Evaluating private practice groups

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EvilE

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I didn't see this in the FAQ (maybe I missed it) but can anyone give me some advice about how they first evaluated their group as an interviewee and what they discovered they should have asked after signing on and starting to work.
Thanks!
 
I didn't see this in the FAQ (maybe I missed it) but can anyone give me some advice about how they first evaluated their group as an interviewee and what they discovered they should have asked after signing on and starting to work.
Thanks!

Good jobs are hard to find. Look at gaswork or talk to any recruiter and 80% of the jobs you hear about are B.S. where you are going to get screwed. Good jobs where you work for straight hourly income or get to bill for your own cases are rare. Most jobs force you to take call and work late for little or no extra compensation.

Yes some anesthesia management company liar will promise an impressive income, "partnership income from day one" but it will be paid thru the imaginary bonus plan. I.E. work for 6 month to a year at 150K per year and be fired for demanding to be paid your bonus. OR You could slave away (80 hour per week at 150K) for two to five years to make partner, then be fired just before you make partner to be replaced by a new graduate or learn that the group is loosing money and partners make little or nothing.

Before you sign the contract you need to know what you are getting into. The anesthesia management company liar or the head liar of a group that is out to screw you will not tell you the truth, so you need to invest a little effort to uncover it your self. Chesterfield's post show some of the basic steps you need to take to see if you prospective employer is going to treat you fairly or not.

You know the routine, Dress the part, be nice, don't say anything controversial or negative. Pretend to be interested no matter how boring their endless discussion of their golfing skills is; don't order a dish more expensive than the boss. Avoid messy dishes.

Keep a copy of every communication you have with the group. Record or immediately write a summary of all oral conversation with any group members.

Use this opportunity to investigate the practice. Before you go check out the hospital web site for the names of the Anesthesia doctor who work there. Your goal is to find the names of all the doctors who have left the practice in the last few years. Google all of those names along with the names of the corporation. Asking for this information from the group will get you labeled as a malcontent but to take a job with out an investigation the backgrounds of your employers is a recipe for disaster.

When you get there try to get as many months of the call schedule as possible. Old call schedules often have phone number of recently departed members of the group, plus they tell you how fair the call schedule is.
While you are in town go to the county court house and look up the names of all of the members of the group looking for lawsuits.

If your interview goes well and you are seriously considering the group you need to contact the people who have left to get the real information about how the group treats its employees.
How to find old employees of a group;

Look up all the anesthesiologist in that town with the state licence database,
http://www.docboard.org/docfinder.html
Look up all the anesthesiologist in that town with the AMA directory, ASA Directories for the last three or four years.

Look up all the anesthesiologist in that town with UPIN number search, great for towns with more than one hospital since it lists the billing address with the name separating out different practice locations.
http://upin.ecare.com/
or
http://www.upinregistry.com/provider_form.asp
Another good database dr-411 since it gives some info not seen elsewhere,
http://www.dr-411.com/default.asp
With all the names you have found you should be able to find a few former employees to contact about the group since this is your best source of unbiased information.

These databases will help you get current names and addresses of former employees.

Google is often helpful.
Searching for current phone number and addresses
http://www.zabasearch.com/
or your favorite directory search database.
Doc board is good for finding some one who has moved;
http://www.docboard.org/docfinder.html
which may give a current address.

If you have no luck you might want to invest a few buck and ask your local detective to search for people you can't locate. They also can search for lawsuits more broadly than the court house.

Now call your names and politely ask them to tell you about there experience at your potential employer.

While this is just the basics, your hospital credential application probably will be ten to twenty pages of invasive questions, many of which will be verified. Why shouldn't you know as much about your potential employer?

If you do not find any skeletons in the closet or areas of concern you need to find a competent lawyer and some trusted friends to look at your contract. Finding a lawyer who knows anything about anesthesia contacts is very difficult many attorneys will claim to be able to review a contact. So just because your buddy and fellow resident used that attorney does not say much about his competence in reviewing anesthesia contacts and providing relevant feedback.

Lastly don't ever buy a house until you have been there at least a year or made partner.

But don't say that to the realtor they force you to take a "tour of the town" with, you can be sure that everything you say to her will funnel back the anesthesia group.
 
Good jobs are hard to find. Look at gaswork or talk to any recruiter and 80% of the jobs you hear about are B.S. where you are going to get screwed. Good jobs where you work for straight hourly income or get to bill for your own cases are rare. Most jobs force you to take call and work late for little or no extra compensation.

Yes some anesthesia management company liar will promise an impressive income, “partnership income from day one” but it will be paid thru the imaginary bonus plan. I.E. work for 6 month to a year at 150K per year and be fired for demanding to be paid your bonus. OR You could slave away (80 hour per week at 150K) for two to five years to make partner, then be fired just before you make partner to be replaced by a new graduate or learn that the group is loosing money and partner make little or nothing.

Before you sign the contract you need to know what you are getting into. The anesthesia management company liar or the head liar of a group that is out to screw you will not tell you the truth, so you need to invest a little effort to uncover it your self. Chesterfield’s post show some of the basic steps you need to take to see if you prospective employer is going to treat you fairly or not.

ditto the above..... sad state of affairs
 
A good way to evaluate a new job is like anything else. Do your homework, compare apples to apples and carefully analyze the WHOLE package.

For example, a Group where the expected partnership is worth $350,000 plus benefits should not have a four year track and start you at $200,000. That is not a wise decision unless the job is REALLY easy (42 hours per week or so) with lots of vacation time 12-14 weeks.

Another example is a Group that offers a two year partnership with expected income of $475,000 plus benefits. You would start at $275,000 and work 50 hours per week with 5 weeks vacation. The following year you earn $350,000.


I know of a Group that hires only FELLOWSHIP trained individuals and has a six year track. They start you at $225,000. The parthnership is worth $600 K but by the time you make partner the LOST income from example number 2 over 4 years (example 2 you are a partner after year 2) is substantial. My point is that the length of the track really does matter.


Thus, you need to carefully assess each job and do your homework.

Blade
 
ditto the above..... sad state of affairs
It is very sad.
You can compare searching for a job to shopping for a used car, and the people you are going to deal with, to used car salesmen.
The majority of private group leaders and management companies executives are the worst kind of crooks you will ever encounter.
My advise: never trust anyone.
 
harryh,
do you honestly expect people to go through all that trouble?
 
My advice is ask all the pertinent questions ON THE PHONE before you waste your morning or afternoon visiting with the crooks. ask about call schedules. partnership track nites and weekends first.. then if you like what you hear then you visit with them. I would caution any job that has a financial partnership track is BOGUS..
 
Blade,
you have to put it in context. It's the supply vs demand what's going to determine your salary. Middle of nowhere you might get 350 or 400 with little time to partnership. In a big nice city you might be offered 200k with 4 to 6 years to partnership. Just because they can, since they have 6 other guys like you applying and they haven't even posted an ad. What matters in the latter is how much you value yourself and how bad you want to stay in the city. I'm actually looking right now at jobs in big cities and there haven't been any mind blowing offers. There have been some crappy ones, though. Academic places are offering about the same and sometimes more for a lot less work. Obviously if you make partner you'll be making about the same as a chairman, but don't expect a walk in the park for that.
 
harryh,
do you honestly expect people to go through all that trouble?

You can not trust the recruiters, the group owners, or the anesthesia management company owners, to tell you the truth about what you are stepping into. The only source of the truth is to find out how they treated their people in the past from former employees or lawsuits. The group owners will say anything to get you to sign up and start working.

How do you know that the salary numbers they throwing around are the truth? You need to verify their claims by taking to someone without a vested interest in getting you to sign the contract and start working there. Otherwise that empty promise of partners making 400k+ is just another lie and you just got taken for a chump.

There are so many ways you can get screwed by a malignant group or anesthesia management company, that you need to find out as much as you can before you sign the contract. Beyond getting paid far less than promised and paying "the stupid tax", .i.e. no bonus or wasting two to five year slaving away for a partnership position that doesn't exist or that they have no intention of giving to you. You can have your 40K per year retirement plan stolen from you or you could get saddled with having to pay a sizable 30+K tail policy cost in order to leave.

You can have your reputation and ability to find further employment destroyed by the hospital and/ or the group providing bad references for you everywhere else you apply. You could get written up and reported to the national physician data base for abandoning the call schedule because you refused to be on call every day for your six month notice period. You also could get saddled with a non compete clause forcing you to leave town for two or more years.

Chesterfield outlines the basics needed to figure out what you are getting into. I would add that you need to research the owners of the company or llc that will be employing you since I have been recently been getting emails from a recruiter pushing a new pain management group at a hospital which has given the anesthesia contract to an anesthesia management company with a well earned national reputation for stealing from their employees. The recruiter claims the group is owned by the hospital which is an obvious lie to cover the fact that it is owned by the crooked anesthesia management company which has begun changing its name to disguise who they are in order to find new victims.
 
Blade,
you have to put it in context. It's the supply vs demand what's going to determine your salary. Middle of nowhere you might get 350 or 400 with little time to partnership. In a big nice city you might be offered 200k with 4 to 6 years to partnership. Just because they can, since they have 6 other guys like you applying and they haven't even posted an ad. What matters in the latter is how much you value yourself and how bad you want to stay in the city. I'm actually looking right now at jobs in big cities and there haven't been any mind blowing offers. There have been some crappy ones, though. Academic places are offering about the same and sometimes more for a lot less work. Obviously if you make partner you'll be making about the same as a chairman, but don't expect a walk in the park for that.


If you are flexible on location there are many good Groups in locations with greater than 500,000 people in the area. Perhaps, the cities with more than 2 million are trying to screw you but not every GRoup is that way.

For example,

Nashville- AMG offers 24 months to partnership
Jacksonville, Florida- time ranges from 6-24 months
Orlando, Florida- JLR offers 24 months to partnership


Keep looking until a fair offer pops up.

Blade
 
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