How do I find good jobs?

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drfeelgood76

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Hi,
What's the best way to pursue job opportunities? Should I just call every hospital in the area I want to work in? I was thinking of using groups like Kendall Davis or other such physician recruitment firms to find a job.

Members don't see this ad.
 
Hi,
What's the best way to pursue job opportunities? Should I just call every hospital in the area I want to work in? I was thinking of using groups like Kendall Davis or other such physician recruitment firms to find a job.


Have a list of things you want and prioritize them:

money
location
practice type
call frequency
type of cases
type of partners

Than call yourself or use a recruiter....but very likely your first job won't be your last....most anesthesiologists go through at least 2 jobs before settling down.
 
I know that smaller groups or hospitals in smaller towns may use recruiters, but many groups won't use them at all. My group is more than happy to accept CV's or resume's, but we won't even talk to a recruiting company. And although gaswork.com is an interesting resource, it is far from being an exhaustive list of available positions.

Do the legwork. Make the calls and/or write the letters. Have a good, concise, and well-written professional-looking CV prepared. Use the contacts you already have - residents who have already finished a program and moved on, attendings that might have been in private practice and/or know or get inquiries from groups or hospitals looking for anesthesiologists. There are dozens of ads in the various professional journals that are worth looking into as well.
 
Members don't see this ad :)
Hi,
What's the best way to pursue job opportunities? Should I just call every hospital in the area I want to work in? I was thinking of using groups like Kendall Davis or other such physician recruitment firms to find a job.


You are unlikely to find a good job with the help of a recruiter. They have one goal making money off you by placing you in a position they represent. They get paid more to place you in garbage positions. Good jobs at good location often are filled without the help of a recruiter. Not using a recruiter will make you a better candidate since many groups would rather not pay the 25K+ fee the recruiters get for placing a candidate in a position.


Recruiters do not care about being honest and will say anything to get you to sign up for their jobs. I once dealt with a recruiter who I specifically told I did not want to work for any Anesthesia Management Company or other absentee ownership situations or group that played the partnership game or who churned through anesthesiologists. The recruiter bragged about his 20 years of experience in the industry but refused to ever acknowledge knowing of any location that churned through anesthesiologists. Every location that he told me was an Anesthesia Management Company or a group with a reputation of abusing its employes. He even had the audacity to call me and yell at me for canceling an interview at a place that had a strong nation reputation for playing the partnership game. I canceled an interview upon hearing that the group had just fired their last half dozen partnership candidates after three years of service just before they were scheduled to make partner.


If you are a new graduate and do not understand the market recruiters will take advantage of that and try to shovel there worst garbage on you. Just last year I was told by a recruiter that 160K was a very good salary and if I was willing to work Q3 or Q4 call I might get as much as 200K. Whenever I deal with a new recruiter they invariably start with the garbage jobs, the low paying holes that churn through people. After wasting my time with the garbage and after firmly restating my goals they occasionally can find something that is reasonable but even then what the recruiter has to say about the location and what I learn from a phone call or site visit are as different as night and day.
 
Chesterfield,

Dude, you are a pretty bitter human being. You must have really gotten screwed over by some Anesthesia Management Company that you seem to hate so much.
 
Chesterfield,

Dude, you are a pretty bitter human being. You must have really gotten screwed over by some Anesthesia Management Company that you seem to hate so much.

Go ahead, work for an Anesthesia Management company.

When you finally come to your senses and quit if you ware not fortunate enough to get fired first for having a bad attitude.

You will see, that, you can turn the other cheek for the AMC stealing 200K of your money and chalk it up to a lesson learned.

I am just trying to warn people about the dangers of working for these people.
 
Go ahead, work for an Anesthesia Management company.

No thanks....I would never work for an AMC. Chief of my department and living large here, kid.

Peace
 
No thanks....I would never work for an AMC. Chief of my department and living large here, kid.

Peace

You da man! Meet me for drinks at the alumni club, my 2 hours of work/day are KILLING me. Need to unwind, figure where to invest my $$$.
 
Go ahead, work for an Anesthesia Management company.

When you finally come to your senses and quit if you ware not fortunate enough to get fired first for having a bad attitude.

You will see, that, you can turn the other cheek for the AMC stealing 200K of your money and chalk it up to a lesson learned.

I am just trying to warn people about the dangers of working for these people.

Everyone here, please read the above post.

And remember it.
 
Thanks for the replies. I think the one thing my residency and probably many others out there, come short on teaching us how to land a good and fair job. I wouldn't have even known about the potential scams of "Anesthesia Management Companies" if it weren't for this forum and all the posts regarding that issue. It looks like ultimately we as anesthesiologists, need to look out for each other. How does another "doctor" have the heart to rip off their colleagues???!! Anyways, thanks again.
 
Thanks for the replies. I think the one thing my residency and probably many others out there, come short on teaching us how to land a good and fair job. I wouldn't have even known about the potential scams of "Anesthesia Management Companies" if it weren't for this forum and all the posts regarding that issue. It looks like ultimately we as anesthesiologists, need to look out for each other. How does another "doctor" have the heart to rip off their colleagues???!! Anyways, thanks again.

greed.....
 
I dont understand how these "management companies" that churn thru MDAs like crazy can operate.

How exactly does this work? Do they use CRNAs to temporarily fill MDA positions until they can get another sucker or what?

If they are continually cycling thru MDAs I dont see how their business model would allow them to stay in business at all. The only way that would work is if MDAs are fairly common to find and they can instantly plug in people who leave. Otherwise I dont see how its sustainable.
 
I dont understand how these "management companies" that churn thru MDAs like crazy can operate.

How exactly does this work? Do they use CRNAs to temporarily fill MDA positions until they can get another sucker or what?

If they are continually cycling thru MDAs I dont see how their business model would allow them to stay in business at all. The only way that would work is if MDAs are fairly common to find and they can instantly plug in people who leave. Otherwise I dont see how its sustainable.

Lots of suckers out there.....lots of people who can't hold a steady job out there,,,
 
Members don't see this ad :)
Lots of suckers out there.....lots of people who can't hold a steady job out there,,,

so on top of being ripped off left and right, some of your colegues are going to be folks who are just miserable to work with - ouch
 
The Anesthesiology News periodical always has ads from NAPA and Sheridan Healthcare. Anyone have experience with these employers? I'm assuming they fall under the dreaded category of Anesthesia Management Company...
 
The Anesthesiology News periodical always has ads from NAPA and Sheridan Healthcare. Anyone have experience with these employers? I'm assuming they fall under the dreaded category of Anesthesia Management Company...

I don't know about NAPA, but Sheridan Healthcare has a string of law suits against it where ever it has ever provided services...

STAY AWAY FROM Sheridan.
 
The Anesthesiology News periodical always has ads from NAPA and Sheridan Healthcare. Anyone have experience with these employers? I'm assuming they fall under the dreaded category of Anesthesia Management Company...

I agree with Mil on his assessment of Sheridan Healthcare you might also want to avoid their shill recruitment agency Tiva Healthcare.


(NAPA) is another Anesthesia Management Company
North American Partners in Anesthesia, (NAPA).

NAPA currently provides anesthesia management services at 18 hospitals, in three (3) states; Maryland, New Hampshire and New York.
 
I dont understand how these "management companies" that churn thru MDAs like crazy can operate.

How exactly does this work? Do they use CRNAs to temporarily fill MDA positions until they can get another sucker or what?

If they are continually cycling thru MDAs I dont see how their business model would allow them to stay in business at all. The only way that would work is if MDAs are fairly common to find and they can instantly plug in people who leave. Otherwise I dont see how its sustainable.

Anesthesia Management Companies are always recruiting since they have much faster turnover than a traditional group. Their recruiters promise above average salaries but the Anesthesia Management Companies have no intention of paying the salary they promise. Their employees will work for a few months at a low base salary with the promise of a large bonus 1/2 of the promised salary at the end of the year. Most employees last only a few months until they learn the bonus is a lie and quit. If an employee learns about the scam and does not quit, they will be fired for having a bad attitude. If they need coverage until they can locate the next sucker they charge the cost of locums against their current employes salary.
 
I agree with Mil on his assessment of Sheridan Healthcare you might also want to avoid their shill recruitment agency Tiva Healthcare.


(NAPA) is another Anesthesia Management Company
North American Partners in Anesthesia, (NAPA).

NAPA currently provides anesthesia management services at 18 hospitals, in three (3) states; Maryland, New Hampshire and New York.

Anybody with more information on NAPA? I have a contract offer from them and it looks pretty straightforward and physician-friendly. I have passed it by some of my consultants and they agreed that it was physician friendly. The base salary is the base salary and the bonus structure seems fair, if somewhat nebulous. They pay tail, base salary is good, benefits are great, and they have expanded into one more state than listed by the poster above...seem to be a pretty stable group. I would love to hear about negative experiences with the large management organizations as I am 50:50 on signing with NAPA vs my other contract. BTW, I too have heard bad things about Sheridan, but who knows? Some people are simply greedy, some people are malcontents no matter the situation...

Cheers,
PMMD
 
Anybody with more information on NAPA? I have a contract offer from them and it looks pretty straightforward and physician-friendly. I have passed it by some of my consultants and they agreed that it was physician friendly. The base salary is the base salary and the bonus structure seems fair, if somewhat nebulous. They pay tail, base salary is good, benefits are great, and they have expanded into one more state than listed by the poster above...seem to be a pretty stable group. I would love to hear about negative experiences with the large management organizations as I am 50:50 on signing with NAPA vs my other contract. BTW, I too have heard bad things about Sheridan, but who knows? Some people are simply greedy, some people are malcontents no matter the situation...

Cheers,
PMMD

the "nebulous" thing....that's the rub...

and they aren't a group in the sense that most of us think of.
 
Anybody with more information on NAPA? I have a contract offer from them and it looks pretty straightforward and physician-friendly. I have passed it by some of my consultants and they agreed that it was physician friendly. The base salary is the base salary and the bonus structure seems fair, if somewhat nebulous. They pay tail, base salary is good, benefits are great, and they have expanded into one more state than listed by the poster above...seem to be a pretty stable group. I would love to hear about negative experiences with the large management organizations as I am 50:50 on signing with NAPA vs my other contract. BTW, I too have heard bad things about Sheridan, but who knows? Some people are simply greedy, some people are malcontents no matter the situation...

Cheers,
PMMD

Mil is right "nebulous bonus compensation" is a dead give away, if they intended to give you a bonus it would be clearly defined in the contract. However whenever money is offered as part of a bonus plan by an Anesthesia Management company that money is compensation that you are highly unlikely ever to receive. That nebulous language is there for one reason, to deny you of that bonus after you sign on and do the work.

"They pay tail" look at their web site and you will see they are self insured through an off shore insurance company.

"NAPA Partnership Physicians founded and capitalized Practice Security Insurance Company SPC, Ltd. (PRASEC), a Cayman Islands licensed segregated portfolio insurance company." From;

http://www.napaanesthesia.org/InsuranceServices/index.php

I have talked to a number of hospital administrators and most frown on off offshore Cayman Islands insurance products, so you are essentially practicing uninsured. The reason people use off shore locations like the Cayman Islands to hide their money is that it is next to impossible sue there and if you win it is next to impossible to collect. Those are qualities that you would not want in an insurance company. If you get sued they could decide not to cover you and you would be left with no legal recourse. When you quit NAPA your next employer is likely to require you to buy a tail since they will most likely interpret the this arrangement a tantamount to not being insured.

If you want to get the truth about NAPA you need to talk to former employees and look for lawsuits. If you find a lawsuit it will layout in black and white how the bonus system really operates and how NAPA treats their employees.

I posted these techniques in another thread but they are just as applicable in your situation.

Use this opportunity to investigate the practice. Before you go check out the hospital web site for the names of the Anesthesia doctor who work there. Your goal is to find the names of all the doctors who have left the practice in the last few years. Google all of those names along with the names of the corporation. Asking for this information from the group will get you labeled as a malcontent but to take a job with out an investigation the backgrounds of your employers is a recipe for disaster.

When you get there try to get as many months of the call schedule as possible. Old call schedules often have phone number of recently departed members of the group, plus they tell you how fair the call schedule is.

While you are in town go to the county court house and look up the names of all of the members of the group looking for lawsuits.

If your interview goes well and you are seriously considering the group you need to contact the people who have left to get the real information about how he group treats its employees.

How to find old employees of a group;

Look up all the anesthesiologist in that town with the state licence database,
http://www.docboard.org/docfinder.html

Look up all the anesthesiologist in that town with the AMA directory, ASA Directories for the last three or four years.

Look up all the anesthesiologist in that town with UPIN number search, great for towns with more than one hospital since it lists the billing address with the name separating out different practice locations.
http://upin.ecare.com/
or
http://www.upinregistry.com/provider_form.asp

Another good database dr-411 since it gives some info not seen elsewhere,
http://www.dr-411.com/default.asp


With all the names you have found you should be able to find a few former employees to contact about the group since this is your best source of unbiased information.

These databases will help you get current names and addresses of former employees.

Google is often helpful.

Searching for current phone number and addresses
http://www.zabasearch.com/

or your favorite directory search database.

Doc board is good for finding some one who has moved;
http://www.docboard.org/docfinder.html
which may give a current address.

If you have no luck you might want to invest a few buck and ask your local detective to search for people you can't locate. They also can search for lawsuits more broadly than the court house.

Now call your names and politely ask them to tell you about there experience at your potential employer.

While this is just the basics, your hospital credential application probably will be ten to twenty pages of invasive questions, many of which will be verified. Why shouldn't you know as much about your potential employer?

If you do not find any skeletons in the closet or areas of concern you need to find a competent lawyer and some trusted friends to look at your contract. Finding a lawyer who knows anything about anesthesia contacts is very difficult many attorneys will claim to be able to review a contact. So just because your buddy and fellow resident used that attorney does not say much about his competence in reviewing anesthesia contacts and providing relevant feedback.

Lastly don't ever buy a house until you have been there at least a year or made partner.
But don't say that to the realtor they force you to take a "tour of the town" with, you can be sure that everything you say to her will funnel back the anesthesia group.
 
Are these Anesthesia Management Companies relatively new, or have they been around for decades?

Do other specialties have management companies like this?

Is their rate of growth steady, or is it fastly becoming more prevalent. Does anyone know?
 
Lots of suckers out there.....lots of people who can't hold a steady job out there,,,

That implies to me that the number of MDAs in this country is too high.

If you can instantly find an MDA and then plug him into a job, then whats all this bull**** I keep hearing about MDA shortages?
 
the "nebulous" thing....that's the rub...

and they aren't a group in the sense that most of us think of.

Right, I know that they're not a traditional group but a conglomerate of 300 anesthesiologists and 100 CRNAs across 19 practices and 4 states. The bonus language is written as a 5% bonus of profits from the anesthesia group at the NAPA hospital, divided among the anesthesiologists, which would be 6 of us. I've talked with former employess who have said that NAPA has been fair and that the average bonus has been between $21k and $25k per year.
 
Mil is right “nebulous bonus compensation” is a dead give away, if they intended to give you a bonus it would be clearly defined in the contract. However whenever money is offered as part of a bonus plan by an Anesthesia Management company that money is compensation that you are highly unlikely ever to receive. That nebulous language is there for one reason, to deny you of that bonus after you sign on and do the work.

“They pay tail” look at their web site and you will see they are self insured through an off shore insurance company.

“NAPA Partnership Physicians founded and capitalized Practice Security Insurance Company SPC, Ltd. (PRASEC), a Cayman Islands licensed segregated portfolio insurance company.” From;

http://www.napaanesthesia.org/InsuranceServices/index.php

I have talked to a number of hospital administrators and most frown on off offshore Cayman Islands insurance products, so you are essentially practicing uninsured. The reason people use off shore locations like the Cayman Islands to hide their money is that it is next to impossible sue there and if you win it is next to impossible to collect. Those are qualities that you would not want in an insurance company. If you get sued they could decide not to cover you and you would be left with no legal recourse. When you quit NAPA your next employer is likely to require you to buy a tail since they will most likely interpret the this arrangement a tantamount to not being insured.

If you want to get the truth about NAPA you need to talk to former employees and look for lawsuits. If you find a lawsuit it will layout in black and white how the bonus system really operates and how NAPA treats their employees.

I posted these techniques in another thread but they are just as applicable in your situation.


Didn't know about the offshore insurance. The contract is written in language that holds them liable in terms of malpractice and tail coverage. My attorney verified that much. I'll have to go look at your link and see. From the employees at NAPA and some former employees I found and talked with, they seemed pleased with how fair NAPA was. I'll have to do more investigating.

The bonus language was pretty straight forward and the base salary is pretty generous and spelled out in the contract. It's an employed position and I'd be OK with the salary they offered even without the possibility of a bonus.

Thanks for the info, though. I'm going to do some digging...

Regards,
PMMD
 
Right, I know that they're not a traditional group but a conglomerate of 300 anesthesiologists and 100 CRNAs across 19 practices and 4 states. The bonus language is written as a 5% bonus of profits from the anesthesia group at the NAPA hospital, divided among the anesthesiologists, which would be 6 of us. I've talked with former employess who have said that NAPA has been fair and that the average bonus has been between $21k and $25k per year.


Do you have the chance to become an owner of the corporation?

Do you care about being an owner?

What's the termination clause?

Is there a non-compete?

Are the books open?

Who does the billing?

What are the benefits?

Who pays for malpractice?

Who buys the tail?

Who owns the accounts receiveable? Do you get to see the accounts receiveable?
 
Do you have the chance to become an owner of the corporation?

Do you care about being an owner?

What's the termination clause?

Is there a non-compete?

Are the books open?

Who does the billing?

What are the benefits?

Who pays for malpractice?

Who buys the tail?

Who owns the accounts receiveable? Do you get to see the accounts receiveable?


Mil,
Thanks, good questions. I only have the answer to some of them.
I don't know if we have the chance to become an owner, but they have a profit sharing arrangement in the form of the bonus plus the ability to invest in their products and captive insurance services, billing agency, etc. This occurs after the first year. I don't care as much about becoming an owner as I recognize that this is an employed position and I'll be looking at a W-2.

Termination clause is long but includes such things on the employer's end as my death, cause (defined as failure to perform my duties and obligations, suspension or revocation of my license, conviction of an act of dishonesty, criminality, malfeasance or negligence, etc.

The non-compete is a 12-month term after termination of employment in which I couldn't work at any hospital in which NAPA provided anesthesia services in the state of PA. At this point, that is a non-issue as they only run this one group in the state of PA.

Tail is covered 100% if I am terminated without cause. If I terminate for any reason during the first year I pay 100%. After that, if I am terminated for cause, I would have to pay 100%.

Benefits are pretty good...6 wks vacation 1st year, 7 wks 2nd, 8 wks 3rd and beyond. CME is $4500/year. Moving is $9k. They pay for disability and life insurance and subsidize health care with premiums of about $190/mo for a family. Vision and dental are reimbursed. They pay $20k per year pension which is immediately vested. I could contribute the regular max on 401k. There are some other little perks (gym membership, investing in NAPA corporate entities, etc).

They provide all malpractice at a minimum of $500k/$1.5 mil.

Records, billing, etc. are provided by NAPA and her corporate entities. I don't know about access to books, but as an employee, and since there's really no "partnership," it doesn't really affect my salary.

Thanks for all of the pointers...I wish I had your experience! I think the contract is pretty fair for what it is...it may not be the most lucrative contract, but it is enough for me as I don't care about making $1 mil a year :)

Please, any and all comments are welcome. I really appreciate all of your advice.

Regards,
PMMD
 
When I responded to your PM, I hadn't read this post....overall, it sounds pretty good....

I would not have any problems with signing this contract...

Any thoughts Chester?
 
Any thoughts Chester?


Practicing bare realy worries me with the new bankruptcy laws


PA is experiencing an insurance crisis. This is part of the reason why PA has so many anesthesia positions on gaswork. Many physicians are electing to leave the state to find a better Medical Malpractice environment.

The Medical Malpractice ‘Crisis’:
Recent Trends And The Impact
Of State Tort Reforms


“Rate increases in other states, such as Pennsylvania, ranged from 26 to 73 percent in 2003”
“Reduced capacity. The structure of the insurance market has changed dramatically in some of the states facing the sharpest rise in premiums (such as Nevada, West Virginia, Pennsylvania, and Ohio).”


AMA Declares War on Malpractice Crisis

Corlin says the situation is so bad that it has reached the critical stage in a dozen states -- Florida, Georgia, Mississippi, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, Texas, Washington, and West Virginia -- and 30 other states are reaching the breaking point.

The only reason one would use an offshore insurance company is so that they can claim to have the required capitalization but keep there money where they have total control over the money with little chance of it being taken away. You the physician being sued and the plaintiff have no guarantee of any coverage since you will have little or no legal recourse.

Heres how it could hurt you. You sign up for the Anesthesia Management company , then no thru no fault of your own you have a bad outcome. The Anesthesia Management Company fires you for cause citing “negligence”. Therefore you are liable to pay for the tail, which the contract most likely obligates you to purchase. They apply your last month’s salary any other money they owe you as a partial payment for the tail, and send you a bill for the rest of the cost of the tail.

The Anesthesia Management Company has the choice of the cost of the tail coverage it could be 40,000 or a year’s salary. You dip into your saving to pay the balance on the AMC Tail, since now you probably can not get a tail from any other carrier due to your bad outcome.

You bite the bullet and get the tail, then get sued. The offshore insurance company doesn’t respond they refuse to represent you. Now you have to pay for you own lawyer to defend yourself. You sue the Anesthesia Management company pay a fortune but when you win you get nothing since you were employed by the local, LLC which the Parent Anesthesia Management Company closed and declared bankrupt as soon as you filed your lawsuit They still operate at that hospital just with a different LLC.

You are unable to find a lawyer willing to sue the offshore insurance company since you have no chance of collecting. You loose the malpractice lawsuit but have no assets left since you have spent everything on lawyers. You can’t declare bankruptcy, due to the new bankruptcy laws so you are required to pay 75% of your after tax salary for the next 5 to 7 years to the Plaintiff and their lawyers.
 
Practicing bare realy worries me with the new bankruptcy laws


PA is experiencing an insurance crisis. This is part of the reason why PA has so many anesthesia positions on gaswork. Many physicians are electing to leave the state to find a better Medical Malpractice environment.

The Medical Malpractice ‘Crisis’:
Recent Trends And The Impact
Of State Tort Reforms


“Rate increases in other states, such as Pennsylvania, ranged from 26 to 73 percent in 2003”
“Reduced capacity. The structure of the insurance market has changed dramatically in some of the states facing the sharpest rise in premiums (such as Nevada, West Virginia, Pennsylvania, and Ohio).”


AMA Declares War on Malpractice Crisis

Corlin says the situation is so bad that it has reached the critical stage in a dozen states -- Florida, Georgia, Mississippi, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, Texas, Washington, and West Virginia -- and 30 other states are reaching the breaking point.

The only reason one would use an offshore insurance company is so that they can claim to have the required capitalization but keep there money where they have total control over the money with little chance of it being taken away. You the physician being sued and the plaintiff have no guarantee of any coverage since you will have little or no legal recourse.

Heres how it could hurt you. You sign up for the Anesthesia Management company , then no thru no fault of your own you have a bad outcome. The Anesthesia Management Company fires you for cause citing “negligence”. Therefore you are liable to pay for the tail, which the contract most likely obligates you to purchase. They apply your last month’s salary any other money they owe you as a partial payment for the tail, and send you a bill for the rest of the cost of the tail.

The Anesthesia Management Company has the choice of the cost of the tail coverage it could be 40,000 or a year’s salary. You dip into your saving to pay the balance on the AMC Tail, since now you probably can not get a tail from any other carrier due to your bad outcome.

You bite the bullet and get the tail, then get sued. The offshore insurance company doesn’t respond they refuse to represent you. Now you have to pay for you own lawyer to defend yourself. You sue the Anesthesia Management company pay a fortune but when you win you get nothing since you were employed by the local, LLC which the Parent Anesthesia Management Company closed and declared bankrupt as soon as you filed your lawsuit They still operate at that hospital just with a different LLC.

You are unable to find a lawyer willing to sue the offshore insurance company since you have no chance of collecting. You loose the malpractice lawsuit but have no assets left since you have spent everything on lawyers. You can’t declare bankruptcy, due to the new bankruptcy laws so you are required to pay 75% of your after tax salary for the next 5 to 7 years to the Plaintiff and their lawyers.


Wow, that paints a dismal picture. Do you know anybody to whom this happened?
 
Oh my God, this thread is so depressing, I ... I .... I just might move to Canada. :scared:
 
Oh my God, this thread is so depressing, I ... I .... I just might move to Canada. :scared:

I hear things are a lot worse in Canada. Higher Taxes more Regulations and Socialized Medicine.


Dear Creditor:
Please accept my apology for being delinquent on your bill.

In reply to your request to send money, I wish to inform you about the difficulties I've had in making ends meet. I have been trying to get a handle on my shattered financial condition, and I've come up with a few possibilities. It seems that the problem is largely due to various laws, taxes, and insurance policies that "I must pay, first." My research has identified numerous federal laws, state laws, county laws, city laws, corporation laws and swarms of other laws, too numerous to mention. I'm also narrowing down a myriad of taxes, but it's seemingly hopeless.

Through these laws, I am "compelled" to pay state sales taxes, state income taxes, federal income taxes, property taxes, business and operating taxes, numerous other business taxes, gasoline tax, phone tax (including, telephone internet national access contribution tax, and I'm not even on it), sewer tax, cigarette tax, meal tax, amusement tax, computer tax, and various other excise taxes. I am required to have a business license, driver's license, license for my car, motorcycle license, and a license for my dog. Last weekend a friend of mine was married and had to get a marriage license.

For "my own safety" I am told to carry health insurance, life insurance, dental insurance, disability insurance, long term care insurance, property insurance, liability insurance, collision insurance, theft insurance, burglary insurance, accident insurance, business insurance, flood insurance, unemployment insurance and old age pension insurance.

My very small business is governed so much by others, that I sometimes wonder who owns it. I am inspected, expected, suspected, disrespected, rejected, examined, re-examined, informed, required, commanded and compelled to provide a seemingly inexhaustible supply of information to just about every Tom, Dick, and Harry who says he's from the alphabet soup government agency. I'm spending up to 40% of my time filling out forms and other mandatory reporting or they say, I'm going to be penalized, imprisoned, or both.

I can tell you honestly that but for a miracle that happened, I could not have enclosed this check. A very dear relative of ours, died a few years ago, and the estate was finally settled. After the attorneys, accountants, and appraisers finished settling the probate jail process, paid court costs, federal and state inheritance taxes, I was left with just enough money to pay your bill. Do you think it's possible that I will be required to pay taxes on this money too? If this is so, would you please be so kind to send it back.

Sincerely yours,

I. M. Brooke

from;
http://www.taxdeferrals.com/letter.htm


Offshore asset protection

A secondary reason why noted people like Michael Jackson and others bank in the Bahamas and other recognizable tax haven jurisdictions, is for unbending asset protection and wealth preservation. Creditors and their very clever contingent fee lawyers cannot seize, lien or investigate bank records in tax haven jurisdictions due to strong bank secrecy laws. All of the largest banks in the world have to go through the local courts. Judgments are not enforceable in non-United States jurisdictions. U.S. contingent fee lawyers and their clients have a significant jurisdictional problem: only citizens of the tax haven jurisdiction can practice law. U.S. lawyers or their clients will have to hire a local law firm and pay up-front legal fees, post bonds, pay court costs, and pre-pay other expenses to pursue their claims. Generally speaking, foreign generated claims/judgments are frowned upon by the local authorities.

from;
http://www.taxdeferrals.com/ibcbuzzword.htm
 
I hear things are a lot worse in Canada. Higher Taxes more Regulations and Socialized Medicine.


Dear Creditor:


Offshore asset protection

A secondary reason why noted people like Michael Jackson and others bank in the Bahamas and other recognizable tax haven jurisdictions, is for unbending asset protection and wealth preservation. Creditors and their very clever contingent fee lawyers cannot seize, lien or investigate bank records in tax haven jurisdictions due to strong bank secrecy laws. All of the largest banks in the world have to go through the local courts. Judgments are not enforceable in non-United States jurisdictions. U.S. contingent fee lawyers and their clients have a significant jurisdictional problem: only citizens of the tax haven jurisdiction can practice law. U.S. lawyers or their clients will have to hire a local law firm and pay up-front legal fees, post bonds, pay court costs, and pre-pay other expenses to pursue their claims. Generally speaking, foreign generated claims/judgments are frowned upon by the local authorities.

from;
http://www.taxdeferrals.com/ibcbuzzword.htm

I had heard that the asset protectin offered by offshore jurisdictions such as the cayman Islands etc had been weakened as of late, anybody know the answer to this?:confused:
 
I had heard that the asset protectin offered by offshore jurisdictions such as the cayman Islands etc had been weakened as of late, anybody know the answer to this?:confused:

Things have changed due to the changes in the US tax laws post 9/11. The government now requires US residents or citizens to report all income and offshore holding. The US and the EU have also pressured the off shore Tax havens to be more open in reporting holding by foreign nationals. This is putting many US citizens in the undesirable position of having to report off shore banking transaction or face possible fines or imprisonment.

The asset protection and laws protecting assets from foreign generated claims or judgments are still present. Another layer of regulation has been added for US citizens which will only affect the upper middle class, like physicians, but will not hinder the very wealth or the criminals from taking full advantage the ability to hide assets aborad.


A great site about US citizen living, working and investing abroad;
http://www.escapeartist.com/
 
Wow, that paints a dismal picture. Do you know anybody to whom this happened?


"ProNational Insurance Co., that represents the doctors, has filed court documents that say it is not responsible for paying because the doctors gave conflicting testimony in court."


When faced with a large payout Insurance companies don’t just write a check as your insurance salesman promised but they deny the claim and force you to fight to get the money you are owed. It seems that whenever an insurance company is faced with writing a large check they fist deny it, then get their adjustors and legal department to look for ways to avoid paying. This lawsuit is not unique but representative of the actual policy of most insurance companies.


Jury Puts Punitive Award At $100 Million
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By THOMAS W. KRAUSE The Tampa Tribune

Published: Oct 4, 2006

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TAMPA - Last week came justice; this week comes punishment, a lawyer told a jury on Tuesday.

Steve Yerrid, representing a man whose stroke was misdiagnosed as a headache, thanked a jury for awarding his client $116.7 million in compensatory damages on Friday. At a hearing Tuesday, he begged them to send a message to doctors and insurance companies everywhere: "Don't ever put profits over patients' safety."

"Now's not the time for mercy," Yerrid said. "Now's not the time, as I said, for compassion. Now is the time for the sword."

The jury complied.

The three men and three women took about a half hour to award Allan Navarro $100.1 million in punitive damages.

On Aug. 9, 2000, Navarro went to University Community Hospital in Carrollwood with nausea, a headache, dizziness, confusion and double vision. He was diagnosed with sinusitis and a headache and, about five hours later, was told to go home.

The next day, Navarro returned. A stroke left him in a coma three months. Now, 50-year-old Navarro has no use of his arms or legs.

During the three-week trial, Navarro's defense team showed the misdiagnosis was not made by a doctor.

University Community Hospital contracts its emergency room services to a doctors group. That group had hired Mark Herranz as an "expediter" who would take patient's histories for the on-duty physicians.

Instead, Yerrid contended at trial, Herranz performed physical exams, including the misdiagnosis of Navarro. Herranz was not a licensed health care provider and had failed a physician's assistant exam four times, Yerrid said.

The jury found Herranz, physician Michael Austin and two physicians groups liable for Navarro's injuries. University Community Hospital was not named in the suit. Howard Franklin, a spokesman for the group, declined comment, as did their attorney.

Family Says Justice Served
Navarro's family was overjoyed with the verdict.

Ed Bilbao, Navarro's brother-in-law and the spokesman for the family, said the family is glad justice has been served but the high award was a bittersweet victory. Navarro, Bilbao said, will never get his life back.

"His mind is very much intact," Bilbao said. "He's trapped in that body that is no use to him."

It could have been worse, Bilbao said.

Bilbao credits his wife, Susan Bilbao, for keeping her brother alive. Many family members considered removing Navarro from life support when he was in the coma. She asked them to wait a little longer.

Navarro, a naturalized citizen, was a former pro basketball player in his native Philippines.

Now that his attorneys have secured a massive jury award, the next step in the legal process is collection.

The two physicians groups - Franklin, Favata & Hulls, M.D.s and Carrollwood Emergency Physicians - filed for bankruptcy on Monday.

Brian Stokes, the attorney for the groups, said in court Tuesday that the companies are disbanded and have no employees. The bank accounts have about $50,000 to $100,000.

ProNational Insurance Co., that represents the doctors, has filed court documents that say it is not responsible for paying because the doctors gave conflicting testimony in court.

Yerrid said he will go after anyone necessary to collect, starting with ProNational.

Insurance Company Offered $300
Before trial, Yerrid said, he tried to get the insurance company to settle for the maximum allowed under the policy - $1 million for doctor Austin and $1 million for the physicians' group. Instead, the insurance company wanted to settle for $300. Yerrid said it offered $100 for Navarro, $100 for his wife and $100 for his 10-year-old son.

In Florida, if an insurance company acts in bad faith while trying to avoid the payment of a policy, it can be subject to damages in excess of the policy limit. Yerrid said he will try to collect the entire $216 million from the company's underwriter.

Tampa lawyer Tom Scarritt, who is not affiliated with the case, said Yerrid probably has a pretty good shot at getting some money from the insurance company.

"It's not as hard as you'd think," Scarritt said.

Navarro would have to take a separate legal action against ProNational and another jury would have to determine that the company acted in bad faith.

If a jury looks at the insurance company's offer of $300 and the jury verdict of $116.7 million, that's not a hard point to prove, Scarritt said.

A spokesman for ProNational said he would not comment on pending litigation.

Yerrid said he also might be able to collect from the physicians' group, or its new entity.

Franklin, formerly of Franklin, Favata & Hulls M.D.s, testified on Tuesday that Tampa Bay Emergency Physicians now runs the emergency room for the hospital. He said he and his two former partners are board members and partners in the new group.
 
That's what insurance companies do.....

They are there FIRST to make money.
 
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