emergentmd

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Do anyone know about EM Hawaii job market?

I am watching the show Hawaii life and think it would be fun to live.

How much does Hawaii EM docs get paid? Are there jobs? Are there any independent group w/ partnership potential?
 

secants

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I was skimming through EP monthly and saw an ad for an Urgent Care job somewhere in Hawaii starting at $300K but then wondered why the place had to advertise in the first place.
 

Apollyon

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I am licensed in Hawai'i, worked there 3 years, and know about the urgent care job with the $300K. However, it is nearly 1am on the east coast, and I have to get to bed. I'll write more later today, whenever I get a chance.
 
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pinipig523

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Do anyone know about EM Hawaii job market?

I am watching the show Hawaii life and think it would be fun to live.

How much does Hawaii EM docs get paid? Are there jobs? Are there any independent group w/ partnership potential?
I watch Hawaii Life and it makes me want to live in Maui. As far as I know, Maui General has very low turnover. No openings as of the last time I checked.
 

pagemmapants

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Looks like Apollyon is the man to know, but in the meantime...

Maui Memorial is hiring, but only for an EM medical director as an IC with EmCare.

On Oahu you could also consider a Kaiser job although last time I looked on their website they weren't hiring EM docs. Kapi'olani has a peds ED, but I kind of think they're staffed with EM-fellowship peds-residency trained folks. Not 100% about that though. Pali Momi has an opening right now and is staffed by EMP. It's in Aiea. http://www.emp.com/kapi-olani-medical-center BC/BE and no "experience" required (as is necessary for most SF-area jobs I looked at)

On Big Island you have HEPA which staffs six (?) hospitals in HI. When I was looking they were looking, but the timing wasn't right for me. http://www.hepa.net/ I want to say they were RVU-based and they did have some 24 hour shifts (but during which apparently the census is so low you often can go take naps or whatever). Also - bonus - if you can manage it they have offered a month long elective rotation on island.

You could also try to contact Dr. Jerris Hedges (U of H Medical School dean, EM) about the market but when I asked about this time last year his response was a little discouraging. Maybe things have changed.

Word to the wise: if you're looking on one of those "Emergency Medicine Job Search" websites to check out what's advertised, use your junk e-mail address/phone or be prepared to field near-daily calls and/or e-mails from recruiters. Then again, I got my job via a recruiter, so they're not all bad.

Per Barb Katz, good old Raleigh-Durham is the tightest market for the 2nd year running, beating out Portland (which, according to her has opened up some) and, narrowly, Seattle. Alaska is still a wasteland.
 
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emergentmd

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I am working 14 days a month and avg 8 hr shift. Does anyone have any idea how much this amount of hrs a month would make a year?

Is 250k reasonable for this type of schedule?
 

Apollyon

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Ok - Hawai'i. There was a study about 5 years ago across all medical specialties - on average, there were 3 docs for every 4 jobs in HI - there are not enough plastic surgeons and dermatologists in HI, believe it or not. However, there was one - and only one - outlier. EM was staffed at 104%, or 26 docs for every 25 jobs. That means a LOT of people working part time. However, when I was looking after my hospital shut down, the only places hiring were places I would NOT work - and, when you have many available workers, and people don't want to come to YOUR shop, that means you have problems.

Pay is abysmal for doctors in HI. For procedural specialties, they say expect 1/3 to 1/4 as much as you would make on the mainland. I made $100/hr as an IC. Granted, it was easy work, but that's it. Jobs on O'ahu range from $90-$120/hr. Democratic groups are none. I was part of a new one, which was started after they spun off from Schumacher. The founding partners were some prima donnas, and they were somewhat predatory. The group went under when the 2 hospitals in the system closed down in 2011. One hospital has been remodeled and is going to be an outpatient thing - no ED, no ORs, and no inpatient. The other finally - finally - is going to reopen, now staffed by the Queen's Medical Center.

Queen's is the flagship of medicine in the Pacific. After transplant left my hospital, it is now at QMC, and Honolulu is the only place in the Pacific where you can get a kidney or heart. The ED is a sweatshop.

The majority of ED jobs are hospital employed. However, EMP is there (Pali Momi and Kapi'olani), and EmCare took over Maui Memorial Medical Center (after being at my hospital years ago, and being bumped by Schumacher). There is a group on the windward side, which also covers the big island. Even after asking, I don't know their model. The one thing I was told, all around, though, was that I didn't want to work there. Back in 2007, when I first checked into it, they were who I found online. I shot them an email with questions, and the person got back to me asking if I could work next month. I said I wasn't even licensed in the state yet.

Outer islands are small hospitals, because no one lives there. There are 7000 people on Moloka'i - there aren't even any streetlights - only stop signs! There are 3000 on Lana'i (the island that Larry Ellison of Oracle bought), and Ni'ihau has 130 people and no hospital. Kaua'i, with 58K people, has Wilcox Memorial, which is part of Straub.

Back to O'ahu - main employers are Queen's, Kaiser, and Straub Healthcare - but the Straub Healthcare network is Straub, Pali Momi, Kapi'olani (which is the women's and children's hospital, and has an EM person always working for the vag bleeders and the homeless that come in), and Wilcox. As such, the models differ. In 2010, for people on the Straub "partnership track" (ie, planning to make a career, instead of just being casual/part time, but no actual ownership), they were paying $75/hr. Yes, you read that correctly. And, Kaiser is gold? I don't know - a classmate from med school was faculty there, and he left to go to Pali Momi (interesting note - it is "Pali Momi at Pearl Ridge" - with "pali" meaning "cliff" or "ridge", and "momi" is the Hawai'ian pearl - so it is "Pearl Ridge at Pearl Ridge" - like "Manos, the Hands of Fate").

The big problem in HI that insurance companies suppress the pay - between HMSA (BC/BS in HI) and Kaiser, the money is kept way down. I mean, what are groups going to do? They say "X", and HMSA and Kaiser say "go to another hospital". However, that is where the perfect storm of Maui enters. First, Maui Memorial Medical Center is the ONLY hospital on Maui - you can't tell the patients to go somewhere else. There are about 100K people on Maui, but there is a higher number of rich folks among them. What this means is that the Maui guys went out of network with all plans, which means they are making mainland-style money. But, "wait", you say! Insurance won't pay out of network rates. But, if you (the patient) are rich, you have sway, and Kaiser and HMSA can't tell you to "suck it", and they can't tell you to go to another hospital. So, it's the "perfect storm" - the triple play of lifestyle, location, and pay. You know the way it has been said you can pick two? Well, that is one of those rarities with all 3, and, like the Denver group about which I heard that has not had a doc leave in 9 years, people don't leave those jobs. Hell, I still have the pager number on my computer desktop of the guy who does (or did) the hiring at Maui - as he told me, "even if we like you, I can only give you 1 shift a month, maybe - it could be 3 or 4 years before a position opens". As for the medical director (that post above mine posted while I was composing here), that's not for everyone - it's not like someone with mainland admin experience can cruise in and do the same thing there that they did back on the mainland. I strongly suspect that the spot will be filled by someone from the islands.

A last word regarding that - for EM, I knew only one native Hawai'ian guy - college in HI, went to med school and residency on the mainland (in flyover country - seriously), and came back. The "native" doctors are mostly Chinese descendants (but 3rd or better generation American). After that, there are the Japanese natives. There are two guys that work at Kapi'olani in the Peds ED named "Inaba" - I don't know if they are related, and I didn't get to ask one if he was related to Carrie Ann Inaba (from "Dancing With The Stars", who went to the Punahou School). However, there are more native Hawai'ians (or part native people/people with native blood) in primary care.
 
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emergentmd

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Thanks for the info and somewhat depressing. I will stick working in texas and just take 1 month vacations.

$75/hr? thats just crazy. So is the pay so poor b/c someone is making alot of money off the docs or are the insured so poor?

Either way, no respectable and trained ED doc would work for less than $150/hr
 

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You might be surprised at the Alaska/Hawai'i corridor. There's quite a pipeline between the two states. I believe Alaska Airlines runs a daily roundtrip between Anchorage and Maui. Seriously.
Yup, it is only about 6 hour flight between Oahu and Anchorage. I think the OP should consider this as a way to live in Hawaii and maximize you time there. Just go work in Alaska for a few weeks at a time. Heck, you could keep an apartment in Alaska somewhere and claim that as your state residence and pay no income tax. That's probably what I would do if I really wanted to live in Hawaii.
 

WilcoWorld

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Yup, it is only about 6 hour flight between Oahu and Anchorage. I think the OP should consider this as a way to live in Hawaii and maximize you time there. Just go work in Alaska for a few weeks at a time. Heck, you could keep an apartment in Alaska somewhere and claim that as your state residence and pay no income tax. That's probably what I would do if I really wanted to live in Hawaii.
6 hours is a pretty long commute.
 

pinipig523

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I call dibs on the next Maui job
Sorry but I got dibs before you.

My dream was to stay at the Four Seasons Maui and go to work for 4 hours a day and return to my ocean view prime suite. Then I can swim and go scuba diving. That's was my dream. Then I realized that I had to wake up.
 

Apollyon

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One can only stand only so much paradise. After 3 years a rock, it was time to go.
That's true for some, but not nearly all. I could stand paradise every day. In fact, that's what one restaurant manager from NJ said one day - "You wake up every morning, and every day is a beautiful day. How can you NOT love that?"

I only left because I was out of money. I write this as I sit here, now, snowed in by a blizzard. As I am prone to saying to my wife (who lived in Alaska), "No one freezes to death on the beach".
 

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If you're working in a smaller town in Alaska where the highest paying jobs are it'll take an extra 1-6 hours of flight time to get there from Anchorage, not counting layovers and weather delays. That plus the travel time to Hawaii means you're looking at about a full day of travel each way. A better plan for splitting your time between Alaska and Hawaii might be May-September in Alaska and October-April in Hawaii. That way you can be in Alaska for the prime fishing, hunting, boating and hiking seasons and then migrate south for the winter to enjoy the beaches. The ER I volunteered at in Fairbanks, Alaska saw more patients during the summer, so they might be hiring more locums then. The pay will probably be higher for someone willing to work in Fairbanks, Barrow or Nome during the winter, but I do not recommend this no matter how much money they offer.
 

Apollyon

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If you're working in a smaller town in Alaska where the highest paying jobs are it'll take an extra 1-6 hours of flight time to get there from Anchorage, not counting layovers and weather delays. That plus the travel time to Hawaii means you're looking at about a full day of travel each way. A better plan for splitting your time between Alaska and Hawaii might be May-September in Alaska and October-April in Hawaii. That way you can be in Alaska for the prime fishing, hunting, boating and hiking seasons and then migrate south for the winter to enjoy the beaches. The ER I volunteered at in Fairbanks, Alaska saw more patients during the summer, so they might be hiring more locums then. The pay will probably be higher for someone willing to work in Fairbanks, Barrow or Nome during the winter, but I do not recommend this no matter how much money they offer.
The biggest demand for locums in Anchorage and Soldotna and Homer and places south like that, but up towards Fairbanks, too, is in June and July. Go figure. One would think that, in the guts of the winter (whether mild or bone-chilling, kill-you-dead way), folks would be leaving then - not working like it's all normal and whatnot. I was told that it was not due to higher pt census, but provider vacations.
 

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Do anyone know about EM Hawaii job market?

I am watching the show Hawaii life and think it would be fun to live.

How much does Hawaii EM docs get paid? Are there jobs? Are there any independent group w/ partnership potential?
That was a residency classmate on a recent episode. Worked at Queen's before moving to the Big Island.
 

EM Kane

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The group at The Queen's Medical Center on Oahu is a democratic group with partnership track. www.teghi.com.
The new Queen's Medical Center - West Oahu is closed and being renovated and is supposed to open this Spring. Projected at 30k visits and 19% admit rate.
The 2 Queen's hospitals on Oahu are being staffed by the same democratic independent group. TEG - The Emergency Group.
We are hiring physicians now for the new hospital.

Let me know if you have questions, or visit the group website.
 

Apollyon

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Wow - that's news to me. When I was in HI, Pacific Emergency Physicians posited themselves as the first democratic EM group in 20 years in HI. Now that it is 5+ years ago, maybe they wrote "first NEW democratic group". Until your post, I'd never ever heard of "The Emergency Group, HI".

In any case, is the guy in charge still there, or did he retire? There was a PA with whom I worked who had the same name (like, "John Smith"), and he met the manager one day, and the first thing the manager asked him was how was his credit rating. Huh?

Word was (2-5 years ago), Queens was a sweatshop, paying low-ball wages, and few people stayed until "partnership". It was massively busy, all the time, and providers were ground down like grain into flour. On the flip side, you were "it", and got to see all the good cases. However, that save you got, you couldn't savor, because you had to go see two back pains and an abscess.

When HMC shut down, the prediction was West to reopen in 12-18 months. Now, on the long end, it will be 30 months before it reopens. At least it will be a "Queen's" hospital, and docs in the ED won't have to beg for any- and everything. I hope the nursing staff is reorganized, too - if the old school, "this is how we've always done it here", people and mentality are present, then there will be problems.
 

EM Kane

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The group became democratic about 5 years ago. The same company has provided services since the 70s , but the structure was different before the change.
 

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Ok - Hawai'i. There was a study about 5 years ago across all medical specialties - on average, there were 3 docs for every 4 jobs in HI - there are not enough plastic surgeons and dermatologists in HI, believe it or not. However, there was one - and only one - outlier. EM was staffed at 104%, or 26 docs for every 25 jobs. That means a LOT of people working part time. However, when I was looking after my hospital shut down, the only places hiring were places I would NOT work - and, when you have many available workers, and people don't want to come to YOUR shop, that means you have problems.

Pay is abysmal for doctors in HI. For procedural specialties, they say expect 1/3 to 1/4 as much as you would make on the mainland. I made $100/hr as an IC. Granted, it was easy work, but that's it. Jobs on O'ahu range from $90-$120/hr. Democratic groups are none. I was part of a new one, which was started after they spun off from Schumacher. The founding partners were some prima donnas, and they were somewhat predatory. The group went under when the 2 hospitals in the system closed down in 2011. One hospital has been remodeled and is going to be an outpatient thing - no ED, no ORs, and no inpatient. The other finally - finally - is going to reopen, now staffed by the Queen's Medical Center.

Queen's is the flagship of medicine in the Pacific. After transplant left my hospital, it is now at QMC, and Honolulu is the only place in the Pacific where you can get a kidney or heart. The ED is a sweatshop.

The majority of ED jobs are hospital employed. However, EMP is there (Pali Momi and Kapi'olani), and EmCare took over Maui Memorial Medical Center (after being at my hospital years ago, and being bumped by Schumacher). There is a group on the windward side, which also covers the big island. Even after asking, I don't know their model. The one thing I was told, all around, though, was that I didn't want to work there. Back in 2007, when I first checked into it, they were who I found online. I shot them an email with questions, and the person got back to me asking if I could work next month. I said I wasn't even licensed in the state yet.

Outer islands are small hospitals, because no one lives there. There are 7000 people on Moloka'i - there aren't even any streetlights - only stop signs! There are 3000 on Lana'i (the island that Larry Ellison of Oracle bought), and Ni'ihau has 130 people and no hospital. Kaua'i, with 58K people, has Wilcox Memorial, which is part of Straub.

Back to O'ahu - main employers are Queen's, Kaiser, and Straub Healthcare - but the Straub Healthcare network is Straub, Pali Momi, Kapi'olani (which is the women's and children's hospital, and has an EM person always working for the vag bleeders and the homeless that come in), and Wilcox. As such, the models differ. In 2010, for people on the Straub "partnership track" (ie, planning to make a career, instead of just being casual/part time, but no actual ownership), they were paying $75/hr. Yes, you read that correctly. And, Kaiser is gold? I don't know - a classmate from med school was faculty there, and he left to go to Pali Momi (interesting note - it is "Pali Momi at Pearl Ridge" - with "pali" meaning "cliff" or "ridge", and "momi" is the Hawai'ian pearl - so it is "Pearl Ridge at Pearl Ridge" - like "Manos, the Hands of Fate").

The big problem in HI that insurance companies suppress the pay - between HMSA (BC/BS in HI) and Kaiser, the money is kept way down. I mean, what are groups going to do? They say "X", and HMSA and Kaiser say "go to another hospital". However, that is where the perfect storm of Maui enters. First, Maui Memorial Medical Center is the ONLY hospital on Maui - you can't tell the patients to go somewhere else. There are about 100K people on Maui, but there is a higher number of rich folks among them. What this means is that the Maui guys went out of network with all plans, which means they are making mainland-style money. But, "wait", you say! Insurance won't pay out of network rates. But, if you (the patient) are rich, you have sway, and Kaiser and HMSA can't tell you to "suck it", and they can't tell you to go to another hospital. So, it's the "perfect storm" - the triple play of lifestyle, location, and pay. You know the way it has been said you can pick two? Well, that is one of those rarities with all 3, and, like the Denver group about which I heard that has not had a doc leave in 9 years, people don't leave those jobs. Hell, I still have the pager number on my computer desktop of the guy who does (or did) the hiring at Maui - as he told me, "even if we like you, I can only give you 1 shift a month, maybe - it could be 3 or 4 years before a position opens". As for the medical director (that post above mine posted while I was composing here), that's not for everyone - it's not like someone with mainland admin experience can cruise in and do the same thing there that they did back on the mainland. I strongly suspect that the spot will be filled by someone from the islands.

A last word regarding that - for EM, I knew only one native Hawai'ian guy - college in HI, went to med school and residency on the mainland (in flyover country - seriously), and came back. The "native" doctors are mostly Chinese descendants (but 3rd or better generation American). After that, there are the Japanese natives. There are two guys that work at Kapi'olani in the Peds ED named "Inaba" - I don't know if they are related, and I didn't get to ask one if he was related to Carrie Ann Inaba (from "Dancing With The Stars", who went to the Punahou School). However, there are more native Hawai'ians (or part native people/people with native blood) in primary care.
Do you mind if I copy this and add it to the jobs thread?


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