Hosed.

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TheLoneWolf said:
Tried that too. "oh most of us don't do blocks but surgeon requested it". He put his foot down on that early, saying he can't block random patient's if he isn't covering that case.
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Dang, how flipping predatory is this place he’s working?? The details keep getting worse and worse.
 
This has got to be the worst job I’ve ever seen on here. Makes me feel good about my probably average one. Some people are out of touch, whether it’s hospital admin, private practice partners, or amc, and there’s nothing you can do to change their mind. Well, there’s one thing..
 
aneftp said:
Beauty of locums. U can pick and choose.

But locums can’t refuse to do certain cases if they are privileged for it. They are paid well and mercenaries hired to do the job.

The fault lies with the schedule makers. They suck (not just scheduling but their own skill set). I made the schedule a lot previously. If people aren’t happy with their assignments I offer to switch with them and do the case myself. That’s when you know who is a good schedule maker. Tell the schedule maker to do the case themselves.

This means the place ur friend is a crap hole and not worth staying at for 425k. For what? To take no calls?

Start getting the cv ready and move on.
This job market is still amazing in most parts of the country.
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That may be true though I have yet to see it at multiple shops. I recall around 2016 a nearby PP group hired a locum and put him in a Whipple within around his first week there. Needless to say, he did not renew his time at that facility.

The inherent expectation I had noticed is locums want to be sitting low volume simple cases by themselves. Even putting them on a day of urology or D&Cs results in complaints.
 
TheLoneWolf said:
That may be true though I have yet to see it at multiple shops. I recall around 2016 a nearby PP group hired a locum and put him in a Whipple within around his first week there. Needless to say, he did not renew his time at that facility.

The inherent expectation I had noticed is locums want to be sitting low volume simple cases by themselves. Even putting them on a day of urology or D&Cs results in complaints.
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it depends how desperate places get

We had this 1099 doc who would only want to supervise endo but when endo got to be more than 15 preop he would complain He was there almost 2 years. Gi didn’t start to 8am and and it was at most 1:2

He didn’t do blocks. He didn’t want to sit his own case. He was a pain but we were super short staff and it’s paper charting and we all hate paper charting sick gi preop so let him slide.

Once we got enough other locums we got rid of him but it took 2 years!

But he was there 7-3 every day. So a warm body is better than no body. The other locums docs think like me. Do long shifts 1099, do calls, fly in an out with 80 hrs for the week. So they were more of a pain to schedule around

He gave us 40 hrs 7-3 1099 which rare these days for 1099 docs or crnas.
 
aneftp said:
it depends how desperate places get

We had this 1099 doc who would only want to supervise endo but when endo got to be more than 15 preop he would complain He was there almost 2 years. Gi didn’t start to 8am and and it was at most 1:2

He didn’t do blocks. He didn’t want to sit his own case. He was a pain but we were super short staff and it’s paper charting and we all hate paper charting sick gi preop so let him slide.

Once we got enough other locums we got rid of him but it took 2 years!

But he was there 7-3 every day. So a warm body is better than no body. The other locums docs think like me. Do long shifts 1099, do calls, fly in an out with 80 hrs for the week. So they were more of a pain to schedule around

He gave us 40 hrs 7-3 1099 which rare these days for 1099 docs or crnas.
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And you guys were giving this guy north of 300 an hour to run a handful of GI preops and watch 1:2?
 
centdoc said:
When your friend leaves, that will be a wake up call for the losers left behind. They will **** bricks. And your friend likely will be making significantly more and working significantly Easier cases wherever he goes.
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Doesn’t matter to the other day docs. They will find suckers w2 docs or locums to do those vascular cases.

Seems like they are all colluding together to avoid doing real cases and wanna cruise to retirement
 
aneftp said:
Doesn’t matter to the other day docs. They will find suckers w2 docs or locums to do those vascular cases.

Seems like they are all colluding together to avoid doing real cases and wanna cruise to retirement
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It surely won't be easy. Every practice out there is struggling to find anesthesiologists. If this is an underpaid position, doing less desirable cases, then recruiting a replacement will by no means by an easy feat. May god bless the poor soul who eventually falls victim as their replacement though...
 
TheLoneWolf said:
Not an AMC. Large metropolitan hopsital in the downtown. Same handful of schedulers making the daily schedules. Non call takers are all salaried. Even the partners are, in a sense, salaried, as they are only surviving on a fat hospital stipend. Payor mix, as with most cities, is trash.
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Even with trash payor mix, how is it possible that they are making 425 with a “fat hospital stipend”? I like to think I know a little about trash payor mix. A trash payor mix alone without a stipend should yield at least 425. Makes me think there is really bad collections or embezzlement of said collections.
 
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nimbus said:
Even with trash payor mix, how is it possible that they are making 425 with a “fat hospital stipend”? I like to think I know a little about trash payor mix. A trash payor mix alone without a stipend should yield at least 425. Makes me think there is really bad collections or embezzlement of said collections.
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It's very possible. Say they have to pay locums, not super busy, 30 dollar ls a unit, 2 million stipend with 15-20 docs, easily could see 425
 
nimbus said:
Even with trash payor mix, how is it possible that they are making 425 with a “fat hospital stipend”? I like to think I know a little about trash payor mix. A trash payor mix alone without a stipend should yield at least 425. Makes me think there is really bad collections or embezzlement of said collections.
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It’s daytime doc position essentially. MD only practice.

At 425k 8 weeks off. MD only

The group has decided the doc is essentially a Crna.

Crna pay is $200-220/hr in most major cities. And crnas are not even reliable with scheduling. Most want to work make thejr schedule take days off when they want.

A day time doc is more reliable 40 hrs a week/44 weeks out off the year than trying to patch up crnas even at 400k a year
 
Simba1711 said:
This was depressing to read. For all we read about how predatory amcs are some of the most malignant and predatory practices are private practice. Sad how selfish and greedy some anesthesiologists are to the point of abusing their colleagues.
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Hopefully people don’t forget this since it was probably the most common type of job 10-15 years ago. Absolute worst deal I ever had was in my first job in private practice with partners making double what I did and working half as hard, taking no call, getting more vacation. There’s a reason AMCs and hospitals were able to easily take over this field, lots of greedy lazy people.
 
ambiturner said:
Hopefully people don’t forget this since it was probably the most common type of job 10-15 years ago. Absolute worst deal I ever had was in my first job in private practice with partners making double what I did and working half as hard, taking no call, getting more vacation. There’s a reason AMCs and hospitals were able to easily take over this field, lots of greedy lazy people.
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Yup, that’s the problem when in the late 1990s early 2000s some of the worst and least thoughtful students were going into anesthesia because it was undesirable. Very little scruples from people who just scrape by. Obviously not the whole field but a lot of small city practices still on the private model have these people in them.

In any case the person in question here seems to be feeling the inertia of a job. I’ve seen it a dozen times with people I know. The best thing that could happen to him is to be forced to leave for some reason, only way to get some people out of the funk of complacency.

In this job market there are no victims, only volunteers.
 
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nimbus said:
Even with trash payor mix, how is it possible that they are making 425 with a “fat hospital stipend”? I like to think I know a little about trash payor mix. A trash payor mix alone without a stipend should yield at least 425. Makes me think there is really bad collections or embezzlement of said collections.
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425 is the non call takers pay.
Partners make around 600. They have to open their books to hospital admin and if they come up short yearly, the hospital guaranteed they will cover the difference.
 
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Maz777 said:
Where is this job so we can all cross it off our list permanently?

It's wild that anyone would work like this in the current market. Pathetic that others in this feeble department won't do these cases equally. Scum.
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This job sounds likely to be the ones you find around Seattle. Tacoma, Olympia and all of Western WA all stink for compensation, work hours, and high acuity. Also predatory PP groups and AMC's.
 
aneftp said:
It’s daytime doc position essentially. MD only practice.

At 425k 8 weeks off. MD only

The group has decided the doc is essentially a Crna.

Crna pay is $200-220/hr in most major cities. And crnas are not even reliable with scheduling. Most want to work make thejr schedule take days off when they want.

A day time doc is more reliable 40 hrs a week/44 weeks out off the year than trying to patch up crnas even at 400k a year
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Not MD only but they are short staffed for sure. Easier to hire day docs than CRNAs in that market.
 
Dr. Anonymouss said:
It surely won't be easy. Every practice out there is struggling to find anesthesiologists. If this is an underpaid position, doing less desirable cases, then recruiting a replacement will by no means by an easy feat. May god bless the poor soul who eventually falls victim as their replacement though...
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Can’t speak to any W2 hires, but no way a locums would stick around long to work these cases exclusively.
 
Who does these cases when ur friend is on vacation? Do these other semi retired docs somehow regain their skill set to do higher risk cases? Or do locums docs do them?
 
aneftp said:
Who does these cases when ur friend is on vacation? Do these other semi retired docs somehow regain their skill set to do higher risk cases? Or do locums docs do them?
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Locums refuse to cover any of those rooms. Group president, nearly always, gets called in to cover these when my friend is on vacation. Otherwise, usually just runs 1:2 robots.
 
TheLoneWolf said:
Locums refuse to cover any of those rooms. Group president, nearly always, gets called in to cover these when my friend is on vacation. Otherwise, usually just runs 1:2 robots.
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1746614115444.jpeg
 
TheLoneWolf said:
Locums refuse to cover any of those rooms. Group president, nearly always, gets called in to cover these when my friend is on vacation. Otherwise, usually just runs 1:2 robots.
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Locums if they have been there a while need to do those cases or else don’t use them

Or is this place so bad Locums just can pick and choose.

Who is paying for Locums? The hospital? Or the private group?
 
aneftp said:
Locums if they have been there a while need to do those cases or else don’t use them

Or is this place so bad Locums just can pick and choose.

Who is paying for Locums? The hospital? Or the private group?
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Locums are hired by both. Sometimes the group, sometimes the hospital system.

Either way, they say they won't take on those rooms or cases. Pushback from the group leads to the locums not renewing their contracts, threatening to leave early, and complaints to their locum company to not send anyone else to these sites.
 
TheLoneWolf said:
Locums are hired by both. Sometimes the group, sometimes the hospital system.

Either way, they say they won't take on those rooms or cases. Pushback from the group leads to the locums not renewing their contracts, threatening to leave early, and complaints to their locum company to not send anyone else to these sites.
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So it’s a crappy place to work if locums don’t want to be there

That’s a tell tell sign to get out of dodge for ur friend. If the work is easy, locums will come back. If the work is hard locums won’t come back.

Pretty basic stuff here of supply and demand.

Like I’m only taking $325-hr-$375/hr this week at locums. But I got chill rooms. I’m by the water ocean view. I’d come back even for $300/hr. It’s like a country club here in Florida.

Ur friend hospital sounds like a dump.
 
aneftp said:
So it’s a crappy place to work if locums don’t want to be there

That’s a tell tell sign to get out of dodge for ur friend. If the work is easy, locums will come back. If the work is hard locums won’t come back.

Pretty basic stuff here of supply and demand.

Like I’m only taking $325-hr-$375/hr this week at locums. But I got chill rooms. I’m by the water ocean view. I’d come back even for $300/hr. It’s like a country club here in Florida.

Ur friend hospital sounds like a dump.
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An old ugly city with horrendous roads, potholes, and vile winters
 
See, what they need are military anesthesiologists that miss those kinds of cases. I did a month of locums between when I separated from the Army and when I showed up for fellowship. The place gave me all these train wreck cancer belly whacks, open AAAs, fem-forevers, cranis, etc. I ****ing loved it, as I like complex cases, and hadn't been able to do them for several years. This was years ago, and I was even excited to get paid a whole $180/hr to do them, as active duty pay is atrocious (~$200k for a fulltime anesthesiologist still paying back initial duty obligation).
 
TheLoneWolf said:
He sat down with the group heads about it. They said to his face it isn't happening. When he showed them months worth of assignments, they unashamedly said yes it is happening, and that it is a good thing as no one else has the skillset to cover those cases.

When he pointed out the same attendings always in robot, breast, and podiatry rooms, they said "oh, they have poor room turnover times and their skills arent great, so it's the safest place to put them so they can't injure anyone."

Place has had some locums since Covid started. Not a single one has agreed to cover vascular, OB, C sections, endoscopy, or even holding the pagers.

I called him yesterday and told him to move a bit more south. Quite literally any job will be at least a marginal bit better. Even call taking jobs with similar hours with much better pay and benefits. Looked up gasworks and 8/10 hospitals within an hour of him are hiring. Also told him to avoid jobs with a busy OB service, for his own sanity.

Even the worst AMC couldn't get away with such behavior.
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Sounds like BS to me. Who handles these cases after hours if he doesn't take call and when on vacation, if no one else has the skill set. If he dropped dead tomorrow, what would the group do to cover the cases? He's being taken advantage of.
 
psycho-matic said:
Sounds like BS to me. Who handles these cases after hours if he doesn't take call and when on vacation, if no one else has the skill set. If he dropped dead tomorrow, what would the group do to cover the cases? He's being taken advantage of.
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Partners do these cases when on call. Just seems like no one else touches them when he's available.
 
psycho-matic said:
Sounds like BS to me. Who handles these cases after hours if he doesn't take call and when on vacation, if no one else has the skill set. If he dropped dead tomorrow, what would the group do to cover the cases? He's being taken advantage of.
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The more I think about this point. Seems like the managing partners (there are always 1-2 who truly run the practice) are phasing the OP’s friend out.

They want him to leave.

There is this full time partner in Florida. Well the group didnt like him. But they still treated him equally. But they didn’t tell him they were in negotiations for big sell off to AMC. They let him quit on his own. And than they sold out 18 months later.

So they want the friend to quit.
 
aneftp said:
The more I think about this point. Seems like the managing partners (there are always 1-2 who truly run the practice) are phasing the OP’s friend out.

They want him to leave.

There is this full time partner in Florida. Well the group didnt like him. But they still treated him equally. But they didn’t tell him they were in negotiations for big sell off to AMC. They let him quit on his own. And than they sold out 18 months later.

So they want the friend to quit.
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What we can't understand is to what end? What do they gain by forcing him out?

Not a partner so buyout is meaningless.

Short on staff and admin is upset that they have to foot the bill to cover some of the rooms as the group can't staff up.

Someone else must cover those cases when he's gone, and it's going to be the partners as the non call takers and locums won't.
 
TheLoneWolf said:
What we can't understand is to what end? What do they gain by forcing him out?

Not a partner so buyout is meaningless.

Short on staff and admin is upset that they have to foot the bill to cover some of the rooms as the group can't staff up.

Someone else must cover those cases when he's gone, and it's going to be the partners as the non call takers and locums won't.
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Not a partnership.

Even more reason to leave. Why is he staying? Afraid to leave.

I met this locums anesthesiologist woman this past week. She’s from up north. Also bad miserable winters.

She was in same private group for 24 years up north. She was also uncertain about quitting. Her two sons in college made the decision much easier. And doing locums the past 7 years.

Unless you friend is tied to the area. And you mention it’s a metro area (and when people say metro area) I’m gonna to assume there are at least 1 million people within a 40 miles radius. There has got to be at least 10 hospitals within that radius to work for.
 
secretasianman said:
Some kind of personality issue ?
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Could be.

I can’t think of any reasonable anesthesiologist willing to tolerate this.

This kind of workload and unfair treatment cannot be healthy long term.

I mean this isn’t normal. I actually feel really bad for him.

Can we help him?
 
AKMD_1984 said:
Could be.

I can’t think of any reasonable anesthesiologist willing to tolerate this.

This kind of workload and unfair treatment cannot be healthy long term.

I mean this isn’t normal. I actually feel really bad for him.

Can we help him?
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Men, IMO from observation, can go both ways. Stoic and willing to do any case on one end (minority). Whiney and entirely avoidant of anything above simple GETA surgeries on the other end (more common). Most fall somewhere in the middle. This guy is definitely in the former camp
 
TheLoneWolf said:
Men, IMO from observation, can go both ways. Stoic and willing to do any case on one end (minority). Whiney and entirely avoidant of anything above simple GETA surgeries on the other end (more common). Most fall somewhere in the middle. This guy is definitely in the former camp
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If he’s your friend, refer him to this thread and make him see these responses.
 
caligas said:
One thing for certain, there is more to this story than we will know
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Always.

He’s a regular employee (daytime)

He’s not a partner who has switched to (daytime)

So we are slowly getting the real details.

The partners protect their other partners (even daytime partners)

Slowly more details are coming through

As any regular non share holder employee. The friend needs to treat the job like any job. Quit if he doesn’t like it. Sounds like he’s a pushover
 
psychbender said:
See, what they need are military anesthesiologists that miss those kinds of cases. I did a month of locums between when I separated from the Army and when I showed up for fellowship. The place gave me all these train wreck cancer belly whacks, open AAAs, fem-forevers, cranis, etc. I ****ing loved it, as I like complex cases, and hadn't been able to do them for several years. This was years ago, and I was even excited to get paid a whole $180/hr to do them, as active duty pay is atrocious (~$200k for a fulltime anesthesiologist still paying back initial duty obligation).
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Ah, memories. Did the same.
 
Hung out with the guy on the weekend and had him open his EMR and review the daily case assignments.

Vascular/OB/GI for 80-90% of the last 6 weeks

I've actually seen a few days where he did all 3 in a shift. 🤣

Asked him why he hasn't outright quit and he said it's the only job in the city which has them doing the majority of their own cases. I rebutted that CRNAs aren't exactly chipper to be covering vascular/Ob/GI/peds.

Also found out how much they are paying their locum CRNAs. Notably higher per hour rate than what he is making.
 
TheLoneWolf said:
Hung out with the guy on the weekend and had him open his EMR and review the daily case assignments.

Vascular/OB/GI for 80-90% of the last 6 weeks

I've actually seen a few days where he did all 3 in a shift. 🤣

Asked him why he hasn't outright quit and he said it's the only job in the city which has them doing the majority of their own cases. I rebutted that CRNAs aren't exactly chipper to be covering vascular/Ob/GI/peds.

Also found out how much they are paying their locum CRNAs. Notably higher per hour rate than what he is making.
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At this point he is just a fool. I don’t say that trivially or with disrespect.

Per Merriam-Webster:

Fool​

1: a person lacking in judgment or prudence​

2b: one who is victimized or made to appear foolish : DUPE​

3a: a person lacking in common powers of understanding or reason​

 
TheLoneWolf said:
Hung out with the guy on the weekend and had him open his EMR and review the daily case assignments.

Vascular/OB/GI for 80-90% of the last 6 weeks

I've actually seen a few days where he did all 3 in a shift. 🤣

Asked him why he hasn't outright quit and he said it's the only job in the city which has them doing the majority of their own cases. I rebutted that CRNAs aren't exactly chipper to be covering vascular/Ob/GI/peds.

Also found out how much they are paying their locum CRNAs. Notably higher per hour rate than what he is making.
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Sorry if this seems like I’m jumping to conclusions

Did you friend even grow up in the USA?

Americans especially Americans born and raised women docs lol don’t put up with this nonsense.
 
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