let me know if you have an in with one of those private groups….that sounds like a big win to capitalize on these amc fallouts

That job doesn’t support summers that average 100 degrees for months with cost of living that expensive…cool city, but I’ll visit
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Dallas has better schools as well if youre looking in the the Plano area. Unfortunately I do not know of them personally, but Gasworks has listings for them. LoneStar is one of them, and I think the other one is called South Texas. Both in San Antonio. Dallas has DAA, Pilot, and Metro anesthesia.
 
No rational reason to be in Austin over San Antonio, other than the idea you are living somewhere "cool"
 
DAA in Dallas used to be good case mix. Lots of plastics/ortho. Little to no call. Do your own cases. Not sure if that’s still the case, but they were good work and fair.

Metro is well run, as well, and you’re not working for an AMC.

Scott & White, all over central Texas and VERY close to Austin, may not be a “dream job”, but the pay is decent, good job security. The nature of the job will depend on what site you’re at (they own everything from small community hospitals to regional medical centers to essentially academic facilities).

If anbody is looking for a legit job on the west side of the state (NOT El Paso and NOT oil country), that pays $625k with 12 weeks of vacation, and NOT an AMC, PM me, and I can hook you up.
 
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DirtDocMD said:
DAA in Dallas used to be good case mix. Lots of plastics/ortho. Little to no call. Do your own cases. Not sure if that’s still the case, but they were good work and fair.

Metro is well run, as well, and you’re not working for an AMC.

Scott & White, all over central Texas and VERY close to Austin, may not be a “dream job”, but the pay is decent, good job security. The nature of the job will depend on what site you’re at (they own everything from small community hospitals to regional medical centers to essentially academic facilities).

If anbody is looking for a legit job on the west side of the state (NOT El Paso and NOT oil country), that pays $625k with 12 weeks of vacation, and NOT an AMC, PM me, and I can hook you up.
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You have pms blocked… for some reason I cannot message you. Pm me?
 
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Howard888 said:
www.kxan.com

Austin housing market sets another record for median home price

It’s an all-time high — again — for the Austin-Round Rock MSA, jumping nearly 28% since February 2021 to $499,995. There were also more than 2,500 closings in February, an increase of more th…
www.kxan.com
Click to expand...

And if your’re lucky enough to buy a house, can you afford it longterm? Property taxes are also skyrocketing. From last year to this year, my taxable amount is going up 50%.
 
DirtDocMD said:
DAA in Dallas used to be good case mix. Lots of plastics/ortho. Little to no call. Do your own cases. Not sure if that’s still the case, but they were good work and fair.

Metro is well run, as well, and you’re not working for an AMC.

Scott & White, all over central Texas and VERY close to Austin, may not be a “dream job”, but the pay is decent, good job security. The nature of the job will depend on what site you’re at (they own everything from small community hospitals to regional medical centers to essentially academic facilities).

If anbody is looking for a legit job on the west side of the state (NOT El Paso and NOT oil country), that pays $625k with 12 weeks of vacation, and NOT an AMC, PM me, and I can hook you up.
Click to expand...
Out in west Texas myself. Looking to communicate but your profile still won’t allow
 
anbuitachi said:
i dont see how austin can be next california, without the 10% state tax
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10% state tax. The residents should be grateful if that’s all that happens.

Unaffordable housing High taxes and low pay jobs are the future of Austin and texas.
 
RadsWFA1900 said:
This is why this whole “hot labor market” thing hasn’t planned out for workers. Everything is wayy more expensive especially the things that matter housing, food and transportation,
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When you factor in the inflation in price and the rise in interest rates the increase in monthly cost is staggering. But we were living inflated lifestyles with purchasing power based on borrowed money, anyway.

One thing that worries me about the housing market, that this article also alludes to: are people really buying houses with just 5% down? That is insane to me, if prices stabilize and you sell for no gain you'll be underwater after transaction fees. Call me old fashioned but I've always put 20% down. Granted I've never bought a house that was 5x my annual income but geez.
 
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so Don’t live in Austin, Texas if you want to be rich as an anesthesiologist ?
 
ambiturner said:
One thing that worries me about the housing market, that this article also alludes to: are people really buying houses with just 5% down? That is insane to me, if prices stabilize and you sell for no gain you'll be underwater after transaction fees. Call me old fashioned but I've always put 20% down. Granted I've never bought a house that was 5x my annual income but geez.
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I just bought a house with 5% down. I'd have put 0% down if they'd let me. With a fixed 2.5% 30y loan, I'll never make an early payment.
 
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pgg said:
I just bought a house with 5% down. I'd have put 0% down if they'd let me. With a fixed 2.5% 30y loan, I'll never make an early payment.
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I just didn’t even know it was an option, or that you could geta rate that low. Maybe next time…
 
pgg said:
I just bought a house with 5% down. I'd have put 0% down if they'd let me. With a fixed 2.5% 30y loan, I'll never make an early payment.
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Nice man
You must have just gotten it in March or April right before rates shot up
 
pgg said:
With a fixed 2.5% 30y loan, I'll never make an early payment.
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that reminds me we have not had a thread about paying off mortgages in a while

Low fixed rate mortgages are about the surest bet possible in terms of helping maximize long term savings/investment. They are tax efficient (though less so with SALT caps), can never go higher in rate (but might go lower in future), and a great hedge against inflation (like right now).

Easy, cheap, (somewhat) tax deductible leverage for your portfolio.
 
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Mman said:
that reminds me we have not had a thread about paying off mortgages in a while

Low fixed rate mortgages are about the surest bet possible in terms of helping maximize long term savings/investment. They are tax efficient (though less so with SALT caps), can never go higher in rate (but might go lower in future), and a great hedge against inflation (like right now).

Easy, cheap, (somewhat) tax deductible leverage for your portfolio.
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Especially true in a moderate-severe inflationary environment. Prior to the last year, prepaying the mortgage was usually better than the after tax risk free rate of return for the last decade for high bracket individuals.
 
Dr. Rude said:
Especially true in a moderate-severe inflationary environment. Prior to the last year, prepaying the mortgage was usually better than the after tax risk free rate of return for the last decade for high bracket individuals.
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paying mortgage may have been better than "risk free rate of return", but when saving for retirement you are always earning more than that rate so it never was a good idea to prepay mortgage as opposed to simply investing more for retirement
 
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GassYous said:
Nice man
You must have just gotten it in March or April right before rates shot up
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December 2021

VA loan through a credit union. No origination fee, no points. Pretty amazing experience compared to the house we bought as a short sale in 2009, when Wells Fargo came at us with a hot iron poker to assess our credit.

I should clarify, they did extend the option of 0% down but it would have jacked up the VA funding fee to 3.6%, which was silly.

We looked at conventional mortgages too but the rates were above 3%.
 
pgg said:
I just bought a house with 5% down. I'd have put 0% down if they'd let me. With a fixed 2.5% 30y loan, I'll never make an early payment.
Click to expand...


With rising interest rates and price appreciation, we couldn’t afford the home we’re living in now that we purchased just 3years ago. I don’t see how this is sustainable. And I have no idea how low and middle income people do it.
 
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pgg said:
December 2021

VA loan through a credit union. No origination fee, no points. Pretty amazing experience compared to the house we bought as a short sale in 2009, when Wells Fargo came at us with a hot iron poker to assess our credit.

I should clarify, they did extend the option of 0% down but it would have jacked up the VA funding fee to 3.6%, which was silly.

We looked at conventional mortgages too but the rates were above 3%.
Click to expand...

Now they are above 5! Can't believe this bs
 
nimbus said:
With rising interest rates and price appreciation, we couldn’t afford the home we’re living in now that we purchased just 3years ago. I don’t see how this is sustainable. And I have no idea how low and middle income people do it.
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Yeah as someone graduating next summer, I’ve had to adjust my expectations about what we’ll be able to afford. This market is nuts.
 
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We finally just closed on our home here in Texas. 3.75% locked in 90 days ago in February. New construction build, only money we put down was the earnest money deposit and something like 15% of any upgrades we added on. Altogether, we put down about 13-15k on a 450k home. The build took 14 months. The ridiculous thing is that the base price of our home is already up like 60k. We did a VA loan too and the lender is giving us back approx 5k (I have no idea how that works but I'm not complaining).
 
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MirrorTodd said:
We finally just closed on our home here in Texas. 3.75% locked in 90 days ago in February. New construction build, only money we put down was the earnest money deposit and something like 15% of any upgrades we added on. Altogether, we put down about 13-15k on a 450k home. The build took 14 months. The ridiculous thing is that the base price of our home is already up like 60k. We did a VA loan too and the lender is giving us back approx 5k (I have no idea how that works but I'm not complaining).
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New builds in my area are going up like 2-300k per year for base price. One I looked at a year ago is doubled.
 
GassYous said:
Now they are above 5! Can't believe this bs
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It's all relative

My parents paid over 10% interest, with 20% down, on a mortgage back in the 1970s. Really anything under 6-7% is pretty great from a long term historical perspective. We've just been spoiled by great mortgage rates the last couple decades.

It's just amazing how fast they've gone up in the last few months. We feel lucky.
 
The fed has to basically cause the housing market to “crash”. It’s their perpetual cycle of boom and then bust. Only solution to 8-9% inflation. Just don’t be the bag holder..
 
pgg said:
It's all relative

My parents paid over 10% interest, with 20% down, on a mortgage back in the 1970s. Really anything under 6-7% is pretty great from a long term historical perspective. We've just been spoiled by great mortgage rates the last couple decades.

It's just amazing how fast they've gone up in the last few months. We feel lucky.
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That's what younger people don't realize. My parents paid 6% on their mortgage in the 60s! I assumed an 8.5% VA loan in 1981 when rates were in the 14-16% range. Rates were still 10%+ until 1990 when they started creeping down. A 5% rate, historically is still a bargain.
 
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jwk said:
That's what younger people don't realize. My parents paid 6% on their mortgage in the 60s! I assumed an 8.5% VA loan in 1981 when rates were in the 14-16% range. Rates were still 10%+ until 1990 when they started creeping down. A 5% rate, historically is still a bargain.
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Rates were high back then…I think my parents had a rate around 10%. However, the difference today is the cost of maintaining and upgrading a house is way more expensive. Between new technology, material costs, and labor, owning a home has gotten a lot more expensive compared to the 1980s. If rates approach double digits again and remain there for any significant length of time, I don’t see how that doesn’t crash the housing market. What might happen in that case is we’ll continue to see a decline in individual homeownership and an increase in institutional investors buying homes and renting them out.
 
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pgg said:
It's all relative

My parents paid over 10% interest, with 20% down, on a mortgage back in the 1970s. Really anything under 6-7% is pretty great from a long term historical perspective. We've just been spoiled by great mortgage rates the last couple decades.

It's just amazing how fast they've gone up in the last few months. We feel lucky.
Click to expand...

Yeah how much was a house vs average income?
 
GassYous said:
Yeah how much was a house vs average income?
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it used to be whatever your annual
Salary was that’s the price of a home you could afford. Now…everyone is paying multiples of that and taking out a 30 year mortgage.

I recently took a look at what you get these days for your money in the town I grew up in. I wanted to vomit.
 
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