Consider MedNax job?

[Mid-Atlantic Doc]

Hey everyone,
I'm currently a private practice general anesthesiologist looking at interviewing with a group that already sold to Mednax. Thus, I would be an "employee" like everyone else. Would you recommend joining a group like this? What have re-negotiations been like once the initial contract period is up? Are people still happy or feel like pawns?

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[deleted162650]

Why would you want to leave your PP gig to be a Mednax employee. Do you also enjoy kicking yourself in the balls in your spare time??

 

[Consigliere]

Worst. Decision. Ever.

 

[deleted126335]

Worst. Decision. Ever.

Kin to cutting and self mutilation.

 

[Psai]

Great idea! Just wait a few years and pm your group manager's email address thanks

 

[caligas]

Hey everyone,
I'm currently a private practice general anesthesiologist looking at interviewing with a group that already sold to Mednax. Thus, I would be an "employee" like everyone else. Would you recommend joining a group like this? What have re-negotiations been like once the initial contract period is up? Are people still happy or feel like pawns?

Are you sure you're not a Mednax exec doing research?

-quick: where are you in your MOCA cycle, what’s your favorite c/s spinal cocktail?

 

[Robotic Wis-Hipple]

Are you sure you're not a Mednax exec doing research?

-quick: where are you in your MOCA cycle, what’s your favorite c/s spinal cocktail?

Answer: whatever the crna wants to give while my employed MDA is off floor doing preops/charts for OR cases.

 

[sbmed100]

Don’t listen to these naysayers. There is huge variability from one AMC practice to another. Why would you not ask the people that currently work at that particular job? Mednax is probably one of the better AMCs...it is headed by an MD and physician-centric.

 

[Arch Guillotti]

Don’t listen to these naysayers. There is huge variability from one AMC practice to another. Why would you not ask the people that currently work at that particular job? Mednax is probably one of the better AMCs...it is headed by an MD and physician-centric.

 

[facted]

Joining mednax sounds like a fantastic idea if you're looking for a failing company to work for...what could possibly go wrong.

Mednax: Slow Bleed Continues, Will Private Equity Step In? - Mednax, Inc. (NYSE:MD) | Seeking Alpha

 

[Mid-Atlantic Doc]

Hey everyone,
I'm currently a private practice general anesthesiologist looking at interviewing with a group that already sold to Mednax. Thus, I would be an "employee" like everyone else. Would you recommend joining a group like this? What have re-negotiations been like once the initial contract period is up? Are people still happy or feel like pawns?

Its really because I'm not from here and want to be closer to home. Not sure what that's worth though

 

[Beach bum]

Hey everyone,
I'm currently a private practice general anesthesiologist looking at interviewing with a group that already sold to Mednax. Thus, I would be an "employee" like everyone else. Would you recommend joining a group like this? What have re-negotiations been like once the initial contract period is up? Are people still happy or feel like pawns?

I have never worked for an amc but over the years have done some research wondering what was available. I interviewed with an amc and was offered a position but when I looked at the contract offered I couldn’t imagine anyone signing anything close to the terms they were putting forth. They asked me to submit to them what I would want changed in their contract. Even though it was a waste of time I submitted a few major points that I fealt would be deal breakers and never heard back from them. At the time I felt that I might agree to their terms if the soup lines became extra long....
It really is too bad that our profession has had this foisted upon us and hope that anyone agreeing to work under those terms would consider some other alternative.

 

[aneftp]

Mednax was the darling of acquisition in late 2000s and early 2010s. They were buying up the more lucrative practices.

Now it’s USAP trying to be the darling and looking good for investors. Because it’s all about cherry picking the most lucrative practice.

Eventually you can only pick up so many lucrative private practices and have to make due with declining reimbursements and docs who have sold out slowly leaving as their time commitment ends or they have enough from the buyout to retire/cut back.

North Carolina is mednax Waterloo. I’ve explained it in the past. Mednax is screwed there.

 

[pgg]

If the $/hr, the work environment (including risk/liability), and the location are acceptable to you, go for it. It's just a job.

I don't think any of us can really answer any of those questions for you. Unless you've been living under a rock the last few years, you're well aware of MEDNAX's reputation when it comes to work environment. If you're still considering the job despite that, then the other pros must be at least approaching the cons.

Its really because I'm not from here and want to be closer to home.

And the geographic anchor drowns another one.

There's a price to be paid for such a narrow geographic preference. You're asking for advice? Here it is: Choose to live someplace else and be happy there. Humans have a long and glorious history of moving, whether they're following work or woolly mammoths. Meeting new people and making new friends. Home is where you make it. You've got 50 states to choose from before you even need to think about learning another language or getting a visa. So many choices. Just move.

 

[Victorinox]

So if mednax goes belly-up in North Carolina, what does that do for Anesthesiology services? Is there the opportunity to start NEW private practice, partnership groups? Or will the hospitals just make everting employees?

What geography in NC is this particularly relevant to? The whole state, or specific cities?

 

[Southpaw]

So if mednax goes belly-up in North Carolina, what does that do for Anesthesiology services? Is there the opportunity to start NEW private practice, partnership groups? Or will the hospitals just make everting employees?

What geography in NC is this particularly relevant to? The whole state, or specific cities?

Just look at current NC Mednax locations and you’ll see where it’s relevant. Mednax scooped up some great locations a while back. Since it’d be tough to find enough anesthesiologists that don’t have non-competes to deal with, and our services need to be provided continuously (Mednax leaves on a Friday, the hospital will NEED anesthesia services on the following Monday) what will likely occur is that a neighboring private practice will expand to cover the needed service, or the hospital will hire their own and it’ll be a hospital run group.

 

[Victorinox]

Just look at current NC Mednax locations and you’ll see where it’s relevant. Mednax scooped up some great locations a while back. Since it’d be tough to find enough anesthesiologists that don’t have non-competes to deal with, and our services need to be provided continuously (Mednax leaves on a Friday, the hospital will NEED anesthesia services on the following Monday) what will likely occur is that a neighboring private practice will expand to cover the needed service, or the hospital will hire their own and it’ll be a hospital run group.

I ask because I’m heading to that area of the world for fellowship in summer and like the region.

I think I would like to stay long term, but feel the prospect of working for an AMC isn’t one I would be too keen on.....

 

[Arch Guillotti]

North Carolina is mednax Waterloo. I’ve explained it in the past. Mednax is screwed there.

So if mednax goes belly-up in North Carolina, what does that do for Anesthesiology services? Is there the opportunity to start NEW private practice, partnership groups? Or will the hospitals just make everting employees?

Since it’d be tough to find enough anesthesiologists that don’t have non-competes to deal with, and our services need to be provided continuously (Mednax leaves on a Friday, the hospital will NEED anesthesia services on the following Monday) what will likely occur is that a neighboring private practice will expand to cover the needed service, or the hospital will hire their own and it’ll be a hospital run group.

GasWork.com - Reference #230871


It would appear that this location imploded and a brand new private practice was formed. Surely there has to be some nasty litigation between the hospital, the health system, MEDNAX and the docs.

 

[Mman]

Just look at current NC Mednax locations and you’ll see where it’s relevant. Mednax scooped up some great locations a while back. Since it’d be tough to find enough anesthesiologists that don’t have non-competes to deal with, and our services need to be provided continuously (Mednax leaves on a Friday, the hospital will NEED anesthesia services on the following Monday) what will likely occur is that a neighboring private practice will expand to cover the needed service, or the hospital will hire their own and it’ll be a hospital run group.

If Mednax leaves on a Friday at 1700, you don't start needing new services at 0700 on Monday, you need them at 1701 on Friday. You need a full complement of physicians and anesthetists that can begin working the second the Mednax contract is over. Now over a weekend you obviously don't need everybody working, get by with a smaller number covering whatever weekend call equates to, but obviously as you point out you need to be full go on Monday morning covering every single location.

I do not know what the legal enforceability of their noncompete is in NC, but I'd imagine it will be challenged by a hospital or two. Much easier to get out from under Mednax if the hospital can hire those docs and anesthetists to work for them directly.

 

[Southpaw]

GasWork.com - Reference #230871


It would appear that this location imploded and a brand new private practice was formed. Surely there has to be some nasty litigation between the hospital, the health system, MEDNAX and the docs.

Wow, great to see. Hopefully it’ll be successful. I grew up in NC and wanted to return after residency, but finding a solid private practice became very difficult.

 

[Southpaw]

I do not know what the legal enforceability of their noncompete is in NC, but I'd imagine it will be challenged by a hospital or two. Much easier to get out from under Mednax if the hospital can hire those docs and anesthetists to work for them directly.

You’re right about the timing, my bad. I was more talking about elective case coverage. But absolutely the hospital will need coverage of anesthesia services 24/7.

We all saw what happened in Asheville. Though that wasnt a denial of Mednax from my understanding (think it was some other AMC if I remember correctly), it was an example of a hospital not liking the corporate folks moving in. I wonder how that situation is going.

Good to see Greensboro going back to a private practice model. That’s a nice area of NC. Guess we will see how this all plays out there and at some of the other Mednax NC locations in the next few years.

 

[Arch Guillotti]

We all saw what happened in Asheville. Though that wasnt a denial of Mednax from my understanding (think it was some other AMC if I remember correctly), it was an example of a hospital not liking the corporate folks moving in. I wonder how that situation is going.

Mission may end agreement with anesthesia services provider

 

[BLADEMDA]

You’re right about the timing, my bad. I was more talking about elective case coverage. But absolutely the hospital will need coverage of anesthesia services 24/7.

We all saw what happened in Asheville. Though that wasnt a denial of Mednax from my understanding (think it was some other AMC if I remember correctly), it was an example of a hospital not liking the corporate folks moving in. I wonder how that situation is going.

Good to see Greensboro going back to a private practice model. That’s a nice area of NC. Guess we will see how this all plays out there and at some of the other Mednax NC locations in the next few years.

Asheville is now all "hospital employees" in terms of anesthesia providers.

 

[DrZzZz]

GasWork.com - Reference #230871


It would appear that this location imploded and a brand new private practice was formed. Surely there has to be some nasty litigation between the hospital, the health system, MEDNAX and the docs.

What's your guys thoughts on something like this? If they're looking, any concerns about the litigation affecting new hires that weren't involved with Mednax?

 

[Mman]

What's your guys thoughts on something like this? If they're looking, any concerns about the litigation affecting new hires that weren't involved with Mednax?

I would assume the only way it could have any implication for a new hire would be if somehow the contract with the hospital for the new group got jeopardized.

 

[timgasman]

Hey everyone,
I'm currently a private practice general anesthesiologist looking at interviewing with a group that already sold to Mednax. Thus, I would be an "employee" like everyone else. Would you recommend joining a group like this? What have re-negotiations been like once the initial contract period is up? Are people still happy or feel like pawns?

Stay away from these big mega groups. They are total dead end jobs that make you work like a partner and earn like an employee. They have only grown due to our own reluctance to exert ourselves. There are better jobs out there - keep looking!

 

[sbmed100]

Ok, so the vibe I’m getting here is that it is preferable to have your private practice group be taken over by your hospital rather than be an employee of an AMC. I don’t know about you but in the Northeast hospital run anesthesia groups are having a hard time recruiting, don’t pay well, have low job satisfaction, and are generally not efficiently run.

 

[deleted162650]

Ok, so the vibe I’m getting here is that it is preferable to have your private practice group be taken over by your hospital rather than be an employee of an AMC. I don’t know about you but in the Northeast hospital run anesthesia groups are having a hard time recruiting, don’t pay well, have low job satisfaction, and are generally not efficiently run.

No, the vibe you're getting here is that it's better to stay in.a high quality, stable PP group.

 

[ERRES2288]

No, the vibe you're getting here is that it's better to stay in.a high quality, stable PP group.

What is the size of most private practice groups still left? Would joining something like a 4-5 physician group carry more risk? It seems like it is always the larger groups >20 docs that get bought out.

 

[sbmed100]

No, the vibe you're getting here is that it's better to stay in.a high quality, stable PP group.

Of course it’s better. Agreed. I’m Not sure what you mean by stable. Where I am (Tri-state Area) way less than 10% of groups are private practice. Ie what is left are groups that can’t sell and are lying in wait for their hospital to take them over.

 

[deleted162650]

Of course it’s better. Agreed. I’m Not sure what you mean by stable. Where I am (Tri-state Area) way less than 10% of groups are private practice. Ie what is left are groups that can’t sell and are lying in wait for their hospital to take them over.

Move

 

[ShaggyDog]

It would appear that this location imploded and a brand new private practice was formed. Surely there has to be some nasty litigation between the hospital, the health system, MEDNAX and the docs.

From NC. that's exactly what happened. The partners in greensboro did not renew their contract with mednax when it came time for renewal and negotiated directly with the facilities they cover. Mednax is obviously suing the group right now and i don't know what the status of it is currently. I know of at least one recent hire who has been screwed by Mednax trying to enforce their noncompete and prevent them from joining this group.

I'm not sure how that works because presumably the entire staff would have signed a non-compete but is still working for the new group?

 

[ShaggyDog]

Asheville is now all "hospital employees" in terms of anesthesia providers.

former co-resident went to work out there. seems like a great gig, shift work, solid pay and benefits.

 

[sbmed100]

Move

Nah I don’t think so...money, colleagues and schedule way too good at current gig.

 

[GravelRider]

Ok, so the vibe I’m getting here is that it is preferable to have your private practice group be taken over by your hospital rather than be an employee of an AMC. I don’t know about you but in the Northeast hospital run anesthesia groups are having a hard time recruiting, don’t pay well, have low job satisfaction, and are generally not efficiently run.

Depends on the hospital. Being employed by a small community hospital may not be a bad thing. Unfortunately, small community hospitals are going the way of private practices. There are not many small community hospitals left in the entire Northeast. They have all joined some larger system. Being employed by the larger system hospitals tends to come with the low salary of academics with none of the perks and a lot of strong contract language designed to try to prevent you from leaving. There is a glaring reason why some of those large hospitals can't hire their own anesthesiologists.

 

[Urzuz]

Answer: whatever the crna wants to give while my employed MDA is off mopping floors

FTFY

 

[Scotty_G]

Northeast is not the greatest for private practice (lot of AMC) but there are still some private groups out there. Also some are still good :0

 

[BLADEMDA]

From NC. that's exactly what happened. The partners in greensboro did not renew their contract with mednax when it came time for renewal and negotiated directly with the facilities they cover. Mednax is obviously suing the group right now and i don't know what the status of it is currently. I know of at least one recent hire who has been screwed by Mednax trying to enforce their noncompete and prevent them from joining this group.

I'm not sure how that works because presumably the entire staff would have signed a non-compete but is still working for the new group?

Well, anyone NOT affiliated with mednax can join the group because he/she is not part of the litigation. I assume hospital privileges is another sticky situation but that isn't the new hire's problem either. If the hospital grants privileges then that is on the hospital.

The issue is with "joining" a group which is in active litigation against a major AMC. That could get expensive and someone needs to pay the legal bills especially if the AMC prevails. So, the best situation is to remain "1099" until the private group either folds or emerges victorious.

 

[Stank811]

Unless AMC change their business model they will most likely continue to shrink but will not disappear. They will remain in highly desirable areas in which they are able to maintain quality staff with a 50% reduction in pay while satisfying hospital needs b/c people are willing to make that sacrifice to live in that area.

The only reason to currently work for an AMC is because you refuse to move.

What remains (PP vs hospital employed) when an AMC leaves is largely dependent on the relationship of the leadership of the previous anesthesiologist and hospital system. Why do you think AMC put a management layer in between the workers/money producers and the hospital C-suite? AMC non-competes will not hold up in the court for those providing care on a daily basis but the non-competes will hold up with their site leads who are the managers. It is a scare tactic for the AMC...if we leave you can keep all the workers but loose the leadership....complete BS line but remember they look at us like a commodity. So if this happens to you and you are not currently in a management spot with the AMC step up to the plate and talk with all the anesthesia providers and develop a leadership team to work with the hospital in developing a PP group...will need to sell the PP vs employed pitch to the hospital C-suite...but that should be a different thread so won't get into arguments to make.

 

[IlDestriero]

What is the size of most private practice groups still left? Would joining something like a 4-5 physician group carry more risk? It seems like it is always the larger groups >20 docs that get bought out.

It’s all about the money. They have to show profits for their owners/investors. If there’s money to be made in a 5 person shop, it’s on the table.
It also could be a way to get a foot in the door of a particular market.


--
Il Destriero

 

[gasmark]

Anybody have any more info on this? Just heard another group in NC did the same thing??

From NC. that's exactly what happened. The partners in greensboro did not renew their contract with mednax when it came time for renewal and negotiated directly with the facilities they cover. Mednax is obviously suing the group right now and i don't know what the status of it is currently. I know of at least one recent hire who has been screwed by Mednax trying to enforce their noncompete and prevent them from joining this group.

I'm not sure how that works because presumably the entire staff would have signed a non-compete but is still working for the new group?