NAPA in NY

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Anew4215

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I do locums and there are multiple sites in NY that NAPA has contracts for, they are often recruiting. These are in often desirable areas or at least mid size cities. Sites currently being recruited for include Hauppage (Long Island), White Plains (Westchester near NYC), Queens, Oceanside (near NYC) Astoria (NYC area), Staten Island, Syracuse, Niagara Falls, etc.

I'm wondering what folks experiences have been with NAPA in NY or if they're familiar with sites like these as I've seriously been considering working with them. I know it's only locums, but I definitely don't want to enter a bad assignment, or at least have a better idea of what to ask the site specifically to help screen if the assignment will be toxic or not.

It's weird these are such desirable areas in many ways, competitive salaries, 100k+ sign on bonuses in a number of them, yet so hard retaining staff...
 
Anew4215 said:
I do locums and there are multiple sites in NY that NAPA has contracts for, they are often recruiting. These are in often desirable areas or at least mid size cities. Sites currently being recruited for include Hauppage (Long Island), White Plains (Westchester near NYC), Queens, Oceanside (near NYC) Astoria (NYC area), Staten Island, Syracuse, Niagara Falls, etc.

I'm wondering what folks experiences have been with NAPA in NY or if they're familiar with sites like these as I've seriously been considering working with them. I know it's only locums, but I definitely don't want to enter a bad assignment, or at least have a better idea of what to ask the site specifically to help screen if the assignment will be toxic or not.

It's weird these are such desirable areas in many ways, competitive salaries, 100k+ sign on bonuses in a number of them, yet so hard retaining staff...
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It’s always bad management that is the issue at these places I have found.

Because I do so much locums. I get a feel why places are short staff.

My bff at Napa locums upstate New York and it’s messy at 2 places he covers for the past 6 years

Management issues. Always has been the case. Locations can change but if you have a bad management team. The problem will always exist.

Thus the w2 staff leave. A good manager will curb the work hours for the staff. Get them more money.

As locums you just come in and do your job.

What you want to ask is do you get paid for any training. Some places will give you no training and throw you in big cases of right away. It is what it is.
That’s just locums.
 
How are you so sure they need locums because they have issues retaining staff? Some of those places have anesthetizing locations that are growing in leaps and bounds. To aneftp's point just ask about the on site local leadership.
 
sbmed100 said:
How are you so sure they need locums because they have issues retaining staff? Some of those places have anesthetizing locations that are growing in leaps and bounds. To aneftp's point just ask about the on site local leadership.
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Because those prime location NAPA spots have not ever run to full capacity for over 10 years. Just ask yourself why?

Also Northwell has replaced NAPA in many of those Long Island and NYC sites.
 
sbmed100 said:
How are you so sure they need locums because they have issues retaining staff? Some of those places have anesthetizing locations that are growing in leaps and bounds. To aneftp's point just ask about the on site local leadership.
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Because we know multiple people that have worked there and left
 
I haven’t heard any good things about Napa. Their locums rate was comically low. My friend left Napa after 1 year for northwell and he likes it there… and I haven’t heard any good things about northwell either.
 
Ok as an update, they are now telling me they want me to agree to a 40 hrs guarantee for pay, but no OT until past 50 hrs, and potentially make me contract for at least 40 hrs preferably 50. It sounds like they want me to work for free for at least a day a week honestly...

This is at a "high needs site" with immediate availability and below market pay
 
Anew4215 said:
Ok as an update, they are now telling me they want me to agree to a 40 hrs guarantee for pay, but no OT until past 50 hrs, and potentially make me contract for at least 40 hrs preferably 50. It sounds like they want me to work for free for at least a day a week honestly...

This is at a "high needs site" with immediate availability and below market pay
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Very simple. Overtime starts after 8 hrs per shift. That’s how you fix it. Or 4 x 10. Restrict your time there

Or ask for 3x 12 and do another locums elsewhere in the 2 days you are off.

Just move on if they say no.

There are so many jobs everywhere these days.
 
I think they are always hiring. I don’t think they mind being short staffed since they can make the current full timers work more hours and take extra call for the same pay. I think they just advertise jobs with low pay for locums and full timers so they can give the illusion that they are trying to get more help and trick the full timers into staying
 
Simba1711 said:
I think they are always hiring. I don’t think they mind being short staffed since they can make the current full timers work more hours and take extra call for the same pay. I think they just advertise jobs with low pay for locums and full timers so they can give the illusion that they are trying to get more help and trick the full timers into staying
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You really think the full timers take extra call for the no extra pay.

Not the Napa in upstate New York. Those docs make extra pay for extra work

There is many gaming the system these days by full timers w2 to make extra cash. Some w2 full timers like it that way. So they can manipulate the schedule more.
 
I’m not sure I’ve never worked for private equity. hopefully they have a choice to work extra call and shifts instead of being forced to. My colleagues that work at other amcs tell me that the rate isn’t worth it. I’ve also seen people have to work extra for no change in pay because their contract doesn’t define specific hours and specific number of calls. Usually something ambiguous like “call is shared equally “

aneftp said:
You really think the full timers take extra call for the no extra pay.

Not the Napa in upstate New York. Those docs make extra pay for extra work

There is many gaming the system these days by full timers w2 to make extra cash. Some w2 full timers like it that way. So they can manipulate the schedule more.
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Simba1711 said:
I’m not sure I’ve never worked for private equity. hopefully they have a choice to work extra call and shifts instead of being forced to. My colleagues that work at other amcs tell me that the rate isn’t worth it. I’ve also seen people have to work extra for no change in pay because their contract doesn’t define specific hours and specific number of calls. Usually something ambiguous like “call is shared equally “
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You seem young

W2 staff at amc, at least the smart ones know how to game the system to their advantage. Most make close to 700k w2 (on a Napa contract that has the base contract around 550-600k) without adding a lot of extra overall hours to their workload.

For instance They pickup extra calls but aren’t working much more. Come in at 3p-7am for a Monday “extra call” an extra $2000 weeknight call

But you see their regular shift is usually 7-3 is Monday and Tuesdays anyways. So they bypass those two days.

They will put the locums doc on 7-3 both days. That’s extra w2 $2000 in their pocket without working extra hours plus they get the long weekend to come in at 3pm Monday.

You guys have a lot to learn

It all depends who the chief is. If you have a good chief who isn’t selfish and spreads the money around. Than it’s all good the extra cash being thrown arounr

Now a bad nasty chief will try to look good to Napa and say you can get the extra $2000 for Monday 3pm call. But force you to work 7-3p Monday as well for “free” than you get the $2000 for 3p-7a call Monday. That’s a bad chief not looking out for their w2 staff while short staff.

But the same chief will game it themselves and only take 3p-7am Monday call for $2000 only and not come in at 7am.
 
aneftp said:
You seem young

W2 staff at amc, at least the smart ones know how to game the system to their advantage. Most make close to 700k w2 (on a Napa contract that has the base contract around 550-600k) without adding a lot of extra overall hours to their workload.

For instance They pickup extra calls but aren’t working much more. Come in at 3p-7am for a Monday “extra call” an extra $2000 weeknight call

But you see their regular shift is usually 7-3 is Monday and Tuesdays anyways. So they bypass those two days.

They will put the locums doc on 7-3 both days. That’s extra w2 $2000 in their pocket without working extra hours plus they get the long weekend to come in at 3pm Monday.

You guys have a lot to learn

It all depends who the chief is. If you have a good chief who isn’t selfish and spreads the money around. Than it’s all good the extra cash being thrown arounr

Now a bad nasty chief will try to look good to Napa and say you can get the extra $2000 for Monday 3pm call. But force you to work 7-3p Monday as well for “free” than you get the $2000 for 3p-7a call Monday. That’s a bad chief not looking out for their w2 staff while short staff.

But the same chief will game it themselves and only take 3p-7am Monday call for $2000 only and not come in at 7am.
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If it’s such a great gig like you make it out to be why are they always understaffed. You’re also the only person who has said positive things about Napa. All other people that I know that worked there told me it sucks.
 
Simba1711 said:
If it’s such a great gig like you make it out to be why are they always understaffed. You’re also the only person who has said positive things about Napa. All other people that I know that worked there told me it sucks.
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People are gaming w2 jobs all the time these days when short staffed. Read my post. Read it closely. And then re read it again. And again.

I said you have a lot to learn. It all depends who the chief is and who is in charge

The goal is to maximize locums workload while minimizing w2 workload. It’s symbolic relationship between w2 and 1099 to co exist at same facility.
 
aneftp said:
Very simple. Overtime starts after 8 hrs per shift. That’s how you fix it. Or 4 x 10. Restrict your time there

Or ask for 3x 12 and do another locums elsewhere in the 2 days you are off.

Just move on if they say no.

There are so many jobs everywhere these days.
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Honestly I didn't try to negotiate it. I just said I'm shocked that's even a suggestion, I'd like to put this on hold for now. With their agreement, even if you commit to 40 hrs, you still sign away 10 hrs of OT rights.
 
Anew4215 said:
Honestly I didn't try to negotiate it. I just said I'm shocked that's even a suggestion, I'd like to put this on hold for now. With their agreement, even if you commit to 40 hrs, you still sign away 10 hrs of OT rights.
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Seriously? Why do you say that? Just work 4 days x 10 Monday -Thursday or Tuesday-Friday

Unless the rate is high like $425-450/hr already.
 
Salaries don’t matter without context being applied
I rarely get gaswork but briefly just looked at New York ads. It’s big money
Too many factors being applied

Biggest factor is
1. Taxes. Big time taxes in nyc

“New York’s top state income tax rate is 10.9 percent, and New York City imposes a tax of 3.876 percent, for a combined 14.776 percent rate on residents of the Big Apple. The top surtax would more than double that rate, to 29.776 percent, and the 20 percent federal tax on long-term capital gains income and the 3.8 percent Net Investment Income Tax yield a 53.576 rate on long-term capital gains and an astonishing 70.576 percent rate on short-term gains.”

Almost 15% of your income is exposed to ny city and state taxes if you make anywhere close to 1 million (13% for income between 200k-1 million)

So a 650k salary is equivalent to a 560k in Florida. (13% state/city income taxes)

2. No defined hours in schedule with those jobs. You could be working to 5pm most days no on call. So calls 5 x a month is essentially q6? But what are the days like? Are you working 645am-3pm most days? Or pre call? What time to leave? That stuff gets old.

Any job like that needs 15 weeks off these days.

So why can’t they fill it? Becuase you can do locums at $400/hr x 42 weeks equals 672k 1099 doing zero calls. Doing zero weekend plus ability to shield taxes with business deductions

That’s why they can’t fill the jobs.

The equivalent amc job in Florida pays 500-550k since no state income taxes with equivalent 10 weeks of q6 falls. Guess what? They can’t fill those jobs in Florida either. It’s nation wide this is happening.

Time and money. That’s what it all comes down to
 
aneftp said:
Seriously? Why do you say that? Just work 4 days x 10 Monday -Thursday or Tuesday-Friday

Unless the rate is high like $425-450/hr already.
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Because if they have no one to relieve me at 5 PM some days, I won't get paid unless I go substantially past 50 hrs in a week even if I'm scheduled for 40. And what if I ask to do 4 days, and the site says no, like they'll only do 5 days. Why am I even negotiating with a site that won't pay overtime unless I go over 50 hrs and I am only guaranteed 40 hrs pay
 
I can’t speak for the east coast, but Napa has had two sites in tx blow up recently. The way the contracts were written there were basically multiple ways to game the system and make much more $$ with little extra work.
Once Napa cracked down on it, basically everyone quit.
 
Anew4215 said:
Because if they have no one to relieve me at 5 PM some days, I won't get paid unless I go substantially past 50 hrs in a week even if I'm scheduled for 40. And what if I ask to do 4 days, and the site says no, like they'll only do 5 days. Why am I even negotiating with a site that won't pay overtime unless I go over 50 hrs and I am only guaranteed 40 hrs pay
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Don’t go there.

It seems you want the job for various reasons.

The laws of supply and demand. Just because they have needs. You want it more. It’s ur choice

If you are local to the area. Just get privileges at mutiple places and don’t go to that place if they aren’t meeting your demands

Again. Do not be a one trick pony. Have multiple gigs going at one time.
 
nycitygas said:
I can’t speak for the east coast, but Napa has had two sites in tx blow up recently. The way the contracts were written there were basically multiple ways to game the system and make much more $$ with little extra work.
Once Napa cracked down on it, basically everyone quit.
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Love it. crack down, the w2 docs leave. It’s a cat and mouse game.

There is very little incentive to being w2 these days. Unless you can work 30-35 hrs a week for 600k with 10 weeks off and limited weekends.

I’m covering locums this week. The w2 doc says he does on weekend (and it’s not a full weekend) every 10 weekends now since locums docs take most of the weekends for 20k Saturday and Sunday 10k each day

He doesn’t get money as w2. So he’s fine letting locums make that money. Win win for everyone.
 
aneftp said:
Love it. crack down, the w2 docs leave. It’s a cat and mouse game.

There is very little incentive to being w2 these days. Unless you can work 30-35 hrs a week for 600k with 10 weeks off and limited weekends.

I’m covering locums this week. The w2 doc says he does on weekend (and it’s not a full weekend) every 10 weekends now since locums docs take most of the weekends for 20k Saturday and Sunday 10k each day

He doesn’t get money as w2. So he’s fine letting locums make that money. Win win for ever
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I will say this-the salaries you are putting out there aren't realistic for many metro areas. There is nobody getting 600k 10 weeks off no weekends W2 in metro Texas.
 
nycitygas said:
I will say this-the salaries you are putting out there aren't realistic for many metro areas. There is nobody getting 600k 10 weeks off no weekends W2 in metro Texas.
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I guess LA, Dallas etc aren’t considered major metro areas.

Lol.

You are right. My bff is at 1.4 million in Dallas as 1099 locums now. The money is insane.

The hustle is on. He got offered 700k w2 weekday and turned them down.

I’m meeting him at his beach place in panhandle in 14 days. We will catch up.

You guys aren’t searching. Hard enough.

And yeah. I’ve spoken to a couple of people in Dallas taking 450-500k w2 I’m like wtf are you doing
 
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aneftp said:
Love it. crack down, the w2 docs leave. It’s a cat and mouse game.

There is very little incentive to being w2 these days. Unless you can work 30-35 hrs a week for 600k with 10 weeks off and limited weekends.

I’m covering locums this week. The w2 doc says he does on weekend (and it’s not a full weekend) every 10 weekends now since locums docs take most of the weekends for 20k Saturday and Sunday 10k each day

He doesn’t get money as w2. So he’s fine letting locums make that money. Win win for everyone.
Click to expand...

I do locums FT and would definitely head to Tx or GA, for a 30K weekend.
 
Lawsuits are always fun reading.



NAPA considers you an “asset”. Price yourself accordingly.

IMG_4650.jpeg
 
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nimbus said:
Lawsuits are always fun reading.



NAPA consider you an “asset”. Price yourself accordingly.

View attachment 405934
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Napa did the same thing in northern Virginia with a couple of hospitals and I think North Star took over mednax/napa one hospital.

It’s all blowing smoke and Napa for nothing when Northstar took over there for one place.

Another place in house w2 in Virginia and Napa ain’t got jack for that in terms of non compete money.

St Joe in Syracuse notorious for being short staff forever
 
Wasn’t it napa that had those lawsuits in NJ. I know they were involved in sevos practice falling apart- how are they still in business ? They seem like a disaster
 
NAPA came down to my area in the south and took over a private practice that had been successful with little turnover for years. Within a year there was a huge shortsge of crnas which led to much more work for doctors. A few months later almost all the doctors left and NaPa basically didn’t care to do anything. Will never work for them again
 
RedandBlack7 said:
NAPA came down to my area in the south and took over a private practice that had been successful with little turnover for years. Within a year there was a huge shortsge of crnas which led to much more work for doctors. A few months later almost all the doctors left and NaPa basically didn’t care to do anything. Will never work for them again
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It’s hard to run anesthesia and try to shave 30% off the top. These management companies need at least 20% off the top to be profitable to pay their own ceo, medical directors, salaries.

The medical directors are likely less than 10-15% clinical as well.

There is no profit in anesthesia anymore. That’s why hca and other hospitals have kicked out or ended contracts with Envison where it doesn’t make any sense to pay Envison a 12-20% management fee. Yes. 12% is one of Envison management fees. That’s low but still 12% is 12% a hospital can save.
 
You know who else is from NY? Diddy. Have you heard that he was acquitted on the most serious of his charges?
 
NicholasPavona said:
You know who else is from NY? Diddy. Have you heard that he was acquitted on the most serious of his charges?
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All bs charges.

I taked to one of my prosecutor friends up north. It’s just amazes ideology of some of these prosecutor.

My friends says regardless if Diddy was being targeted. He’s guilty because he did it.

Ok…it means the govt can go after anyone they want and that’s why Joe Biden pardon his family.

Becuase I know my prosecutor friend cheats on his taxes cause he’s married to my cousin. And they shady tax deductions also

It’s hypocrisy of the world we live in. Regardless if u like Diddy ttrump hunter biden , etc.
 
aneftp said:
My friends says regardless if Diddy was being targeted. He’s guilty because he did it.

Ok…it means the govt can go after anyone they want and that’s why Joe Biden pardon his family.

Becuase I know my prosecutor friend cheats on his taxes cause he’s married to my cousin. And they shady tax deductions also
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I think you need a reality show on Bravo.
 
FatKid said:
Lawsuits are very valuable for Docs to read. You can see how the Hospitals and AMCs truly view us…

Just recently, HCA said in a legal filing that they have no obligation to provide “quality healthcare” in their lawsuit against Mission Health in Asheville, NC.
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Just read the first 8-10 pages and follow the money. All roads lead to NAPA. You residents should learn about this business of Medicine. It’s a dirty game, if you don’t read the contract you sign.
 
FatKid said:
Lawsuits are very valuable for Docs to read. You can see how the Hospitals and AMCs truly view us…

Just recently, HCA said in a legal filing that they have no obligation to provide “quality healthcare” in their lawsuit against Mission Health in Asheville, NC.
Click to expand...
Wow. They said that? What’s going on in Asheville? I hear from a friend of mine they’re desperate for locums but won’t pay and are running extended care team/firefighter craziness… I hear it’s quite malignant at the moment… anyone know what’s up? I’ll I’ve heard is second hand
 
amyl said:
Wow. They said that? What’s going on in Asheville? I hear from a friend of mine they’re desperate for locums but won’t pay and are running extended care team/firefighter craziness… I hear it’s quite malignant at the moment… anyone know what’s up? I’ll I’ve heard is second hand
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Near my neck of woods in TN. Been like that for a while. Even prior to Helene they were most independent crna practice in state though. CRNAs do lines, float swans for cardiac…huge cardiac volume too…near 1000 pump cases a year.

Prior to Helene MDs ate the lower salaries as it was Asheville. Now between Helene and higher cost of living they are leaving in droves. HCA did do a raise but it’s not enough. Asheville lost some of its charm so can’t rely on that. Prisma is paying higher in Greenville (6-700) which is arguably nicer and 90 minutes away.

Honestly need to get an amc or something to take over. That wouldn’t be great either but better than hca
 
Direct Laryngoscopy said:
Just read the first 8-10 pages and follow the money. All roads lead to NAPA. You residents should learn about this business of Medicine. It’s a dirty game, if you don’t read the contract you sign.
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And you should treat it as a business and leave when the time clock it up. Unless it’s some dire emergency case. 99% of surgery cases are elective. Don’t bend over backwards to do another case or stay later.

I just uber surge price gouge a place for last min coverage. When my buddy would have done it 1/2 the cost. I’m face palming myself why he doesn’t value his services.

I have no emotion when I do it. It’s business. We can still be professional about it.

Just remember there is no loyalty in this business.
 
aneftp said:
And you should treat it as a business and leave when the time clock it up. Unless it’s some dire emergency case. 99% of surgery cases are elective. Don’t bend over backwards to do another case or stay later.

I just uber surge price gouge a place for last min coverage. When my buddy would have done it 1/2 the cost. I’m face palming myself why he doesn’t value his services.

I have no emotion when I do it. It’s business. We can still be professional about it.

Just remember there is no loyalty in this business.
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100% correct.

Unfortunately, in 2025, Medicine is no longer a calling, it is a business.
 
aneftp said:
Most definitely. We are the prize.

Literally in locums nirvana. Another doc just resigned from this place I’ve been covering for 4 years. It’s endless. It’s pick a shift. Show up anytime lol. Like Burger King. Have it your own way now.
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Only problem is credentialing is a pain in the butt and 90 days each time...
 
2Fast2Des said:
Only problem is credentialing is a pain in the butt and 90 days each time...
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That’s why u gotta have mutiple active privileges going at any one time.

Just be organized. It’s basically 99% the same stuff.

I usually complete my new credential paperwork in less than one hour.

Remember to ask for updated case logs like once every 18 months.
 
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