Cooperman Barnabas vs NAPA

[amyl]

Anyone have an update on what’s going on there? ORs still going? What’s the status of the multiple back and forth lawsuits

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[2Fast2Des]

From what I understand, it's Barnabas, they are trying to retain despite NAPA threatening enforcement of noncompete. Barnabas will deal with noncompete issues. But they are hiring very competitive rates, last I heard was 400 an hour for docs

 

[amyl]

I heard that- I also heard that barnabas was suing Napa - blaming poor outcomes on inadequate staffing. Heard a bunch about this and the nada

 

[IMGASMD]

Just got another recruiting email these few days. So maybe still short. Or trying to built up a reserve.

 

[NovAsthesia]

From what I understand, it's Barnabas, they are trying to retain despite NAPA threatening enforcement of noncompete. Barnabas will deal with noncompete issues. But they are hiring very competitive rates, last I heard was 400 an hour for docs

I know this was a few months ago, but do you have any new updates? Did the hospital end up retaining their doctors, or did Napa enforce the non-compete? Did another anesthesia management company take over or did the hospital hire the staff directly? I am not from that area but I think this situation will soon be happening in many places, so trying to learn some lessons.

 

[Gator7]

Yes the group now works for Barnabas. They were offering pretty competitive rates for the area the last I heard. I’m not too legally minded but I was told the hospital offered to cover any legal fees for staff that stayed on if NAPA tried to enforce non-compete. I keep in touch with some people that work there

I mean they were a sinking ship for years. Barnabas is a major hospital in the area and NAPA failed to staff. They attempted to plug the holes by burning out their residents instead of hiring more staff and the residency program was removed by the ACGME.

 

[MirrorTodd]

Yes the group now works for Barnabas. They were offering pretty competitive rates for the area the last I heard. I’m not too legally minded but I was told the hospital offered to cover any legal fees for staff that stayed on if NAPA tried to enforce non-compete. I keep in touch with some people that work there

I mean they were a sinking ship for years. Barnabas is a major hospital in the area and NAPA failed to staff. They attempted to plug the holes by burning out their residents instead of hiring more staff and the residency program was removed by the ACGME.

That's pretty effing stupid of them.

 

[NovAsthesia]

Yes the group now works for Barnabas. They were offering pretty competitive rates for the area the last I heard. I’m not too legally minded but I was told the hospital offered to cover any legal fees for staff that stayed on if NAPA tried to enforce non-compete. I keep in touch with some people that work there

I mean they were a sinking ship for years. Barnabas is a major hospital in the area and NAPA failed to staff. They attempted to plug the holes by burning out their residents instead of hiring more staff and the residency program was removed by the ACGME.

For those of us who are still working for a management company, how should we think about direct employment by a hospital? Is that a good thing or bad? Would't the hospital have control of all aspects of the daily work environment? Again, I am just trying to learn from someone who went through this experiment because it sounds like sooner or later it's coming to a hospital near you 😈

 

[narcotics999]

For those of us who are still working for a management company, how should we think about direct employment by a hospital? Is that a good thing or bad? Would't the hospital have control of all aspects of the daily work environment? Again, I am just trying to learn from someone who went through this experiment because it sounds like sooner or later it's coming to a hospital near you 😈

What is the big deal that hospital controls all aspects of daily work environment? As long as check/work is good, I will work for anyone.

 

[NovAsthesia]

What is the big deal that hospital controls all aspects of daily work environment? As long as check/work is good, I will work for anyone.

No big deal if you/me are a locum or a per diem doc. But if you are hired full-time directly by the hospital (after they kick out the AMC), how do you respond to these theoretical situations:
- Hey, we really need you guys to stick around to finish these spine cases 3 days/week... could you stay til 8 pm? We will gladly pay you $200/hr
- It really helps the hospital weekly census variation if we run 1-2 rooms on weekends, and we would like you to be available for that...
- Locums are really costing us a fortune, so we would like to offer you the benefit of making more money as you ramp up your weekly hours to 70
- Not sure why you guys take 10 weeks PTO while our trauma surgeons never take more that 4 (even though we give them "unlimited" vacation)
Just a few scenarios that come to mind... I have no personal experience with this, but trying to plan for the future as I see this as a 100% probability in many many hospitals...

 

[Dr. Rude]

I have never worked for an AMC. But I have been a hospital employee with two systems. I consider both hospitals and AMCs as predators that look upon us as antelope to feed on. My sense is that AMCs are more effective predators in general.
Hope that helps.

 

[Anesthesia_Guy]

No big deal if you/me are a locum or a per diem doc. But if you are hired full-time directly by the hospital (after they kick out the AMC), how do you respond to these theoretical situations:
- Hey, we really need you guys to stick around to finish these spine cases 3 days/week... could you stay til 8 pm? We will gladly pay you $200/hr
- It really helps the hospital weekly census variation if we run 1-2 rooms on weekends, and we would like you to be available for that...
- Locums are really costing us a fortune, so we would like to offer you the benefit of making more money as you ramp up your weekly hours to 70
- Not sure why you guys take 10 weeks PTO while our trauma surgeons never take more that 4 (even though we give them "unlimited" vacation)
Just a few scenarios that come to mind... I have no personal experience with this, but trying to plan for the future as I see this as a 100% probability in many many hospitals...

- Hey, we really need you guys to stick around to finish these spine cases 3 days/week... could you stay til 8 pm? We will gladly pay you $200/hr 🖕
- It really helps the hospital weekly census variation if we run 1-2 rooms on weekends, and we would like you to be available for that... 🖕
- Locums are really costing us a fortune, so we would like to offer you the benefit of making more money as you ramp up your weekly hours to 70 🖕🏼
- Not sure why you guys take 10 weeks PTO while our trauma surgeons never take more that 4 (even though we give them "unlimited" vacation)🖕

 

[cincincyreds]

- Hey, we really need you guys to stick around to finish these spine cases 3 days/week... could you stay til 8 pm? We will gladly pay you $200/hr 🖕
- It really helps the hospital weekly census variation if we run 1-2 rooms on weekends, and we would like you to be available for that... 🖕
- Locums are really costing us a fortune, so we would like to offer you the benefit of making more money as you ramp up your weekly hours to 70
- Not sure why you guys take 10 weeks PTO while our trauma surgeons never take more that 4 (even though we give them "unlimited" vacation)🖕

People really stay until 8pm for $200/hr these days?? Seriously??

 

[JoelJoel84]

- Hey, we really need you guys to stick around to finish these spine cases 3 days/week... could you stay til 8 pm? We will gladly pay you $200/hr 🖕
- It really helps the hospital weekly census variation if we run 1-2 rooms on weekends, and we would like you to be available for that... 🖕
- Locums are really costing us a fortune, so we would like to offer you the benefit of making more money as you ramp up your weekly hours to 70
- Not sure why you guys take 10 weeks PTO while our trauma surgeons never take more that 4 (even though we give them "unlimited" vacation)🖕

If you’re a hospital employee, I’m not sure these would even be questions, rather than a strong hint that this is what you do now….

And forget about the extra pay.

 

[NovAsthesia]

If you’re a hospital employee, I’m not sure these would even be questions, rather than a strong hint that this is what you do now….

People really stay until 8pm for $200/hr these days?? Seriously??

I consider both hospitals and AMCs as predators that look upon us as antelope to feed on. My sense is that AMCs are more effective pr

That's exactly my point. I am not currently a hospital employee, but we may all soon be ones (AMCs are falling like dominos). So I feel like if a hospital employs anesthesiologists directly (as FT) that is the natural progression of things... the hospital will practically be in control of all these aspects (as in the hypothetical scenarios above).
Other than the well-deserved emoji that Anesthesia_Dude suggests, what protect us from being abused by the hospital predators? Any practical advice?

 

[MirrorTodd]

That's exactly my point. I am not currently a hospital employee, but we may all soon be ones (AMCs are falling like dominos). So I feel like if a hospital employs anesthesiologists directly (as FT) that is the natural progression of things... the hospital will practically be in control of all these aspects (as in the hypothetical scenarios above).
Other than the well-deserved emoji that Anesthesia_Dude suggests, what protect us from being abused by the hospital predators? Any practical advice?

Personally I would rather be hired as a 1099 directly by the hospital. Pay me a higher rate and cover malpractice maybe and you don't have to worry about all that admin overhead. I'll take care of my own cme, health insurance, etc etc, but I retain the right to dictate my own hours.

 

[abolt18]

That's exactly my point. I am not currently a hospital employee, but we may all soon be ones (AMCs are falling like dominos). So I feel like if a hospital employs anesthesiologists directly (as FT) that is the natural progression of things... the hospital will practically be in control of all these aspects (as in the hypothetical scenarios above).
Other than the well-deserved emoji that Anesthesia_Dude suggests, what protect us from being abused by the hospital predators? Any practical advice?

The practice I'm joining this summer is a hospital employed position. They transitioned ~10 years ago I believe. My impression from interviews, chatting, and moonlighting there for a week recently is that they have maintained a great deal of control over their practice...

Most docs bringing home >95%ile MGMA W2. President of the group negotiates the contract with hospital admin, even though everyone is employed. (I just got an 8% raise before I even started!) Group has control over hiring and firing. 8 weeks vacation. Hospital wanted them to bring in midlevels, and the group was able to keep out crnas and only bring in AAs (and only a few). Still doing 90%+ solo cases. I feel good about it because the biggest growing/transition pains are in the past and they seem to have managed to maintain control. I'm also aware that hospital admins change and that can affect a lot.

Alternatively, I had an acquaintance on partner track in Indianapolis. 2 months before becoming partner he's told the group will become employed by IU in the fall. Lots of people have left (including the acquaintance), call burden skyrocketed, more people left for numerous reasons... It's been a painful transition I'm told. I have significant hesitation when it comes to going through the process of becoming hospital employed just because you're opening a black box and have no way of predicting how it will go. Very scary indeed.

 

[ambiturner]

That's exactly my point. I am not currently a hospital employee, but we may all soon be ones (AMCs are falling like dominos). So I feel like if a hospital employs anesthesiologists directly (as FT) that is the natural progression of things... the hospital will practically be in control of all these aspects (as in the hypothetical scenarios above).
Other than the well-deserved emoji that Anesthesia_Dude suggests, what protect us from being abused by the hospital predators? Any practical advice?

If there’s a silver lining of hospital employment it’s that they’ll never piss you off so much at once that a bunch of people go walking and they can’t staff. So, if a change would be so unpopular that you can credibly suggest that you wouldn’t be able to ‘recruit and retain’ then they’ll actually not go through with their bad ideas. Note that this only works as long as there’s a strong job market and people have other good options.

Alas, I can sadly say that NovAsthesia’s first, second and fourth points have all come up in my time as an employee. For the late stays we don’t really have a choice but developed a mechanism for compensation among the group. For the weekends we were bailed out by the (employed) surgeons who didn’t want to operate either. For vacation we pulled the ‘recruit and retain’ card since every other nearby group gets 8 weeks or more. We’ve never had locums amazingly.