Laryngospasm

Trench Dog
15+ Year Member
May 8, 2005
397
73
Missouri
Status
Attending Physician
We recently had a new member of our group quit after only four months. I as well as other partners personally liked the guy, we have several young "fun" partners, and we feel that we tried to help this individual fit it and learn the ropes so to speak
Admittedly our group can be stressfull at time with multiple locations, supervising 30 cases a day just after residency etc, but we feel this new member did not give it a chance. We have a good relationship with most of the surgeons, good vacation, salary, benefits, etc. There really is no reason to not at least give it a year.
So, to you new graduates, realize that the first six months are going to be hard, but it DOES get better. If you never give it more than a few months to feel good about it you will constantly be jumping around.
 

urge

10+ Year Member
Jun 23, 2007
3,804
1,186
Status
Attending Physician
Money wasn't right for the workload. That's my guess. Better pony up more dough more the next victim.

Money makes the world go around.
 

coprolalia

Bored Certified
10+ Year Member
Aug 5, 2007
3,084
17
Paradise
Status
Attending Physician
So, to you new graduates, realize that the first six months are going to be hard, but it DOES get better.
If it's any consolation, I know a guy who's on his fourth job in the past three years. He's likeable, too. Just finicky. I told him he better stay put for a while now or he's really going to get a reputation (and, no, he's not doing locums).

The guy goes through women like toilet paper, too... treats them like they're only there to take his crap and then flushes 'em... hard to pick that up on a job interview, I'm sure.

-copro
 
About the Ads

bulgethetwine

Membership Revoked
Removed
10+ Year Member
Jan 4, 2005
779
2
Status
We recently had a new member of our group quit after only four months. I as well as other partners personally liked the guy, we have several young "fun" partners, and we feel that we tried to help this individual fit it and learn the ropes so to speak
Admittedly our group can be stressfull at time with multiple locations, supervising 30 cases a day just after residency etc, but we feel this new member did not give it a chance. We have a good relationship with most of the surgeons, good vacation, salary, benefits, etc. There really is no reason to not at least give it a year.
So, to you new graduates, realize that the first six months are going to be hard, but it DOES get better. If you never give it more than a few months to feel good about it you will constantly be jumping around.
Wow, that seems rash to quit a job after only 4 months. I can understand how frustrating it is to go through all the hassle of recruiting, helping to fit in, etc.

Did he give any indication why? Did he also see it the same way you did: that you have good vacation, salary, benefits, collegiality, etc?
 

Laryngospasm

Trench Dog
15+ Year Member
May 8, 2005
397
73
Missouri
Status
Attending Physician
Wow, that seems rash to quit a job after only 4 months. I can understand how frustrating it is to go through all the hassle of recruiting, helping to fit in, etc.

Did he give any indication why? Did he also see it the same way you did: that you have good vacation, salary, benefits, collegiality, etc?
Well this individual had several complaints from different people about how he did things etc, and I feel that thiss may have made them feel uncomfortable and picked on. As for the benefits, I wont go into specifics but 10 wks vacation and 350 first year with benefits seemed hard to beat to me when I was recruited. A 40K sign on bonus didnt hurt either. I personally think he thought the grass was greener and will come to regret the decision.
 

urge

10+ Year Member
Jun 23, 2007
3,804
1,186
Status
Attending Physician
Maybe that's not competitive in your market. I have had much better offers than that, but it would cost me a divorce to mo into rural whatever.
 

Laryngospasm

Trench Dog
15+ Year Member
May 8, 2005
397
73
Missouri
Status
Attending Physician
Maybe that's not competitive in your market. I have had much better offers than that, but it would cost me a divorce to mo into rural whatever.
Yes, it was obviously the benefits that made him leave. Now can we have a real discussion here?
 

bulgethetwine

Membership Revoked
Removed
10+ Year Member
Jan 4, 2005
779
2
Status
Yes, it was obviously the benefits that made him leave. Now can we have a real discussion here?
Well, whether it was or wasn't the benefits, seems like the take home message is that he left after a very short interval without trying to address with you why, exactly, he was unhappy. Actually, I find that to be the most shameful thing -- the failure to discuss the reasons, etc. why the job wasn't meeting his expectations -- rather than any specific interval after he started that he chose to quit. At the very least, he short-changed himself an opportunity to see if the factors that were lacking could be provided.

Considering it from the employer's perspective, if I hired someone, and they came to me saying that the practice wasn't meeting their expectation for some reason and if I couldn't figure out a way to make it meet their needs, I'd just assume they move on ASAP before they start to cause problems with other staff, patients, etc. whether it was after 20 years of 20 days.

I bet you'll be better off in the long run without him. It would have been nice, maybe, to know his reasons (perhaps you're more out of tune with the prevailing offers in your geographic area than you realize, but that seems unlikely!) so you could consider if you needed to change your recruiting packages, but in the end, assuming this isn't a trend in your practice -- losing new hires habitually after short intervals, good riddance!
 

coprolalia

Bored Certified
10+ Year Member
Aug 5, 2007
3,084
17
Paradise
Status
Attending Physician
What kind of notice did he have to give you? What was in the contract? Are you guys paying the tail?

-copro
 

maceo

Membership Revoked
Removed
10+ Year Member
Apr 1, 2008
1,050
6
Status
Attending Physician
it wasnt him. Prolly nothing against you or anybody else. Il be honest im surprised he stuck around 4 months. You can figure out if a place isnt for you after 10 days. and i dont think its reasonable to complain about how someone does things. its his personal style. If its not grossly negligent, leave him alone.

if you are in militarymd's group and you are black, a woman or a jew.. better look somewhere else...
 

sevo85288

Junior Member
10+ Year Member
7+ Year Member
Jul 13, 2005
224
3
Status
Attending Physician
your benefits, pay, etc seem very reasonable. sometimes, it is just location/family/friends/etc. not the job.
 

jwk

CAA, ASA-PAC Contributor
15+ Year Member
Apr 30, 2004
3,721
909
Atlanta, GA
it wasnt him. Prolly nothing against you or anybody else. Il be honest im surprised he stuck around 4 months. You can figure out if a place isnt for you after 10 days. and i dont think its reasonable to complain about how someone does things. its his personal style. If its not grossly negligent, leave him alone.

if you are in militarymd's group and you are black, a woman or a jew.. better look somewhere else...
Amazing how u can make a reasonable opinion to start with and then turn it all to crap by the end of your post
 
About the Ads

coprolalia

Bored Certified
10+ Year Member
Aug 5, 2007
3,084
17
Paradise
Status
Attending Physician
Amazing how u can make a reasonable opinion to start with and then turn it all to crap by the end of your post

I'M GONNA KEEP SAYING IT UNTIL PEOPLE START LISTENING. IF YOU IGNORE IT, IT USUALLY (EVENTUALLY) GOES AWAY. RESIST THE URGE.... RESIST THE URGE.... RESIST THE URGE TO RESPOND.

-copro
 

2ndyear

Senior Member
15+ Year Member
Jul 11, 2002
917
39
New England
Visit site
Status
Attending Physician
I've said it before, but the first month of private practice is harder than all of residency combined. Just getting into the swing of running multiple rooms, doing 4 things at once, and putting out fires all day is not what residency exposes you to at all. Sitting in the OR is a most welcome break for me now, but at many high volume supervision style practices it just isn't what you do very often.

It DOES get better though. Second month was better, by the third month things were alright. 6 months in now and life is good. But at first it is really trial by fire.
 

zippy2u

Senior Member
10+ Year Member
5+ Year Member
Feb 19, 2005
501
5
Status
maceo's post brings to mind a rather insightful web site with the recent wordly events... www.israelshamir.net Throw it all in the pot, stir it up and take a drink---Koolaid for heretics... ---Regards, -----Zip
 

BubbleHead

Senior Member
10+ Year Member
5+ Year Member
Jan 2, 2006
168
1
Status
Resident [Any Field]
Well this individual had several complaints from different people about how he did things etc, and I feel that thiss may have made them feel uncomfortable and picked on. As for the benefits, I wont go into specifics but 10 wks vacation and 350 first year with benefits seemed hard to beat to me when I was recruited. A 40K sign on bonus didnt hurt either. I personally think he thought the grass was greener and will come to regret the decision.
I've gone 4 months on a submarine in state 6 seas above the arctic circle without fresh air, sunlight, or the opposite sex. For my first Attending gig after residency you can form a gauntlet and throw verbal insults at me daily when I arrive and when I leave for that kind of Coin/Vaca combo. If any physical abuse is to take place we'll need to adjust the signing bonus to $41K.
 

desflurane

10+ Year Member
Aug 24, 2008
78
2
Status
Attending Physician
This is subject near and dear to me as I have been struggling with similar issues. A lot has to do with the market and the reality that demand is still high and "practice jumping" is all too common.

In this particular case, with so little info, it's impossible to surmise what caused the departure. Asides from money, hours, vacation, benefits there are numerous factors that could have affected his decision. The reality is that many of us in the "new generation" chose passing gas as a way to balance work/income/lifestyle. Many old timers just don't get that. I'm all for working hard and doing my job well but sacrificing other aspects of life to sit in a hospital 60+ hours a week is just no longer acceptable to me.

I don't know how your group is set up but consider the possibility of a generational gap. This is pretty much how most people my age feel so it may be a recurring problem. I just left a group for that very reason. Money was great but I chose to make less and get my time back.

Some groups are just full of nasty, greedy people too. Maybe that has something to do with it? :)
 

turnupthevapor

10+ Year Member
Oct 7, 2008
173
24
Status
Attending Physician
maybe he couldn't handle the stress....>We don't have an easy job! I would imagine some people can't deal
 

Jeff05

Senior Member
10+ Year Member
15+ Year Member
May 30, 2001
1,059
2
Visit site
Status
Attending Physician
Harvard Business School has a podcast on Itunes.
Several of the episodes have been devoted specifically to intergenerational issues in the work place.

In short:
Baby boomers (senior partners) have very different goals from generation X (us) and Y. Much of the time they (Baby B's) just plain don't get where we're coming from. It's a huge issue in many industries.

-jeff
 

doerun

10+ Year Member
Jan 4, 2009
7
0
Status
Attending Physician
There are a number of bad places in Missouri, places I wouldn't blame someone for working a few weeks and leaving. I was sent to Missouri for some interviews by a dishonest recruiter, first he sent me to interview at AMSOL and the recruiter and AMSOL both intentionally tried to cover up that the AMSOL was an anesthesia management company not a real anesthesia group. While being mislead to by AMSOL, I heard the next place I was going to just fired all new graduates they hired three years ago and were now looking for a new set of new graduates to start their three year partnership track. That is just one small section of MO. I have seen, worked, or interviewed more than a dozen of other places throughout MO, that are just as bad or worse.

I don't know Laryngospasm or anything about his group, but a malignant group or situation can really hurt you and your career, if things are not right get out fast before things start going downhill. There are a lot of bad things a dishonest group can do to you to hurt your career. They can start sending out hospital evaluations full of lies to keep you from getting another job. Obviously if this is your first or second job it is hard to know what is normal versus what is pathological anesthesia group behavior. You can't fault someone for erroring on the side of caution, it is just your career you have only spent 12 hard year since high school to get here, don't let some greedy dishonest suit take it all away from you.
 
Last edited:

doerun

10+ Year Member
Jan 4, 2009
7
0
Status
Attending Physician
Stay far away from AMSOL.
I agree and would add stay away from Anesthetix Management (AKA Anthem Associates or what other names they are using.)

Unfortunately, I told the recruiter like I tell ever other recruiter that tells me about an interesting sounding anesthesia positions, that I do not want to waste my time talking to any anesthesia management company. The recruiters are so motivated by greed to get rid of these lucrative to them toxic waste AMC positions that they still try to fool me. They deny that the position is at an AMC and will try to fool me into thinking I am interviewing for a job a private group.You need to try to figure out who really runs the group and how many other places they control and how they treat their employees.
 
Last edited:

maceo

Membership Revoked
Removed
10+ Year Member
Apr 1, 2008
1,050
6
Status
Attending Physician
the question is. who do you wanna be screwed hard by? someone you know? or someone you dont know?
 

SleepIsGood

Support the ASA !
10+ Year Member
5+ Year Member
Apr 16, 2006
1,965
2
Status
Fellow [Any Field]
I agree and would add stay away from Anesthetix Management (AKA Anthem Associates or what other names they using.)

Unfortunately, I told the recruiter like I tell ever other recruiter that tells me about an interesting sounding anesthesia positions, that I do not want to waste my time talking to any anesthesia management company. The recruiters are so motivated by greed to get rid of these lucrative to them toxic waste AMC positions that they still try to fool me. They deny that the position is at an AMC and will try to fool me into thinking I am interviewing for a job a private group.You need to try to figure out who really runs the group and how many other places they control and how they treat their employees.
How do you figure out if they are a AMC?

The CEO or senior partner isnt a physician?

Details would be great. Thanks!
 

doerun

10+ Year Member
Jan 4, 2009
7
0
Status
Attending Physician
How do you figure out if they are a AMC?

The CEO or senior partner isnt a physician?

Details would be great. Thanks!
If a recruiter tells me about a job, that I am the slightest bit interested in I try to get as much info as possible about the place. I want to know as much as possible about the names titles and locations of everyone involved. If it is an AMC you see people who are not working at the primary practice location like the group owners, AMC recruiters or AMC personnel department types, of course they will hide behind some fancy title but their address, area code, origin of their emails will giveaway their location. That is a sure sign of an AMC, absentee owners running the show taking half the money while you do all the work.

Look at chesterfields post on what look for when you interview.
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 he 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.
 

ProRealDoc

ASA Member
10+ Year Member
Jan 2, 2009
1,357
201
Status
Attending Physician
If a recruiter tells me about a job, that I am the slightest bit interested in I try to get as much info as possible about the place. I want to know as much as possible about the names titles and locations of everyone involved. If it is an AMC you see people who are not working at the primary practice location like the group owners, AMC recruiters or AMC personnel department types, of course they will hide behind some fancy title but their address, area code, origin of their emails will giveaway their location. That is a sure sign of an AMC, absentee owners running the show taking half the money while you do all the work.

Look at chesterfields post on what look for when you interview.

That explains calls I get from missouri offering jobs in Michigan, texas, etc.
 

maceo

Membership Revoked
Removed
10+ Year Member
Apr 1, 2008
1,050
6
Status
Attending Physician
If a recruiter tells me about a job, that I am the slightest bit interested in I try to get as much info as possible about the place. I want to know as much as possible about the names titles and locations of everyone involved. If it is an AMC you see people who are not working at the primary practice location like the group owners, AMC recruiters or AMC personnel department types, of course they will hide behind some fancy title but their address, area code, origin of their emails will giveaway their location. That is a sure sign of an AMC, absentee owners running the show taking half the money while you do all the work.

Look at chesterfields post on what look for when you interview.

usually they arent trying to hide the fact that they are an anesthesia management company; you cant hide from them forever, they are coming to a neighborhood near you soon. there will be no more private practice in anesthesia in the next 10-15 years. Wont happen. it will be all amc. thats where i see it going. Even as we speak there are anesthesia management companies cold calling every single hospital in your city state region for their business and they will get it eventually. Im not saying this because i work for them, i loathe them. I just see the writing on the wall, they seem to offer hospitals a low cost turn key solutions to their problems so they think.
 
Last edited:

doerun

10+ Year Member
Jan 4, 2009
7
0
Status
Attending Physician
usually they arent trying to hide the fact that they are an anesthesia management company; you cant hide from them forever, they are coming to a neighborhood near you soon. there will be no more private practice in anesthesia in the next 10-15 years. Wont happen. it will be all amc. thats where i see it going. Even as we speak there are anesthesia management companies cold calling every single hospital in your city state region for their business and they will get it eventually. Im not saying this because i work for them, i loathe them. I just see the writing on the wall, they seem to offer hospitals a low cost turn key solutions to their problems so they think.
Anesthesia management company [AMC] is a for profit entity that will con the hospital administrators into getting the exclusive anesthesia contract and then do everything in their power to make as much money as possible. Despite a constant stream of lies to the contrary, treating employees fairly and honestly or providing quality anesthesia services are not important goals of the AMC. The one and only goal of the AMC is to make as much money as possible for its, out of town absentee, owner.

The basic economic reality is that there is only so much money that an anesthesia practices can generate. The AMC owner will lie all day long about how they will improve efficiency, how they are how the will reorganize the schedule, how they will improve billing and collections, thus making the practice so much more successful. The truth is while the AMC may be able to make small changes to improve efficiency and collections, their need to take at least a 25% to 50% management fee will guarantee that working for the AMC is going to mean a big cut in your pay, more hours for you, and more call for you.

So as long as there still are non AMC places available to practice do your self and your career a favor and avoid getting coned into working for an AMC. You will never be paid fairly, you will never have any ownership of your practice, and you will have no job security.
 

maceo

Membership Revoked
Removed
10+ Year Member
Apr 1, 2008
1,050
6
Status
Attending Physician
Anesthesia management company [AMC] is a for profit entity that will con the hospital administrators into getting the exclusive anesthesia contract and then do everything in their power to make as much money as possible. Despite a constant stream of lies to the contrary, treating employees fairly and honestly or providing quality anesthesia services are not important goals of the AMC. The one and only goal of the AMC is to make as much money as possible for its, out of town absentee, owner.

The basic economic reality is that there is only so much money that an anesthesia practices can generate. The AMC owner will lie all day long about how they will improve efficiency, how they are how the will reorganize the schedule, how they will improve billing and collections, thus making the practice so much more successful. The truth is while the AMC may be able to make small changes to improve efficiency and collections, their need to take at least a 25% to 50% management fee will guarantee that working for the AMC is going to mean a big cut in your pay, more hours for you, and more call for you.

So as long as there still are non AMC places available to practice do your self and your career a favor and avoid getting coned into working for an AMC. You will never be paid fairly, you will never have any ownership of your practice, and you will have no job security.

while i agree with you completely i keep saying who would you rather be screwed by, people you know and see everyday or people you dont know and dont have to look in the face everyday. pick your poison.

the only way you will get a fair shake is if you move far away from civilization; and as jet mentioned do that for 10 years and you are DONE!!
 

Noyac

10+ Year Member
Jun 20, 2005
7,963
2,709
Status
Attending Physician
usually they arent trying to hide the fact that they are an anesthesia management company; you cant hide from them forever, they are coming to a neighborhood near you soon. there will be no more private practice in anesthesia in the next 10-15 years. Wont happen. it will be all amc. thats where i see it going. Even as we speak there are anesthesia management companies cold calling every single hospital in your city state region for their business and they will get it eventually. Im not saying this because i work for them, i loathe them. I just see the writing on the wall, they seem to offer hospitals a low cost turn key solutions to their problems so they think.
The sky must be falling!:sleep:
 
About the Ads