Changes after AMC Buyout

[dannyboy1]

The crime is robbing Peter to pay Paul.

The whole concept of the AMC buyout is strange. The value of the practice is its contract with the hospital. I never understood why the hospital doesn’t try to sell the contract to the AMC, instead the AMC buys it from people who don’t really own it.

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[deleted171991]

Now, if you had a practice to sell...... then you would have the money.....

A-ha!

 

[Hoya11]

The whole concept of the AMC buyout is strange. The value of the practice is its contract with the hospital. I never understood why the hospital doesn’t try to sell the contract to the AMC, instead the AMC buys it from people who don’t really own it.

The hospital doesnt try to sell the contract to the AMC because the AMC has no doctors or CRNAs to staff the place...

The AMC needs to woo the partners so they stay and keep doing what they are doing for X amount of years until the AMC recoops the buy-out they paid.

 

[Hoya11]

This sounds exactly like what the old group in Vegas that had about 100 docs who sold out to USAP in 2016/2017 are going through now. People are unhappy and overworked and money ain't was was promised, etc. And the overhead keeps increasing for some reason. LOL

Quite frankly, when you are a group that large and want to sell out when you have the capability to negotiate very well with the insurance companies makes no sense to me.

I guess plenty of people want "fast money" but it comes with a price.

one thing to keep in mind is maybe the groups that are selling out have no other choice.

Good PP groups making great money and with acceptable lifestyle dont just sell out for more money there are usually other issues.

Many groups sell out when they start to spiral downward: if salaries are down and/or, hours are ridiculous, hospital wont help you, what choice do you have? would you work 80 hrs a week with call for 250k? Hospital says no stipend... (it happens and is the reason I believe this whole trend started)

sometimes its a middle finger to a stubborn hospital, after the buyout you do your 5 years that you are obligated to at 350k and you walk away with something rather than letting the partners go down the drain financially and/or have to find other jobs.

Then things inevitably don't work out with the AMC and the hospital kicks out the AMC, but you have kept your buy out money and probably made more or close to equal salary than before the buy out. Then the hospital has to start from scraps having learned a lesson, but by then you are gone on to somewhere else and the cycle repeats..

 

[dannyboy1]

one thing to keep in mind is maybe the groups that are selling out have no other choice.

Good PP groups making great money and with acceptable lifestyle dont just sell out for more money there are usually other issues.

Many groups sell out when they start to spiral downward: if salaries are down and/or, hours are ridiculous, hospital wont help you, what choice do you have? would you work 80 hrs a week with call for 250k? Hospital says no stipend... (it happens and is the reason I believe this whole trend started)

sometimes its a middle finger to a stubborn hospital, after the buyout you do your 5 years that you are obligated to at 350k and you walk away with something rather than letting the partners go down the drain financially and/or have to find other jobs.

Then things inevitably don't work out with the AMC and the hospital kicks out the AMC, but you have kept your buy out money and probably made more or close to equal salary than before the buy out. Then the hospital has to start from scraps having learned a lesson, but by then you are gone on to somewhere else and the cycle repeats..

Yup. An older guy told me that the decision to sell was easy when one year the partners made less than their mommy track employees.....

 

[nimbus]

The whole concept of the AMC buyout is strange. The value of the practice is its contract with the hospital. I never understood why the hospital doesn’t try to sell the contract to the AMC, instead the AMC buys it from people who don’t really own it.

Asheville and Charlotte demonstrate exactly this.

 

[nimbus]

Yup. An older guy told me that the decision to sell was easy when one year the partners made less than their mommy track employees.....

They wouldn’t get much for the practice if that were true.

 

[dannyboy1]

They wouldn’t get much for the practice if that were true.

Maybe they didn’t. Sometimes an AMC is in “acquisition mode” and really don’t care about the product they are buying. Seems to be more about stock prices....

 

[chocomorsel]

one thing to keep in mind is maybe the groups that are selling out have no other choice.

Good PP groups making great money and with acceptable lifestyle dont just sell out for more money there are usually other issues.

Many groups sell out when they start to spiral downward: if salaries are down and/or, hours are ridiculous, hospital wont help you, what choice do you have? would you work 80 hrs a week with call for 250k? Hospital says no stipend... (it happens and is the reason I believe this whole trend started)

sometimes its a middle finger to a stubborn hospital, after the buyout you do your 5 years that you are obligated to at 350k and you walk away with something rather than letting the partners go down the drain financially and/or have to find other jobs.

Then things inevitably don't work out with the AMC and the hospital kicks out the AMC, but you have kept your buy out money and probably made more or close to equal salary than before the buy out. Then the hospital has to start from scraps having learned a lesson, but by then you are gone on to somewhere else and the cycle repeats..

I can see that. Except out in Vegas, there were no exclusive contracts except for trauma at two hospitals in town and the one hospital in the North Side. The University Hospital paid Now things are changing since USAP stepped in. I hear they are trying to shut out other non USAP docs to certain hospitals.
I don't know why they sold out really, but people are unhappy now.

 

[deleted50478]

...and Paul is yourself.

No I’m Peter and I said f u to Paul and left. He’ll just rob another Peter though. There are only so many jobs to go around.

 

[pgg]

Except those few years of your life will be even harsher. And almost half of that mil goes to Uncle Sam. And the other half is given to you in stock shares. So what you take home is really far from a mil.

Eh

I can see the appeal. If I was within $X of my number, and I was offered $X after taxes to sell out and agree to stay a couple or three years, I'd consider it. Those years would only be harsh if you let them be harsh. Agree to a contract of X hours with some max supervision ratio you can tolerate, and then just passively refuse to work more. Stay late? Nah. Worst case, finish the case going at the end of your shift, ignore the list of cases still on the board, decline to start another, go home. Committee meeting? Nah, no thanks. What are they going to do?

Unavoidably stay late on Monday, hit your Y hours/week number? "Sorry, I'm at my hour limit. I won't be here on Friday." What are they going to do?

We're all motivated people, willing to work hard, else we wouldn't be here. It's possible to turn it off and just let that stuff go.

 

[IMGASMD]

Eh

I can see the appeal. If I was within $X of my number, and I was offered $X after taxes to sell out and agree to stay a couple or three years, I'd consider it. Those years would only be harsh if you let them be harsh. Agree to a contract of X hours with some max supervision ratio you can tolerate, and then just passively refuse to work more. Stay late? Nah. Worst case, finish the case going at the end of your shift, ignore the list of cases still on the board, decline to start another, go home. Committee meeting? Nah, no thanks. What are they going to do?

Unavoidably stay late on Monday, hit your Y hours/week number? "Sorry, I'm at my hour limit. I won't be here on Friday." What are they going to do?

We're all motivated people, willing to work hard, else we wouldn't be here. It's possible to turn it off and just let that stuff go.

Isn’t that the employee mentality that people saying about the millennials?

Different mindset, because it is not a business that is under physicians control anymore. Everything we do now is associated with a dollar sign.

Not to say the old way is better either. I am sure I am not saying anything new.

 

[Mikkel]

We're all motivated people, willing to work hard, else we wouldn't be here. It's possible to turn it off and just let that stuff go.

It's hard to turn it off though. I feel really guilty for turning down requests from surgeons and schedulers. I don't want to be known as the guy who doesn't help out.

Maybe that's the reason why I let myself get taken advantage of by an AMC previously. And maybe why AMCs get away with it usually across the country. It's easy to take advantage of docs... They usually go into medicine to help. And AMC execs love taking advantage of others, that's why they went into the business.

Talk about a match made in Hell.

 

[IMGASMD]

It's hard to turn it off though. I feel really guilty for turning down requests from surgeons and schedulers. I don't want to be known as the guy who doesn't help out.

Maybe that's the reason why I let myself get taken advantage of by an AMC previously. And maybe why AMCs get away with it usually across the country. It's easy to take advantage of docs... They usually go into medicine to help. And AMC execs love taking advantage of others, that's why they went into the business.

Talk about a match made in Hell.

https://www.nytimes.com/2019/06/08/opinion/sunday/hospitals-doctors-nurses-burnout.amp.html

 

[dannyboy1]

It's hard to turn it off though. I feel really guilty for turning down requests from surgeons and schedulers. I don't want to be known as the guy who doesn't help out.

Maybe that's the reason why I let myself get taken advantage of by an AMC previously. And maybe why AMCs get away with it usually across the country. It's easy to take advantage of docs... They usually go into medicine to help. And AMC execs love taking advantage of others, that's why they went into the business.

Talk about a match made in Hell.

Time to get over it. Be a wh0re dressed in scrubs. No money no honey .....

 

[Mikkel]

Time to get over it. Be a wh0re dressed in scrubs. No money no honey .....

I joined a private practice, swallowing Australian crocodiles whole. I'm haulin' ass and getting paid.

 

[deleted126335]

My husband has been through two buyouts. I have nothing positive to say. If you can leave, then do it. If more docs/nurses quit it’s the only way to hurt AMCs. Remember, AMCs can’t staff ORs. Only actually doctors and nurses can do that. Doctors and nurses have more power than they know..... if they stick together.

Not enough unity. Everyone will make the individual choice as to what they perceive as best for them and their family. The AMC thing is not new. Started in the 80s. Growth slowed and they lost a lot of contracts in the late 90s and 00s because the job market was good for most people in many parts of the country. People left these jobs. Those that stayed did just enough to fly under the radar. Also they drew from the left side of the personnel curve disproportionately because there were opportunities for good people who were willing to go to where the good jobs are/were. They didn’t have the best reputation among hospital administrators.

Absent a dearth of Med students entering the field for several years I see little hope.