Houston job market??

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Ravenclaw90

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Does knows what the Houston market is like, if there is anything besides USAP or AMCs? Are certain USAP divisions more attractive than others?

How does working at UT Houston, BCM compare? Also curious about University of Houston and Texas A&M.
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Yes, there are some differences between divisions within USAP. However, there is a movement within the organization to be grouped geographically rather than strictly by hospital system. I’m happy to answer any questions you may have on here or via PM.

Best of luck with your search - Houston is a great town to practice
 
Yes there is. There is another large physician owned private group in Houston. PM me for details
 
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How much are people making in Houston?
I see and have been offered low ball offers since, you know, it’s “market rate.”
I say keep your market rate. Even in places like Woodlands where people have money and insurance.
 
chocomorsel said:
How much are people making in Houston?
I see and have been offered low ball offers since, you know, it’s “market rate.”
I say keep your market rate. Even in places like Woodlands where people have money and insurance.
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Very hush hush what partners are making. I'm pretty sure they would never "open the books" to anyone that isn't a partner. Not sure how common that is, but my first gig showed me the payroll for the partners during my interview. I thought that was amazing

The tracks (partner or non partner) are pretty much laid out with very little wiggle room.....until competition changes, then that unfortunately "market rate"
 
Anesthesia19 said:
Very hush hush what partners are making. I'm pretty sure they would never "open the books" to anyone that isn't a partner. Not sure how common that is, but my first gig showed me the payroll for the partners during my interview. I thought that was amazing

The tracks (partner or non partner) are pretty much laid out with very little wiggle room.....until competition changes, then that unfortunately "market rate"
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Because they tend to offer about 280-350 in town to start. Ain’t exactly amazing. But maybe the partners are killing it.
 
GandalfTheWhite said:
Would be nice to know what the gain is if they would only open up their books.
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I agree but the it is fraught with risk for the group. I would only do it if I were certain a prospective hire was going to join the group.
 
GandalfTheWhite said:
Would be nice to know what the gain is if they would only open up their books.
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$750K-$900K is the likely partnership number. They don't want that figure to get out to the hospital or C-Suite in case they need to negotiate a subsidy or re-negotiate a subsidy. Once the executives find out the partners are earning $900k do you think they will be getting a subsidy?
 
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PlayToWin said:
Any info on UTH?
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Memorial Hermann is usually hiring I believe. Tough place to work 90+ ORs difficult cases staffing on low end. Probably good experience for fresh grads. All residents and AAs no CRNAS in main hospital only surg center. Pay is good for academics I think starts at 320-350 with some peeps making over 700 when working like dogs.
 
blockstar said:
Memorial Hermann is usually hiring I believe. Tough place to work 90+ ORs difficult cases staffing on low end. Probably good experience for fresh grads. All residents and AAs no CRNAS in main hospital only surg center. Pay is good for academics I think starts at 320-350 with some peeps making over 700 when working like dogs.
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What kind of schedule does one have to do to make 700k in academics (without being a department chair or having a crap ton of tenure)?
 
blockstar said:
Memorial Hermann is usually hiring I believe. Tough place to work 90+ ORs difficult cases staffing on low end. Probably good experience for fresh grads. All residents and AAs no CRNAS in main hospital only surg center. Pay is good for academics I think starts at 320-350 with some peeps making over 700 when working like dogs.
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I was told With regular call the package is like 395k. Plus state benefits . Vacation is not much to start but can build up over time. No getting around the difficult cases.
 
yea I dont work there so Im not sure. I wouldnt be surprised. I talked to them before completing oral boards so lower number. Probably higher with fellowship since academics but I dont know for sure. The money and location and if you dont want to work with crnas are the pros. The workload is the con.
 
blockstar said:
yea I dont work there so Im not sure. I wouldnt be surprised. I talked to them before completing oral boards so lower number. Probably higher with fellowship since academics but I dont know for sure. The money and location and if you dont want to work with crnas are the pros. The workload is the con.
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seems like if you want to be in Houston, you gotta work with USAP, Texans, Academics and some smaller groups. Gotta pick out what works for you.
 
BLADEMDA said:
$750K-$900K is the likely partnership number. They don't want that figure to get out to the hospital or C-Suite in case they need to negotiate a subsidy or re-negotiate a subsidy. Once the executives find out the partners are earning $900k do you think they will be getting a subsidy?
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Is this working for an AMC as a partner?
 
blockstar said:
Memorial Hermann is usually hiring I believe. Tough place to work 90+ ORs difficult cases staffing on low end. Probably good experience for fresh grads. All residents and AAs no CRNAS in main hospital only surg center. Pay is good for academics I think starts at 320-350 with some peeps making over 700 when working like dogs.
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Is 320-350k good for academics ?
 
BLADEMDA said:
$750K-$900K is the likely partnership number. They don't want that figure to get out to the hospital or C-Suite in case they need to negotiate a subsidy or re-negotiate a subsidy. Once the executives find out the partners are earning $900k do you think they will be getting a subsidy?
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Unless there were some very unusual aspects of the job if someone was making 900k and trying to negotiate an additional subsidy I would wonder what on earth was wrong with them.
 
<(^_^)> said:
Unless there were some very unusual aspects of the job if someone was making 900k and trying to negotiate an additional subsidy I would wonder what on earth was wrong with them.
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If the hospital demands staffing for a money losing service the partners have every right to negotiate a subsidy. Many profitable groups in the 90th percentile still get some subsidies for trauma, ob, etc from the hospital. Do you think the hospital executives don't try to get bonuses on top of their $900K salaries? Or, the CEO of insurance companies? This is just business and one thing (your revenue/profits) has nothing to do with the other (losing money staffing a service). Of course, one wants to be fair and reasonable when dealing with the C-suite but if you demand nothing for a money losing service that slippery slope could end up destroying the group.
 
GassYous said:
I know a guy who worked like a demon, took a ton of call and made bout 500
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This seems more in line with reality

MirrorTodd said:
320-350 seems pretty crappy unless it's like 12 weeks vacation and robust benefits package.
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Meanwhile, this is not in line with reality. At least, not initially until several years of working there. Do you know any Academic jobs that make this salary with that much vacation for an early career Anesthesiologist? Please be specific if so
 
sethco said:
This seems more in line with reality



Meanwhile, this is not in line with reality. At least, not initially until several years of working there. Do you know any Academic jobs that make this salary with that much vacation for an early career Anesthesiologist? Please be specific if so
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it’s hard to even find a PP gig in a desirable area to find something like this. More likely to be 350 with 4-6 weeks depending .
 
BLADEMDA said:
AMC partnership in many USAP subgroups is worth around $650K. The $900K number is for a non AMC partnership position in a highly profitable group like the one in Houston (non AMC).
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650 is high. Maybe the top 10% of workers who work the most at maybe 25% of usap groups.

but plenty making 500k after partnership. Although they give up 7 figures to get that “partnership”

if United wins Vs USAP and sets a precedent expect those numbers to drop 20-30%
 
Howard888 said:
650 is high. Maybe the top 10% of workers who work the most at maybe 25% of usap groups.

but plenty making 500k after partnership. Although they give up 7 figures to get that “partnership”

if United wins Vs USAP and sets a precedent expect those numbers to drop 20-30%
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What “seven figures” are they giving up? The buy in? It’s not that high.
 
Checking in here as I wonder what has happened/is happening to USAP given the FTC business and news on the street that many docs are leaving/unhappy? Any reasonable competition to USAP and Texans in this area?
 
I’ve found that it takes awhile for markets to open up. After the ftc cracked down in Colorado things are very slowly opening up. Unfortunately none of the hospital systems in Colorado have gotten it - pay people and give them reasonable time off and you’ll get people. The only groups that have popped up are pretty predatory pp groups that make USAP look fair.

Idk about Houston but USAP still has a monopoly on all the business in dallas. It is true that many partners are leaving 🙋‍♀️ dallas and Orlando.
 
1) USAP in Houston is being stretched thin, asking existing members to cover wider areas, and typical workdays stretching longer/unpredictable.
2) New hires in the area do not have non-compete as boilerplate part of their contract, but existing employees cannot have it removed.
3) I know many unhappy existing members, but many less are willing to actually walk.
4) The non-academic options in Houston are limited. Lots of fresh meat from the ignorant graduates of the nearby training programs.
 
amyl said:
I’ve found that it takes awhile for markets to open up. After the ftc cracked down in Colorado things are very slowly opening up. Unfortunately none of the hospital systems in Colorado have gotten it - pay people and give them reasonable time off and you’ll get people. The only groups that have popped up are pretty predatory pp groups that make USAP look fair.

Idk about Houston but USAP still has a monopoly on all the business in dallas. It is true that many partners are leaving 🙋‍♀️ dallas and Orlando.
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Can confirm both of those places with usap. Some
Partners leaving Orlando and Dallas

But in general , people are afraid to leave. Maybe things will get better? 6 months will quickly become 1 year. Some people don’t know any better. Maybe it’s the only job they ever had? So going from residency to a busy usap practice and making good money as a partner 750k seems good.

But ask yourself. Are the original partners (2014 and earlier) still working the same hours. And I’m sure some of them are or already cut back.

They aren’t stupid. They will claim they have enough already. Those are half truths. They know the truth is that the work load is pretty bad plus their return on their work load isn’t worth it compared to pre buyout especially with their finances in place. Less motivation to work extra full load.

A usap partner making 750k really should be making 1 million with that workload. Regular w2 amc employed doc likely is making 90% of what a usap partner doc if you compare apples to apples with workload and hours and that’s without the original 3 year buying.

Workload. Think about it.
 
aneftp said:
Can confirm both of those places with usap. Some
Partners leaving Orlando and Dallas

But in general , people are afraid to leave. Maybe things will get better? 6 months will quickly become 1 year. Some people don’t know any better. Maybe it’s the only job they ever had? So going from residency to a busy usap practice and making good money as a partner 750k seems good.

But ask yourself. Are the original partners (2014 and earlier) still working the same hours. And I’m sure some of them are or already cut back.

They aren’t stupid. They will claim they have enough already. Those are half truths. They know the truth is that the work load is pretty bad plus their return on their work load isn’t worth it compared to pre buyout especially with their finances in place. Less motivation to work extra full load.

A usap partner making 750k really should be making 1 million with that workload. Regular w2 amc employed doc likely is making 90% of what a usap partner doc if you compare apples to apples with workload and hours and that’s without the original 3 year buying.

Workload. Think about it.
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But will it hold up? Revenue down costs up- is there room for PE’s cut???
Orlando already had a 20% pay cut for docs to give crna/aa raises. Heard Houston took a hit but idk how much per partner. Dr salary cuts anticipated in other markets….
… and to run extended care team liability…. Uh no
 
amyl said:
But will it hold up? Revenue down costs up- is there room for PE’s cut???
Orlando already had a 20% pay cut for docs to give crna/aa raises. Heard Houston took a hit but idk how much per partner. Dr salary cuts anticipated in other markets….
… and to run extended care team liability…. Uh no
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20% cut to give to extenders? How much were they making before the cut? That seems nuts in this market, maybe they’re trying to fail on purpose.
 
Gotta run the ORs or the house of cards falls immediately - if that means crna raises…. Then they get raises…. That $ has to come from somewhere. I don’t know if Orlando market is running extended care team or not… maybe aneftp does, other markets are though
 
These extended care team jobs - are they in major cities (ie, Orlando, Houston, etc) or are you seeing them elsewhere too?

Just wondering as I have no desire in ever signing up for that.
 
ambiturner said:
20% cut to give to extenders? How much were they making before the cut? That seems nuts in this market, maybe they’re trying to fail on purpose.
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Follow the money trail. Who is making those decisions. Medical directors. They usually get anywhere between 50k-150k extra in stipend to be medical directors.

Their job in making these decisions is to
1. Show the upper admin they are “saving money”
2. More importantly to protect their own skin without over working themselves

If the same medical directors who made these extended care models decisions do 90% of the same clinical work as the regular staff. It would be tolerable. But most often these medical directors have as little as 20% clinical responsibility. That varies from location to location.

So the decisions they make often have no bearing on their overall workload.
 
Zero sum game here. CRNAs know how to win and are much more valuable than mds in markets. So they’ll get their raises. Hospital admins are onto PE and won’t pay a ridiculous amount for a stipend -they’ll just decide to employ. PE can’t raise rates because of no surprises act. Insurance companies will make them go to arbitration which is also expensive. But…PE gets their 20-40% cut no matter what. So ultimately Md pay has to go down…or you have to work a lot more…to point folks leave. Throw in these cities have gotten much more expensive to live. Will be a slow attrition to hospital employment for a majority of these amcs
 
Agree w aneftp…. Management is part of the problem.
Agree with Howard that the model doesn’t work anymore…. Tried to fix it within, at least in my little pond, but I couldn’t - so I speak with my feet.
Thankfully sold my house in two days 🙏
Put offer in and accepted on new house….Becoming very real all of the sudden. Never in a million years did I think I’d walk from this partnership…. But it’s not the group I joined
 
lolnotacop said:
These extended care team jobs - are they in major cities (ie, Orlando, Houston, etc) or are you seeing them elsewhere too?

Just wondering as I have no desire in ever signing up for that.
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It’s everywhere except states that don’t allow independent practice of CRNA.

Anywhere it’s allowed, it is done, no exceptions that I’ve seen except out west
 
I moved to Houston and currently at academic. I chose this because it was the best alternative to USAP or other predatory PP. at the time USAP “partnership “ was 3 years and nothing guaranteed so I balked at that idea. Downside is everyone is getting stretched thin in Houston and I suspect everywhere. So far no extra calls required for us but our days have been going longer . I’ll probably ride it out and see what shakes free.
 
The only way to to change pay/work structure is to have a mass exodus at one time.

Meaning if a practice with 100 anesthesiologist docs/400 crnas

If 50’docs walk away. It will bring the system to its needs quickly. If hospitals know they in danger of losing Or revenue. That’s the only way to get administration attention.

They depend on the slow attrition and make the remaining staff work more. Dangling some extra pay in front of the remaking staff.

Crnas are somewhat protected because many have built in overtime protection which makes them just as expensive as docs.
 
PainInTheAnes said:
It’s everywhere except states that don’t allow independent practice of CRNA.

Anywhere it’s allowed, it is done, no exceptions that I’ve seen except out west
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My new job in SC swears they don’t. Schedule the day I was there reflected that. It’s kinda rural so maybe (hopefully) there’s no shenanigans
 
Extended care team essentially unheard of in my area. We also have some of the highest paid crnas in the nation and comparatively low MD salaries so it’s easier to just have some MDs solo.
 
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