Difficult to find a job in Southern California..

[gasp]

Hey guys/girls,
I'm a board certified anesthesiologist looking for part time / full time work in Southern California. I'm finding it a bit difficult especially because I did not have many connections here and most anesthesia jobs go through word of mouth.. Other than cold calling hospitals and surgery centers in the area, does anyone who knows the system or recently found employment care to share what the best strategies/resources are for this area? Also if anyone is interested in expanding their group, let me know. Thanks in advance for any info..

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[Consigliere]

Best strategy? Find a job in another state. That advice is solid gold, son and will save you a lot of time and grief.

 

[gasp]

Best strategy? Find a job in another state. That advice is solid gold, son and will save you a lot of time and grief.

Yes, I guess that is one way to deal with it. However I like SoCal and moving isn't an option anyway. I can deal with it being difficult, wouldn't move unless it was impossible.

 

[BuzzPhreed]

Can you deal with being a poor pre-op monkey?

 

[Obnoxious Dad]

Hey guys/girls,
I'm a board certified anesthesiologist looking for part time / full time work in Southern California. I'm finding it a bit difficult especially because I did not have many connections here and most anesthesia jobs go through word of mouth.. Other than cold calling hospitals and surgery centers in the area, does anyone who knows the system or recently found employment care to share what the best strategies/resources are for this area? Also if anyone is interested in expanding their group, let me know. Thanks in advance for any info..

I am amazed by the strange uneconomic behavior of physicians when it comes to locating their careers and this is especially true of this California mania so prevalent on this message board. Southern California is a polluted, expensive, crime ridden, congested tax hell and yet so many of you want to live in that dump.

If you want warm weather and beaches, move to the states on the Gulf of Mexico. If you want to make a great living and avoid being under the malpractice microscope, move to states like Wisconsin, Minnesota, Iowa and Nebraska. This California fixation is just stupid.

 

[IlDestriero]

Not everyone needs the money.

 

[deleted171991]

Not everyone needs the money.

Show me the nothing! Show me the nothing!

 

[HollywdAnesth]

If you want warm weather and beaches, move to the states on the Gulf of Mexico.

Spend a week in the hell hole known as Corpus Christi, TX and see if your attitude changes.

 

[Baller MD]

Spend a week in the hell hole known as Corpus Christi, TX and see if your attitude changes.

There are other cities along the Gulf...

 

[IlDestriero]

Galveston? Louisiana? Mississippi? No.
These places don't compare to the LA area, San Diego, the OC, Santa Barbara, etc.
OK, I don't actually like the OC. But you get the point. You can have some nice ocean views from the hills though.

 

[nimbus]

Just got back from a run at Torrey Pines State Preserve. I don't miss chipping ice off my car.

 

[nimbus]

Can you deal with being a poor pre-op monkey?

All the PP gigs in metro SoCal are physician only. No Preop monkeys....for now.

 

[anbuitachi]

Galveston? Louisiana? Mississippi? No.
These places don't compare to the LA area, San Diego, the OC, Santa Barbara, etc.
OK, I don't actually like the OC. But you get the point. You can have some nice ocean views from the hills though.

galveston looks pretty nice from google maps...

 

[Baller MD]

Just got back from a run at Torrey Pines State Preserve. I don't miss chipping ice off my car.

I love San Diego.

 

[BuzzPhreed]

All the PP gigs in metro SoCal are physician only. No Preop monkeys....for now.

... for now.

 

[ZzzPlz]

Want my opinion? Work in a nice quiet flyover state for a few years and then buy a vacation home or two.

 

[deleted171991]

Want my opinion? Work in a nice quiet flyover state for a few years and then buy a vacation home or two.

Better: work in a flyover state for a few years, and then retire in a flyover country for the rest of your life. Vacation home included.

 

[Ezekiel2517]

Jeez I don't think anyone actually helped the op with his original question. I work in the LA area. I live in CA because it is my home and my ties are here . Groups in SoCal are dominated by grads from Ucla , usc, Irvine, Ucsf , Stanford , UCSD, etc and big name East Coast programs. Can you get a gig here if you're not from one of these programs ? Sure , but it will be tougher unless you bring something to the table that sorta separates you from the pack. Jobs in socal are not well advertised and there really isn't a well known mega group that runs the show like in other parts of CA (personally I think this is a good thing). Honestly I think your best bet is calling/emailing groups and hospitals directly. Kaiser is a big employer and is an option as well. Would I work in CA if I wasn't from here? Probably not, because of the cost of living and high percentage of medi-cal pts. But I've also lived in other parts of the country and everything CA offers can't be found anywhere else. It simply comes down to what you want in life, no need to judge

 

[BuzzPhreed]

It simply comes down to what you want in life, no need to judge

No one's judging.

If you're dually trained maybe you can score an academic gig? Just a thought.

 

[deleted162650]

Aside from Kaiser (very difficult to get hired especially w/o a fellowship) and academics, ASMG in San Diego is another practice to get in touch with. They are a "mega" group which hires at a fairly steady rate. Other than that reach out to some people on this board who are in CA. My practice isn't currently hiring unfortunately.

 

[GaseousClay]

Aside from Kaiser (very difficult to get hired especially w/o a fellowship) and academics, ASMG in San Diego is another practice to get in touch with. They are a "mega" group which hires at a fairly steady rate. Other than that reach out to some people on this board who are in CA. My practice isn't currently hiring unfortunately.

Is your practice is SD also? I heard from a friend ASMG isn't taking any more applications at the moment. not sure how long that will be for though. Are there any big groups in LA similar to ASMG?

 

[kilvinsky]

Seriously, reconsider moving to Cali. 2nd worse job market next to Hawaii. Low unit value combined with low hospital support and high cost of living makes the lifetime cost here in the millions of dollars. You will live in a tract house and drive a Honda accord. The water is cold, full of seaweed, and you will not be able to park there as the rich folks there are constantly trying to limit access from the riff raff (ythat is you). High competition for ****ty jobs makes for serious ass kissing as a job requirement.

 

[kilvinsky]

By the way, I always find it hilarious when people brag about being about having access to the beach. What the forget to tell you is the hour they spent looking for a parking spot, the wetsuit they had to wear, the used car they drove there, or the tract house they drove back to 10 miles away.

 

[fakin' the funk]

By the way, I always find it hilarious when people brag about being about having access to the beach. What the forget to tell you is the hour they spent looking for a parking spot, the wetsuit they had to wear, the used car they drove there, or the tract house they drove back to 10 miles away.

*I* find it hilarious that when there is a post about finding a job in Southern California, unhelpful douches like yourself come on here to talk mad **** about it. The OP wasn't asking for your opinion on Socal culture, cost of living, or geography.

But duly noted, you like warmer water.

 

[aneftp]

Jeez I don't think anyone actually helped the op with his original question. I work in the LA area. I live in CA because it is my home and my ties are here . Groups in SoCal are dominated by grads from Ucla , usc, Irvine, Ucsf , Stanford , UCSD, etc and big name East Coast programs. Can you get a gig here if you're not from one of these programs ? Sure , but it will be tougher unless you bring something to the table that sorta separates you from the pack. Jobs in socal are not well advertised and there really isn't a well known mega group that runs the show like in other parts of CA (personally I think this is a good thing). Honestly I think your best bet is calling/emailing groups and hospitals directly. Kaiser is a big employer and is an option as well. Would I work in CA if I wasn't from here? Probably not, because of the cost of living and high percentage of medi-cal pts. But I've also lived in other parts of the country and everything CA offers can't be found anywhere else. It simply comes down to what you want in life, no need to judge

Totally agree. My brother is an anesthesiologist at a hospital in good part of Los Angeles.

Market is super tight. You either gotta be from a big name problem (out of state) or local grad. Even the local grads still have problems finding jobs in LA proper. One of my brother collegue wife who was finishing up at on of the southern Cali programs couldn't find a job in LA proper. So my brothers collegue and his wife had to go find work south and they moved to San Diego.

My brother got me a job a couple of years ago with his group (total nepotism!) or else I would have had difficulty getting in. I turned it down at the last minute chase my wife wanted to stay in Florida. Zero percent state income taxes (super nice $750k Florida house). Vs my brother's 1.7 million dollar house in cali and Cali's new state income tax rate due to Prop 30. It's like 11.25% now for incomes above $500k and a ridiculous 13.25% for incomes above 1 million.

Fortunately most Md in private practice can shield money with defined benefits plan close to $100k or more.

But you gotta love the weather in souther California. No humidity as well.

San Fran area is almost as bad and housing is even worst. My other buddy there owns a 1.2 million dollar condo 1400 square ft inside the city. And it's nothing special. And he barely makes $200k in outpatient center. He does only work 30-35 hours a week and is a hippie and rides his motorcycles and travels a lot.

 

[Planktonmd]

This thread is a clear indication of how saturated the market is and how grim the future looks for this specialty if the ivory tower ******s continue to produce more and more hungry new grads.
We have reached a critical point where partnership in private groups is almost unheard of, and starting salaries for anesthesiologists are declining rapidly because of the overwhelming number of new grads being dumped on the streets every year.

 

[IlDestriero]

If the private practice partner ******s want to exploit new grads with their 4:1 CRNA cash cows and not offer partner tracks to protect their ocean front retirement house fund, that's on them. They're not doing that because there are too many new grads released onto the market.

 

[kilvinsky]

*I* find it hilarious that when there is a post about finding a job in Southern California, unhelpful douches like yourself come on here to talk mad **** about it. The OP wasn't asking for your opinion on Socal culture, cost of living, or geography.

But duly noted, you like warmer water.

Guess I touched a nerve. Did you get a parking ticket today at the beach when you couldn't find a legal spot next to all the multimillion dollar houses whose owners have restricted beach access in your California paradise?

 

[kilvinsky]

DONT move to California. The decision will cost you millions over your lifetime. For those who "have" to move to California, think about moving your family to you, or working part time and flying in every other week. It makes better financial sense, and if you really "have" to be in California every day and you have school age kids, consider becoming a full time parent instead. Makes better financial sense than working and hiring a nanny. Yes, the pay is that low.

 

[anbuitachi]

If the private practice partner ******s want to exploit new grads with their 4:1 CRNA cash cows and not offer partner tracks to protect their ocean front retirement house fund, that's on them. They're not doing that because there are too many new grads released onto the market.

that may be true, but more grads do contribute to lower salary, since regardless of the model, supply vs demand is always in effect

 

[user3]

This thread is a clear indication of how saturated the market is and how grim the future looks for this specialty if the ivory tower ******s continue to produce more and more hungry new grads.
We have reached a critical point where partnership in private groups is almost unheard of, and starting salaries for anesthesiologists are declining rapidly because of the overwhelming number of new grads being dumped on the streets every year.

planktonmd,

how would you rank the following factors as far as their contribution to the saturated job market:
-growth of AMC's
-more CRNA's and more CRNA practice rights
-increase in anesthesiology grads (9% from 2007 to 2013)

 

[IlDestriero]

... and if you really "have" to be in California every day and you have school age kids, consider becoming a full time parent instead. Makes better financial sense than working and hiring a nanny. Yes, the pay is that low.

I'd love to see the math where not working at all for 10+ years makes more financial sense than making $225k starting at Da U or 300 at Kaiser or an AMC and getting an au pair or even a nanny. Don't forget to explain how to make up the 36-52k/yr of lost tax advantaged retirement savings. It might be true if you're working at Starbucks.

 

[GaseousClay]

DONT move to California. The decision will cost you millions over your lifetime. For those who "have" to move to California, think about moving your family to you, or working part time and flying in every other week. It makes better financial sense, and if you really "have" to be in California every day and you have school age kids, consider becoming a full time parent instead. Makes better financial sense than working and hiring a nanny. Yes, the pay is that low.

kilvinsky did you make an account just to bash on california? where are you from btw and how much do you know about california markets, pay, cost of living and lifestyle? I know recent grads in the past 1-2 years making anywhere from 350-500k this is SF area, Orange county and SD

 

[sevoflurane]

Plenty of good jobs left out west (including MD-only practices).

Looking forward to 300+ days of sunshine and some of the best outdoor recreatinoal activities across the US.

Sure... I'll be making a little less... but you just can't put a price on what I'm getting in exchange. Especailly if you are coming from midwest/east coast gloomy sky territory. I've served my time in purgatory and I'm ready for a new chapter.

 

[Planktonmd]

If the private practice partner ******s want to exploit new grads with their 4:1 CRNA cash cows and not offer partner tracks to protect their ocean front retirement house fund, that's on them. They're not doing that because there are too many new grads released onto the market.

The abuse of new anesthesiologists by greedy private practice bastards is not the cause, it's the result of the over saturated market.
Everyone wants to make as much money as possible and if there are new anesthesiologists willing to work for half the money and without any hope of partnership, it should be expected that employers will take full advantage of the situation.

 

[Planktonmd]

planktonmd,

how would you rank the following factors as far as their contribution to the saturated job market:
-growth of AMC's
-more CRNA's and more CRNA practice rights
-increase in anesthesiology grads (9% from 2007 to 2013)

All these factors are equally significant but the only one that is under the control of our leadership is the number of new grads.
That number should have decrease not increased had these guys really cared about the future of this field.

 

[IlDestriero]

The abuse of new anesthesiologists by greedy private practice bastards is not the cause, it's the result of the over saturated market.
Everyone wants to make as much money as possible and if there are new anesthesiologists willing to work for half the money and without any hope of partnership, it should be expected that employers will take full advantage of the situation.

The employers I'm referring to are other anesthesiologists that had the good fortune to get there first and make partner. It's too bad that you think that it should be expected that they take advantage of new graduates. That's not the kind of group I would want to be a partner in, and certainly not an employee.

 

[deleted126335]

The employers I'm referring to are other anesthesiologists that had the good fortune to get there first and make partner. It's too bad that you think that it should be expected that they take advantage of new graduates. That's not the kind of group I would want to be a partner in, and certainly not an employee.

It is human nature and unfortunately very common practice. Most AMCs were founded or cofounded by anesthesiologists.

 

[Mman]

Just curious, but what do you mean PP anesthesiologists get to shield benefits of 100k ish? {that non PPs can't?]

If you work for an AMC or academic practice, your benefits are what they are.

If you work for a private group, the group can do whatever they want (within the law) for benefits including establish a defined benefit plan that let's you put up to $100K per year (once you reach age 50? before that it's 50K) of your own pre-tax money (this is in addition to 401K) in to it to grow tax free. Helps your retirement planning immensely.

 

[anbuitachi]

All these factors are equally significant but the only one that is under the control of our leadership is the number of new grads.
That number should have decrease not increased had these guys really cared about the future of this field.

Who exactly decides whether residencies increase spots or decrease? I can imagine ACGME or something preventing more places from opening, but who has the authority to shut down an existing residency (or decrease in size) from the outside..?

 

[gasdoc77]

The abuse of new anesthesiologists by greedy private practice bastards is not the cause, it's the result of the over saturated market.
Everyone wants to make as much money as possible and if there are new anesthesiologists willing to work for half the money and without any hope of partnership, it should be expected that employers will take full advantage of the situation.

Agreed. Furthermore, many AMC's are simply large mutant multistate private practices with no hope of equal partnership that have a supra hierarchical structure. They have proven profitable because of nothing more than supply and demand. Blaming the small private practices for following suit is misguided. Regarding such a model, small groups are deciding if you can't beat em.....

 

[deleted171991]

The obvious parallel is what happened to law, when the supply of lawyers got out of control. The problem is, unlike lawyers, we don't bring in our own patients, and our old patients don't really refer new ones, and don't follow us to a new practice. That's very-very bad, because that means that a group (private or AMC) has zero incentive to give one partnership, unless one is really too much headache to replace. <- Which almost never happens. Nobody is irreplaceable especially in a disadvantageous supply/demand situation.

So get used to the idea that, except for pain docs and difficult to find subspecialists, who bring something special to the practice, nobody will get partnership in the future. And, unlike competent lawyers, one cannot just get out of the AMC and start a successful solo/group practice elsewhere (except for pain, again).

Which makes me question every day my decision not to pursue pain...

 

[kilvinsky]

I'd love to see the math where not working at all for 10+ years makes more financial sense than making $225k starting at Da U or 300 at Kaiser or an AMC and getting an au pair or even a nanny. Don't forget to explain how to make up the 36-52k/yr of lost tax advantaged retirement savings. It might be true if you're working at Starbucks.

The UC's start at 160, 195 with call for clinical instructors. Kaiser starts you per diem at 120 an hour, no benefits. You also need 2 nannies with anesthesiologists hours, and the current rate in desirable areas is 60-70k for a non molester. Why so much for a nanny? remember you are competing with the rich for decent child care. Throw in the cost of eating out, dog walkers, gardeners, pool maintenance, housekeeping, gas, it is almost a wash.

 

[kilvinsky]

Not sure why no one believes how little money you make in Cali. Medicaid is 11-15 buck a unit, Medicare is 20, and most practices have around 50%. Throw in AMC takeovers, senior partners raping you and cherry picking, the second highest taxation and cost of living west of Manhattan.

 

[kilvinsky]

The Local u starts at 160. 195 with call. Kaiser only starts you per diem at 120 an hour. You also need 2 nannies with anesthesiologists hours, and the current rate in desirable areas is 60-70k for a non molester. Why so much for a nanny? remember you are competing with the rich for decent child care.

 

[Planktonmd]

The employers I'm referring to are other anesthesiologists that had the good fortune to get there first and make partner. It's too bad that you think that it should be expected that they take advantage of new graduates. That's not the kind of group I would want to be a partner in, and certainly not an employee.

Unfortunately that's the way it is in private practice everywhere... these anesthesiologists who get there first always exploit and abuse the ones who come after.
These groups are small or midsize businesses and their only goal is to make as much money as possible for the owners or share holders.
They are no longer physicians with ethical obligations towards other physicians and anyone who thinks otherwise is either naive or dishonest.

 

[Arch Guillotti]

Unfortunately that's the way it is in private practice everywhere... these anesthesiologists who get there first always exploit and abuse the ones who come after.
These groups are small or midsize businesses and their only goal is to make as much money as possible for the owners or share holders.
They are no longer physicians with ethical obligations towards other physicians and anyone who thinks otherwise is either naive or dishonest.

Not every practice is like this.

 

[Arch Guillotti]

If you work for an AMC or academic practice, your benefits are what they are.

If you work for a private group, the group can do whatever they want (within the law) for benefits including establish a defined benefit plan that let's you put up to $100K per year (once you reach age 50? before that it's 50K) of your own pre-tax money (this is in addition to 401K) in to it to grow tax free. Helps your retirement planning immensely.

The limit for contribution to a defined benefit plan is $210,000 in 2015.

 

[anbuitachi]

Wouldn't this violate sherman antitrust law?

Pharmacists, for example, complain about new schools constantly opening, but apparently their accrediting body cannot deny new programs approval as long as they meet standards. Denying new programs simply to restrict supply would be deemed illegal anticompetitive behavior and subject them to lawsuits under the Sherman anti-trust act.

interesting, i didnt know that about pharmacy. though from my feeling, it seems like Medicine is in its own world in terms of laws...

 

[deleted171991]

I doubt that antitrust law applies here. These are non-profit corporations, not business entities.