Management Companies - SE

[CrazyJake]

Doubt I do it, but considering move to southeast for fresh start and to be closer to brother.

Have briefly spoken with American and ApolloMD....as they are best located in preferred area. Of course they make it sound incredible. Of course.

Any feedback would be appreciated. deep inside I keep hearing run,run,run.

CJ

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[norwood]

AMC's = run, run, run.

 

[gasdoc77]

Can only speak for Northstar. The goalposts WILL move after you are there and settled. Predators.

 

[CrazyJake]

I feel sure its not good. I'm only guessing people work for these companies b/c geographically they have to be there. Maybe some are happy...don't know.

It's been a few years, but I have heard horror stories about American in NC. Buddy took a job with them....he realized rather quick that he got suckered.

 

[aneftp]

Well the big NC group that sold themselves out was screwing over junior attending for years. So lets not make this that only management companies screw young attending. It happens in private practice all the time.

The group down in Florida that sold themselves (or "merged" cough cough with private equity money 2.6 million per partner ($600K held). Surprise they haven't been hit with sex discrimination when you looked at their group of "partners". Like a good ole boys club.

Private practice groups have screwed many junior attending over for decades.

Saying all that, it is what it is with AMCs. Take it or leave it. The only real advantage of working for American Anesthesiology is they are self insured (same with Sheridan). Which means you are free to leave without worrying about paying your malpractice tail.

Look at the contract closely. Look at their non compete miles radius very closely. In my opinion if you are a straight W2, you should have a non compete in anesthesia. It's not like you are "stealing" patients and causing harm to the company hiring you.

Apollo MD is a little more "creative" with their pay structure. Watch them very closely. Not all their contracts are the same. Some are straight forward W2, some are 1099 set pay, some are billed per unit rate (except Apollo MD sets the rate....say they will pay you $27/unit (this is a real rate by the way so it's not a made up rate). Obviously Apollo is probably averaging $40-45/units (when you account for private/medicare/medicaid patients). So Apollo is definitely shaving 30-40% off your work).

 

[norwood]

In my opinion if you are a straight W2, you should have a non compete in anesthesia.

From the rest of what you wrote, you mean "should not", right? I'd certainly agree. Only purpose of noncompetes in anesthesia is to prevent people from leaving a job once they realize they've gotten suckered. The more onerous they are, the more I assume the company is hiding something.

 

[aneftp]

From the rest of what you wrote, you mean "should not", right? I'd certainly agree. Only purpose of noncompetes in anesthesia is to prevent people from leaving a job once they realize they've gotten suckered. The more onerous they are, the more I assume the company is hiding something.

Yes. I meant "should not". I am very leery of non competes. Especially a straight W2 job with no chance for partnership. Or a very limited no compete (say 1 mile radius).

Saw one of American anesthesiology non compete once before and it was like 30 miles (in a major metro area on east coast). It's like you got to be kidding me. That 30 miles radius covered 10 hospitals and multiple surgery centers).

 

[norwood]

Yes. I meant "should not". I am very leery of non competes. Especially a straight W2 job with no chance for partnership. Or a very limited no compete (say 1 mile radius).

Saw one of American anesthesiology non compete once before and it was like 30 miles (in a major metro area on east coast). It's like you got to be kidding me. That 30 miles radius covered 10 hospitals and multiple surgery centers).

UPMC was also infamous for extremely onerous (50 miles, IIRC?) noncompetes.

IMHO the only noncompete that isn't antisocial is one that forbids working at the same facility minus the group, to make it harder to replace the group. Anything else is just there to punish people for leaving.

 

[CrazyJake]

Good info and I fully agree that there are plenty of private groups screwing over young partners.

Hopefully we'll get some more insight. I'd be shocked with someone replying loving their AMC.

I have great job now, just not geographically ideal. Gut still says run, run, run.

 

[BLADEMDA]

In Florida retention rates for Anesthesiologists employed by AMCs were notoriously poor in the past. These days retention rates are high with most NOT moving around very much. What do you think that says about the field of anesthesia?

Instead of bitching about AMCs I suggest finding a good practice with good people even if they are owned by an AMC.

 

[norwood]

I suggest finding a good practice with good people even if they are owned by an AMC.

Blade, do you mean there are practices that AMCs buy but don't operate in the AMC model? I'd once seen one that Sheridan sorta-kinda operated, but apparently let do its own thing. But that one doesn't exist anymore, and I can't think of any others along those lines.

 

[BLADEMDA]

Blade, do you mean there are practices that AMCs buy but don't operate in the AMC model? I'd once seen one that Sheridan sorta-kinda operated, but apparently let do its own thing. But that one doesn't exist anymore, and I can't think of any others along those lines.

The larger AMC practices are managed at that location by the docs. The AMC controls the flow of money (salary, benefits, etc) but the docs have a bigger say in hours worked, call schedule, days off, etc.

 

[criticalelement]

The larger AMC practices are managed at that location by the docs. The AMC controls the flow of money (salary, benefits, etc) but the docs have a bigger say in hours worked, call schedule, days off, etc.

You are still working for a management company and the job security is not there. Termination without cause clause (instantly) is the norm. HOw does one sign one of these with a straight face.

 

[aneftp]

In Florida retention rates for Anesthesiologists employed by AMCs were notoriously poor in the past. These days retention rates are high with most NOT moving around very much. What do you think that says about the field of anesthesia?

Instead of bitching about AMCs I suggest finding a good practice with good people even if they are owned by an AMC.

Blade. A lot of retention has to do with sheridan fully staffs most of their locations these days.

In the past (way past) like when I looked at a few sheridan jobs in South Florida circa 2007. Those jobs are very understaffed. MDs were having to work post call. Instead of having a 8 MDs , 7 Crna staffing. One place had 6Mds and 7 crnas. So sheridan was having to use locums to fill those 2 MDs slots. Some weeks they would have locums. Some they wouldn't.

So those hours start to pile on (having to work post call). But these days the working conditions are much better since staffing is full. That's why less moving around. People tend to work roughly 50 hours a week fultime these days at sheridan at
Most of their places. In the past 60-65 hour work weeks were more common since they were short.

Now places say where NAPA has taken over (philly area). Some of those places. Fultime MDs are getting hosed working call every 2 or 3 days in 2015 even with the tight job market. Napa can't retain MDs and working conditions are getting worst at a few of their newly acquired hospitals. Who knows if it will take them 1 year to stabilized a new practice.

So blade. It all depends on various factors. Locations, staffing and of course pay. If you are getting lower pay and still working their butt off, people aren't going to stay. That's what it says about the anesthesia market. It's one thing being paid $270-300k in south Florida W2 working 50 hours roughly a week. It's another thing getting paid $325-350k w2 up northeast and working 60-65 hours. I see more people leaving that slightly higher paying and northeast job because of the work conditions.

No one as we age can work 60-65 hours fultime (especially in their 50s or older) at a level 2 hospital where rooms are constantly running to 12-2am. Even younger ones say F this. Easier just to move and leave the area.

 

[BLADEMDA]

You are still working for a management company and the job security is not there. Termination without cause clause (instantly) is the norm. HOw does one sign one of these with a straight face.

Why would they terminate you without cause? How does it benefit the AMC to fire a productive employee? It's not like the new hire will be cheaper or do better clinical work. I suspect the AMC fires the malcontents and those unwilling to follow the rules or do their job.

 

[BLADEMDA]

Resolute Anesthesia and Pain Solutions Welcomes Two Practices

Boca Raton, Florida; July 8, 2014 —
Resolute Anesthesia and Pain Solutions, LLC (“Resolute”), a leading provider of anesthesia and interventional pain management services, today announced the acquisitions of Perth Amboy Anesthesiology, P.C., based in Perth Amboy, New Jersey and St. Lucie Anesthesia Associates, LLC, based in Port St. Lucie, Florida.

Founded in 1994, Perth Amboy Anesthesiology. P.C. (“PAA”) employs 23 physicians who provide anesthesia services at Raritan Bay Medical Center, with locations in Perth Amboy and Old Bridge, NJ, and six Ambulatory Care Surgery Centers. “Our priority has always been our patient care,” said David Handlin, M.D. and Andrew Citron, M.D., co-founders of PAA, “and joining Resolute will provide access to significantly greater clinical and administrative resources that will allow us to focus on clinical care.”

St. Lucie Anesthesia Associates, LLC (“SLAA”) employs 8 physicians and 13 CRNAs, providing anesthesia services at St. Lucie Medical Center and two ASCs. “In joining Resolute, we are able to partner directly with Resolute physicians already providing anesthesiology and pain management services in our local market, as well as gain access to Resolute’s practice support infrastructure and resources,” said Julie Crispin, M.D. and Stephanie Drabin, M.D., co-founders of SLAA.

“Resolute is pleased to add two established physician practices that share our values regarding patient focus, clinical excellence and physician leadership,” said Brian Gillon, CEO of Resolute. “Our partnership with PAA provides Resolute with entrance into a new geographic market, and with SLAA, we expand our already significant presence in the Florida market.”

 

[BLADEMDA]

CRNA
Sheridan Healthcare, Inc. Port Saint Lucie, FL, 34953
Posted 13 days ago
Sheridan Healthcare is currently seeking qualified CRNAs for full-time opportunities at St. Lucie Medical Center, located in Port St. Lucie, Florida. St. Lucie Medical Center (SLMC) is a 229-bed hospital offering a full range of acute care services, including rehabilitation, obstetrics, inpatient and outpatient surgery and services. Its Orthopedic Center of Excellence is considered one of the best...
Job details & apply
Anesthesiologist
Sheridan Healthcare, Inc. Port Saint Lucie, FL, 34953
Posted 13 days ago
Sheridan Healthcare is currently seeking qualified Anesthesiologists for full-time opportunities at St. Lucie Medical Center, located in Port St. Lucie, Florida. St. Lucie Medical Center (SLMC) is a 229-bed hospital offering a full range of acute care services, including rehabilitation, obstetrics, inpatient and outpatient surgery and services. Its Orthopedic Center of Excellence is considered one...
Job details & apply

 

[BLADEMDA]

It appears Resolute only had the St. Lucie Medical Center contract for less than 1 year before Sheridan took over. That's quite a turnover even for an AMC.
Anyone know why Resolute lost the contract so fast?

 

[Mman]

I have a friend from residency that works at a group that was taken over by American. They were not included in the buyout but they are still happy with their current working conditions/salary as it isn't far off (maybe 20% less) from what they would've made as a partner in the group before it got bought out.

I suspect American isn't a bad company to work for provided you are happy being an employee. And as mentioned above, every location is managed by the physicians locally. It's the collections and pay that are handled by the corporate office and they only get involved locally if their is a dispute over things like call or hours that can't be resolved by the docs working there.

 

[aneftp]

It appears Resolute only had the St. Lucie Medical Center contract for less than 1 year before Sheridan took over. That's quite a turnover even for an AMC.
Anyone know why Resolute lost the contract so fast?

More has to do with the current anesthesia local leaders within PSL that admin wants gone. At least that's what one of crnas who used to work there told me.

Anyways resolute isn't going down without a fight as they are demanding $$$$ for non compete to retain most of current staff.

Big fish fighting big fish. Love it. Sheridan desperately trying to get people credentialed and Florida hospitals are notorious for slow credendialing time.

 

[aneftp]

Not that I am pro AMC. But I have know quite a few people burned on both 3 and 5 year partnership tracks in the mid 2000s.

At least with AMCs you sorta of know ur place.

In the early 2000s most big partnerships in northeast were still paying their young grads roughly 200k year, 220k second year and 240k third year. Partners were making $450-550k.

Many of these practices would string their young along and recruit the next round of suckers.

In my opinion these groups are even worst than AMCs. Most of these top loaded groups are the same ones selling out.

At least the new grad knows what they are getting these days.

So much uncertainly in private practice on partnership tracks in the past with many groups preying on newly minted MDs without a clue.

 

[Mman]

So much uncertainly in private practice on partnership tracks in the past with many groups preying on newly minted MDs without a clue.

I don't think it has to be that way. When negotiating your partnership track contract, you could force them to include language entitling you to a percentage of any future buyout if they sell. Maybe ramp it up per year worked. If they sell in the first 12 months then you get 33% share, next 12 months you get 66%, etc.

If they were reluctant to include such language, they were probably already planning on screwing you. If they didn't intend to screw you, they probably wouldn't mind having that clause.

 

[aneftp]

I don't think it has to be that way. When negotiating your partnership track contract, you could force them to include language entitling you to a percentage of any future buyout if they sell. Maybe ramp it up per year worked. If they sell in the first 12 months then you get 33% share, next 12 months you get 66%, etc.

If they were reluctant to include such language, they were probably already planning on screwing you. If they didn't intend to screw you, they probably wouldn't mind having that clause.

Google didn't exist in the mid 1990s when my brother and sister signed their anesthesia partnership contracts.

These Internet blog /student doctor forums weren't readily available even in the early to mid 2000s. It's only within the last 7-8 years many of these "forums" have exploded in popularity combined with google searches.

So fresh grads really don't have the same type of information many residents have these days.

If this type of information were available to fresh grads in the late 90s early 2000s with less supply and more demand. Groups like my sister old screwing new grads after 5 year partnership tracks would have been set straight more earlier if word got out on the street no one became partner unless they were a certain religion/faith. Or a certain group in central Florida routinely abusing it's new grad. Notice how that same group sold out to a big management company recently. That group (and its 2-3 partners) knew the writing was on the wall. They took the cash rather than lose everything and have nothing

But now the market is completely different with more supply than demand. Groups do what they want to do.

 

[2ndyear]

I don't think it has to be that way. When negotiating your partnership track contract, you could force them to include language entitling you to a percentage of any future buyout if they sell. Maybe ramp it up per year worked. If they sell in the first 12 months then you get 33% share, next 12 months you get 66%, etc.

If they were reluctant to include such language, they were probably already planning on screwing you. If they didn't intend to screw you, they probably wouldn't mind having that clause.

While I don't disagree with you in the theory of not wanting to screw new docs, the current market doesn't dictate a job candidate being able to force any kind of language of being entitled to money in a buyout when not a partner. One could always ask, but I suspect the answer would fairly universally be 'no'. Like anything, there are risks and benefits to partnership track positions, including the group not being around when you make partner. The whole concept of private equity money buying groups is fairly recent, and there are still groups that just plain lose contracts to other groups or become hospital employed with no money changing hands.

 

[Mman]

While I don't disagree with you in the theory of not wanting to screw new docs, the current market doesn't dictate a job candidate being able to force any kind of language of being entitled to money in a buyout when not a partner. One could always ask, but I suspect the answer would fairly universally be 'no'. Like anything, there are risks and benefits to partnership track positions, including the group not being around when you make partner. The whole concept of private equity money buying groups is fairly recent, and there are still groups that just plain lose contracts to other groups or become hospital employed with no money changing hands.

I never said a job candidate could "force any kind of language". But they should ask. A group that is completely above board would probably be OK with it. We ourselves have started including such language in our contracts for partnership track physicians so they know ahead of time what our intentions are. We have no plans of "selling out". But none of us can predict the future. If some AMC offered me $10M after tax to walk away, I'd probably do it no questions asked. And in that scenario, I'd like to take care of our partnership track docs and not just leave them hanging in the wind.

 

[criticalelement]

A group that is completely above board would probably be OK with it. .

That is exactly the point. They are not above board. The only thing the entity is concerned about is MONEY. Thats it!!! NOTHING ELSE. IF you think they care about you it is only insofar as you making money for them. PEriod. That is the structure in anesthesia.

 

[criticalelement]

Why would they terminate you without cause? How does it benefit the AMC to fire a productive employee? It's not like the new hire will be cheaper or do better clinical work. I suspect the AMC fires the malcontents and those unwilling to follow the rules or do their job.

Blade,
Cuz they dont like you. Thats why they would fire you. As long as they dont fire you for the protected civil entities.
I know a gentleman personally who was working for a group. He was in the 3 or 4th year or a partnership. The partners sold out to a large group. He made some noise. As he should have. The next week he was fired... being escorted out of the hospital.. ALl legal. They fired him on the spot. Just like he was a MCdonalds employee. All legal. They exercised their NO cause termination.

 

[Mman]

That is exactly the point. They are not above board. The only thing the entity is concerned about is MONEY. Thats it!!! NOTHING ELSE. IF you think they care about you it is only insofar as you making money for them. PEriod. That is the structure in anesthesia.

Incorrect. You can't speak to the inner workings of every anesthesiology group in the country. We've turned down short term profit to maintain our independent practice. Other groups have done the same. You can't lump everybody in together unless you want to talk about humans on the whole. All people are basically greedy and look out for themselves.

 

[aneftp]

Blade,
Cuz they dont like you. Thats why they would fire you. As long as they dont fire you for the protected civil entities.
I know a gentleman personally who was working for a group. He was in the 3 or 4th year or a partnership. The partners sold out to a large group. He made some noise. As he should have. The next week he was fired... being escorted out of the hospital.. ALl legal. They fired him on the spot. Just like he was a MCdonalds employee. All legal. They exercised their NO cause termination.

Depends on the no cause termination clause in contract.

Most employment contracts have termination without clause ranging anywhere between 30-90 days. Now there are a few with termination without clause less than 14 days.

I highly doubt they would let someone go (immediately) without cause if they a 60-90 day clause. The group would essentially be paying someone a nice termination with pay If they did that.

And you mentioned some emoloyee making "noise". No one likes trouble makers. So there was a reason group didn't want them. That's why they were let go. Obviously there is more to the story than what you are saying.

1. What was the termination without clause in their contract (0 days to 90 days?). I'd like to know. If it's zero days, than the gentlemen making noise dug his own grave knowing he could be let go without further compensation.

 

[criticalelement]

Incorrect. You can't speak to the inner workings of every anesthesiology group in the country. We've turned down short term profit to maintain our independent practice. Other groups have done the same. You can't lump everybody in together unless you want to talk about humans on the whole. All people are basically greedy and look out for themselves.

i am correct. An anesthesia group wont let you set terms of your own contract to their detriment. Unless they are hard pressed to find anyone else which is NOT the case in this climate. SORRY Charlie! They put in a termination without CAUSE to protect THEM not YOU. Do you understand that? YOu can choose to sign or not. As long as people are signing this they wont change it.

 

[criticalelement]

And you mentioned some emoloyee making "noise". No one likes trouble makers. So there was a reason group didn't want them. That's why they were let go. Obviously there is more to the story than what you are saying.

1. What was the termination without clause in their contract (0 days to 90 days?). I'd like to know. If it's zero days, than the gentlemen making noise dug his own grave knowing he could be let go without further compensation.

When I say make noise, I mean voicing your opinion as to how things should run which is your perogative as a physician. YOu WANT that. You dont want people who just go along to get along. How can you possibly be a professional when you are employed and have a no cause termination in your contract.

 

[Mman]

i am correct. An anesthesia group wont let you set terms of your own contract to their detriment. Unless they are hard pressed to find anyone else which is NOT the case in this climate. SORRY Charlie! They put in a termination without CAUSE to protect THEM not YOU. Do you understand that? YOu can choose to sign or not. As long as people are signing this they wont change it.

Since I'm in a group that is doing the hiring, I'm going to disagree with you. Every single person we've ever hired has been a negotiation for what the contract exactly spells out. We've never had anybody ask for something outrageous to be added. We've gone along with some minor provisions individual candidates wanted added in.

 

[anbuitachi]

Since I'm in a group that is doing the hiring, I'm going to disagree with you. Every single person we've ever hired has been a negotiation for what the contract exactly spells out. We've never had anybody ask for something outrageous to be added. We've gone along with some minor provisions individual candidates wanted added in.

man i want to work for your group

 

[Mman]

man i want to work for your group

There are still good groups out there. We are handicapped by being in a geographic area very few people want to live in. When you search for a job, you gotta compromise. Our partners have essentially all given up on living in a nice geographic area in exchange for a well run and well compensated group. We maintain our sanity by taking lots of vacation so you can go have fun elsewhere.

 

[Arch Guillotti]

I never said a job candidate could "force any kind of language". But they should ask. A group that is completely above board would probably be OK with it. We ourselves have started including such language in our contracts for partnership track physicians so they know ahead of time what our intentions are. We have no plans of "selling out". But none of us can predict the future. If some AMC offered me $10M after tax to walk away, I'd probably do it no questions asked. And in that scenario, I'd like to take care of our partnership track docs and not just leave them hanging in the wind.

I usually agree with you but disagree for the most part on this point. I think it is fine to ask for a provision in case of buyout but I doubt there are many groups that would oblige. I find it hard to believe that you are putting a provision in a contract about an event that may not even occur. Props to your group for doing so.

 

[aneftp]

When I say make noise, I mean voicing your opinion as to how things should run which is your perogative as a physician. YOu WANT that. You dont want people who just go along to get along. How can you possibly be a professional when you are employed and have a no cause termination in your contract.

So you are telling me this guy worked with a contract that stayed zero (0) days clause for termination without clause?

Please clarify. Even most locums contract have 30 days termination clause without clause.

I've seen a couple of contracts in Florida with a 2 weeks no cause termination.

But for a group (or management group) to have a zero day "no cause termination" seems awful strange. Because it cuts both ways where the employee gets the same clause (aka if my contract states zero says termination without clause). I could literally tell my emoloyer I am done and not showing up to work.

This would leave the employer at a huge disadvantage in terms of staffing.

 

[Mman]

I usually agree with you but disagree for the most part on this point. I think it is fine to ask for a provision in case of buyout but I doubt there are many groups that would oblige. I find it hard to believe that you are putting a provision in a contract about an event that may not even occur. Props to your group for doing so.

If a group wouldn't oblige, I'd suggest they are looking to sell out and screw you over in the short term. If they have no plans on selling out any time soon (and keep in mind a partnership track position is only 2-4 years on average), it literally means nothing to them. Keep in mind that a group selling out to an AMC is usually a 9-24 month process. It doesn't happen overnight.

Like I said, I wouldn't expect all groups to honor such a request. To me, however, it'd be a big red flag if they didn't want to and it might affect my desire to work with them in the first place.

 

[criticalelement]

Since I'm in a group that is doing the hiring, I'm going to disagree with you. Every single person we've ever hired has been a negotiation for what the contract exactly spells out. We've never had anybody ask for something outrageous to be added. We've gone along with some minor provisions individual candidates wanted added in.

Fine. The candidates can negotiate their pay, hours and the such. But most certainly you wont let them remove the "termination without cause" clause.

 

[criticalelement]

So you are telling me this guy worked with a contract that stayed zero (0) days clause for termination without clause?

Please clarify. Even most locums contract have 30 days termination clause without clause.

I've seen a couple of contracts in Florida with a 2 weeks no cause termination.

But for a group (or management group) to have a zero day "no cause termination" seems awful strange. Because it cuts both ways where the employee gets the same clause (aka if my contract states zero says termination without clause). I could literally tell my emoloyer I am done and not showing up to work.

This would leave the employer at a huge disadvantage in terms of staffing.

Let me clarify. Without cause termination has typically a 30 day notice (vis a vis locum companies). With cause termination (typically in every AMC contract) is pretty much immediate. (Read. They can make up anything about you. Substandard care, hostile behavior, etc etc. And substandard care can be anything. Missed IVS,(this is what they usually bring forth), patient complaints, staff complaints...

This is what the hospital wants. Ability to get rid of anesthesia personell at will.

There is no way you can negotiate away termination clauses. Without or with cause.

 

[criticalelement]

Let me clarify. Without cause termination has typically a 30 day notice (vis a vis locum companies).
This is the hospital or AMC tells you that they dont need you after (30 days from now). Nothing you can do about this. With cause termination (typically in every AMC contract) is pretty much immediate. (Read. They can make up anything about you. Substandard care, hostile behavior, etc etc. And substandard care can be anything. Missed IVS,(this is what they usually bring forth), patient complaints, staff complaints...

This is what the hospital wants. Ability to get rid of anesthesia personell at will.

There is no way you can negotiate away termination clauses. Without or with cause.

 

[Mman]

Fine. The candidates can negotiate their pay, hours and the such. But most certainly you wont let them remove the "termination without cause" clause.

I haven't said one word about terminating with or without cause in this thread. I'm in a right to work state. People can be terminated for no reason at any point here and it has nothing to do with a contract. When we do that, we choose to pay them for an additional 2-6 weeks depending on the circumstances.

 

[aneftp]

Let me clarify. Without cause termination has typically a 30 day notice (vis a vis locum companies).
This is the hospital or AMC tells you that they dont need you after (30 days from now). Nothing you can do about this. With cause termination (typically in every AMC contract) is pretty much immediate. (Read. They can make up anything about you. Substandard care, hostile behavior, etc etc. And substandard care can be anything. Missed IVS,(this is what they usually bring forth), patient complaints, staff complaints...

This is what the hospital wants. Ability to get rid of anesthesia personell at will.

There is no way you can negotiate away termination clauses. Without or with cause.

You are making zero sense.

You stated someone you knew was fired without clause immediately.

Yes or no?

That is what you wrote. Aka someone was fired without clause and escorted off that same day.

And no, it's very difficult to fire a professional "with cause". Extremely difficult short of incompetence and it's very hard to prove incompetence. Because that person would drag the entire group down with them. Aka you fire someone "with clause" you gotta have reasons.

If you try to claim they are incompetence. You better have all ur documentation down. It will bite the group if the fired employee proves you wrong.

Cause in point. My friends group wanted to fire one guy. They made a list of fire able offense
1. Code blue in room
2. Multiple times tardy for work.
3. Airways problems.

Cool right?

Nope. The dude was keeping tabs on his fellow colleagues. Ran a list of issues they had as well over the past 12 months. Consulted attorney. Grouped lawyered up. Ended up giving him 30 days pay to make the problem go away.

People aren't dumb these days. Try to fire someone with cause. You better have ur ducks in a row. It will end up costing u more in the long run if you don't.

 

[aneftp]

I haven't said one word about terminating with or without cause in this thread. I'm in a right to work state. People can be terminated for no reason at any point here and it has nothing to do with a contract. When we do that, we choose to pay them for an additional 2-6 weeks depending on the circumstances.

That's usually the end result if a group wants someone gone asap.

My buddy got paid 2 months when they let him go immediately back in 2006.

Another guy 17 months ago got in huge argument with surgeon. Group knew he was hot head. He got paid for last 8 weeks as well.

It's just a pain to deal with legal consequences from a fight with termination without clause if someone has a 30-60-90 day notice period. Just easier to just pay some or most of that time period off and move on.

The instances I do know someone was fired for cause had to do with criminal or drug activity. (Crna breaking into ex boyfriend neurosurgeon's house and stealing stuff, MD shooting up fentanyl in locker room while on duty (second offense).

 

[anbuitachi]

man it sucks that anesthesiologists get fired just for having a big argument with a surgeon

 

[gasdoc77]

man it sucks that anesthesiologists get fired just for having a big argument with a surgeon

It simply reiiterates the fact that the only order of importance for anesthesia to the OR is
1. Availability
2. Affability
3. Ability
Otherwise, right or wrong, they could care less what the credentials the person sitting there may or may not have. It's merely who will fill that criteria the cheapest. A race to the bottom.

 

[aneftp]

man it sucks that anesthesiologists get fired just for having a big argument with a surgeon

It doesn't suck.

They tried to fire my buddy unless he took anger management "therapy". His reply was that the surgeon needed the same anger management therapy. Both were hot heads.

They told my buddy not to come back. First they thought they wouldn't pay him at all. He lawyered up. They tried to say two weeks pay. Than one months pay. Nope. No. He got full 60 days pay.

Because hospital knew surgeon had huge anger issues himself. If they let go buddy for anger management. My buddy had 4-5 OR nurses ready to go with written statements about surgeon history of anger.

Case close. 60 days pay as per contract even though he was told to go home "immediately".

Again it's very difficult to fire someone with clause. Very. Sort of MD being a danger to the public or patient. Or committing fraud, criminal activity etc.

 

[PracManCA]

Interesting thread. It is quite interesting how some perceptions of AMCs have changed just in the past 5 years on this board.

 

[deleted126335]

Interesting thread. It is quite interesting how some perceptions of AMCs have changed just in the past 5 years on this board.

Denial...Anger...Bargaining...Depression...Acceptance.

 

[criticalelement]

You are making zero sense.

You stated someone you knew was fired without clause immediately.

Yes or no?
.

Im sorry the gentleman I know was fired FOR (WITH) CAUSE. So they trumped up something on him. He sued actually.......spentabunch of money . So you are right. I was making NO SENSE. I hope that cleared things up. When they get rid of you FOR CAUSE... no notice needed. aneft is correct if you fight back they may relent. IF they do not, are you willing to go the distance? Pay a lawyer 300 per hour to look into this for you? HOw much do they owe you? People will google your name and find out how much of an as shole they thought you were. I am not saying it's not worth it. It may be.

 

[aneftp]

Im sorry the gentleman I know was fired FOR (WITH) CAUSE. So they trumped up something on him. He sued actually.......spentabunch of money . So you are right. I was making NO SENSE. I hope that cleared things up. When they get rid of you FOR CAUSE... no notice needed. aneft is correct if you fight back they may relent. IF they do not, are you willing to go the distance? Pay a lawyer 300 per hour to look into this for you? HOw much do they owe you? People will google your name and find out how much of an as shole they thought you were. I am not saying it's not worth it. It may be.

There are always two sides to every story. I don't know the specific situation why that person you mentioned got fired. Most groups don't bother getting rid of someone "for cause". It just becomes too messy especially if 2-3 months salary is involved.

Most MDs have money. Lawyer retainer for these type of causes is generally $2000-3000 up front. My buddy got around a 55k lump payment (2 months salary) plus forced a letter from old employer saying employee parted mutual ways with employer and big penalty ($180k per event) if any disparaging remarks for any cross reference checks for future employment. This is serious stuff if you feel like you were wrongfully terminated. Lawyer up. And my friend took on a big state University system with millions in their war chest for legal fees to spend if they wanted to. The university chose to just pay up. Imagine a small employer trying to fight off a wrongful termination (with cause). It's more headache and easier just to pay out the notice period income loss.

And no. Not everything is "google able". There are strict confidentially agreements.

Like I said, there is usually more to the story in your example.

But if you were at fault urself (personality issues, racists remarks, incompetence). Than that's a whole different issue.