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kaiser california

Discussion in 'Anesthesiology' started by GaseousClay, Oct 18, 2015.

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  1. GaseousClay

    GaseousClay :) 2+ Year Member

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    anyone have any thoughts on kaiser? looking to apply after residency and haven't found too much on this forum about it. any current kaiser employees? from what I have heard pretty low pay up front but benefits and eventual raises make up for it long term.
     
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  3. Ezekiel2517

    Ezekiel2517 Anesthesiologist Physician 10+ Year Member

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    Norcal kaiser pays more than Socal. Benefits and "raises" don't make up for the low pay. I'd personally never work for them but apparently there are enough who will.
     
  4. IlDestriero

    IlDestriero Ether Man Physician Faculty 10+ Year Member

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    The ivory tower.
    They used to have a pension plan, probably still do. You'd have to do the math on that and factor that in over your career there. It might be worth more than you think. I did some kind of phone pre interview with them years ago and neither of us seemed particularly interested in moving forward. Their true income wasn't clear and the person I was talking to couldn't or wouldn't clear it up for me. The impasse came when I said that if they want me to take vacation to fly there leave a good job to work for them, I need to know what they are actually offering. Now and 5 years from now. I guess they found another sucker, I'm still waiting on the call back with more info.
     
    Last edited: Oct 18, 2015
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  5. Ezekiel2517

    Ezekiel2517 Anesthesiologist Physician 10+ Year Member

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    pm me if you want the income for kaiser socal and yes they do still have a pension plan. I've done the math and to me its not worth it.
     
  6. Shinkansen

    Shinkansen 2+ Year Member

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    why not just post the income?
     
  7. imfrankie

    imfrankie Anesthesiologist 5+ Year Member

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    You will work for nurses at Kaiser.
     
  8. GaseousClay

    GaseousClay :) 2+ Year Member

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    did you actually work there?
     
  9. aneftp

    aneftp 7+ Year Member

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    Kaiser is a lot like the VA.

    In terms that the pay is around the same at most of their locations for those starting out.

    The issue is that like the Va. Some places work harder than others (that why u see job openings at some places and not at others). So why should someone work harder and get paid the same? Bingo. That's why less desirable Kaiser locations have openings.

    It's been a couple of years. But I know the SoCal places haven't been hiring full time directly. Usually u has to job to hoops and work per diem hours around $125/hr w2 with no benefits until they determine you are the "right fit".
     
  10. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    Per diem I believe is $120 at Kaiser SoCal and they are not above stringing you along for a looooong time. Just happened to a buddy of mine before he said screw it and came back to work with us. That was after 9 solid months of Kaiser per diem (everyday).
     
  11. Man o War

    Man o War 2+ Year Member

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    $120 an hour with no bennies? That's CRNA level pay in a lot of places. Throw Cali taxes on top of that and that's terrible. Forget them.
     
  12. Consigliere

    Consigliere 7+ Year Member

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    Neither here nor there
    That crummy level of pay is becoming the norm; get used to it.
     
  13. GaseousClay

    GaseousClay :) 2+ Year Member

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    per diem definitely sounds like a terrible deal. if you can somehow be an associate right off the bat its not a bad gig. the difference with the VA is that there is plenty of cases at some spots so the overtime can be quite significant in pay.
     
  14. caligas

    caligas ASA Member 5+ Year Member

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    Crnas can and do practice independently in Cali, and Kaiser is most interested in cost cutting, so don't expect much more than "crna pay" for a Cali Kaiser gig. Pensions make up for some of it.
     
  15. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    To be hired directly as an associate at a SoCal Kaiser location essentially requires a fellowship. Even if they don't particularly need your specific fellowship they want that feather in their cap and they get enough applications that they can be picky like that.

    Interestingly enough, Kaiser is very gradually reducing their number of CRNA's as they are actually a money loser (according to some very expensive consultant reports). Probably true when you can get away with paying docs 120$/hr and they typically don't supervise > 2:1.

    And CA taxes aren't that bad at just $120/hr. In fact you may actually qualify for Medi-Cal and EBT at that income level in this very blue state :rolleyes:. Oh and next person to say "Cali" gets a :slap:.
     
  16. Ezekiel2517

    Ezekiel2517 Anesthesiologist Physician 10+ Year Member

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    its NSFW
     
  17. fakin' the funk

    fakin' the funk ASA Member 10+ Year Member

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    People seem very happy there. It is very hard to get a job in Norcal Kaiser. A lot of internal hires and "word of mouth" job openings.

    The benefits etc are sometimes referred to as the "golden handcuffs" ... they get better the longer you stay, resulting in a lot of Kaiser lifers.
     
  18. teeva

    teeva 2+ Year Member

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    I get emails from Kaiser HR for openings in SoCal from time to time. They are only looking for per diem, and only want weekday daytime hours and I think minimum 4-6 days a month. Too high of a requirement for me to try per diem on post call days or free weekends there while keeping a full time job.
     
  19. aneftp

    aneftp 7+ Year Member

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    Yeah. My buddy has been with one of the Southern California Kaiser (right outside Los Angeles) for 9 years. So he's almost halfway thorough towards pension.

    Tortoise may eventually win the race since he could "retire" at age 50 and go work another job in private practice.

    He said Kaiser Southern California had a "few bad hires" in 2008-2010 period. So that's when they started doing the per diem requirement to see how someone worked inside the Kaiser system

    From 2000-2006 Kaiser was practically begging people to join. But that's just supply vs demand. And it's very hard to get into the Kaiser system unless you know someone
     
  20. Consigliere

    Consigliere 7+ Year Member

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    Neither here nor there
  21. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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  22. GaseousClay

    GaseousClay :) 2+ Year Member

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    keep hearing this is the most sought after gig in california. starting salary may be low but that is for a 40hr work week. If you hit 50-55 hours/week your starting pay is around 330k from what i hear plus the best benefits around (amazing health care, Keogh/401k (up to 60k per year), pension, disability). plus salary up every for 12 years so by year 12 50-55hrs/week you are above 450k. can anyone confirm or deny?
     
  23. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    I don't know about "most sought after in CA." At least Kaiser SoCal anyways. I know somebody there that has a cardiac fellowship although he's not yet doing any cardiac (fellowship a must for securing the job at the time though). He's only 1 year outta training and he's doing well financially there though he's taking a lot of overtime to do it. Not bad if you're young and single and don't mind working the off-hours, but it would suck one day to have to take a significant pay cut because now you have kids and wanna see them evenings and weekends. I've heard they are starting to prefer non-fellowship trained people right now so they won't have to pay the extra sub-specialty pay. If you're gonna go Kaiser, you gotta do it right outta residency and stay there for it to make sense. You also have to be the type of person that won't mind conforming to their system and playing by their rules.

    I think it all depends on what your options are. If you have the opportunity to join one of the premier private practices around, I would go that route. If your choices are Kaiser v. average PP group, then I would consider Kaiser a viable option. The numbers I've heard from friends are very comparable between Kaiser and the UC's. Personally I would rather go academic than Kaiser (but again, that's just me).

    Now Kaiser Denver is another story. Their numbers are very attractive. Plus, you'd be wise to leave CA if you can.
     
  24. lakersbaby

    lakersbaby 10+ Year Member

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    IMO Kaiser >> Academics. Kaiser you can work as much as you want if you want to ramp up income, you can't always do that at academic places; there is a max amount of overtime you will be allowed. Also I argue that kaiser is equal to the premier PP because by year 12 you will be making 450 range and you have 10-12 weeks of vacation PAID. The premier PP groups are very lucrative but lifestyle + pay gots to go to kaiser
     
  25. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    450K at year 12 is working how much/week?? Are you referring to SoCal or NorCal? That number sounds pretty high to me for Kaiser SoCal. Definitely doable but would require A LOT of overtime. Are you currently with a Kaiser?
     
  26. IlDestriero

    IlDestriero Ether Man Physician Faculty 10+ Year Member

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    The ivory tower.
    That's definitely higher than what I've heard. Maybe 450 if you're counting the pension/retirement plan.
     
  27. imfrankie

    imfrankie Anesthesiologist 5+ Year Member

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    these people are smoking crack--aint no 10-12 weeks vaca, nor any $450k either. I know plenty begged to leave so cal kaiser and find other jobs. you will work for nurses also--believe it.
     
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  28. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    Keep in mind that you accrue vacation time there just like you would if you were working in a normal non-medical job. You're not just handed 10-12 weeks vaca every January. You also must schedule that time all faaaaar in advance. No last minute trips.
     
  29. lakersbaby

    lakersbaby 10+ Year Member

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    imfrankie sounds bitter like he got passed up for a job there. My cousin is in so cal kaiser, he is in year 14. Education time is vacation time so even at year 1 as a first year associate you get i believe 5 weeks paid vacation. His BASE salary at year 12 is 320k. Overtime is 1.5x hourly rate at night and 1.2x hourly rate past 40 hours. 55 hours per week he is above 430k. He does not work for nurses at all, stop drinking the haterade frank. BTW he does not accrue the 10 weeks vacation. he has already accrued way more vacation than that that he gets paid out for whenever he wants. get your facts right people before you hate. I work at private practice and make more than him but still think he is much happier.
     
  30. imfrankie

    imfrankie Anesthesiologist 5+ Year Member

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    Never got passed up anywhere my man. "I gotta cousin" also. Go Warriors!
     
  31. lakersbaby

    lakersbaby 10+ Year Member

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    another sacramento queen fan turned warriors fan eh
     
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  32. GaseousClay

    GaseousClay :) 2+ Year Member

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    his numbers may be a little off but ive heard similar stories about docs who have been there for a while. also not sure why he would lie and try to boost up kaiser, they really don't need to try to get people from SDN. Heard that they get hundreds of applications for any associate spot in california.
     
  33. imfrankie

    imfrankie Anesthesiologist 5+ Year Member

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    I'm not a huge Warriors fan--I really prefer NCAA hoops. But you can bet I've never liked Kobe Bryant, and I'll definitely root for Steph to beat the team from TV-land any- and everyday.
     
  34. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    Ok, ok. No need to drag the NBA into this. I think those of us that are familiar with the SoCal market can agree that the above numbers from Lakers' "cousin" are fair compensation (albeit on the lowish side) for that amount of work. Keep in mind that's after 12 years though. Everybody here likes to bitch that a 3 year track at a solid PP is waaaaay too long.

    Bottom line is, Kaiser isn't raping their 'ologists, but total compensation is still gonna be less than what you'll find at a premier PP over the course of your career. It just boils down to if you'll be happy working in that kinda system and trading some cash for bennies. Do you like to have some control over your practice and your professional life, or will you be happy just punching the clock? Different strokes as they say.

    Me? I'm just a baby with a good 30+ years left in my career. I'm fairly convinced we'll all be employees of somebody before I retire be it AMC's, hospitals, or Uncle Sam. I wanna piece of PP anesthesia while it still exists.
     
  35. Ezekiel2517

    Ezekiel2517 Anesthesiologist Physician 10+ Year Member

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    I'm not at kaiser but I know that starting for full time position at kaiser socal is 220. even if you do reach 400 range eventually, that's gonna be after many years of service and working overtime and weekends. Lot of money you'd be giving up in the process. NorCal does pay more I understand . Also realize this is in context of kaiser having probably the best payer mix in the state
     
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  36. guitarguy

    guitarguy Member 10+ Year Member

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    Keep in mind that the benefit package at Kaiser includes a generous pension. The amount depends on how long you work there, but you'll be hard pressed to make at much as you do at Kaiser over the course of your lifetime, as you do at many private practice groups over the course of your career.
     
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  37. Ezekiel2517

    Ezekiel2517 Anesthesiologist Physician 10+ Year Member

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    i don't really agree, and I know exactly what their pay structure is and how "generous" the pension is. i've ran the numbers. but i don't think it's a bad gig, especially if you aren't into the eat what you kill system and want a good lifestyle
     
    Last edited: Dec 29, 2015
  38. GassmanMD

    GassmanMD ASA Member 5+ Year Member

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    The key element that no one has mentioned yet is job security, something you can not put a price on. Most of the new grads I talk to nowadays in SoCal agree that PP is a short term game because the AMCs keep buying up groups all around us. Everyone in my program this year, including fellows, applied to kaiser. It's in huge demand right now.

    A lot of the comments above seem very near sighted. If you still have 30 years left on your career, IMO you should be thinking academics or kaiser. Those are the best long term careers in this climate.
     
  39. imfrankie

    imfrankie Anesthesiologist 5+ Year Member

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    If you are a resident then you've never worked at Kaiser. If you are talking about other residents, fellows, then they have never worked at Kaiser. The most severe form of near-sightedness belongs to those who've never seen. What job security do you have at Kaiser exactly? Do you know?
     
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  40. Ezekiel2517

    Ezekiel2517 Anesthesiologist Physician 10+ Year Member

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    I don't recall a single group in that entire region that has sold to an AMC. Which groups all around you are you referring to?
     
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  41. deltamed

    deltamed Member 10+ Year Member

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    I've worked for kaiser denver in the past (in a different specialty). Agree the salary per amount of work done is quite attractive, although I think the benefits could be much better (only 3 wks vaca to start and 401k match not guaranteed). Whats the base for anesthesia?

    Cant rely on a pension that may or may not be present when you retire in X number of years.
     
  42. deltamed

    deltamed Member 10+ Year Member

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    I thought Keogh was only for independent contractors or small businesses? Anyone with knowledge of kaiser california know how you could do 60k pretax at a big employer? Sounds hard to believe.
     
  43. imfrankie

    imfrankie Anesthesiologist 5+ Year Member

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    Base in Cali was in 2s. There is ~5 step ladder for salary maybe 10ish per year. I know a lot of people personally who left SoCal Kaiser anesthesia. And not because of money so much as the culture. Yes, nurse administrators run stuff. And anesthesia is just that: anesthesia.
     
  44. GassmanMD

    GassmanMD ASA Member 5+ Year Member

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    You are correct, the major groups have not sold out yet but they are still feeling the shockwaves from the big acquisition up north. Forgive me if I misinterpret what is happening out there as I am still in the sheltered Ivory Tower, but all I can do is interpret what I see and make decisions based off of them. I go to CSA meetings and I see the fear. Its palpable.
     
  45. Scotty_G

    Scotty_G Junior Member 10+ Year Member

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    Just be happy you are on the west coast. If you were in the big east coast markets you would see real fear. The pp gigs are mostly AMC's.
     
  46. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    A residency buddy of mine recently interviewed at Kaiser Denver. Starting base was mid 3's (can't remember 325 v 350) with either 6 or 8 was vaca. A good 100k more than Kaiser SoCal but maybe 2 wks less vaca.
     
  47. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

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    OK, so a little misinformation here. To date there have been no AMC take overs or sell outs in SoCal. The SD deal did not go through, and I think it will be quite a while until something like that comes around again given the current climate/aftermath. The deal up in the East Bay (as well as the attempt in SD) were the product of the partners/board members actively shopping around looking to sell out. AMC's have not yet made a big push into the market, though I realize that doesn't mean it won't eventually happen. I think one thing that factors against the AMC movement here is that almost every practice is MD only, and most are structured pretty fairly. The "super-partner" set-up just isn't as prevalent so the buy-out money is much less relative to annual salary so the financial incentive just isn't there for most groups to sell.

    Now back to Kaiser. As I said earlier, I'm not anti-Kaiser, and I don't think it's a bad gig, I just don't think it's the wundergig some people tend to think it is. The whole job security argument is laughable at best. I'll bet my left testicle that you will never be outright unemployed as a BC anesthesiologist. We possess a certain set of skills (say it like Liam Neeson in Taken) that are very valuable to the healthcare community and to society as a whole. If my group sells to AMC somewhere down the line, then guess what, I'll take my 7 figure pay-out and take it easy workin for the AMC or wherever, but at least the decision will be mine. What happens if Kaiser decides to downsize or outsource some cases or just doesn't want to keep paying current overtime rates? You just have to accept whatever comes down the pipe at you. Just doesn't seem real secure to me.

    It's also funny that people will talk in fear of working for an AMC but then go stand in line for a Kaiser interview. What is Kaiser (or more specifically Permanente Medical Group) if not a BIG multi specialty AMC?? Both involve being paid a set salary under working conditions set forth by a suit somewhere.

    And the pension. Where does that money come from? Well it comes from the money they have been saving by not paying you over the course of your career and investing it instead. The same thing you could have/should have been doing on your own anyways.

    Just wanna keep things in perspective. Also, the reason these jobs are competitive is because they tend to be in good locations and they are openly advertised. The good PP jobs are never advertised. They just cherry pick the Rockstars outta residency/fellowship without the open casting call. The competition/selection happens before the CV's even get sent.
     
    Last edited: Dec 31, 2015
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  48. kaioukenx

    kaioukenx ASA Member 10+ Year Member

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    SaltyDog,

    Reasonable points regarding Kaiser.

    "Most desirable in SoCal" as suggested by OP is probably an exaggeration. To expand a bit further, good PP jobs generally require good connections, whether through networking, being a rockstar, or nepotism. The majority of job seekers will not achieve that just by the laws of the bell curve. On the flip side, there are plenty of mediocre/bad jobs ranging from $30/unit employee positions to $20/unit with tons of call. So Kaiser, being more desirable than the crappy jobs and more accessible than the great jobs, is going to be considered by a lot of grads. You can do better than 375-500k total compensation at Kaiser for 50 hrs/week but you can also do much worse. Which leads to the perception that the jobs are very desirable even if that's not true in an absolute sense. It's simply the best game that most people can get a ticket to.
     
    Last edited: Dec 31, 2015
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  49. GassmanMD

    GassmanMD ASA Member 5+ Year Member

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    Last two posts :thumbup::thumbup::thumbup:
    I think you both nailed it.
     
  50. Eyefixer

    Eyefixer 10+ Year Member

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    Interesting discussion. I am not an anesthesiologist, but I used to work for TPMG for several years and had to leave due to move to So Cal. First of all, you guys have to know that different Kaisers are very different. TPMG is very different from SCPMG- one is a corporation, the other is a partnership. In 3 years, you hopefully become a shareholder at SCPMG and start getting a K1 instead of W2 thus all the tax benefits. At TMPG, you are a W2 employee forever. I have a very close anesthesiologist buddy at TPMG about 15 years in and it's all supervision. He hates it and counts days to retirement. By the way, at TPMG, earliest you can retire is 55 not 50 and I believe you have to do 30 years for full retirement benefits. Not sure about SCPMG, but probably similar.

    Overall, there are lots of benefits to being at Kaiser and lots of drawbacks. Once you become a shareholder, it's VERY hard to get rid of you. You also practically can not be sued. All patients sign arbitration agreement and vast majority of issues get settled quickly. Pension is also very nice and at TPMG it was roughly worth 3-4 M$ for someone making 3-400k. You get to keep your medical plan for life if you retire from KP. Now- you are cog in a wheel, absolutely no say in terms of how you practice. This is very rough mentally. Also, since everyone is on salary, docs quickly become very lazy. All docs, not just particular speciality. Goal in life become not to see parents at all costs. Another huge issue- your staff does not work for you and is all unionized. Your bonuses also depend in part on staff evaluations, so technically you work for them. Maybe not such a huge deal for anesthesia since you are not office based, but I am sure OR nurses get to evaluate anesthesiologists. I also hear that SCPMG now has a 16 billion $ pension fund short fall. How do you think they will be dealing with it?

    Overall, still very very competitive gig.
     
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  51. Scotty_G

    Scotty_G Junior Member 10+ Year Member

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    So who wins? Norcal vs Socal Kaiser :0
     

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