Big difference $250-400 so which is it? $250 isnt that hard to clear without being raped by the SDG owner-czars. I know of several well functioning groups where all providers range $300-330 from day 1 without having to put money in your (SDG partner) pocket. They certainly don’t advertise though.
SDG isn’t necessarily the holy grail if it’s still a two-tiered pyramid scheme, and the risks are higher than ever (of losing contract). At least in a CMG you know the rules of engagement (even if bad). Many CMGs have the numbers in a black box while they feast on new grads to keep the premium $$$ coming in for the greedy partners and they can devastate the non partners mere weeks before their “partnership track” is up under dubious circumstances.
Agreed. You can find a gig for 300/hr in certain geographic regions. I also know in hawaii finding 200/hr takes an act of god. IMO SDG quality is a function of whats around you. my first job out of residency i made roughly 1/4 of what the partners made. It pissed me off. That being said once i became a partner i made 2x what the local cmgs were paying in a nice system where work was pretty easy and straightforward.
Note there are tiers in everything including some CMGs. For the CMGs you are nothing but a med mal sponge and a billing widget. Now there is nothing wrong with that if thats what you want your career to look like and i think in EM there is nothing wrong with that with the often generous time we can allocate to other interests/business. If you plan to do this for 150/160 hours a month thats a major mistake IMO.
One other nugget ill put out there, most of the SDGs that wanted to sell have already sold the top of the EM market was about 5-7 years ago. I think USACS is still buying with you taking at least 30% of your sale price in their trash stock and TH is looking to buy at a stupid discount. Essentially TH is bargain shopping to see which groups are desperate. USACS doesnt want to give up cash so you get 50-70% of your sale price in actual money the rest in stock you cant sell.
I think most (not all) of the predatory SDGs have sold and are out of the market. Most of the ones left are relatively fair when you look at what else is out there in the market.
Some SDGs are doing quite well even without scraping off the back of anyone else, some have to use an army of MLPs to keep their pay up high. Others surely do it by churning their new docs.
You do have to be smart. As I tell those who i counsel how many partners have left to work another EM job for any reason. IMO the highest paying jobs fully put the partners in golden handcuffs. People dont leave for another EM job for any reason. My prior group was like this. I was there 6 years, we had 40 partners. 0 of the 40 ever left to work in another ED.
Then once the long term looks promising, who are their hires, what happened to them and why? Many people in the beginning of their career will move. Ask to talk to the last 3 people who left, when you talk to them ask who else they knew that left and ask for a connection if the list is different than what the group gave you. You must do your due diligence.
Starting your career it is important you know what you are getting into and the people who quit are the best ones to give you an unfiltered take on whats going on.
In this and many other forums when a person leaves it is often portrayed as the SDG screwed them. My guess is thats true 75% of the time. About 25% of the time this was a doc who didnt know how to behave, was late to work, was disruptive, felt they were more special than everyone else. These entitled people exist. Again, we have all worked with some version of this person. Desperate sites will allow these people to erode the culture. Better jobs will push them out or simply ask them to leave / force them to go elsewhere.
Take this for what it is worth. I have no horse in this race.
