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This may become my favortie thread since the post pad threads 10+ years ago.
Daily reminder to do the bare minimum
Started by GonnaBeADoc2222
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Is there a business or industry that lets someone automatically become an owner on Day 1 without some kind of buy in?
I mean, sure, reserve ownership and voting for the partners after x period of vetting and partnership is granted.
Doesnt mean that everyone can't make the same money from day one. Stealing from newbies to pay partners is predatory, hard stop.
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Also @JacobMcCandles
You never answered me if you refund the prepartners you dont hire, or include contractual language protecting them from a buyout at the 11th hour.
You never answered me if you refund the prepartners you dont hire, or include contractual language protecting them from a buyout at the 11th hour.
I imagine that you consider every business in the world with employees ‘predatory, hard stop’?
Sorry, I must have missed where you asked that.
All of our docs on the partnership track have all made partner so we haven’t been in that position. If there were a buyout, I have no doubt they would be made whole but we’re not interested in being bought out.
Yes I consider the hospital i work for predatory.
CMGs aren’t currently in a position to realistically meet anyone’s price.
We’ve never strongly considered selling out and our contracts haven’t changed for decades. On the flip side, why would we put in the contract when we can keep it out and still do it? I’d be hesitant to sign any contract in medicine that mentions selling out to PE/CMG. That’d make me think it’s a sure thing to happen.
1) for sure
2) the real answer is there is no need and 2 they can hire plenty of good docs without it. Might it happen sure.
Understand when a group sells the new owner buys stock. Non owners by definition can’t own stock.
If a group did this which wouldn’t happen you might then say it’s still unfair cause the owners pay capital gains and this person wouldn’t.
I would also say if you didn’t make this person a partner for legit reasons they could have another potential claim that you did this because you didn’t want them to have money.
One of my friends worked for ema when they sold to envision. He wasn’t a partner. He got like 30-50k. I imagine most ema docs got $1m.
Sucked bad for him. But anyone in the know knew ema was a slimy ass company. So no shock. That being said he felt he was making market rate money.
In lieu of what you are asking if the sdg paid a fair market rate would that work? Docs would take no risk? Just trying to see where your fairness line falls.
For the sake of example let’s say a market rate is $200/hr as an ic to keep it all simple. The sdg had a similar location and also paid $200/hr but the partners made $500/hr. Curious your thoughts on that.
I think we got off topic. This devolved into CMG vs. SDG. What it really should be is: "How to survive at a CMG site while doing the bare minimum, making decent money, and maintaining good work/life balance"
Nah, that will always be the 2002 pre-med "Would you eat a poop hot dog" thread.
Would you eat a poop hot dog to gain admission to your first choice school?
I'm talkin' foot long. I know I would.
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Ill be honest i think i spent all the time i ever recall only on this forum. never perused the others.Nah, that will always be the 2002 pre-med "Would you eat a poop hot dog" thread.
Would you eat a poop hot dog to gain admission to your first choice school?
I'm talkin' foot long. I know I would.
For many of us it's nearly impossible to do SDG. Can I do an SDG in a no-tax state with sunny weather? I'm not willing to trade 6 months of snow, and/or $30K in taxes to get a slightly higher salary (FYI my baseline salary is $300/hr).
Also for someone who wants to do the bare minimum, a CMG is a better fit. I get the allure of being a partner in a business like an SDG, but it still sounds like an awful lot of non-clinical work for which you aren't compensated to keep the business running. Not a good fit for us burnt-out, lazy, minimalists.
I think fair market rate is a fine deal for prepartners.
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People turn into burnt out, lazy, minimalists when they feel as though their voice isnt heard, their work isnt appreciated, and their expertise is devalued.
The SDG model is a potential remedy for this as your efforts and work are more strongly correlated with the level of reward than in other models.
Below market pay for prepartners is predatory however. Closed books to non partners is equally so. People have real families that they need to support. How can one embark on the path to partner without even knowing the true benefits that await them on the other side?
I think you hit the key point in your last sentence. If SDGs are so lucrative, then new partners should start at market rate. If the local CMG is paying $250/hour, that's what new hires should start at. If the SDG is that profitable, then once you make partner it should be significantly more. In this way there would literally be no risk to starting with an SDG. The risk profile is what most of us are concerned about.
I also feel that we blame a lot of new grads. But please try to remember we were all new grads and then after working 20 shifts, making 50 K as well as studying. You sign anything since even Denver is a pay increase
Also if you have a family you are very desperate to work with those loans and you have been living on credit cards
Also if you have a family you are very desperate to work with those loans and you have been living on credit cards
Much like sdgs may sell whenever you mention some numbers. Would you leave for a job that paid 450/hr? 500? 600?
Define slightly higher. I would argue that working for an sdg for a slightly higher salary (for partners) never makes sense. You do have to do extra. To me that’s not worth $10-20/hr.
Again I think I’m the next 3-5 years that spread is gonna become mich bigger than today. Most sdgs are making 30-100% more than the surrounding cmgs.
In many places, CMGs pay more because they’re trying to keep their contract from imploding. They’re hemorrhaging money. SDGs can’t/shouldn’t do that. I have no desire to try to match CMG’s last ditch efforts before they implode. If a doc wants to chase that money, go for it.
#1 - Docs out of residency typically are 29+ YO. They can read contracts, do their due diligence, etc. If they chose to join a SDG/CMG, then that is their choice. A contract may appear "predatory" to some, but if you signed it and knew what you were getting yourself; If it turns out bad then take blame/learn for the next time, its not the groups fault IMO. You learn more by making mistakes than not. Now, there are Fair groups and groups that takes advantages of new hires. Its the doc's job to figure this out. The fair ones will have longevity and the "predatory" ones will have a short existence.
Its a tough world. Life if not always fair. Groups may treat docs poorly. But I would never call them predatory. Docs can leave if they want. Docs read the contract. Docs "should" know what they got themselves into. The blame ultimately is on them.
#2 - A SDG is NOT a business. A SDG Partner does NOT own anything. Would you call a hair stylist at Super Cuts owning a business? Truthfully, the stylist has more of a business b/c she can set up shot across the street and have her clients follow her/him. Sorry to Pop SDG "Owners" bubble, but a SDG if not a business. You own nothing of value. You have nothing to sell. You essentially have a promise to see the hospital's patients, in the hospital, using the hospital's staff to bill insurance. I was part of a SDG similar to Mount. I would even call it a Unicorn and more fair than what Mount described. But it was NOT a business. We were forced to sell to TH, and they essentially paid us to "shut up/do your job" x 2 yrs. They did NOT pay us for anything other than good will.
I am a partner of a FSER and this is a business. We own the equipment, we "own" the patient panel, we have staff on payroll. There is a tangible value.
I have a bunch of rentals. This is a business. I have property to sell. People pay me to live in it. I can use it as collateral.
I own a RE syndication LLC. I have an office. I have an investor panel. I pay bills. I have some tangible value.
Its a tough world. Life if not always fair. Groups may treat docs poorly. But I would never call them predatory. Docs can leave if they want. Docs read the contract. Docs "should" know what they got themselves into. The blame ultimately is on them.
#2 - A SDG is NOT a business. A SDG Partner does NOT own anything. Would you call a hair stylist at Super Cuts owning a business? Truthfully, the stylist has more of a business b/c she can set up shot across the street and have her clients follow her/him. Sorry to Pop SDG "Owners" bubble, but a SDG if not a business. You own nothing of value. You have nothing to sell. You essentially have a promise to see the hospital's patients, in the hospital, using the hospital's staff to bill insurance. I was part of a SDG similar to Mount. I would even call it a Unicorn and more fair than what Mount described. But it was NOT a business. We were forced to sell to TH, and they essentially paid us to "shut up/do your job" x 2 yrs. They did NOT pay us for anything other than good will.
I am a partner of a FSER and this is a business. We own the equipment, we "own" the patient panel, we have staff on payroll. There is a tangible value.
I have a bunch of rentals. This is a business. I have property to sell. People pay me to live in it. I can use it as collateral.
I own a RE syndication LLC. I have an office. I have an investor panel. I pay bills. I have some tangible value.
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Huh? I was following you until you went off on a business definition tangent. There are lots of businesses that are based solely on contracts. CPA firms, law firms, etc. SDGs typically have one large customer, I’ll give you that. But, that’s why it’s important to make them changing contracts very difficult. For whatever reason, your SDG’s only customer wasn’t happy so they switched.
Law Firms/CPA firms are a business. They have tangible assets/client lists. If they lose a customer, they can get more.
SDGs are the customers of the hospital just to be clear. SDGs have zero assets. Our SDG was bought out b/c they made an unreasonable demand and wanted us to do Non ER duties. But this further proves it is not a business.
I went on a diversion to point out how fragile any unicorn SDG is because they are not true businesses.
SDGs are the customers of the hospital just to be clear. SDGs have zero assets. Our SDG was bought out b/c they made an unreasonable demand and wanted us to do Non ER duties. But this further proves it is not a business.
I went on a diversion to point out how fragile any unicorn SDG is because they are not true businesses.
I’ll jump in and disagree with you. There are sdgs with multiple clients.
Would you consider Vituity a business? If so then your issue is only scale. We have some auto manufacturers near me. There are businesses who only make car seats for a single auto manufacturer is that a business cause they only have one client?
The cpa /lawyer doctor thing is because we are all service businesses. Consultants too. Heck private equity too. We don’t sell a tangible product.
I think you issue is scale. Most (imo) sdgs have one contract and one system they serve. That seems to be your issue.
If an sdg can be sold it’s a business. You may consider them at high risk but a business nonetheless.
To the point above unreasonable demands were made in your opinion and this might be true. TH met them. That’s the reality when you have one client. You don’t keep them happy and they leave. You then have 2 options. Keep your client happy or fold up shop if you wont diversify.
Some CPAs have one or two very large clients and that’s it. SDGs can get more contracts but it’s up to them if it’s worth it to them or not. You only need one client to be in business. Every business you mentioned you’re involved in is at the mercy of many things outside of its control, no matter what you think.
Daily reminder to do the bare minimum.
I know by the definition of a business, its a business. You guys have missed my point that the fragility and lack of control is huge.
If a business doesn't do well, they can shut down, sell their properties and recoup some money. There is value.
A SDG can have their contract taken away and have zero value.
Pay package with benefits was around $250-275/hr. After 2 yrs, buy in was 100k which was optional. Partnership was essentially guaranteed after 2 yrs unless the doc was a bottom 5%.
If a business doesn't do well, they can shut down, sell their properties and recoup some money. There is value.
A SDG can have their contract taken away and have zero value.
Our SDG. 2 yr partner track. Pay rate (around 225-250/hr) was the same as partners except they did not get a yearly distribution which amounted to about 50k/yr or about $35/hr. Everything else was equal. Benefits, shift differential, nights, holidays, etc were the same. Most of our profits were paid out as salary thus the minimal $35/hr differential.
Pay package with benefits was around $250-275/hr. After 2 yrs, buy in was 100k which was optional. Partnership was essentially guaranteed after 2 yrs unless the doc was a bottom 5%.
You said your became partner in a little less than 3 yrs and made less than 150/hr. My SDG was 2 yrs track, 50k/yr less, plus 100K buyin.
I will give you all of the benefit of the doubt and assume Zero buy in, 150/hr, Partner 300/hr, and 3 yr track with everything else equal between partner/nonpartners with 120 hr/mo work schedule. 150/hr x 120 x 12 x3 = 648K gap.
Our SDG was equal other than 50k/yr, 2 yr track, 100K buying = 200K.
The difference in partnership track is even more drastic when you look at a time component. If two new hires in each group happened to get "screwed" and was not made partner then Our SDG is out of 100K over 2 yrs. Your non partner would be out of 648K over 3 yrs.
Most looking at this would say our SDG track was very fair and yours is "Predatory".
The point you are missing is life never happens to go as you plan. What if you have to move, contract lost, decide not to be a partner? You would have been out of 648K and I would be out 100K max.
And don't say life doesn't happen b/c many it does
I didn't criticize anything. I just compared what you put in your posts which you stated made less than 150/hr as a prepartner, partners made in the 90%=300/hr, and it took close to 3 yrs. But hey, go ahead and move the goal posts.
If I intended to criticize, I would have said it is predatory when partners makes 2x more than prepartners.
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#bareminimumgang check in!
BulgeDaTwine
Full Member
I have been reading your threads and responses for awhile and I think the more you shout “it’s a business” the more it reinforces that you are part of the problem in EM. I’m glad it’s working for you (right now) but the Schadenfreude is pretty rich. Glad you think it’s a business because that will come in handy when it eventually impacts you and you might have to start one of your own.
Somebody has to be the one making typical business decisions such as staffing, pay, benefits, etc. no matter what setting you work in. The difference is that with an SDG, the people making these decisions are also the ones working in the pit.
SDG not quite but close to unicorn checking in. I don't do the bare minimum, but I also go out of my way to leave on time and avoid any charting at home. Or email, compliance training, etc from home. We have enough people willing to destroy themselves for the cause.
Sorry to steer this thing off.
I have been fascinated by these compliance trainings.
Once every 2-3 years I have to do some stupid attestation for procedural sedation required by the hospital. I get it done in 10 mins. Once a year i attest to some Stroke stuff. Takes well under 30 mins.
I get CMGs like USACS force you to do their stupid work so they can spew their nonsense in their meetings but what sort of nonsense is your hospital/system requiring and how many hours are you guys doing a year?
Literally i think thats all i do. Essentially 30 mins a year (maybe less). What nonsense are they forcing on you guys.
Stroke nonsense generally takes 2-3 hours a year.
"High risk" education modules.
and the usual IT security (don't share your password, don't click on dumb emails), sexual harassment, and EMTALA/corporate compliance training.
"High risk" education modules.
and the usual IT security (don't share your password, don't click on dumb emails), sexual harassment, and EMTALA/corporate compliance training.
Having just become hospital employed, the hospital where I have worked for 11 years now wants us all to do all their orientation modules. So far I’ve spent about 90 minute on it and I am about halfway through one of 16 modules. I’m only doing it at work during (rare) downtime , I have more important things to do at home lol
Daily reminder to do the bare minimum.
Thanks to your daily reminder, my whole group did the bare minimum and it may have actually lead to better working conditions for the foreseeable future. Possibly details to come if this goes as expected. Little too soon to celebrate quite yet.
I've found that it's easy to do the bare minimum on this garbage. Many have caught on and force you to watch/play the whole video before moving on which can be 20-30 min per video. I set my laptop up at work and have the video play in the background while I'm seeing patients or other tasks. Most of the time the "Knowledge Check" test at the end can be passed easily enough. Some of the harder tests I have to run through 2-3 times, but I copy the questions down in notepad, and note the correct/incorrect answers. This strategy allows me to get through 90 minute modules in maybe 5-10 minutes of actual time.
I will say I have never read anything on a module. Click, click, go do something click, pay my kids to click. Tests? Just take it and retake if you fail. They usually tell you what you got right or wrong. No one cares if you know the modules, it all for admin checking off a box.
I mean, how many hippa and cybersecurity modules do you need?
I mean, how many hippa and cybersecurity modules do you need?
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I may or may not have used this strategy when I had to do online driving school.
The world is so upside down it’s mind boggling.
Everything is just about blame avoidance. If companies/governments make some stupid course you have to take, they can absolve themselves from responsibility. Sexual harassment in the workplace? It's not their fault because they EDUCATED the employees.
True story
back when I was a research tech I had to do these modules, which included sexual harassment
there was a questions like, "it is okay to grope other staff" and it was true/false (basically the statement, it was quite direct and had a picture of a woman looking uncomfortable as a man touches her shoulders).
So I marked it true
still got the necessary >80% on exams
Later I was chatting with the HR person about random **** and these modules came up. I told them they are still liable for my groping because i passed the test
I found out next year that conversation is why the module now requires 100% accuracy
For anyone affected by my sarcasm I'm truly sorry
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My wife had to do these silly things with her last job too (biomed related). It got to her one night. I can still hear her screaming out:
"What DO you do with the blood?" Well, let's see what you DON'T do with the blood!!"
"Don't DRINK the blood. Don't SELL the blood. Don't POUR the blood in the RIVER."
"What DO you do with the blood?" Well, let's see what you DON'T do with the blood!!"
"Don't DRINK the blood. Don't SELL the blood. Don't POUR the blood in the RIVER."
I ignore the security training because it comes as an email from an external source which could be a phishing attempt. I should pass the training specifically because I won't open the training.
I constantly get the sentiment here with this particular thread of assuming some type vicious motive when our colleagues see patients. I’m part of a SDG but even when I was part of a CMG my goal was to help see and move patients. When I come on shift I will typically move to knock out at least 5 in that first hour who are waiting to be seen. I know that the docs before me are starting to get worn out and need to catch up on charts etc. I just want to help and Never once do I have the mindset of sh&&! “Look at all this RVU money I can make and steal from my colleagues”. I mean i assume my colleagues approach this the same way. Everyone constantly bi###es about the crazy business of medicine, but it seems we all add to this and take part in doing this to ourselves. Assuming that everyone is out for themselves is not the way to go about this. It just seems we all should not be doing the least possible and instead be doing the most to make the life of our fellow ER colleagues easier while on shift. EM is hard enough as it is, so why make it more difficult for others by doing less on shift.
We need this balanced perspective, hope you’re willing to go back and forth with the pitchforks about to come out.
With that said, daily reminder to do the bare minimum.
Because my "bare minimum" is still more than most of my colleagues, who get paid more than I do.
That's why.
(Also why would you give free labor to a cmg?
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