EM and Kaiser

[docB]

A question about the pros and cons of practicing EM in the Kaiser system popped up on a different thread. While I know we've had some good discussion about this in the past, and we even have some attendings here who either work for Kaiser or used to, I couldn't find any of the old threads by searching. Since this is an important topic for anyone considering working in the west I'm starting this thread for discussion and so it can be searched easily.

I have never worked for Kaiser although I know several EPs who do and we trained at Kaiser hospitals in my residency.

What I know of Kaiser is that they have a reputation for paying less than you'd make with a true private or even a corporate group but they pay more than you'd make in academics. They have really comprehensive benefit packages which are really attractive although you are covered by Kaiser so you will get your care in an HMO environment. Kaiser also has a very good retirement package if you work for them for 20 years or more.

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[roja]

I almost worked for Kaiser. Not sure how it is in other places, but in NoCal, its a pretty nice gig. I have a number of friends working for them and they are pretty darn happy. Really good benefits. Decent pay. (more than academics, less than some private places) Research opportunities through thier research institute.

 

[oxytocin]

This is exactly what I wanted to know, specifically in California, but any Kaiser info would be helpful. Thank you for your inputs. Please keep them coming!

 

[diphenyl]

Nor cal girl born and raised here. They just opened a new kaiser hospital across town complete with ED. One of my colleagues currently does part time work there. He's insane, not because he works there but because he works 25 days a month. He says he's pretty happy there. Nice pay for a part time gig. During the daytime they have a urgent care in addition to the ED with non EP peeps staffing it. If any patient presents there that looks emergent they are taken over to the ED right away. For the most part, the payor mix can't be beat. You do end up having to do a lot of transfers. Due to the fact that they are an ED accepting ambulance traffic they quite often get non kaiser people that if they need to be admitted their hospitalist looks for any reason to transfer especially if they are self pay. What is great is they have hospitalists and ped's in house 24/7 who personally present to eval and admit all the pt's you call them about. One minor downside I should also mention. They may be able to get away with it because their ED's are small but this would kill the docs in a bigger one. Nurses have no standing orders. A doc must order absolutly everything. No verbal orerds accepted at all either.

 

[oxytocin]

25 days a year? Thanks for the input! I didn't know it was possible to do EM parttime. How flexible is Kaiser in letting physicians do that? Why did your friend decide to go down that route?

 

[roja]

Kaiser was pretty flexible when I was considering working there. Others do part time, some per diem

 

[GeneralVeers]

25 days a year? Thanks for the input! I didn't know it was possible to do EM parttime. How flexible is Kaiser in letting physicians do that? Why did your friend decide to go down that route?

That's the minimum required # of days to work, in order to afford living in California.....

 

[deleted77919]

…

 

[diphenyl]

Sorry just wanted to clear it up. The colleague I was referring to works about 15-18 day per month with my group aka full time. He works part time at Kaiser as a side gig 7 to 10 days per month aka part time.
either way 25 total work days per month is insane. In residency I never went past 22. I'm far too old to go back to that. (Not too old boys I'm only 33)

 

[spyderdoc]

I worked in Kaiser system here in NCal for almost 2 years, and in SoCal for almost 2 years...

Kaiser is a great job "for the long haul". It is relatively low stress. You have GREAT coverage so ever doc sees about 1.5 pts/hr. We had up to 7 ER docs on at a time during peak hours.....You generally do your shift and go home at the end of the day with no worries. One call to make for a consultant, and they are generally in-house.

I left for a FFS job and make A LOT more money, but I see A LOT more patients....Moneywise, I think I probably make about the same, or even a bit less, per patient in my job now than I did at Kaiser.....Sometimes I am so busy, I can't get to all my charts, so I do charting at home the next day. We don't sign out patients, so we stay until they are dispo'ed, sometimes 1-2 hours after shift done. Trying to admit someone can be painful since we have to figure out what insurance they have, then call the appropriate consultant for that insurance, etc....In genreal though, it seems that it is easier to get consultants to see patients in FFS world since there is more financial incentive. At Kaiser, a doc makes same salary no matter what the volume they see, so no incentive to work harder....


Kaiser is great for benefits. Health care benefits for whole family. Retirement plans and pension are very nice, but a pension nowadays is not guaranteed to be there (although in Kaiser, I am sure it is stable).....Sick and vacation time benefits. Malpractice covered with no tail. Kaiser patients are bound by arbitration.

We are still Kaiser patients since my wife is a hospitalist there, so we get benefits thru her......I feel we get great care, esp routine stuff. Can get seen pretty much anytime with same day appts.....I really can't complain about Kaiser as a patient.....

The downside to Kaiser as a doc is the salary is based on a 40 hr work week, so you have to work a lot of shifts/hours to get the salary, which is generally lower than other EM jobs, but def enough to make a living and retirement....I think they are starting around 225-230k/yr, but again, that is based on 40 hr work week, so per hour, can look pretty low. In my current FFS job, I work 14 8hr shifts/mo, so I get more days off in a month to hang out with family/kiddos......

Well, I will post more as I think of things.....

 

[takotsubo]

Can any attendings out there comment on the other major groups in the Bay Area? I'm interested in hearing about CEP, VEP, and other groups that you may have come in contact/interviewed with or considered.


Thanks!

 

[Hard24Get]

Bump

 

[merlin]

Bump. Curious if anyone at Kaiser finds that they miss the acuity and trauma that you see either in residency or at other hospitals.

 

[docB]

Bump. Curious if anyone at Kaiser finds that they miss the acuity and trauma that you see either in residency or at other hospitals.

Again, I never worked for Kaiser, just rotated there. But the hospitals I was in (Kaiser South Sac and Morse Ave Sacramento) were busy, high acuity places. I believe South Sac is a trauma center now. I know the Kaisers in the Bay Area hop. So you may not have to trade acuity for Kaiser.

 

[deleted109597]

Also, few hospitals actually see trauma like the level 1-2s we work at in residency. At my community site, I haven't seen one in over a year.

 

[jendc08]

Also, few hospitals actually see trauma like the level 1-2s we work at in residency. At my community site, I haven't seen one in over a year.

Anyone else that can comment on working for kaiser?

 

[jendc08]

Anyone? Buehler?

 

[old_boy]

Resurrecting an old thread. Looking at Northern California jobs (Bay Area, Sacramento Area). CEP and Kaiser big players that I'm interviewing with. I understand the differences in terms of models and pay. Obviously each site is different, but in terms of organizations which do you think will be the better one to join going forward? My hunch tells me that we are in a bit of a boom right now in ER pay and job prospects right now are good, with the affordable care act overall helping our speciality. Both CEP and Kaiser are doing very well. I see Kaiser better positioned to keep growing pay for ED physicians in the coming decade or two. Much of the growth of CEP's bonus pool (a large percentage of total compensation once you make full partner) seems to come at the expense of new sites and new hires. I worry that CEP's pay, while decent now, may not be able to keep pace with Kaiser. Thoughts?

 

[Averagemanboy]

I worked in Kaiser system here in NCal for almost 2 years, and in SoCal for almost 2 years...

Kaiser is a great job "for the long haul". It is relatively low stress. You have GREAT coverage so ever doc sees about 1.5 pts/hr. We had up to 7 ER docs on at a time during peak hours.....You generally do your shift and go home at the end of the day with no worries. One call to make for a consultant, and they are generally in-house.

I left for a FFS job and make A LOT more money, but I see A LOT more patients....Moneywise, I think I probably make about the same, or even a bit less, per patient in my job now than I did at Kaiser.....Sometimes I am so busy, I can't get to all my charts, so I do charting at home the next day. We don't sign out patients, so we stay until they are dispo'ed, sometimes 1-2 hours after shift done. Trying to admit someone can be painful since we have to figure out what insurance they have, then call the appropriate consultant for that insurance, etc....In genreal though, it seems that it is easier to get consultants to see patients in FFS world since there is more financial incentive. At Kaiser, a doc makes same salary no matter what the volume they see, so no incentive to work harder....


Kaiser is great for benefits. Health care benefits for whole family. Retirement plans and pension are very nice, but a pension nowadays is not guaranteed to be there (although in Kaiser, I am sure it is stable).....Sick and vacation time benefits. Malpractice covered with no tail. Kaiser patients are bound by arbitration.

We are still Kaiser patients since my wife is a hospitalist there, so we get benefits thru her......I feel we get great care, esp routine stuff. Can get seen pretty much anytime with same day appts.....I really can't complain about Kaiser as a patient.....

The downside to Kaiser as a doc is the salary is based on a 40 hr work week, so you have to work a lot of shifts/hours to get the salary, which is generally lower than other EM jobs, but def enough to make a living and retirement....I think they are starting around 225-230k/yr, but again, that is based on 40 hr work week, so per hour, can look pretty low. In my current FFS job, I work 14 8hr shifts/mo, so I get more days off in a month to hang out with family/kiddos......

Well, I will post more as I think of things.....

I know this was posted awhile ago, but when you say the salary is based on a 40 hr work week, so you have to work a lot of shifts to get the salary does that mean er docs their work more than 40 hours? how many hours do er docs work their typically? apologize for my ignorance

 

[coachB]

I know this was posted awhile ago, but when you say the salary is based on a 40 hr work week, so you have to work a lot of shifts to get the salary does that mean er docs their work more than 40 hours? how many hours do er docs work their typically? apologize for my ignorance

There is huge variability. Different structures regionally and even locally. So, it depends.