HCA vs USACS

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I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
 
20Hopeful16 said:
I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
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No no no no no. No no no no No NO NO. Nooooo. No. No. No. NoNoNoNoNo. No.

No.
 
20Hopeful16 said:
I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
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Lol. The eyes do not see what the mind does not know young grasshopper.

put another way of the attendings think it’s trash wouldn’t that matter to someone who aspires to train under attendings? Or are you hoping to do some np version of a residency. Online with no patient contact.
 
20Hopeful16 said:
I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
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Attendings from some of those HCA shops have freely admitted no one wanted residencies, but were forced to start them. What kind of learning environment do you think that will create? That's just one thing, there's many things that could be said about CMG residencies. And of course applicants will take any interview. Once you apply EM, it's literally too late to apply anything else unless you were smart enough to get backup LORs. CMGs are purposely creating an oversupply and it's working because of what you just said.
 
Oh. You rotated at a place for a month? Tell us more, medical student.

Shut up attendings, you obviously don't know anything.
20Hopeful16 said:
I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
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Despite being told that these programs are being created for the sole purpose of flooding the market and depressing salaries, they still flock to them.

Literally the definition of sheep.
Rekt said:
Attendings from some of those HCA shops have freely admitted no one wanted residencies, but were forced to start them. What kind of learning environment do you think that will create? That's just one thing, there's many things that could be said about CMG residencies. And of course applicants will take any interview. Once you apply EM, it's literally too late to apply anything else unless you were smart enough to get backup LORs. CMGs are purposely creating an oversupply and it's working because of what you just said.
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20Hopeful16 said:
I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
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HCA won’t even take their prelims to categorical programs. Also when I workedfor one the IM Program director would complain that we didn’t admit enough patients to their service (There was a private IM admitting service that takes patients who have an established PCP or if they are an established specialist)

These programs are a last resort.
 
TheSingularity said:
Oh. You rotated at a place for a month? Tell us more, medical student.

Shut up attendings, you obviously don't know anything.

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I can tell you that the HCA program was at a Level II trauma center with over 90,000 ED visits per year and I saw a whole bunch of penetrating trauma in my month there, I also saw medical resuscitations on every shift. I even got to do two central lines, intubated once, did one LP and one para, in my month there. And you know if a medical student is getting procedures, that’s a pretty damn good sign that there is no shortage of procedures to be had. I thought I would get excellent training if I matched there, and would be trained by fellowship trained faculty who are experienced in academia at other residencies. After talking with chief residents and recent HCA grads during my interviews, it appears that they have absolutely no problem getting non-HCA jobs, fellowship positions, and even academic positions in residencies in desirable locations.

Just this year in the past few months for the 2019-2020 match, we’ve already had a bunch of other non-HCA programs starting up. There probably was more non-HCA programs starting this year compared to HCA, because most HCA programs started 2-4 years ago.

Nazareth in Philadelphia
Oschner New Orleans
Summa Health Ohio
Healthquest in New York
Valley Health in Las Vegas

Why would training at these brand new non-HCA programs be better than training at HCA programs that have 3-4 years experience? In other words, what makes training at an HCA program intrinsically less desirable versus other new programs that aren’t for the “sole purpose of flooding the market and depressing salaries”?
 
You're right. They're all trash.
20Hopeful16 said:
I can tell you that the HCA program was at a Level II trauma center with over 90,000 ED visits per year and I saw a whole bunch of penetrating trauma in my month there, I also saw medical resuscitations on every shift. I even got to do two central lines, intubated once, did one LP and one para, in my month there. And you know if a medical student is getting procedures, that’s a pretty damn good sign that there is no shortage of procedures to be had. I thought I would get excellent training if I matched there, and would be trained by fellowship trained faculty who are experienced in academia at other residencies. After talking with chief residents and recent HCA grads during my interviews, it appears that they have absolutely no problem getting non-HCA jobs, fellowship positions, and even academic positions in residencies in desirable locations.

Just this year in the past few months for the 2019-2020 match, we’ve already had a bunch of other non-HCA programs starting up. There probably was more non-HCA programs starting this year compared to HCA, because most HCA programs started 2-4 years ago.

Nazareth in Philadelphia
Oschner New Orleans
Summa Health Ohio
Healthquest in New York
Valley Health in Las Vegas

Why would training at these brand new non-HCA programs be better than training at HCA programs that have 3-4 years experience? In other words, what makes training at an HCA program intrinsically less desirable versus other new programs that aren’t for the “sole purpose of flooding the market and depressing salaries”?
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Sent from my Pixel 3 using SDN mobile
 
20Hopeful16 said:
I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
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Like anything, it probably depends on the individual hospital. I've known of county hospitals that provide terrible training. Memorial Health in Savannah is owned by HCA now. They have quality residency programs (do not currently have an EM residency).
 
20Hopeful16 said:
I can tell you that the HCA program was at a Level II trauma center with over 90,000 ED visits per year and I saw a whole bunch of penetrating trauma in my month there, I also saw medical resuscitations on every shift. I even got to do two central lines, intubated once, did one LP and one para, in my month there. And you know if a medical student is getting procedures, that’s a pretty damn good sign that there is no shortage of procedures to be had. I thought I would get excellent training if I matched there, and would be trained by fellowship trained faculty who are experienced in academia at other residencies. After talking with chief residents and recent HCA grads during my interviews, it appears that they have absolutely no problem getting non-HCA jobs, fellowship positions, and even academic positions in residencies in desirable locations.

Just this year in the past few months for the 2019-2020 match, we’ve already had a bunch of other non-HCA programs starting up. There probably was more non-HCA programs starting this year compared to HCA, because most HCA programs started 2-4 years ago.

Nazareth in Philadelphia
Oschner New Orleans
Summa Health Ohio
Healthquest in New York
Valley Health in Las Vegas

Why would training at these brand new non-HCA programs be better than training at HCA programs that have 3-4 years experience? In other words, what makes training at an HCA program intrinsically less desirable versus other new programs that aren’t for the “sole purpose of flooding the market and depressing salaries”?
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Nazareth...50k volume facility...lulz

Health quest....TH run...lulz

Summa....just lulz

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southerndoc said:
Like anything, it probably depends on the individual hospital. I've known of county hospitals that provide terrible training. Memorial Health in Savannah is owned by HCA now. They have quality residency programs (do not currently have an EM residency).
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Some HCA MBA just got a stiffy. Probably forgot. I give it 18 months before they're next to open.
 
20Hopeful16 said:
I can tell you that the HCA program was at a Level II trauma center with over 90,000 ED visits per year and I saw a whole bunch of penetrating trauma in my month there, I also saw medical resuscitations on every shift. I even got to do two central lines, intubated once, did one LP and one para, in my month there. And you know if a medical student is getting procedures, that’s a pretty damn good sign that there is no shortage of procedures to be had. I thought I would get excellent training if I matched there, and would be trained by fellowship trained faculty who are experienced in academia at other residencies. After talking with chief residents and recent HCA grads during my interviews, it appears that they have absolutely no problem getting non-HCA jobs, fellowship positions, and even academic positions in residencies in desirable locations.

Just this year in the past few months for the 2019-2020 match, we’ve already had a bunch of other non-HCA programs starting up. There probably was more non-HCA programs starting this year compared to HCA, because most HCA programs started 2-4 years ago.

Nazareth in Philadelphia
Oschner New Orleans
Summa Health Ohio
Healthquest in New York
Valley Health in Las Vegas

Why would training at these brand new non-HCA programs be better than training at HCA programs that have 3-4 years experience? In other words, what makes training at an HCA program intrinsically less desirable versus other new programs that aren’t for the “sole purpose of flooding the market and depressing salaries”?
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Summa? Really?

Kid, you don’t know what you’re talking about. Have you ever heard the saying “if you don’t know who the sucker is at the poker table, it’s you?” Everyone here is telling you that you’re the sucker and your saying “hey guys, it’s not so bad!”
 
This doesn't matter tho. These junk places will shepherd in all these less than stellar medical students, probably the same ones graduating from these new pop up medical schools in order to continue to dilute the supply.
TimesNewRoman said:
Summa? Really?

Kid, you don’t know what you’re talking about. Have you ever heard the saying “if you don’t know who the sucker is at the poker table, it’s you?” Everyone here is telling you that you’re the sucker and your saying “hey guys, it’s not so bad!”
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Can anyone tell me why Gainesville, yes, Gainesville FL needs another residency program? UF is a fantastic institution. How the hell does HCA justify opening a residency at North Florida? That hospital is absolute garbage. Does ACGME have any standards left? My God.
 
Getting a job at a non-HCA hospital is meaningless when you are still working for envision. (look it up young grasshopper).

In the end we all know these places will fill. I assure you my SDG will never hire an HCA/CMG trained resident. If you are dumb enough to fall for that you arent smart enough to find a good job.
 
Alvarez13 said:
Can anyone tell me why Gainesville, yes, Gainesville FL needs another residency program? UF is a fantastic institution. How the hell does HCA justify opening a residency at North Florida? That hospital is absolute garbage. Does ACGME have any standards left? My God.
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So someone can profit and also flood the market with docs. I have said it before. If you work for a CMG you better get your financial house in order. BUddy of mine who works in texas told me they fired all their PT docs cause they will replace them with MLPs.

young grasshopper this is an HCA site. I believe over the past 6 years there are 1000 more residency spots annually. yikes.
 
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EctopicFetus said:
Getting a job at a non-HCA hospital is meaningless when you are still working for envision. (look it up young grasshopper).

In the end we all know these places will fill. I assure you my SDG will never hire an HCA/CMG trained resident. If you are dumb enough to fall for that you arent smart enough to find a good job.
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This! We need more of this.
 
Alvarez13 said:
This! We need more of this.
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What we really need are more SDG jobs. WCI said its only about 8% of EM jobs. We have probably 20 applicants per spot. From what i read/know there are no jobs in many metro areas. Im not talking about the typical SD, LA, SF, portland, denver. Im talking atlanta, dallas phoenix. Insanity.
 
SDG's are selling out like crazy. One of the few SDG's in metro Atlanta recently burned some bridges by selling out. One of my friends was 4 months away from making partner. A non-disclosure agreement preventing the SDG from discussing with him their imminent sell to a CMG.
 
I work at an HCA/CMG facility. If a student or resident were to rotate here, he would have ample opportunity to perform intubations, central lines, and lumbar punctures. We see 70,000 patients a year and are an accredited stroke and STEMI center...

And we are starting a residency program against the will of everyone who works here. If a student or resident were to rotate here, he would miss out on performing paracentesis and thoracentesis (as the attendings are too busy to perform them and interventional radiology does them instead), trauma education (as we are not a trauma center), pediatric emergencies (as our pediatric emergency department is a joke and has general pediatricians working in it), and general academics (as none of our attendings our fellowship-trained). Anyone who rotates here is probably going to have to spend a lot of time at other institutions making up for the lack of teachable moments. No one, not even my medical director, can tell me how we plan on training people.
 
deuist said:
I work at an HCA/CMG facility. If a student or resident were to rotate here, he would have ample opportunity to perform intubations, central lines, and lumbar punctures. We see 70,000 patients a year and are an accredited stroke and STEMI center...

And we are starting a residency program against the will of everyone who works here. If a student or resident were to rotate here, he would miss out on performing paracentesis and thoracentesis (as the attendings are too busy to perform them and interventional radiology does them instead), trauma education (as we are not a trauma center), pediatric emergencies (as our pediatric emergency department is a joke and has general pediatricians working in it), and general academics (as none of our attendings our fellowship-trained). Anyone who rotates here is probably going to have to spend a lot of time at other institutions making up for the lack of teachable moments. No one, not even my medical director, can tell me how we plan on training people.
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Any thoughts on why it seems like a lot of practicing EM docs don't really care about what's happening? The market is flooding. What's to stop the CMGs from firing you guys and hiring me for 50-100$/hr less? It's not like their reimbursement would change. Once I graduate, I HAVE to find something.
 
deuist, if your peds faculty aren't peds EM fellowship trained/certified, are the general EM docs going to staff the ER when residents do their peds rotations? RRC requires either a board-certified EM physician or a peds-EM physician oversee residents during their pediatric ER rotation.
 
Rekt said:
Any thoughts on why it seems like a lot of practicing EM docs don't really care about what's happening? The market is flooding. What's to stop the CMGs from firing you guys and hiring me for 50-100$/hr less? It's not like their reimbursement would change. Once I graduate, I HAVE to find something.
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I guess it begs the question - WTF are you or anyone else going to do about it?

For 30+ years we have known that healthcare was thought to be too expensive in America, and emergency departments are at the tip of the spear when it comes to costs. If you doubt me, register in a local ED with a cut on you finger and watch as your bill surpasses $2K for a couple of stitches.

While we can argue that physician compensation is a rounding error in the grand scheme of it all, we have burned our bridges with the public and policy makers over stupid crap like surprise out-of-network billing. In other words, we are all alone in the woods, and our salaries have a big f-ing target on their backs.

Keep in mind there are only 2 ways to control those labor costs: 1) increase the supply of cheap labor, and/or 2) ration access to care. Number 2 has been deemed unacceptable for the immediate future by society. That means that policy makers, with the full support of the public, have decided to open the flood gates on labor supply with EM residencies galore and mid-levels “practicing are the top of their licenses.” Any attempt at ACEP, AAEM, ABEM or any other professional society to curtail the growth of the labor pool would result in a massive public and political outcry about rent controls and doctors price fixing.

In other words, the horse has left the stable. This is happening and there is not a damn thing that you or any other EP can do about it. You had better diversify you skill set so that you have something to offer outside of seeing 2.5 patients per hour because the prospectus on that stock is looking dim. Do a fellowship in CCM, hospital administration (with a Masters in Administration), or go get a law degree and be a risk manager. If you were in the military, look at the FBI, NASA, or NTSB (all of their medical directors are EPs). If you like computing, learn IT. If you are an athlete, do a sports medicine fellowship and work your way up a pro or college team. All of these thing will take more work, more dues, more time away from your family, but you better goddamn well be prepared to do that or you will become insignificant.
 
Semi related but since HCA hospitals/residencies seem to be seen negatively. How to residencies view applicants who did many rotations at HCA hospitals. I'm a 3rd year DO student with no home hosptial so we spend much (probably half) of our time at HCA or Advent hospital systems. They all are pretty new so they are really nice and we generally enjoy our time and experience there compared to the other, older and larger, hospitals in the city.
 
southerndoc said:
SDG's are selling out like crazy. One of the few SDG's in metro Atlanta recently burned some bridges by selling out. One of my friends was 4 months away from making partner. A non-disclosure agreement preventing the SDG from discussing with him their imminent sell to a CMG.
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Yep. This is common and unfortunate. The NDA thing is pure BS btw. They keep it quiet to screw people cause if everyone bails it would ruin the deal. Lawsuits have been filed when similar things happened elsewhere. I tell folks the days of taking highly below average comp to be a partner somewhere are long gone. Taking that job is for idiots.

A decent SDG should have their pre-partners make close to market if not above. I have the best job in town. our associates have the 2nd best job. Of course they will be partners after a few years but my point is that job as a non partner is better than and CMG job in town.
 
I appreciate the insight and responses. So it sounds like they are on a similar level with similar issues. The biggest draw back that I can gather is that they are more focused on churning out high volumes of ED physicians in order to flood the market and drive prices down which in turn benefits them. Since this is their main goal, quality of education takes a backseat.

I’ll be honest and say that this issue with HCA has been difficult to navigate as a fourth year student currently applying for residency. One one hand, I see the above argument and understand how that is a major issue to our profession. On the other hand, I wonder how the accrediting body would allow for sub par training, especially since (I’m guessing here), that body is made up of emergency physicians.


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Stephanopolous said:
I appreciate the insight and responses. So it sounds like they are on a similar level with similar issues. The biggest draw back that I can gather is that they are more focused on churning out high volumes of ED physicians in order to flood the market and drive prices down which in turn benefits them. Since this is their main goal, quality of education takes a backseat.

I’ll be honest and say that this issue with HCA has been difficult to navigate as a fourth year student currently applying for residency. One one hand, I see the above argument and understand how that is a major issue to our profession. On the other hand, I wonder how the accrediting body would allow for sub par training, especially since (I’m guessing here), that body is made up of emergency physicians.


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The point is moot overall when it comes to picking a residency. CMGs are in bed with physicians from the top down, which is why the proliferation continues. They make a few people a lot of money. This is done by selling out current docs, docs who will give anything for location, and the future of EM and us residents. The real threat overall is hoping you have a job after.
 
On your interview days, tactfully ask about ACGME accreditation if it concerns you.

They can go on probation for various things.
They can get ~3 year accreditation.
They can get ~10 year accreditation.

If you interview at a newer place and they already earned 10-year accreditation... it means ACGME was there on-site for an extended period and completely dissected the program -- from residents, faculty, APD/PD to didactic curriculum, training spaces, ED involvement. After the intensive review (i.e. days of assessment) ACGME deemed they have their stuff together when it comes to residency education/experience (as much as it might upset some of the posters on here).

That said, few newer programs likely achieve that credential.

This does not address the philosophical/pragmatic stance regarding market saturation. Rather just the issue of resident training.
 
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southerndoc said:
deuist, if your peds faculty aren't peds EM fellowship trained/certified, are the general EM docs going to staff the ER when residents do their peds rotations? RRC requires either a board-certified EM physician or a peds-EM physician oversee residents during their pediatric ER rotation.
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No one knows. We've heard that we are starting the residency program, yet no one from HCA administration has ever bothered to meet with us to discuss the logistics of running such a program.
 
What if you just "forget" to submit a match list?
deuist said:
No one knows. We've heard that we are starting the residency program, yet no one from HCA administration has ever bothered to meet with us to discuss the logistics of running such a program.
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deuist said:
I work at an HCA/CMG facility. If a student or resident were to rotate here, he would have ample opportunity to perform intubations, central lines, and lumbar punctures. We see 70,000 patients a year and are an accredited stroke and STEMI center...

And we are starting a residency program against the will of everyone who works here. If a student or resident were to rotate here, he would miss out on performing paracentesis and thoracentesis (as the attendings are too busy to perform them and interventional radiology does them instead), trauma education (as we are not a trauma center), pediatric emergencies (as our pediatric emergency department is a joke and has general pediatricians working in it), and general academics (as none of our attendings our fellowship-trained). Anyone who rotates here is probably going to have to spend a lot of time at other institutions making up for the lack of teachable moments. No one, not even my medical director, can tell me how we plan on training people.
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It's the same story at my HCA shop, except we're a bit lower volume and acuity than deuist's so there aren't too many lines or LPs. I probably get one tube per week on average. As a fairly new attending, I'm not yet comfortable giving my tubes to a roton.

The other thing applicants should be aware of is that I and many other community EPs don't really *want* to teach you. If that was my bag, I would've gone to a place with an established residency instead, and it does bother me as well about HCA that they just unilaterally start these residencies after they hire us. I personally would rather just move all the meat and write all the notes and then chill for the rest of the night without needing to think about all that academic fantasyland stuff. If you get me into teaching mode, I think I'm pretty good at it, but then I'm focused on teaching you and not moving the meat/meeting HCA's numbers and my life gets that much more stressful.

We have an IM residency here, and when I get a student or resident on my shift, I always give them a choice: (a) stay and actually learn some community medicine, or (b) go home and rest or study for Step 3 or whatever they need to do. All but 1 of my rotons has taken option (b).
 
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ShockIndex said:
I guess it begs the question - WTF are you or anyone else going to do about it?

For 30+ years we have known that healthcare was thought to be too expensive in America, and emergency departments are at the tip of the spear when it comes to costs. If you doubt me, register in a local ED with a cut on you finger and watch as your bill surpasses $2K for a couple of stitches.

While we can argue that physician compensation is a rounding error in the grand scheme of it all, we have burned our bridges with the public and policy makers over stupid crap like surprise out-of-network billing. In other words, we are all alone in the woods, and our salaries have a big f-ing target on their backs.

Keep in mind there are only 2 ways to control those labor costs: 1) increase the supply of cheap labor, and/or 2) ration access to care. Number 2 has been deemed unacceptable for the immediate future by society. That means that policy makers, with the full support of the public, have decided to open the flood gates on labor supply with EM residencies galore and mid-levels “practicing are the top of their licenses.” Any attempt at ACEP, AAEM, ABEM or any other professional society to curtail the growth of the labor pool would result in a massive public and political outcry about rent controls and doctors price fixing.

In other words, the horse has left the stable. This is happening and there is not a damn thing that you or any other EP can do about it. You had better diversify you skill set so that you have something to offer outside of seeing 2.5 patients per hour because the prospectus on that stock is looking dim. Do a fellowship in CCM, hospital administration (with a Masters in Administration), or go get a law degree and be a risk manager. If you were in the military, look at the FBI, NASA, or NTSB (all of their medical directors are EPs). If you like computing, learn IT. If you are an athlete, do a sports medicine fellowship and work your way up a pro or college team. All of these thing will take more work, more dues, more time away from your family, but you better goddamn well be prepared to do that or you will become insignificant.
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Preach. We don't have a book of business and are thus are easiest to slice and dice.
 
20Hopeful16 said:
I rotated at an HCA sponsored residency and honestly it did not even cross my mind the whole month that they were HCA. The only downside of HCA programs is that they are new, and not because they are HCA and thus inherently bad. I bet you nearly all of the HCA bashing you see on SDN or the spreadsheet comes from attendings who are already finished residency, and from applicants who are just echoing what they read online and don’t have personal experience. I bet you there are tons of applicants right now that would do anything for an interview invite from an HCA program.
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HCA is an enormous entity, and like any large group of people, it is inherently heterogenous. So there may be exceptional programs and hospitals that are "good." That being said--these are the exceptions--the "rule" of HCA hospitals and residencies is that they suck.

I have (past) worked for HCA for years and staffed a site with a residency. I could go on for 10 pages about all the problems with HCA. For the purpose of this discussion in particular regarding their residencies, I would tell you they are sub optimal. I would dissuade any prospective resident from applying to their programs and/or ranking them highly unless they are your only choice as a weaker applicant. I would strongly encouraged any prospective resident to consider/favor a traditional university based residency program.
 
Wait Wait Wait. let me get this straight.

I can be an owner with USACS but I have no voting rights, I can't look at the books, I can't make any decisions, I can't cash out, I have nothing tangible?

Man those guys set up one of the best ownership structure I have ever seen. No liability while hooking up servants.

I think I am going to start a investment syndication tomorrow. It will be called EmergentMD care. Just give me $100K and You will get ownership in the group. You can even pick how much shares you want for the 100K. Why do I care, as they are essentially worthless. Opps... I didn't mean to mention that.
 
emergentmd said:
Wait Wait Wait. let me get this straight.

I can be an owner with USACS but I have no voting rights, I can't look at the books, I can't make any decisions, I can't cash out, I have nothing tangible?

Man those guys set up one of the best ownership structure I have ever seen. No liability while hooking up servants.

I think I am going to start a investment syndication tomorrow. It will be called EmergentMD care. Just give me $100K and You will get ownership in the group. You can even pick how much shares you want for the 100K. Why do I care, as they are essentially worthless. Opps... I didn't mean to mention that.
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Dom (aka DBag) is getting his money so everyone should be happy! WOOOO-HOOO!
 
I find it interesting that not one person who's worked for USACS will defend them or their tactics on here. Their higher-ups are so bad at their jobs that they can't even make an alias to come online and support their company. They have to realize that tons of new grads read this forum.
 
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