Is being a hospital employee worse than working for the big groups?
Started by ToKingdomCome
Says who?
It’s not.
As in life. It depends.
There are some amc employees who have it super chill. Even better than private practice partners who own their practices these days
It all depends what the hospital wants to pay you and ur work conditions.
The real variable is you need to have some type of extra pay compensation built in these days in ANY W2 contract model regardless of who is cutting the check every 2 weeks or every month
Employers will want to pay as little as possible for the maximum work they can get from you. While controlling your available time you need to work.
I’ve said it time and time again. The hourly work model based on 40 hours for docs is the now.
When I started 20 plus years ago. 55-58 hours was considered “normal” for w2 hospital employee
Than the place had a mutiny. Hospital caved and it was based on 52 hours.
10 years later it was based on 45 hours.
Now the contract is based on 40 hours worked.
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My entire very large group, nearly 300 docs and anesthetists, is now hospital-employed after 7+ years with a well-known PE company. Happy to be on board. Stability is now rock solid - no chance someone can come in and underbid. Benefits are better. Our day-to-day operations and schedules are unchanged and we retained our own group management structure. We just answer to the hospital now instead of the PE group.
Win win. Those partners got a huge buyout in 2015. Than the hospital dump the amc a 2 years ago. I know a couple of the peeps there.
The difference between ur Atlanta surburb based practice after the 2015 buyout was the management was fair to everyone for
The most part.
Where some practice like Lawrenceville senior partners after their buyout to mednax in 2013. They tried to do as little as work as possible and dump the weekend calls to new people. If these partners were shady back than. U can bet either they left after American anesthesiology imploded or aren’t running the Gwinnett practice anymore
They were w2 with large amc cough cough that recently left California. Lol
I’d say much much better if you are getting what you deserve as hospital employee. Minimum 600k and 10 weeks vaca. That’s pretty common for employee jobs these days. 450 or something a wash I guess. Hours call etc important too
But overall employee better
AMCs are terrible
But overall employee better
AMCs are terrible
Just make sure that you aren’t reporting to the hospital c suite… it needs to be a separate chain, ideally with an anesthesiologist in the chain of command. That being said, some have employed for awhile now (like HCA). Some are newer. I don’t know whats happening at HCA but I heard they just did a total restructure and unclear if anesthesia even reports to anesthesia anymore. I cover locums at one of their FL sites and everyone is uneasy to see them get rid of essentially every anesthesiologist in corporate leadership. And no idea what they are doing with all their residencies they have planned if they have no anesthesiologists to run them.
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deleted1130227
AMCs and Hospital employers are both predators that look upon us as prey to feed on. In my experience, IN GENERAL, AMCs are more effective predators because they used to be us.
The key to almost any w2 job amc or hospital base practice is to limit ur workload as a w2
The key to any hospital administration employing w2 docs is to maximize ur workload for the time you are there under the pretense it’s fair pay.
It’s a cat and mouse game. We all know that.
I love it when hospital admin tells docs their weekend calls are part of their normal pay. But they give the crnas a 20% extra incentive (on top of their normal pay) to cover weekends. And mind u t the crna weekend hours are PART OF their NORMAL 40 hour week.
Hospital admin claims they need to do it because crnas won’t sign on as full time and need incentives to work.
So they try to take advantage of doctors salary structure. Say docs can leave at 11/12p early and that makes up for weekends.
No it doesn’t. For me to show up. It doesn’t matter if I’m there for 4 hours or 8 hours or 12 hours
I don’t know when I’m leaving even if I’m early out doc. I can’t plan a dental appointment at 1pm cause I have no clue. That’s how being a w2 employee can hurt you. You are tied down.
If I’m hourly. I know if I want to leave early. I won’t get paid. Which is fine with me. If the hospital wants me to work nights or weekends. They gonna to pay me extra. And it will be hourly.
Similar structure to ours although we are far smaller than your group and we are outside the perimeter. I would say that stability has been much better once we became W2 employees in 2006, but aneftp is right about the cat and mouse game and the use of salary structure to include all calls and weekends. Overall I think it has been a good deal and we have been treated fairly by the C-suite. As the current chief of our group, I have been included in leadership meetings, dyads, a million committees, and have had a direct line to the CMO and COO which has kept our group relevant. Compared to friends in other places, I am thankful that we have been invited to have a seat at the table and have been allowed some degree of self-direction.
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deleted1183938
Let’s not forget the Classic Predator who started this mess and is still going strong in some places….Private Practice!!!
Yes, not all, but we all know of some.
Very true - as much as I hate private equity and corporate overlords, there were plenty of highly predatory ponzi scheme private practices before all of the external actors started to exploit doctors. In fact, it was the private practice people who came up with 1:4 medical direction and then sold out to private equity (to make a quick buck) in the first place. Sadly now that the cat's out of the bag there's no going back... The brainwashed ivory tower academics and corporate shills at the top of the ASA certainly aren't advocating for anything better.
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Yup
That's why I don't generally care if it's PP, PE, AMC or academics. It's all about pay, equality, lifestyle, etc.
This is a best case scenario...... there are many other scenarios, as if your group was good to begin with it is irrelevant who cuts the checks. I have been back and forth and the one thing that AMCs do offer is a buffer between you and the hospital. I agree this brings instability when they decide to kick out the AMC but it also does not allow the hospital to call all the shots singularly.. If hospital admin and/or your chair is a deuch yes man who is only out to protect themselves (as is the case with most academic institutions these days) you are screwed. No way to remove them no way to fight them.... if, on the other hand, your group/practice was always solid well staffed quality oriented then yes you enjoy more stability... and that is still a big maybe if the hospital knows how to run finances for anesthesia correctly (many don't coding GI cases as sedation vs GA for example). Furthermore I have seen hospitals with no recruiting resources go back to employee an AMC. The sauce is what makes the meal.... if the sauce is bad it will taste bad regardless who is running the show.
As @lotsapain pointed out at least the AMC is a buffer. You ain't getting 10 weeks vacation if the surgeons are getting four or five. Not happening whatever the anesthesia market is. You are a hospital employee, hospital wants to do elective cases all hours of the night you're doing them. At least the AMC can say well this is not the norm at other sites and CRNAs have to be hired to do overnights etc. Also, a lot of smaller hospitals just give up cause they don't understand anesthesia staffing, anesthesia billing, or anesthesia anything and it goes right back out to RFP after a few painful years.
well said.... this is not even limited to smaller hospitals, larger entities are not protected either as in a system the virus of failure spreads even more rapidly of course the clueless execs will throw the anesthesia leadership under the bus not the fact that they can't raise salaries / vacations to competitive levels nor control / fire the loudest surgeons and attract competent/fast/ friendly staff...
