CEP

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Still corporate, but yes democratic. Not always a stress free relationship between the two, but is open book, locally focused (for the most part). They do have some really nice resources being so big. If the job is otherwise good, I wouldn't let CEP be a negative, it's just not perfect.
 
Of all the CMGs they are one of the most open. Again you are dealing with something of a pyramid scheme, though it is less egregious than some others. One problem with how they do pay is that you are paid "distributions" as a K-1 rather than a W-2. That has some tax implications, and means you need to deduct everything as if you are a 1099. Additionally they require you to buy health insurance from the company, which is Humana. It's relatively expensive health insurance, and is similarly priced to what you can get on the individual market. On the plus side their overhead and corporate structure seems smaller than some others.
 
While they're not a SMALL democratic group, I certainly wouldn't consider them a CMG. They're a large democratic group.

From their website:

CEP America is a democratic physician partnership, with ownership of the Partnership and our subsidiaries distributed equitably among the practicing physicians. There are no outside owners or investors, so all income from the practice - after operational expenses and billing and malpractice costs - is fully returned to our physicians.

This Partnership structure provides an inherent incentive to meet the expectations of our client hospitals and patients. The Partnership has no debt, and all capital needs for business purposes are self-financed. Our practice management company is owned by the Partnership, which, in turn, is owned by all physician Partners. CEP America has no physician employees, as all physicians are Partners from the day they work their first clinical shift.

http://www.cep.com/AboutUs/WhoWeAre.aspx

That's not a CMG, that's a large DG.

We use the same 401(k) as them (which is a good one) so I have been to meetings with them before. I have a good friend who recently changed from their group to ours. The main problem with CEP is they're mostly in California, which is financially speaking a toxic wasteland for emergency physicians. High cost of living, high taxes, crappy reimbursement, poor payor mix, lots of self-pay illegals, crappy MediCAL etc. I think CEP is doing pretty darn well against that background.
 
The White Coat Investor said:
While they're not a SMALL democratic group, I certainly wouldn't consider them a CMG. They're a large democratic group.

From their website:

CEP America is a democratic physician partnership, with ownership of the Partnership and our subsidiaries distributed equitably among the practicing physicians. There are no outside owners or investors, so all income from the practice - after operational expenses and billing and malpractice costs - is fully returned to our physicians.

This Partnership structure provides an inherent incentive to meet the expectations of our client hospitals and patients. The Partnership has no debt, and all capital needs for business purposes are self-financed. Our practice management company is owned by the Partnership, which, in turn, is owned by all physician Partners. CEP America has no physician employees, as all physicians are Partners from the day they work their first clinical shift.

http://www.cep.com/AboutUs/WhoWeAre.aspx

That's not a CMG, that's a large DG.

We use the same 401(k) as them (which is a good one) so I have been to meetings with them before. I have a good friend who recently changed from their group to ours. The main problem with CEP is they're mostly in California, which is financially speaking a toxic wasteland for emergency physicians. High cost of living, high taxes, crappy reimbursement, poor payor mix, lots of self-pay illegals, crappy MediCAL etc. I think CEP is doing pretty darn well against that background.
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If you don't mind me asking, which 401(k) administrator / plan?
 
Once again, you are an employee, and not an "owner". Just by working there you don't get stock in the company, and your "ownership" can be taken away at any time. A more accurate description would be "Employee model with democratic component and open books".

I always think the "owner" title is misleading when it relates to physician groups. If I work for a company (say an investment bank) and am granted stock as compensation, then I am an "owner". In most cases, a company can fire me, but they cannot take away my "ownership" which is private property.
 
GeneralVeers said:
Once again, you are an employee, and not an "owner". Just by working there you don't get stock in the company, and your "ownership" can be taken away at any time. A more accurate description would be "Employee model with democratic component and open books".

I always think the "owner" title is misleading when it relates to physician groups. If I work for a company (say an investment bank) and am granted stock as compensation, then I am an "owner". In most cases, a company can fire me, but they cannot take away my "ownership" which is private property.
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My small democratic group can also fire a partner, but we have to buy him out. That's really no different. Is mine also an employee model with democratic component and open books? If so, I say "good enough."
 
traxus said:
If you don't mind me asking, which 401(k) administrator / plan?
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MedAmerica. The 401(k) is getting better all the time and is now quite good. If you don't like it, it doesn't cost you much to get a brokerage window at Schwab where you can buy anything you like.
 
A democratic group is often seen as this perfect model because since you are your own boss, you can do what you want and nobody can fire you. I used to think this when I first started out of residency as well. But now, I'm starting to feel that this type of arrangement truly doesn't exist. They can fire you in whatever model you work in if they feel you are threatening the contract. A lot of groups call themselves democratic because you get a vote in how things are run and you can be called owner because the way collections are distributed. Maybe it's just me, but I am guessing that while most physicians can follow the discussion above between White Coat and General Veers, most of us cannot or do not want to take the time to understand the topic to the depth that those 2 guys do. Just remember that no matter where you work, you can always be fired. They can fire you for poor outcomes, you piss off the hospital staff, bad PG scores, long wait times, etc. So I wouldn't base my job decision on the ability to be fired.

The main difference I see with CMG vs SDG's is that IN GENERAL, the person dictating the rules usually still has to work within those rules in a SDG. For example, our group does not have any physician that does not work in the ED. I think this gives him some "street cred" when it comes to rules and regulations and hoops we have to jump through. Things that frustrate us and piss us off while in the ED also affect him.

This is contrary to what I have seen from larger groups that staff hospitals in multiple states. Sure, they may have a director that works at your site, but I feel that he/she has far less autonomy than one would think. He doesn't negotiate the contract, he doesn't stipulate how much press ganey will affect our pay, he doesn't have the ability to hire more PAs without approval. When the administration is not happy with things in general, I am not even sure they call him and not the corporate office. He mostly does the schedule, listens to everyone's complaints (doctors, nurses, administration, patients), and answers to corporate.

The above is a gross generalization, and I realize this. If I had to, I could work in either circumstance (in fact, I have). My point was that the owner/democratic model that everyone dreams of is quite rare and possibly doesn't exist and you can always be fired....though if you do your job as you were trained and act professionally most of the time, you probably will do just fine in either setting.
 
Apollyon said:
In my first post-residency job, partners could be canned only with a 75% vote of the other partners.
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Same here. And to be honest, if you piss off 75% of your partners enough for them to want you gone, then you need to get out.
 
CEP, EMP, etc often have a buyout, however their contacts usually contain clauses that if you are fired "for cause", then they can take away your buyout/ownership and you are left for nothing. Often "for cause" can be nothing more than saying something to piss off the director, or ask too many questions of corporate. Most of the time there is no due process built into the contract. It would be great if my prior job required a 75% vote of the partners, but I knew more than one excellent doc who was shown the door simply at the whim of the director or a VP.
 
Birdstrike said:
Editing
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If you can't leave a post up for 24-48 hours so those actively participating in the discussion can have a chance to read it before deletion, don't bother writing it. I mean, I can understand why you might not want something on the internet forever, but if it can't stay for a couple days under a pseudonym, what's the point?
 
The White Coat Investor said:
If you can't leave a post up for 24-48 hours so those actively participating in the discussion can have a chance to read it before deletion, don't bother writing it. I mean, I can understand why you might not want something on the internet forever, but if it can't stay for a couple days under a pseudonym, what's the point?
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Seriously, dude. You think there's a point to all this? It's student doctor network. Who cares if I post, don't post, or post and delete, or "edit" or whatever? I personally don't take it that seriously, either way. It's just for fun. A hobby.
 
Birdstrike said:
Seriously, dude. You think there's a point to all this? It's student doctor network. Who cares if I post, don't post, or post and delete, or "edit" or whatever? I personally don't take it that seriously, either way. It's just for fun. A hobby.
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editing
 
winkleweizen said:
Fight, fight, fight!
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No, no, no. There will be no forum fight. I don't think he would have posted what he did if he didn't want to read what I had written. (Or maybe he's just a hater, I don't know.) But I get it, it's completely irritating the way I post, delete, edit, re-edit, with seemingly complete randomness. Watching sausage made is completely disgusting also, but every once in a while, out splurts something halfway consumable. Birdstrike = sausage.
 
MedPsy82 said:
Editing fight?! :corny:
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Yes. In fact, there was a massive, multi-page gore-filled flame war in just our two posts alone. It was there, but after a few seconds, it was gone. Only me, ActiveDuty, and 3 1/2 med students saw it. We both immediately replaced it with "Edit." You shoulda been there. Man, it was simply, awesome. It will be SDN lore, for centuries.
 
Birdstrike said:
Yes. In fact, there was a massive, multi-page gore-filled flame war in just our two posts alone. It was there, but after a few seconds, it was gone. Only me, ActiveDuty, and 3 1/2 med students saw it. We both immediately replaced it with "Edit." You shoulda been there. Man, it was simply, awesome. It will be SDN lore, for centuries.
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Already saw the thread talking about it and figured I would check it out. It sounded like it was brutal.
 
It was like a Lord of the Rings battle sequence with thousands of armed creatures battling, scaling walls, giants catapults firing. It was truly awesome in its scale and grandeur!
 
Birdstrike said:
Yes. In fact, there was a massive, multi-page gore-filled flame war in just our two posts alone. It was there, but after a few seconds, it was gone. Only me, ActiveDuty, and 3 1/2 med students saw it. We both immediately replaced it with "Edit." You shoulda been there. Man, it was simply, awesome. It will be SDN lore, for centuries.
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Lol. No hating here. Birdstrike has lots of great posts. I just miss half of them. Or perhaps only half of his posts are great and he deletes the rest, dunno.

But I do try to check back on threads I've commented on if there has been a new post. And it kind of feels like I wasted 8 seconds when I come back to find the new post says nothing but "." or "editing". That's all. No hating.
 
Anyone have any experience with CEP in Atlanta in particular?
 
Does anybody know anything about the CEP residency that opened up in Visalia, California at Kaweah Delta Health Care District? Is this the first time CEP has opened up a residency?

Lastly, does CEP pay relatively competitively with some of the other groups that staff CA EDs?
 
Trauma2015 said:
Does anybody know anything about the CEP residency that opened up in Visalia, California at Kaweah Delta Health Care District? Is this the first time CEP has opened up a residency?

Lastly, does CEP pay relatively competitively with some of the other groups that staff CA EDs?
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As with all CMGs, the pay is based one the payer mix, overall reimbursement and overhead. From my experience with them bidding on our site in Nevada, they pay about the same as EmCAre, EMP when including things like 401K and health benefits.
 
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