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Denver Job Market

Discussion in 'Anesthesiology' started by Shimmy8, Nov 13, 2016.

  1. Shimmy8

    Shimmy8 ASA Member
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    Seeing some recent posts on gaswork for jobs in Denver, from the look of it seems like two large practices merged AND sold out to USAP?

    Anyone have any insight? Overall climate there and working in these facilities?
     
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  3. chocomorsel

    chocomorsel Senior Member
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    One of the guys in our town was there for 10 years. He says that USAP is now in charge and that being an anesthesiologist there is crap. There are smaller groups still in play though I think. On the outskirts.
     
  4. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay
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    Kaiser Denver is worth a look. They pay significantly better than Kaiser CA.
     
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  5. jthedestroyr

    jthedestroyr ASA Member
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    I dont know whats worse, kaiser or an amc.

    Kaiser is terrible! speaking from a close family member thats worked for them for >20years, ive seen how bad kaiser is.
     
  6. caligas

    caligas ASA Member
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    Why did they stay 20 years?
     
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  7. nimbus

    nimbus Member
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    Probably the famous Kaiser handcuffs, er pension.
     
  8. FootballFoot

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    Why do physicians hate working for Kaiser?
     
  9. caligas

    caligas ASA Member
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    Makes sense.
     
  10. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay
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    Well, not all do. I have 3 buddies at Kaiser SD that seem to be happy there. It really depends on your personality. At Kaiser you have to be OK with a factory worker mentality. Clock in-Clock out. OK not having much administrative control over your practice, etc. I think the younger generation is gonna be more OK with this than the old guard. Still not for me though.
     
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  11. jthedestroyr

    jthedestroyr ASA Member
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    Winner

    Plus life time free healthcare although getting care at Kaiser is meh!

    Kaiser wasn't too terrible until the last 10 years. Since they started taking Medi-cal patients, it's gotten exponentially worse.
     
  12. Jlaws67

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    Bump

    About to be a CA-3 and just getting started with job searching. Does anyone have any insight to the current market in Denver? Looks like it's almost all USAP jobs with Kaiser, and maybe a small practice or two on the outskirts of town. I need to be in the area for the spouse, and would love to hear if I'm missing out on any other gigs, or if anyone has feedback on how working for the above groups actually is.

    Would also love to hear any feedback about the other groups in the area(i.e. Fort Collins/Boulder/Springs).
     
  13. Ezekiel2517

    Ezekiel2517 Anesthesiologist
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    TPMG (Kaiser NorCal) pays pretty well, much more than Socal
     
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  14. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay
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    That’s true. Kaiser SoCal is insulting when you consider what they pay in other regions.
     
  15. Skindoc83

    Physician

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    I’ve heard that kaiser Denver no longer offers a pension. Does anyone know of this is true? I wasn’t surprised when I heard the news because pensions are no longer tenable in this day and age.
     
  16. Noyac

    Noyac ASA Member
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    And what is it like to work for USAP? Have they gobble up more groups since this thread was started back 2016?
     
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  17. Velefunt

    Velefunt ASA Member
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    They're trying to gobble a ton in WA state.
     
  18. chocomorsel

    chocomorsel Senior Member
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    From what I have heard some groups suck and some don’t. But it is the better AMC to work for. And some groups still make really good money.
     
    #17 chocomorsel, May 14, 2018
    Last edited: May 14, 2018
  19. AdmiralChz

    AdmiralChz ASA Member
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    Very regional dependent. I have no direct knowledge of Colorado, but a lot of Florida had some garbage AMC jobs. There are some solid ones in Texas, and in the Midwest. All about knowing what you’re getting in to - the same is true for academics or independent PP.
     
  20. GaseousClay

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    denver kaiser offers starting $420k+ for 40 hours a week with benefits and pension still exists. Thats almost $150k more than starting at so. cal kaiser. :(
     
  21. ahl9974

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    I have worked for USAP in Denver. There are some very nice people in the group but I ultimately left after a few years. Bottom line is similar to any other AMC- it’s impossible to be compensated fairly when such a large portion of every dollar you collect goes to investors.
     
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  22. Jlaws67

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    What range of salary and benefits could someone expect in an AMC like this? Is this a situation where you'll be worked to death for salaries that people were seeing 15 years ago?
     
  23. ericL

    ericL Member
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    Does anyone know about academics in CO?


    Sent from my iPhone using SDN mobile
     
  24. nimbus

    nimbus Member
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    Got this recruiter email today. Assume it is USAP

    “Join the largest single-specialty anesthesia practice in the country
    • 179 physician partners currently in the greater Denver area
    • 2-year partnership track
    • Earn the income you want from day one—average partner income of $450,000 +/- with some physicians earning as much as $600,000
    • Expansion into new facilities—need multiple anesthesiologists to start over the next 3 to 6 months
    • Seeking general bread and butter anesthesiologists willing to work across all specialties
    • Collegial work environment in which physicians and CRNAs work in concert—no more than 4:1 CRNA to physician ratio
    • Full benefits including occurrence-based malpractice insurance, health insurance, matching 401k, and profit sharing
    • Quality of life balance—partner track physicians can expect a call rotation of 1:9 weekdays and 1:4 weekends”
     
  25. ghastly75

    ghastly75 ASA Member
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    Sounds about right. Work more and make more $. Have a few friends/colleagues in USAP Denver. Many were in it before it became USAP, and yes they were happier then. Have known various folks at the Academic Shop to hop across town and love it. More CRNA/AA to be hired and working in ACT model but still lots of opportunities to do own cases. Don’t know about leadership or culture because group so large and covers many different facilities, resulting in a different “feel” for each place. Also, this merger between mega groups (SDA and GCA) resulted in USAP, but the two former groups had quite different operating styles. Again, not a member of group just relaying what I’ve heard and a bit of what I’ve seen. Denver is pretty nice: weather warmer then northeast , traffic kinda sucks but better then LA, DC and other metro places. Real estate has seen a boon but still fairly affordable compared to west coast. Love the people, healthy, active , good natured for the most part.
     
  26. marr65

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    I am not working for USAP or affiliated group, but I have interviewed at several groups affiliated with USAP. As long as you are comfortable with giving 20-25% of what you earned that month back to corporate than it's a good job. So, that average partner income of 450K might be before USAP take 20-25% off the top and don't forget that if you have CRNAs than their salary is your overhead cost. It's also expected that once you make partner, you are then expected to use your salary to buy equity stake in USP. Also, if you joined an all MD group expect to start supervising because corporate expect physicians to leave after the merger with CRNAs to take their place.
     
  27. nimbus

    nimbus Member
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    The income advertised should be what’s on the W2 after any USAP tax is paid. Otherwise it would be very misleading.
     
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  28. resp228

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    I understand that in the past things may have been better for anesthesiologists. However, as a medical student deciding between anesthesia and internal medicine (+/- subspecialties), it is really hard to choose internal medicine when the vast majority of internists/subspecialists make far less than what is being listed in this thread. As well, at least for me, anesthesiology is far more interesting and stimulating than a lot of internal medicine.

    Can someone please explain some of the downsides of these Kaiser/USAP jobs? I understand pay is likely lower than private practice, but it appears job stability/hours may be better. Not to mention, it appears like the majority of internists/subspecialists are becoming employed as well.
     
  29. chocomorsel

    chocomorsel Senior Member
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    Honestly that pay is pretty good. Like 50% MGMA and more.
    The problem is, you will never keep all the money you get from the insurance companies. At least 20% will go to cooperate and that’s the problem for most people.

    People also forget that these Mega groups often negotiate higher rates from the insurance companies than the old group that they bought out. So, the money may not change much depending what you were making before.

    However, how you run your practice will be changed as you no longer have control. They usually let you have control at first but over time they introduce more and more CRNAs if they weren’t already there.

    So basically if you are ok with being in a “cooperate” like lifestyle then you can work there happily. A lot of people do. And make a lot of money doing it. I have never made that kind of money myself and the closest I came to it entailed working like a sleigh dog, and I was not having that.
     
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  30. C4C

    C4C

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    USAP, who bought us out in Denver, has had to retain the services of both Merritt Hawkins and Kendall & Davis to fill positions that used to be filled exclusively by word-of-mouth. Using a recruiter would have been unthinkable to us 5-10 years ago.

    To their credit, the salespitch seems mostly to be accurate, with the exception that the recruiters' ads don't mention overseeing AAs. As long as you know that you are working exclusively as a supervisor (of both CRNAs and AAs) , you probably won't be too disappointed. I note that the Gaswork ad states you will be doing 90% of your own cases, which, of course, is 100% wrong.

    My former colleagues are all less happy than they used to be, but they dry their tears with unmarked C-notes, so there's no need to feel bad for them. The new ones don't know how it used to be, so they don't even feel like they've missed out. And, again, $450k/year isn't chump change, even if your corporate overlords are getting their take.
     
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  31. chocomorsel

    chocomorsel Senior Member
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    So why did you guys sell? Were you on the brink of losing your contract and had to sell?

    Are you guys having buyer's remorse? Did you not get any C notes yourself?

    Why do you think you are having a hard time recruiting?
     
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  32. C4C

    C4C

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    Sorry. I wasn't very clear.

    I was with South Denver Anesthesiologists. USAP bought out Greater Colorado, then bought us. I left shortly thereafter because I did not work my tail off in medical school and residency just to be a chart-signing monkey overseeing a stable of CRNAs and AAs. YMMV.

    I ought not to speak for my former partners who remained with USAP, though the general--if not unanimous--consensus is that everything about the job is now worse than before: hours, enjoyment, sense of responsibility, prestige, pay, autonomy, respect, quality of care. The conversations we used to have centered around how we anticipated keeping up with the state of the art into our 50s or 60s; now when I speak with them they are all wondering how soon they can punch out for the last time.

    Trying to be fair to the core that remained back, it is possible that recruiting is no longer their concern. Now everything about the job is corporate. Maybe the corporate know-it-alls have a long-standing relationship with the recruiters, or maybe they have bylaws that state any openings must be advertised on a national level in order to make positions available to other worker bees in the USAP system. I don't know. But it is possible that they aren't "having a hard time recruiting" as much as the former owners aren't going to hustle and work the phones to bring in the rockstars from each graduating class. Now they're not recruiting partners; they idly watch as corporate assigns co-workers. C'est la vie.
     
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  33. BLADEMDA

    BLADEMDA ASA Member
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    Good post for all the info. What about the USAP 401K plan? Any idea if it is real 401K with USAP contributing a nice sum of money or is it the usual AMC package of zero to $5K per year?
     
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  34. Noyac

    Noyac ASA Member
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    Interesting post. Can you explain why the nurses are an overhead cost? Remember, I don’t have nurses in my practice.
     
  35. Noyac

    Noyac ASA Member
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    You will be much happier if you focus on the specialty that makes you happiest. The one the interests you the most. The one that you think is right for you no matter what the income is. Then adjust accordingly. I for one am extremely glad I didn’t pursue the higher income specialties I was in line for. I believe I am much happier today because of this. My outside of work life is richer for this.
     
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  36. Arch Guillotti

    Arch Guillotti Senior Member
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    They cost money if you employ them.
     
  37. Noyac

    Noyac ASA Member
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    Ok. It just seemed like you were eluding to some other expenses.
     
  38. resp228

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    Thanks, this is great advice!
     
  39. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay
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    Yes, but you are also keeping their billings. I’m curious how that math shakes out as well.
     
  40. Noyac

    Noyac ASA Member
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    Ok, I still stand by my statement but with a disclaimer.
    Holy Crap does orthopods have opportunities to make money hand over fist.
    I’m talking about patents, surgery centers, etc. They can make the median orthopedic salary with shares in a free standing physician owned surgery center alone.
    But these same orthopods still complain about their income so I guess we are all the same still.
     
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  41. Globulinus

    Globulinus ASA Member
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    Anybody has more insight on what USAP in Denver actually is?
    Specifically Northwest region?
    From my understanding they split Denver market by areas, you will be rotating via hospitals in the area, but, if necessary could be send to another location.
    Buying in 100k of USAP shares is mandatory, weird thing. What exactly constitutes the partner - also very ill defined.
    As far as Blade question about 401 k, yes, it sucks as usual AMC, may be worse. Can look up specifics later( tossed folder into check in).
     
  42. IMGASMD

    IMGASMD ASA Member

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    Isn’t it after a year or two then you become partner? But then you have to chip in for whatever the overhead? I didn’t take good notes during my conversation with the recruiter. So after you make partner, you may actually make a little less?
    And there are thousands of share out there.... Didn’t get into it with the recruiter, as we know usually they don’t understand what’s going on either.
     
  43. Globulinus

    Globulinus ASA Member
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    After you make a partner you will need to pay "office" overhead around 6K.
    Before partner they pay 90% of unit cost. Partner - 100%
     
  44. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay
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    What an F’in scam.
     
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