HCA Virginia taking anesthesia in-house

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Anyone know what’s going on in Richmond? Looks like a big private practice group is on their way out.

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wondered - some recruiter texted me today from there offering 325 an hour and seemed very urgent
 
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The PP group has been in the news for their collection efforts. Taking patients to court to collect balances owed. HCA probably figures they can control the narrative and fill the spots with grads from their residencies.
 
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The PP group has been in the news for their collection efforts. Taking patients to court to collect balances owed. HCA probably figures they can control the narrative and fill the spots with grads from their residencies.


 
HCA probably figures they can control the narrative and fill the spots with grads from their residencies.
Damn lol

Talk about betrayal

I would definitely not feel comfortable backstabbing the people who trained me like that
 
General question. How much responsibility should fall to the anesthesia company or billing company, in this case Commonwealth Anes Assoc, to make sure the patient is covered? It seems unrealistic to expect the patient to know that their hospital in in-network, but once you get there, certain specialists are not. Most lay people would not question anything once being told their surgery is covered in network.
 
General question. How much responsibility should fall to the anesthesia company or billing company, in this case Commonwealth Anes Assoc, to make sure the patient is covered? It seems unrealistic to expect the patient to know that their hospital in in-network, but once you get there, certain specialists are not. Most lay people would not question anything once being told their surgery is covered in network.

how can they make sure the patient is covered if its an emergency appendectomy, which usually happens at odd hours
 
Being not in network and sending patients bills causes displeasure to patients, hospital administrators, and surgeons.
Sending Patients to collection agencies ups the ante.
Suing patients ups the ante even more.
 
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Commonwealth has been struggling for years. For a number of reasons.
The HCA related reasons are that the Capital division of HCA is a HORRIBLE partner. CEOs that they hire there are complete scumbags. Of the 3 HCA facilities in the south Richmond region, only one has an even remotely acceptable payor mix. That one is a medium sized community hospital, with busy OB and neurosurgery. HCA ties that hospital to the disgusting level 1 trauma and heart hospital 20 minutes away, so you can’t just cover the decent one. In addition, HCA has hospitals in north Richmond with much better payor mix that used to be covered by a PP group that became one of the first VA NAPA practices a decade ago or so. Separate HCA CEO at those hospitals, and from what I am told they colluded with each other to ratchet down stipends between North and South sides, in a race to the bottom. Commonwealth had to compete directly with NAPA working for the same hospital corporation in the same region. Both Commonwealth and NAPA had serious problems recruiting physicians due to the toxic work environment at the HCA facilities as well as the ****load of malignant and arrogant CRNAs in that region, who come from the self-proclaimed greatest CRNA program in the universe, VCU. Add to that one of the largest VA referral centers on the east coast luring away CRNAs with sweetheart deals to work easy days while VCU anesthesia residents do the heavy lifting nights and weekends.

It wasn’t all HCA, out of touch and lazy senior partners at Commonwealth also had a significant hand in their own demise. That newspaper article was a partisan hit job orchestrated by HCA.

The underlying message is that with HCA and Bon Secours as the competing hospital companies in Richmond there is no real money to be made for anesthesiologists in Richmond anymore. Really anywhere in VA.
You do NOT want to have ANYTHING to do with working for HCA in Virginia.
 
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Agree with above poster. Nothing good in the Richmond area. Remember interviewing there back when I finished residency. At commonwealth associates they offered a very low salary and no partnership track. All while 90% supervision model
 
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Commonwealth has been struggling for years. For a number of reasons.
The HCA related reasons are that the Capital division of HCA is a HORRIBLE partner. CEOs that they hire there are complete scumbags. Of the 3 HCA facilities in the south Richmond region, only one has an even remotely acceptable payor mix. That one is a medium sized community hospital, with busy OB and neurosurgery. HCA ties that hospital to the disgusting level 1 trauma and heart hospital 20 minutes away, so you can’t just cover the decent one. In addition, HCA has hospitals in north Richmond with much better payor mix that used to be covered by a PP group that became one of the first VA NAPA practices a decade ago or so. Separate HCA CEO at those hospitals, and from what I am told they colluded with each other to ratchet down stipends between North and South sides, in a race to the bottom. Commonwealth had to compete directly with NAPA working for the same hospital corporation in the same region. Both Commonwealth and NAPA had serious problems recruiting physicians due to the toxic work environment at the HCA facilities as well as the ****load of malignant and arrogant CRNAs in that region, who come from the self-proclaimed greatest CRNA program in the universe, VCU. Add to that one of the largest VA referral centers on the east coast luring away CRNAs with sweetheart deals to work easy days while VCU anesthesia residents do the heavy lifting nights and weekends.

It wasn’t all HCA, out of touch and lazy senior partners at Commonwealth also had a significant hand in their own demise. That newspaper article was a partisan hit job orchestrated by HCA.

The underlying message is that with HCA and Bon Secours as the competing hospital companies in Richmond there is no real money to be made for anesthesiologists in Richmond anymore. Really anywhere in VA.
You do NOT want to have ANYTHING to do with working for HCA in Virginia.

I think we'd all appreciate it if you didn't hold back. Tell us how you really feel.
 
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Anyone up for 1:4 in Richmond with malignant CRNAs? Look at those ads on Gaswork.
 
Not every Virginia group is horrible, but I have heard nothing but bad things about the Richmond, Virginia Beach, and Northern Virginia areas.

I used to do locums for HCA's critical care company, ICC, and covered one of their Richmond hospitals. Overworked and underpaid, with a ****ty system definitely describes how HCA operates. My ICU group recently rescued an HCA refugee from another of their hospitals
 
Not every Virginia group is horrible, but I have heard nothing but bad things about the Richmond, Virginia Beach, and Northern Virginia areas.

I used to do locums for HCA's critical care company, ICC, and covered one of their Richmond hospitals. Overworked and underpaid, with a ****ty system definitely describes how HCA operates. My ICU group recently rescued an HCA refugee from another of their hospitals
You are correct. There are only two groups in Virginia that I would remotely consider working with: Atlantic Anesthesia in Virginia Beach, or ACV in Roanoke. There is also a small boutique group in Newport News that covers Mary Immaculate that has a sweet setup.
 
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ACV is solid. The group in Fishersville remains MD mostly (previously MD only). There’s a private group in Charlottesville that is MD mostly (previously MD only). I’ve heard Atlantic is good. Harrisonburg used to be MD only and private but Sentara wouldn’t leave them alone so now they’re hospital employed. I don’t know the CRNA situation there. The rest is pure trash.

Honestly, if you need to live in VA or NC I feel sorry for you.

Head west friends…..head west….

Or, do surgery and get control of your career.
 
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The Fishersville group became nonvoluntary hospital employees in the last 6 months or so.
 
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Ouch
The Fishersville group became nonvoluntary hospital employees in the last 6 months or so.
Ouch, hadn't heard that. Harrisonburg went employed, messy situation there with multiple specialties. Sentara are idiots. The department there now is a mix of solo and direction.

If the one in C-ville is the one I'm thinking of, I think they're employed now, after UVA purchased the hospital. I do not have first-hand knowledge of that situation, however.
 
It was more voluntary than not. That’s all I’m willing to say about it on the public forum.
It’s a tough area from the standpoint of payor mix. All the richies in Ivy head EAST for their care instead of west.
 
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Ouch, hadn't heard that. Harrisonburg went employed, messy situation there with multiple specialties. Sentara are idiots. The department there now is a mix of solo and direction.

If the one in C-ville is the one I'm thinking of, I think they're employed now, after UVA purchased the hospital. I do not have first-hand knowledge of that situation, however.

Sentara forced employment in Harrisonburg (RMH) and Charlottesville (MJH). That wasn’t the case in Fishersville.
 
You are correct. There are only two groups in Virginia that I would remotely consider working with: Atlantic Anesthesia in Virginia Beach, or ACV in Roanoke. There is also a small boutique group in Newport News that covers Mary Immaculate that has a sweet setup.
What about the Fairfax group?
 
You are correct. There are only two groups in Virginia that I would remotely consider working with: Atlantic Anesthesia in Virginia Beach, or ACV in Roanoke. There is also a small boutique group in Newport News that covers Mary Immaculate that has a sweet setup.


the newport group group is virginia anesthesia and perioperative care specialists
 
You are correct. There are only two groups in Virginia that I would remotely consider working with: Atlantic Anesthesia in Virginia Beach, or ACV in Roanoke. There is also a small boutique group in Newport News that covers Mary Immaculate that has a sweet setup.
Second Atlantic worked 1099 for them for years. Good good people…..
 
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One of the VA Beach hospitals got taken over by Northstar and is a complete **** show
 
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Commonwealth has been struggling for years. For a number of reasons.
The HCA related reasons are that the Capital division of HCA is a HORRIBLE partner. CEOs that they hire there are complete scumbags. Of the 3 HCA facilities in the south Richmond region, only one has an even remotely acceptable payor mix. That one is a medium sized community hospital, with busy OB and neurosurgery. HCA ties that hospital to the disgusting level 1 trauma and heart hospital 20 minutes away, so you can’t just cover the decent one. In addition, HCA has hospitals in north Richmond with much better payor mix that used to be covered by a PP group that became one of the first VA NAPA practices a decade ago or so. Separate HCA CEO at those hospitals, and from what I am told they colluded with each other to ratchet down stipends between North and South sides, in a race to the bottom. Commonwealth had to compete directly with NAPA working for the same hospital corporation in the same region. Both Commonwealth and NAPA had serious problems recruiting physicians due to the toxic work environment at the HCA facilities as well as the ****load of malignant and arrogant CRNAs in that region, who come from the self-proclaimed greatest CRNA program in the universe, VCU. Add to that one of the largest VA referral centers on the east coast luring away CRNAs with sweetheart deals to work easy days while VCU anesthesia residents do the heavy lifting nights and weekends.

It wasn’t all HCA, out of touch and lazy senior partners at Commonwealth also had a significant hand in their own demise. That newspaper article was a partisan hit job orchestrated by HCA.

The underlying message is that with HCA and Bon Secours as the competing hospital companies in Richmond there is no real money to be made for anesthesiologists in Richmond anymore. Really anywhere in VA.
You do NOT want to have ANYTHING to do with working for HCA in Virginia.
The Reston VA HCA hospital private 6-7 partners are making a boatload of money. So much. I don’t think they have sold out yet.

So I would not say stay away from hca. That Reston group has a ton of outpatient places as well. I’m shocked they haven’t sold out yet.
 
Yes, but only the 6 or 7 partners make that boatload of money. Any other physician that joins that group gets paid less than the local NAPA practices that they “compete” against. In the most expensive place in Virginia.
 
The Reston VA HCA hospital private 6-7 partners are making a boatload of money. So much. I don’t think they have sold out yet.

So I would not say stay away from hca. That Reston group has a ton of outpatient places as well. I’m shocked they haven’t sold out yet.
Maybe they have picks of the CEO on Epstein's island.
 
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ACV is solid. The group in Fishersville remains MD mostly (previously MD only). There’s a private group in Charlottesville that is MD mostly (previously MD only). I’ve heard Atlantic is good. Harrisonburg used to be MD only and private but Sentara wouldn’t leave them alone so now they’re hospital employed. I don’t know the CRNA situation there. The rest is pure trash.

Honestly, if you need to live in VA or NC I feel sorry for you.

Head west friends…..head west….

Or, do surgery and get control of your career.
Yep reimbursement in Virginia has sucked for a long time. I am from there and so have always had my heart strings tugged by the thought of going back but couldn’t get my head around the horrendous pay cut!
 
ACV is solid. The group in Fishersville remains MD mostly (previously MD only). There’s a private group in Charlottesville that is MD mostly (previously MD only). I’ve heard Atlantic is good. Harrisonburg used to be MD only and private but Sentara wouldn’t leave them alone so now they’re hospital employed. I don’t know the CRNA situation there. The rest is pure trash.

Honestly, if you need to live in VA or NC I feel sorry for you.

Head west friends…..head west….

Or, do surgery and get control of your career.
ACV??
 
The Reston VA HCA hospital private 6-7 partners are making a boatload of money. So much. I don’t think they have sold out yet.

So I would not say stay away from hca. That Reston group has a ton of outpatient places as well. I’m shocked they haven’t sold out yet.

they are the worst. they start you at 300k and after 10 YEARS salary finally bumps to 350k. thats it. no partnership track

CRNAs also run the OB floor there
 
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there's also the Dominion group in arlington
This group “doesn’t offer partner track positions.” So it may be a great option if you don’t mind another anesthesiologist getting paid for your labor. At least they are honest about the predatory nature of the arrangement, though?
 
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they are the worst. they start you at 300k and after 10 YEARS salary finally bumps to 350k. thats it. no partnership track

CRNAs also run the OB floor there

Why would anyone take this job? Seriously
 
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Why would anyone take this job? Seriously
I looked at it years ago. (7-11 years ago) Depends on ur goals. It wasn’t bad. 350k back than. Plus 25k into retirement. 7 weeks paid vacation. Healthcare malpractice etc

4 days a week (10 hour days) bread and butter. One overnight 12 hours I think once a month. More mommy track. So basically a 4 day week job and one overnight shift on a weekend. All asa 1/2 some 3s.
 
I looked at it years ago. (7-11 years ago) Depends on ur goals. It wasn’t bad. 350k back than. Plus 25k into retirement. 7 weeks paid vacation. Healthcare malpractice etc

4 days a week (10 hour days) bread and butter. One overnight 12 hours I think once a month. More mommy track. So basically a 4 day week job and one overnight shift on a weekend. All asa 1/2 some 3s.
Agree that sounds like decent gig if were paying about 400k now
 
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The question is did the Commonwealth Anesthesia partners stay on or did they all leave? And if they left, did they take the crnas with them. This isnt 12 years ago when your entire anesthesia dept can depart and you can make do with locums. This aint that kinda market anymore.

If the Commonwealth partners stayed, WHY?
 
Commonwealth was a group like many other. In our profession mistakes get repeated over and over.
There were two types of partners in Commonwealth. There was an older group of partners (in their 50’s and 60’s) who were the original founding members of the group. There were also younger partners in the group (in their 40’s). They were all supposed to be equal, but they weren’t really. A handful of those senior partners basically ran everything; they had their sticky fingers in every detail of the practice. The younger group of partners saw the writing on the wall and attempted to get the older partners to adapt, but those older partners wouldn’t do it.
A number of those younger partners left the group in the last several years. The ones who stayed were either of the out of touch ones or the weak ones who had kids in private school and wives that would have shouted them down if they tried to change jobs.
I’m sure several of those older partners will just retire now as they have run the group into the ground and don’t really care about anyone else who was younger. Commonwealth is not completely dead however, they still have a contract with Bon Secours to cover a decent size community hospital with a medium quality payor mix and a smaller **** hospital downtown. Who knows what will happen with that.
 
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Yes, I recall a partner-->super-partner structure there a couple years ago when I talked with them. It sounded like you had to jump through all these nonsensical hoops like distance learning at Duke or some other business school to even have a chance to make regular "partner," and then it was put to a vote on a nebulous timeline. It wasn't clear how long one would have wait to make true partner, probably forever. Not sure what would draw anyone to that group unless one wants to be a 40 hour per week convenience employee.
You got it. That “program“ was created entirely by those same senior partners. It provided a pretext to keep newly hired physicians at a fixed income, therefore allowing those senior partners to preserve their own incomes. From what I am told a number of the younger partners pointed out repeatedly that they would never keep anyone for the long term if that program continued. The older partners didn’t care, because they knew they would just retire when the end came.
Typical greed and lack of collegiality.
 
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We're our worst enemy. What kind of an ***hole would join a group like that? No wonder it's days are numbered

Maybe somebody who believed the lies that they were told?
 
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Maybe somebody who believed the lies that they were told?
In my mind, anything anyone tells me about a prospective job is complete BS until confirmed otherwise. Youre gonna be equal partner in 2 years. Put that language in the contract and show me the books... IF that doesnt happen.. you're gonna get swindled. People take jobs on emotion.
 
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