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.