Disadvantages of HCA EM residencies?

[EctopicFetus]

Small enough that you don't have the bargaining power of a CMG.
Look at what happened at Summa with SEA. Look at what has happened at any number of other shops.
Sure, you can have your docs be on committees, and be active, and never have an issue with staffing. At the end of the day, only the small hospitals care. Any hospital system will always fall for the "we can cover all of your sites" spiel, even with expansion. Your SDG won't. If you aren't taking money from the hospital, the CMG will come in and offer to pay for the privilege of staffing. They're in it to make money. Period.

Disagree. Also re summa. It’s not like cmgs don’t lose their residencies. See ut Chattanooga

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[deleted109597]

Disagree. Also re summa. It’s not like cmgs don’t lose their residencies. See ut Chattanooga

Corpus lost theirs too. The difference was, none of the rank and file changed. It just changed from EmCare to Schumacher.

 

[EctopicFetus]

Corpus lost theirs too. The difference was, none of the rank and file changed. It just changed from EmCare to Schumacher.

CMG tocmg transition no one cares. It’s like McDonald’s or burg r king. Whoever is signing the checks doesn’t matter cause you have already been defeated.

 

[deleted109597]

CMG tocmg transition no one cares. It’s like McDonald’s or burg r king. Whoever is signing the checks doesn’t matter cause you have already been defeated.

You're not wrong.
But I argue that the reason the CMGs keep winning is the same reason @southerndoc argues it. They have the volume, the billing, and the BS to convince the C suite.
I'm not happy about it. It's just rationality.

 

[EctopicFetus]

You're not wrong.
But I argue that the reason the CMGs keep winning is the same reason @southerndoc argues it. They have the volume, the billing, and the BS to convince the C suite.
I'm not happy about it. It's just rationality.

Explain the volume
And billing. Yes to the bs but that ship is sailing. Hospitals and CEOs having bad experiences with cmgs becoming more and more common.

Do they likely make more per patient (aka better contracts) of course I agree. But united showed everyone else how to handle envision and now team.

Speaking recently to a pe guy he said the delta between cmgs and sdgs is shrinking. A well run cmg has expenses under 15%. On the light side at a cmg it’s 30%.

Also the use of mlps is viewed as a downside by both insurers and hospitals.

Cmgs moving to a near 1:1 hours breakdown between doc and mlp.

 

[deleted109597]

Volume meaning "a whole bunch of doctors to fill up any gaps in schedule or can staff the other sites in case of expansion".
Billing? They've got more clout. "We see 1,000,000 of these a year, so you should be in network".

There's a lot of reasons you don't hear frequent (if any) stories about sites going from CMGs back to SDGs. But you hear a ton of the opposite.

 

[EctopicFetus]

Volume meaning "a whole bunch of doctors to fill up any gaps in schedule or can staff the other sites in case of expansion".
Billing? They've got more clout. "We see 1,000,000 of these a year, so you should be in network".

There's a lot of reasons you don't hear frequent (if any) stories about sites going from CMGs back to SDGs. But you hear a ton of the opposite.

My sdg has 20 to 30 people come knocking every year and we have no spots. The lack of sdgs means we can double in size with minimal effort. We as an sdg have no gaps in coverage. Ever. We also wisely overstaff for +1 over need because life happens.

The reason you don’t hear about cmg —> sdg is because few people have those skills and many are too afraid to challenge the cmgs. My group snagged some sites from a cmg. Screw em. We didn’t exactly come and tell everyone. No need.

 

[GeneralVeers]

My sdg has 20 to 30 people come knocking every year and we have no spots. The lack of sdgs means we can double in size with minimal effort. We as an sdg have no gaps in coverage. Ever. We also wisely overstaff for +1 over need because life happens.

The reason you don’t hear about cmg —> sdg is because few people have those skills and many are too afraid to challenge the cmgs. My group snagged some sites from a cmg. Screw em. We didn’t exactly come and tell everyone. No need.

The problem is that the decision about who runs the ED is entirely up to the C-suite and doctors have almost no say. When they kicked out EMP (Now USucks), we told the hospital we would all stay at the site and form a SDG. The hospital refused, and gave the contract to our last-ranked CMG prompting most of the doctors to leave.

 

[TooMuchResearch]

We staff 2 docs heavy. Everyone works at or just slightly under what they want, it's easy to swap or give away shifts, we're covered in the case of unexpected and expected leave, and as always people routinely cut their shift number by 1-2 per year.

My sdg has 20 to 30 people come knocking every year and we have no spots. The lack of sdgs means we can double in size with minimal effort. We as an sdg have no gaps in coverage. Ever. We also wisely overstaff for +1 over need because life happens.

The reason you don’t hear about cmg —> sdg is because few people have those skills and many are too afraid to challenge the cmgs. My group snagged some sites from a cmg. Screw em. We didn’t exactly come and tell everyone. No need.

 

[Hercules]

The reason you don’t hear about cmg —> sdg is because few people have those skills and many are too afraid to challenge the cmgs. My group snagged some sites from a cmg. Screw em. We didn’t exactly come and tell everyone. No need.

I know anecdotes don’t establish trends, but TeamHealth lost their contract to an SDG (not mine) in my area as well.

 

[RustedFox]

I know anecdotes don’t establish trends, but TeamHealth lost their contract to an SDG (not mine) in my area as well.

Same here.
My main gig kicked out TH in favor of a very small CMG that lets us basically operate with little interference. I'll let you all know how it works out come December.

 

[miacomet]

I can hardly myself! I'm full-time W2 again for the first time in 6 years. We will see how long that lasts. If the bottom hadn't fallen out on Texas locums I'd probably still be doing that.

Tell us more...

 

[RustedFox]

Tell us more...

I know, right ?

Someone once said on here that I was on the "Mt. Rushmore of this forum".

If that's true, then Veers is on the "Mt. Olympus of this forum."

 

[GeneralVeers]

I remember when vituity was still cep and they were offering some crap like 150/hr for a place in Chicago. I can't stop thinking why do people take jobs like this?!?!?!

Because after 5 years of working for slave wages you can become a full PARTNER!

 

[GeneralVeers]

I know, right ?

Someone once said on here that I was on the "Mt. Rushmore of this forum".

If that's true, then Veers is on the "Mt. Olympus of this forum."

I consider myself more infamous than anything. I don't always share the same views as other EPs.

I think it's productive to have dissenting views on things, and a skeptical attitude to everything.

 

[Birdstrike]

I know, right ?

Someone once said on here that I was on the "Mt. Rushmore of this forum".

If that's true, then Veers is on the "Mt. Olympus of this forum."

If this forum has monuments to it's members, not only is Veers on its Mt. Rushmore and Mt. Olympus, he also rules over it's highest, otherworldly realms.

 

[cyanide12345678]

I wanna be like veers when i grow up.

 

[GeneralVeers]

I wanna be like veers when i grow up.

There's no copying the original.....