Envision (formerly Sheridan) acquired by KKR

[caligas]

How would this even work? If partners owe 5 years back of employment to the AMC in exchange for the buyout, would you really take a 1/3 buyout and still have to do 5 years? I wouldn’t.

I recon you would owe 5/3 years, but I’m super into fraction math.

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[NightNight]

How would this even work? If partners owe 5 years back of employment to the AMC in exchange for the buyout, would you really take a 1/3 buyout and still have to do 5 years? I wouldn’t.

Well, I wouldn’t be a partner so the required 5yrs wouldn’t apply to me. The partners would honor my contract separately. Whether I stayed on with the new AMC I suppose would be up to me and the AMC.

 

[okayplayer]

I recon you would owe 5/3 years, but I’m super into fraction math.

Damn bro, why didn’t I think of that??

 

[okayplayer]

When I’ve heard of people nearly done with but not done with partnership track when their group sells, most often they are taking 1/2 the money for the full time commitment on the back end. Sh@tyy deal. I’d walk.

 

[deleted162650]

Well, I wouldn’t be a partner so the required 5yrs wouldn’t apply to me. The partners would honor my contract separately. Whether I stayed on with the new AMC I suppose would be up to me and the AMC.

Exactly - he isn't an owner of the anesthesia practice, so he never made the deal with the AMC.

 

[nimbus]

Well, I wouldn’t be a partner so the required 5yrs wouldn’t apply to me. The partners would honor my contract separately. Whether I stayed on with the new AMC I suppose would be up to me and the AMC.

The deals usually have a non disclosure clause. The partners could pull a number out of their a** and you would have no idea what the actual numbers are.

 

[Man o War]

IMO the only way these practice sales are worth it is if there is a small group of “super partners” who share the whole pot. Then who cares if they have to work there for a few more years at a reduced rate, the payout is big enough.
Sometimes I look at these sales and wonder what the heck these groups were thinking. There’s most certainly a diminishing return.

 

[AdmiralChz]

IMO the only way these practice sales are worth it is if there is a small group of “super partners” who share the whole pot. Then who cares if they have to work there for a few more years at a reduced rate, the payout is big enough.
Sometimes I look at these sales and wonder what the heck these groups were thinking. There’s most certainly a diminishing return.

Many of the groups that sold out very early were in Florida - mostly in and around Tampa that had different tiers of partners. To my knowledge there aren’t too many of these (quite predatory) PPs left.

 

[NightNight]

The deals usually have a non disclosure clause. The partners could pull a number out of their a** and you would have no idea what the actual numbers are.

Eh. It’s not that big a group. I’m pretty sure I’d find out. And I’m even more confident that my future partners wouldn’t do that anyway.

 

[Twiggidy]

When I’ve heard of people nearly done with but not done with partnership track when their group sells, most often they are taking 1/2 the money for the full time commitment on the back end. Sh@tyy deal. I’d walk.

Some do, but it all depends your financial situation and your family situation. If you're in a "desirable" area and have a mortgage and kids in school it may not be so easy to say "peace".

 

[NightNight]

When I’ve heard of people nearly done with but not done with partnership track when their group sells, most often they are taking 1/2 the money for the full time commitment on the back end. Sh@tyy deal. I’d walk.

That does sound sh itty.

But that’s not the contract I signed.

 

[deleted682700]

Seems like there are decent PP jobs in gaswork in smaller towns, is everyone that hot to be in a big city?

Yes, better pay 250$/hr and the billing for the patients that you do. The billing also helps in productivity. The billing depends on patient insurance. But usually it is mostly 75-90% medical Medicare. On average you can expect to collect 100$per hour. So totally if you are on your own and had the contract with the hospital 350$/hr. No benefits. This is boonyville towns all across America. Before contract negotiation between anesthesia group and the hospital they have to fo fair market value analysis paperwork. That was 275$/hr

However, you will have to pay all expenses such as malpractice, health insurance, getting to and from work, flight and hotel expenses etc and you probably end up at 250-300/hr.

If you go through locums company, then you get 150-200$/ hr depending on the need, time of the year and your ability to negotiate.

Groups will usually have clever ways of underpaying by stating unit value. In California the commercial insurance say blue cross pays 44-49$ per unit. The medical Medicare payment per unit averages 14$ -19$ per unit. Let's say we did a choly, then it's 7 units to start plus time units usually an hr=4 units, round it to 10 units. That is 440 $ from commercial insurance and if it is medical 140$.

If the hospital where you are going to practice has a high amount of govt or no insurance, it's better to negotiate a salary or fixed amount per hour. Hope this helps the new grads

 

[deleted162650]

In California the commercial insurance say blue cross pays 44-49$ per unit. The medical Medicare payment per unit averages 14$ -19$ per unit.

A) Medicare = 21$/unit
B) Medi-Cal = 12$/ unit in OR and 16$/ unit on OB
C) You have really sh*tty commercial contract rates

 

[okayplayer]

A) Medicare = 21$/unit
B) Medi-Cal = 12$/ unit in OR and 16$/ unit on OB
C) You have really sh*tty commercial contract rates

$12/unit?!?! Jesus Christ

 

[mmag]

$12/unit?!?! Jesus Christ

It's actually 14 bucks a unit (and 17 for OB) if that makes you feel a little better.
Medi-Cal: Medi-Cal Rates Conversion Factors

 

[deleted162650]

It's actually 14 bucks a unit (and 17 for OB) if that makes you feel a little better.
Medi-Cal: Medi-Cal Rates Conversion Factors

Sweeeet! Daddy needs a new pair of shoes!

(Visions of diving into a vault of gold coins a la Scrooge McDuck dancing in my head)

 

[Echo33]

I used to recommend a fellowship as a form of job security, but I don’t anymore. Do a fellowship if doing that particular field brings you some kind of joy or satisfaction. Otherwise, it’s a waste of time and money. It’s one less year of earning money to give you that financial flexibility that is so critical to happiness in this field. Fellowships don’t necessarily get you better jobs, they just get you different jobs. There are plenty of cardiac anesthesiologists out there working for an AMC with Q4 call, 300k, and 4 weeks “PTO.”

I understand your point but I think you’re taking it to an extreme. Fellowships can be incredibly useful in this field. My current position was for fellowship trained only. I’m pretty happy with my job, but more importantly I would not have gotten it without the fellowship.

That said, I agree that there are some pretty wasteful fellowships out there. Choose wisely.

 

[deleted682700]

A) Medicare = 21$/unit
B) Medi-Cal = 12$/ unit in OR and 16$/ unit on OB
C) You have really sh*tty commercial contract rates

You are correct. That's why the hospital supplements a stipend for 250$/hr. The problem with commercial is that they start indexing 150% of what Medicare pays etc. Slowly the reimbursements with every insurance is coming down in California.

The other aspect is that the surgeons get a better contract with the insurance companies and we were forced to sign up with the same insurance companies but with bad rates (so we are all in network and on contract).

Better to negotiate with the hospital and get a flat rate and be done with that

 

[deleted682700]

$12/unit?!?! Jesus Christ

So for all the effort of getting up at night and doing the epidural and assuming every liability for the child and the mother you get 60$. And 1 unit per hr for duration of the epidural.

 

[deleted162650]

So for all the effort of getting up at night and doing the epidural and assuming every liability for the child and the mother you get 60$. And 1 unit per hr for duration of the epidural.

My last gig was straight fee for service on OB. There were times I would be stuck in house babysitting 1 MC epidural. Nothing like making $17/hr - Yippee!!

 

[Twiggidy]

$12/unit?!?! Jesus Christ

Dude. Medi-Cal patients are basically you doing work for free. It’s why payor mix is very important

 

[deleted162650]

Medi-Cal patients are basically you doing work for free.

Sometimes I wish that instead of paying us, they would just let me deduct that amount from my taxes.

 

[Twiggidy]

So for all the effort of getting up at night and doing the epidural and assuming every liability for the child and the mother you get 60$. And 1 unit per hr for duration of the epidural.

But remember....you went into anesthesiology to help people......

 

[Consigliere]

But remember....you went into anesthesiology to help people......

Right. And I used to get Playboy....for the articles.