EmCare?

[Lukin]

Hey,
I recently was hired as a hospital employee in a rural ED. there is a total of 10 docs who staff an ED with a volume of 16,000 a year. The Hospital CEO just came to the ED physicians and said that he wants the contract with the hospital to now go to EmCare. They would hire us as independent contractors paying us a hourly salary.
I think this is generally a horrible idea, but this is based off of lots of hearsay from other doctors. I was hoping to get some tangible data on why this is a bad idea.

What people have told me is the following: 1. they will slowly lower our pay 2. they will limit the control of our own ED 3. There is no way to provide feedback for improvement.

My brief google search did not yield much information. Other than EmCare being the devil vs the greatest thing ever. no actual data or actual real accounts of direct experience.

I know there are people out there who have direct experience with this group or similar groups. Or at least can direct me to a good website with some data.

Thanks

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[deleted109597]

Answering as someone who gets paid by them.
1. Can't answer the question about slowly lowering pay, but depending on what you're getting paid now, they might.
2. They will have certain things done their way, but you (or more specifically the medical director) will still have local control. Of course, that person may be someone sent in by EmCare. The CMO of the hospital holds as much control over the ED as anyone else though.
3. They frequently ask for feedback. Some things they listen to, others they don't.

 

[The White Coat Investor]

What problem is he trying to solve by hiring EMCare and why hasn't your group addressed it?

 

[Arcan57]

Hey,
I recently was hired as a hospital employee in a rural ED. there is a total of 10 docs who staff an ED with a volume of 16,000 a year. The Hospital CEO just came to the ED physicians and said that he wants the contract with the hospital to now go to EmCare. They would hire us as independent contractors paying us a hourly salary.
I think this is generally a horrible idea, but this is based off of lots of hearsay from other doctors. I was hoping to get some tangible data on why this is a bad idea.

What people have told me is the following: 1. they will slowly lower our pay 2. they will limit the control of our own ED 3. There is no way to provide feedback for improvement.

My brief google search did not yield much information. Other than EmCare being the devil vs the greatest thing ever. no actual data or actual real accounts of direct experience.

I know there are people out there who have direct experience with this group or similar groups. Or at least can direct me to a good website with some data.

Thanks

I don't have specific experience with EmCare, but have worked for several contract management groups.

The first thing to know would be what about your group pissing off the CEO. That's likely going to be the reason behind EmCare getting the contract, and you can expect that it will be the first thing addressed once EmCare takes over.

If it's Press-Ganey issues, then expect to go through customer service training and expect the lowest performers to not retain their jobs.

If it's an unhappy medical staff, expect to start writing in-patient orders (a common bargaining tool to get the med exec committee on board with the change) or to have the EM docs that run afoul of the big-time admitting docs to be disciplined or let go (less likely in a situation where you were already a hospital employee).

If it's a productivity issue, then expect multiple rounds of reorganization of patient flow in the ED along with the termination of your slowest docs and at least temporary replacement with high-efficiency locum docs.

If it's a cost saving measure then you are screwed because the hospital CFO is either brain-dead or they are going to pay the contract-management group less than the aggregate of what they are paying the EM employee docs. Except EmCare needs to turn a profit so that means your salary is going to decrease at least proportionate enough to make up the difference. Either that or EmCare is figuring it can produce enough additional RVUs out of the existing workforce that it won't need to cut salaries. Replacing physicians with midlevels would be the most likely way to do this.

Finally, it may be that your shop is on the cusp of needing additional provider hours and the hospital hasn't been successful in recruiting additional providers. EmCare will have a pool of docs (locum type or part-timers in a specific region) that they can rotate in to maintain staffing. This is probably your best hope for the contract switch, although the quality of these locum docs varies significantly. This is especially true if your shop isn't located in an areas that either pays very well or is a vacation destination.

As an IC, you won't get benefits (which may or may not be important to you) and some of the protections that employees have won't apply. You can expect that your compensation and/or workload will change as the contract management group tries to figure out how to optimize revenue. They have a lot of data from their prior contracts, so they are usually pretty savvy regarding how many provider hours are needed to see x number of patients and are usually quick studies about how much money it takes to retain docs of sufficient quality that they will meet the requirements of their contract.

 

[Arcan57]

The two posts above me occurred while I was entering in that wall of text. Looks like all three of us are on the same page.

 

[EM_Rebuilder]

I am covering some of the same bases as above, but...

First and foremost, I assume someone in your group is a 'go to' person to your hospital CEO. They need to ask ASAP why the CEO is even interested in this change and are they interested in working on your differences?

If you cannot work out your differences, AND you are indeed a good group of people that have been at the hospital for sometime.. let the CEO know all of you will be leaving when/if a staffing group comes on board... everyone in your group needs to be on board with that.... If your ED is indeed very rural, I am assuming attracting new folks is near impossible. I have heard some small groups doing this in rural america and saving their practice. Make sure to let the staffing company know all 10 of you intend to leave the area. Occasionally, the staffing group may back out.

EMCare, ECI, Schumacher, Keystone, TeamHealth... IMHO they are all the same. I have worked some shifts with 4 of these 5. They are for profit businesses that are trying to make money off emergency physicians....Plain and simple. I am not saying the companies are all bad; and none are better/worse than the next. Its a business model and thats what they do.

Almost certainly, if they do buy the contract and employ you; there WILL be a pay cut. I personally was credentialed at a hospital where the pay went from 195/hr to 150/hr when a staffing company bought the contract. They will try to 'sale' it to you as they are now taking care of malpractice, billing, etc..

I would not have shyed away from working full time where I am working because one of the big companies have it; but I would fight tooth and nail if one came in to try to take it over after I am already there...

Good Luck....

 

[EctopicFetus]

I worked for EmCare and my concern and why the overall satisfaction with them is low is because 1) they dont care about physician satisfaction. 2) its a bottom line business 3) it can be quite unfair in their practices.

I was a resident moonlighting there and while the medical director at one of my facilities was horrid the asst med director was great. When the medical director couldnt win the vote to also be the chairman they scrambled and it turned into a cluster. just before EmCare lost their contract they panicked and fired both the med dir and asst med dir.

They just dont care. I am so happy to be working for a private group. No corporation stealing the money I earn.

Just be cautious of EmCare / teamhealth etc.

EmCare is a 3 billion+ business and that fortune is made off the backs of hardworking EPs.

 

[Hamhock]

I worked for EmCare and my concern and why the overall satisfaction with them is low is because 1) they dont care about physician satisfaction. 2) its a bottom line business 3) it can be quite unfair in their practices.

I was a resident moonlighting there and while the medical director at one of my facilities was horrid the asst med director was great. When the medical director couldnt win the vote to also be the chairman they scrambled and it turned into a cluster. just before EmCare lost their contract they panicked and fired both the med dir and asst med dir.

They just dont care. I am so happy to be working for a private group. No corporation stealing the money I earn.

Just be cautious of EmCare / teamhealth etc.

EmCare is a 3 billion+ business and that fortune is made off the backs of hardworking EPs.

Finally, a bit of truth.

Why on this anonymous board do people hold back?

Share freely.

HH

 

[Apollyon]

Finally, a bit of truth.

Why on this anonymous board do people hold back?

Share freely.

HH

At least two of our regular posters are EmCare folks, in the same city. I'm not saying where, as to reserve their respective privacies. If either or more is so inclined, any might reveal.

 

[TysonCook]

We have EmCare and now Teamhealth coming in to our area. There are a few private groups that have a bad taste in their mouths as both tried to come in and "undercut" them. Several contracts were lost to The Man, but a lot of the private groups kept their contracts.

I think that the post was spot on, in that if you are private and you want to keep your contract you need to do/be more than what a mega group can provide.

Some examples:
1) Your group needs to be integrated into the hospital (i.e. serve on committees, and high up if possible)
2) Have good PR (this does NOT include giving Narcs to pill heads), it does suck but good PG scores matter (this is an art in and of itself).
3) Be a part of the local community (be staff at the high school football game, do the local charity drives, have the wives part of the wives groups)
4) Financially make your group competitive
5) Show initiative (new protocols, new technology)... Don't WAIT for admin to come to you.
6) Show how your group can increase the bottom line, don't wait for them to come to you.
7) Play nice with other groups within the hospital (if they b*tch about you to admin it just becomes easier for them to let you go).
8) Have defined goals set with admin. Its hard to let a group go if you are meeting goals/benchmarks.

I know it sounds dorky, but you have to be a part of the "solution" to admins headaches. Its hard to fire a group that is head of pharmacy, has the CMO spot, and has raised $30k for the local charity while your wife is best friends with the COO's wife, and met all benchmarks mutually agreed on in the last 6 months.

Just my $.02

 

[docB]

I'm one of the EmCare guys. As mentioned this is a board for collegial discussions about EM topics and corporate EM is a perfectly valid and controversial issue. Anyone can say anything they want in a civil, collegial manner.

I'd be the first to admit that EmCare can be predatory. It is a bottom line business and it will cut pay if that's what it has to do to make a contract make money.

My feeling on corp EM is that it is what it is. I mean it has some good points like more efficient overhead and self insurance. But it's not locally controlled, totally independent situation.

Crap. Gotta go. Will post more later.

Note to self talk about service improvement issues.

 

[EctopicFetus]

My view on all jobs is this. As long as you know what you are getting yourself into then thats fine. The key is doing the research and comparing jobs. There was a very controversial group here in town (not my group) that was taken over by TeamHealth and then broke from them and teamhealth sued them.

Bottom line is its not for everyone but it does have some benefits depending on what you are looking for.

 

[deleted109597]

So, EmCare was able to get my hospital to agree to non-PO contrast CT abd/pelvis as a way to increase throughput, not because the radiologists agreed that their literature supports it, etc.

Yes they don't pay benefits (at least not to the grunts), but the nice thing is that my wife has a job that does pay them, so I enjoy the relatively higher salary because of this. Based on the compensation survey, I'm higher than 90% of hourly employees and just starting out. And they don't only have meatgrinder facilities either.

All the big groups are able to work by economies of scale. Just like Wal-Mart or any other business, they cut some of the redundancy out of by running several shops in the same area and using the same scheduler/coder for all of those.

Also, while they make money "off the backs of the EPs", the same is true of every group. That's why you aren't partner immediately in any group I've ever looked at. Plus, the fact that they all have successful practices in many other locations means that the CEO/CMO is more likely to listen to them when it comes to changes than they will be to "the local guy", even if they're saying the same thing.

The only beef I have with any of them is because they have so much volume, that they recruit non-EM folks simply because there aren't enough to go around. However, there are plenty of sites that they only have BC/BE people. You just have to look around.

 

[EctopicFetus]

Not looking to get into an argument McNinja, but a buy in in a private group is just that. Eventually no one makes money off your back.

2) I know of groups where there is no buy in and you are equal day 1.

The issue isnt in year 1-3 but a guy who has been there for 10 years gets paid the same as the guy from day 1 and while the day 1 guy might not be able to do better if the 10 year guy was somewhere else he would be doing better.

The Daniel Sterns Compensation Survey is out for this year.

Employee Compensation:
10th percentile $199K, 1300 hours, $110/hour
50th percentile $258K 1700 hours, $145/hour
90th percentile $365K, 2184 hours, $195/hour

Partner Compensation
10th percentile $220K, 1300 hours, $120/hour
50th percentile $316K, 1632 hours, $178/hour
90th percentile $469K, 2040 hours, $260/hour

Just proving my point that partner money is better and usually with better benefits too. EmCare typically doesnt take a small amount but a large amount. Also, for what they make up in economies of scale they lose since they always have to recruit etc.

I worked for them I had a fair experience but am infinitely happier as a partner with my current group. Physician satisfaction matters, pay is better, benefits are better and that was from day 1 out here.

 

[EctopicFetus]

At the top end the hourly salary between partner and IC is $30-$40 per hour more for partners.

 

[tkim]

Also, while they make money "off the backs of the EPs", the same is true of every group. That's why you aren't partner immediately in any group I've ever looked at.

A 'sweat equity' buy-in for a year or so at a private group is different from the many different levels of 'partnership' that are offered by the large CMGs. There is a point in which the private group partnership allows you an equal share of all profits, where you may never get to an equal share of the profits because there are investors to pay at the CMG.

 

[docB]

Ok, I'm back.

The physician satisfaction thing is a luxury as far as I've seen. When administrators are happy groups (not just corp or private groups, all groups) can work for better conditions. When times get tough, which usually means admins get antsy, then physician satisfaction goes out the window. Note I'm talking about EM physician satisfaction. Satisfaction for the perceived cash cows like the internist with a big panel full of insured patients of the surgical sub specialist who fills the OR twice per week, they are always a priority.

My point from before was that corp EM isn't really evil, it's just a particular way of doing things. I think that you do get back some of the money they take by using the aforementioned economies of scale, particularly when talking about insurance and some types of overhead. You can usually choose if you want to work in that environment or not. The exceptions to that rule are when you really want to work somewhere and a corp has the contract or when your contract gets picked up.

As for why do contracts get lost to corp groups I agree with the previous posters that there is always some issue that the admin thinks will get fixed. It's usually not a quality issue with the current docs. In the past it's usually been the belief that the ED could be handled cheaper. That usually pops up in contracts where the hospital is subsidizing the EPs. Any contract where there is a subsidy is a target.

Lately, however, it's had more to do with regulatory stuff like core measures and HCAHPs. These administrators are scared constipated because they don't know what's going to happen yet but they are being told by their financial people that if x,y and z aren't met they'll lose all of their billing. So anyone who comes along and assures them that they can keep the money rolling in can prey on that contract.

Big EM corps have lots of things they can point to to argue that they'll deliver, reams of data from other contracts, relationships with giant consulting firms, and so on. Administrators love data and they believe in consulting firms. That's the "service improvement" end.

 

[deleted109597]

Not looking to get into an argument McNinja, but a buy in in a private group is just that. Eventually no one makes money off your back.

No argument, but the buy in is when they are making that money. It just so happens that in the corporate groups, the "buy in" is typically a lot longer, and you're never really "profit sharing". You only make more money if you want to take on more responsibility in those situations, which is why TH, EmCare, SG, etc pay more for their "director" roles than they do for the "grunt" roles.
On the flip side, not everyone wants to be the boss. Part of my enjoyment of my new job is that I go in, work hard, make patients, nurses, and the staff happy, and then go home. I don't give a **** about scheduling, I don't feel obligated to cover shifts that aren't mine, and I don't take call. So yeah, I could probably make more if I did, but not so much more that I think it would be worth it at this point. But then again, what's important to me is different than other people.

2) I know of groups where there is no buy in and you are equal day 1.

That's pretty cool. They're not very common from my experience though. I expect them to be less common as reimbursement declines as well.

The issue isnt in year 1-3 but a guy who has been there for 10 years gets paid the same as the guy from day 1 and while the day 1 guy might not be able to do better if the 10 year guy was somewhere else he would be doing better.

On the flip side, at some of the RVU places, the guys at day 1 make more than the guys at year 10 because they work harder. Each model has its place, and I can't argue that any of them are the best.

Just proving my point that partner money is better and usually with better benefits too. EmCare typically doesnt take a small amount but a large amount. Also, for what they make up in economies of scale they lose since they always have to recruit etc.

Partner money isn't always better though. It can be, but there are IC jobs that pay more than any partner job.

I worked for them I had a fair experience but am infinitely happier as a partner with my current group. Physician satisfaction matters, pay is better, benefits are better and that was from day 1 out here.

And that's all any of us want, are jobs that pay good and don't suck.

 

[EctopicFetus]

Mcninja,

Much agreement. Only point of contention, I would strongly argue that the absolute highest paying jobs are partner jobs where you screw the nonpartners. They make more than the ICs. I also think that there are partner jobs where even without screwing your non-partners you make more than the highest IC but thats just a matter of debate among a few groups.

Lilke I mentioned as long as people know what they are getting into then its all fair. all we can hope for is to be happy with our jobs and our incomes. Sounds like you and me have found both.

 

[noia]

So, EmCare was able to get my hospital to agree to non-PO contrast CT abd/pelvis as a way to increase throughput, not because the radiologists agreed that their literature supports it, etc.

That's very interesting... EmCare at our hospital in MA has also been pushing hard to do abd/pelvis CT without PO contrast to increase throughput, against the strong objections of radiology, who, like you say, state that the literature doesn't support it.

To get around giving oral contrast, the EmCare docs typically order these to "r/o renal stone" or "r/o ruptured AAA." If the patient is admitted, surgery then has to reorder the test with oral/IV to figure out what's going on.

I wonder if it's part of a business plan/strategy to increase throughput nationwide.

 

[thorg12]

I'm speaking from a resident point of view and having only read a little about contracts and seeing some fellow residents contracts. I have a few questions. Some big red flags seem to be no open books, meaning I can't see how much money I earn; and being fired without cause, meaning no due process. This is based mostly on my aaem loving residency and few talks with residents and attending.
Are these "red flags" more common in the team health emcare places or do the private practices do the same?
Also I feel when your young and a couple years out of residency you can really move fast, work nights and be a great "grunt" but as you age and want better hours the corporate groups will just cut you and if your a partner in a private group you can negotiate these things. Is this off base?

 

[Arcan57]

I'm speaking from a resident point of view and having only read a little about contracts and seeing some fellow residents contracts. I have a few questions. Some big red flags seem to be no open books, meaning I can't see how much money I earn; and being fired without cause, meaning no due process. This is based mostly on my aaem loving residency and few talks with residents and attending.
Are these "red flags" more common in the team health emcare places or do the private practices do the same?
Also I feel when your young and a couple years out of residency you can really move fast, work nights and be a great "grunt" but as you age and want better hours the corporate groups will just cut you and if your a partner in a private group you can negotiate these things. Is this off base?

Open books is important in some circumstances, mostly the small democratic groups. You can assume the contract management groups are generating profit off of your labor, you just have to shop the area and see if the compensation is noticeably better elsewhere. Sometimes it is, sometimes it isn't. Being fired without cause is an issue, and I think it's a universal/non-negotiable clause in the CMGs' contracts. Essentially it means you can't really piss off the hospital, since the CMG has no interest in losing it's contract over your behavior. If the hospital is a reasonable place to work with non-hostile leadership then it's not as big an issue as it could be, if the opposite is true than make sure you have 6 mo cash reserve on hand at all times. I'm not sure outside of academics that there is a whole lot of job protection, but I imagine there is significant variability regarding removing partners from a group. The key with the partnership is there's usually an audition period where they figure out if you're going to be an issue before they let you in. The bar is usually lower for CMG employment.

I don't think the view changes much if you stay in a grunt level position with the CMGs, which means if you want fewer nights when you're older than you either need to land in a group with people that like working nights or you need to climb the administrative ladder (hard to go to all those am meetings post-night shift). As a young doc this is nice because you're not getting screwed ferociously on nights and weekends. But it does mean that the 50yos in our group are working as hard (or harder since a lot have alimony payments and a kid(s) in college) as the new grads.

But remember, employment is not marriage. As long as you don't move out to a place with only one shop and then buy a ridiculous house, you can move around. Most new attendings change jobs within two years (I bucked the trend by about 7 months), and your marketability goes up substantially once you're board certified. With all the changes coming to healthcare in the next 5 years, maximizing your earnings now may be the smart play.

 

[Birdstrike]

.

 

[deleted65604]

Beautiful post Birdstrike. Freedom is a prerequisite to happiness. Preserve your freedom at all costs. I think both myself and Birdstrike have had the same glorious experience of telling an over-bearing employer to take their unreasonable demands and shove them where the sun doesn't shine.

However, it is a big bluff, and comes at great personal cost sometimes. If I didn't have 6 dependents, I would be a lot more willing to act in the manner described by birdstrike in the future. When you have a family, you realize that sacrificing for other people's freedom is sometimes more important than your own.

 

[NinerNiner999]

On the other side of the coin...

What about the possibility that the hospital was simply losing money on the ER group, and there was no sinister reason or deficiency within the group for them to give the contract to Emcare?

I have worked for a nearly identical situation and these corporate groups also acquire groups for the whole intention of holding another contract - even if it's not a windfall moneymaker.

Case in point - Hospitals in general are HORRIBLE at collecting revenue from Emergency Department patients. As a volume industry, Emergency Medicine relies on volumes and volumes of low dollar collections to create a total profit. Hospitals on the other hand rely on big-ticket procedures by Cardiac Surgeons, Orthopedists, Neurosurgeons, etc. They are more likely to work harder to collect $20,000 for a single elective spinal procedure that took place in 4 hours, than to collect $400 for a single ED visit that might never pay. If the collection process took the same amount of time and resources to get done, where would you focus your time and energy?

It is likely that, in a rural setting such as the OP's, this was the scenario. Enter Emcare or (enter large corporate group with economy of scale here). The Hospital now doesn't have to worry about the volumes of small-dollar collections, and no longer have to take the loss on the no-pays. They no longer have to pay benefits to their physicians, and they no longer have to pay the ED physician's salaries. Also, since they have gone with a large group, they probably don't even have to pay a stipend to the ED group.

It is likely that EmCare is exactly what the hospital wants in this scenario - complete freedom from the ED physician cost, and the ability to maximize their collections on their hospital charges alone. They can let EmCare do its thing and go about their business.

EmCare and the other large corporate ED groups profit because of several reasons, but the biggest of these is that they are masters of collecting from insurers. They take those $400 charges seriously for every patient they bill, and this is how they have made their success. They save cost through the IC model, and don't pay extra for benefits.

Again, having been through a similar transition myself (private group bought out by corporate group), it actually improved every aspect of the group. Nobody left, and everyone was happier. Give it a chance. It is likely that the hospital had more to lose than the group...

 

[docB]

On the other side of the coin...

What about the possibility that the hospital was simply losing money on the ER group, and there was no sinister reason or deficiency within the group for them to give the contract to Emcare?

I have worked for a nearly identical situation and these corporate groups also acquire groups for the whole intention of holding another contract - even if it's not a windfall moneymaker.

Case in point - Hospitals in general are HORRIBLE at collecting revenue from Emergency Department patients. As a volume industry, Emergency Medicine relies on volumes and volumes of low dollar collections to create a total profit. Hospitals on the other hand rely on big-ticket procedures by Cardiac Surgeons, Orthopedists, Neurosurgeons, etc. They are more likely to work harder to collect $20,000 for a single elective spinal procedure that took place in 4 hours, than to collect $400 for a single ED visit that might never pay. If the collection process took the same amount of time and resources to get done, where would you focus your time and energy?

It is likely that, in a rural setting such as the OP's, this was the scenario. Enter Emcare or (enter large corporate group with economy of scale here). The Hospital now doesn't have to worry about the volumes of small-dollar collections, and no longer have to take the loss on the no-pays. They no longer have to pay benefits to their physicians, and they no longer have to pay the ED physician's salaries. Also, since they have gone with a large group, they probably don't even have to pay a stipend to the ED group.

It is likely that EmCare is exactly what the hospital wants in this scenario - complete freedom from the ED physician cost, and the ability to maximize their collections on their hospital charges alone. They can let EmCare do its thing and go about their business.

EmCare and the other large corporate ED groups profit because of several reasons, but the biggest of these is that they are masters of collecting from insurers. They take those $400 charges seriously for every patient they bill, and this is how they have made their success. They save cost through the IC model, and don't pay extra for benefits.

Again, having been through a similar transition myself (private group bought out by corporate group), it actually improved every aspect of the group. Nobody left, and everyone was happier. Give it a chance. It is likely that the hospital had more to lose than the group...

Everything you said is true. But, if all a hospital wants is to be rid of its management responsibilities for its EM group (for those hospitals that still employ physicians) they don't need EmCare. All they need then is to tell their docs that they have to form a group and bid for their own contract.

EmCare bids on a lot of those situations and often loses to the higher bidding docs who have a leg up from having been there for years. If EmCare is able to get the contract in a situation like that it means one of three things: The native doc bid was way too high, the hospital thought they'd get some additional benefit that the local group could not provide or the local group themselves asked EmCare to come in and absorb them to manage their overhead.

 

[PokeHer]

I recently signed with a private democratic group, but interviewed for some positions with larger contract groups. I felt the ED directors at these sites were forthright in presenting the contracts and were fairly honest in basically saying positions with a large corporate aren't for everyone. Ultimately, I could not stomach the idea of a large chunk of the revenue I generated going to "the man." I agree with ectopicfetus though in that you need to do your homework and that as long as you know what you're getting into, then so be it.

It bothered me that my wife and I were being flown to places first class, staying at 5 star hotels, having bar tabs at dinners that approached $1K let alone the entire bill, and then having large gift baskets sent after interviews. I think it's nice to entertain prospective applicants and it certainly was appreciated. I felt the treatment by one contract group in particular was a bit excessive though. I couldn't help but feel a little guilty knowing that instead of some ER doc not getting a bonus because his PG scores weren't in the 90th percentile, that the money was instead going to entertain me.

 

[RustedFox]

Medical student says what ?

Sniff.... 6 posts... sniff....

 

[PokeHer]

med student 3y ago...

 

[pinipig523]

I recently signed with a private democratic group, but interviewed for some positions with larger contract groups. I felt the ED directors at these sites were forthright in presenting the contracts and were fairly honest in basically saying positions with a large corporate aren't for everyone. Ultimately, I could not stomach the idea of a large chunk of the revenue I generated going to "the man." I agree with ectopicfetus though in that you need to do your homework and that as long as you know what you're getting into, then so be it.

It bothered me that my wife and I were being flown to places first class, staying at 5 star hotels, having bar tabs at dinners that approached $1K let alone the entire bill, and then having large gift baskets sent after interviews. I think it's nice to entertain prospective applicants and it certainly was appreciated. I felt the treatment by one contract group in particular was a bit excessive though. I couldn't help but feel a little guilty knowing that instead of some ER doc not getting a bonus because his PG scores weren't in the 90th percentile, that the money was instead going to entertain me.

That's some crazy interview stipend you got there.

 

[EctopicFetus]

On a more serious note. EmCare and TeamHealth always put on a ridiculous event at ACEP. Nothing wrong with it and in the grand scheme of the 11 million ED visits team health does its nothing but that money comes from somewhere. My group puts on a good show too but honestly we do it for ourselves as much as anything.