OC/LA Groups (Sanitized Version)

[Peterluger]

Confirming some of the info about the group in Santa Monica above. At the rate they pay per hour (they pay per hour in OR, meaning if the nurses/janitors take a long time to mop floors between cases and set up, youre not getting paid) and you will NOT afford to buy in Santa Monica. Money is always relative, and the amount you make is not at all proportional to the cost of real estate in the city where you will be working. So good luck if you take the job, and have fun not being able to afford to live close to work, god bless you. To anyone considering taking jobs like this, if you’re willing to make CRNA salary for 5 years, the joke’s on you honestly.

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[deleted941485]

Confirming some of the info about the group in Santa Monica above. At the rate they pay per hour (they pay per hour in OR, meaning if the nurses/janitors take a long time to mop floors between cases and set up, youre not getting paid) and you will NOT afford to buy in Santa Monica. Money is always relative, and the amount you make is not at all proportional to the cost of real estate in the city where you will be working. So good luck if you take the job, and have fun not being able to afford to live close to work, god bless you. To anyone considering taking jobs like this, if you’re willing to make CRNA salary for 5 years, the joke’s on you honestly.

If there were ever a place on this planet that needed less healthcare it’s probably SOCAL

 

[Peterluger]

If there were ever a place on this planet that needed less healthcare it’s probably SOCAL

Well there seems to be some kind of shortage because almost every group in LA county is still hiring. Clearly the demand is there. I think the problem has more to do with the pushover nature of anesthesiologists in the LA area, letting themselves be sh1tted on left and right, while lots of surgeons there are making 7 figures.

 

[deleted941485]

Well there seems to be some kind of shortage because almost every group in LA county is still hiring. Clearly the demand is there. I think the problem has more to do with the pushover nature of anesthesiologists in the LA area, letting themselves be sh1tted on left and right, while lots of surgeons there are making 7 figures.

Interesting to note that. I mean I’d buy that if it were plastic surgeons but certainly not anyone else.

 

[Peterluger]

Interesting to note that. I mean I’d buy that if it were plastic surgeons but certainly not anyone else.

Orthopedics, likely some even at that same santa monica hospital

 

[deleted941485]

Orthopedics, likely some even at that same santa monica hospital

Hmm something about that maybe they don’t take Medicaid and get a fat stipend to do so.

Well just like New York City. Plenty of useful tools willing to take this on.

 

[true_dat]

Thanks for the shout out!

I have one correction to make to the OP's summary.

Allied started at St. Joseph's in Orange, which remains its best hospital. Ten to fifteen years ago or so, Allied had a decent reputation, but over that time they have made a series of terrible decisions, each with predictable results. Limiting partnership, picking up below average contracts, and chasing growth at any cost led to infighting, backbiting, and--when they spread themselves too thin--the loss of their best outpatient gigs.

For instance, they no longer have the bankable contract at Pavilion Surgical Center ON THE ST. JOSEPH'S CAMPUS. Whoops. Like, big whoops. And, as they promise hospitals more and more call, they end up unable to meet the needs of surgeons who are taking their best paying cases to physician-owned surgical centers. So, Allied is sucking up all the call, all the uninsured cases, all the weekends and nights, all the Medicaid, and most of the Medicare, while losing the high paying M-F 0730-1600 cases to smaller, more nimble groups who, understandably, are having a hard time containing their glee.

In the name of sucking up more call, Allied recently agreed to bail out a former partner who, banished to the wilds years previously because of his history of addiction, couldn't get a decent job, so he had slummed at a 3- or 4-OR hospital, and within a year or two found himself as the most senior doc, and the de facto department chair. When a washed up fentanyl fiend thinks the job sucks so bad that he'd rather pull his kids out of schools and leave the state than continue as Chairman...you can be pretty sure the job sucks. Nevertheless, Allied hurriedly rushed in, agreed to uncompensated call coverage, and quickly found itself running new ads on Gaswork and on SDN.

From my vantage point independent from both Allied and Orange Coast, it seems to me that they teamed up to race to the bottom by underbidding each other for worse and worse contracts. Orange Coast is such a famous mess that they had to sell themselves to NAPA because they could no longer recruit locally--not even FMGs, addicts, or uninsurable wrecks. Both groups have inadvertently conspired to completely bugger up the non-Kaiser hospital-based anesthesia market in Orange County and into Riverside, Upland, Apple, and Victor.

 

[nimbus]

For instance, they no longer have the bankable contract at Pavilion Surgical Center ON THE ST. JOSEPH'S CAMPUS. Whoops. Like, big whoops. And, as they promise hospitals more and more call, they end up unable to meet the needs of surgeons who are taking their best paying cases to physician-owned surgical centers. So, Allied is sucking up all the call, all the uninsured cases, all the weekends and nights, all the Medicaid, and most of the Medicare, while losing the high paying M-F 0730-1600 cases to smaller, more nimble groups who, understandably, are having a hard time containing their glee.

I wonder how those nimble outpatient groups are doing right now. At the moment OB, trauma and emergencies are all their is. All the high paying elective stuff is gone for a while. It’s good to be diversified. We can survive on the ramen of anesthesia.

 

[deleted162650]

the ramen of anesthesia.

 

[narcotics999]

I wonder how those nimble outpatient groups are doing right now. At the moment OB, trauma and emergencies are all their is. All the high paying elective stuff is gone for a while. It’s good to be diversified. We can survive on the ramen of anesthesia.

These cases will come back. On the other hand, we in the hospital, have to cover the emergent/urgent cases with medicare/medicaid. Oh, don't forget covid-19 exposure with very limited PPE.

I would rather stay home and entertain my little boy.

 

[witothewi]

Is it common for physician-owned partnerships like some of the groups mentioned in this thread to not reimburse new hires for expenses such as credentialing, DEA registration, relocation/moving?

 

[deleted941485]

Is it common for physician-owned partnerships like some of the groups mentioned in this thread to not reimburse new hires for expenses such as credentialing, DEA registration, relocation/moving?

My limited time in PP now hosp employed is that PP doesn’t really reimburse for anything if you don’t ask about it and even if you do they give a whole song and dance as to why they can’t.

 

[Southpaw]

Is it common for physician-owned partnerships like some of the groups mentioned in this thread to not reimburse new hires for expenses such as credentialing, DEA registration, relocation/moving?

depends on the group. In my opinion it’s a sign of fair treatment to a new grad if they’re willing to help you out. There’s no random pot of money sitting around to pay for those things, so it comes out of the partners’ pockets. And it often amounts to a salary advance on your end and is eventually repaid to the group.

 

[witothewi]

I appreciate the replies. Just wanted peace of mind knowing this was not out of the ordinary for PP in California (or anywhere else, for that matter). Thanks!

 

[IMGASMD]

I appreciate the replies. Just wanted peace of mind knowing this was not out of the ordinary for PP in California (or anywhere else, for that matter). Thanks!

They may have a business expense allotment that you can eventually get some of tones things paid for with before tax money.

 

[deleted162650]

They may have a business expense allotment that you can eventually get some of tones things paid for with before tax money.

Thats how most true PP groups around here do it. Either the group covers it as a business expense before processing payroll, or you pay it and then expense it though the group as a personal business expense. Either way, the net cost to you personally is the same.

 

[witothewi]

I was offered a "bridge loan" to help with these types of costs, interest free but of course has to be repaid in full.

 

[deleted162650]

I was offered a "bridge loan" to help with these types of costs, interest free but of course has to be repaid in full.

That’s very common, and I would say almost all our new hires do this since their AR’s won’t really be coming in for 2-4 months anyways.

 

[tecumseh]

I read True-Dat's reviews of Riverside County anesthesia groups with great interest. I thank him (or her) for his review.

.
Orange Coast

These guys suck even harder than IAMG, but their hospitals aren't quite as awful as Prime Hospitals. The president is an arrogant horse's @$$. He has a fast-talking toadie who is almost as loathsome.
Their pay is almost as bad as Fountain Valley, and yet their ads act like they are a picky group. They are not. They are desperate. Don't bother with them.

They excel in the "Bait and Switch." They run ads for "great location outside LA" or "Southwest OC," utilizing at least three different accounts on Gaswork. They will even invite you to an interview at their "flagship" hospital, Orange County Global Medical Center, even though the job they have been trying to fill for at least the last two years is outside of Victorville. In their ads they claim to be the premiere private practice group in Orange County. That is not possibly the case, though it does tell me that they are only trying to recruit people who are moving to Southern California without knowing anybody or anything. Do not be fooled.

Just wanted to make corrections. I'm an anesthesiologist at Orange Coast and you either have some very very old information or you've confused us with another group. Your description of our chair is like the opposite. We also aren't affiliated with Orange County Global or any practices in Victorville. Our group only has two contracts...Orange Coast Memorial Medical Center which is part of the MemorialCare health system and a surgery center that is on-site at Orange Coast Memorial Medical Center but it is a separate entity than the hospital. Pretty happy here overall.

 

[Tony C anesthesia]

Just wanted to make corrections. I'm an anesthesiologist at Orange Coast and you either have some very very old information or you've confused us with another group. Your description of our chair is like the opposite. We also aren't affiliated with Orange County Global or any practices in Victorville. Our group only has two contracts...Orange Coast Memorial Medical Center which is part of the MemorialCare health system and a surgery center that is on-site at Orange Coast Memorial Medical Center but it is a separate entity than the hospital. Pretty happy here overall.

Why are here all of a sudden jumping to defend your chair? Who cares? If your chair is a "down to earth" dude then enjoy and good for you.

 

[caligas]

Why are here all of a sudden jumping to defend your chair? Who cares? If your chair is a "down to earth" dude then enjoy and good for you.

I don’t understand, what is wrong with him correcting incorrect info?

 

[Peterluger]

It’s all good, oc/la had garbage unit value on average even before covid, and now they dont have cases. Maybe the anesthesiologists there can start driving uber for cash. Doesnt matter who the chairman is

 

[circleK]

Isn’t Orange Coast owned by NAPA now?

 

[Peterluger]

Isn’t Orange Coast owned by NAPA now?

I mean I think it would make more sense if Uber owned them, this way the anesthesiologists would have a source of income during a time of no cases in a dump that pays people per unit instead of a real living

 

[deleted162650]

Not sure where @Peterluger is getting his info. I posted in another thread that my SoCal hospital is back up to normal volume. In fact, I’ve come in 2 days this week when I wasn’t scheduled ‘cuz we’re so busy.

 

[Peterluger]

Not sure where @Peterluger is getting his info. I posted in another thread that my SoCal hospital is back up to normal volume. In fact, I’ve come in 2 days this week when I wasn’t scheduled ‘cuz we’re so busy.

You might be doing well, i believe you. but it seems that the majority of groups in that region were fugazi to begin with, covid just made it worse

 

[likewhatevs]

Just wanted to make corrections. I'm an anesthesiologist at Orange Coast and you either have some very very old information or you've confused us with another group. Your description of our chair is like the opposite. We also aren't affiliated with Orange County Global or any practices in Victorville. Our group only has two contracts...Orange Coast Memorial Medical Center which is part of the MemorialCare health system and a surgery center that is on-site at Orange Coast Memorial Medical Center but it is a separate entity than the hospital. Pretty happy here overall.

I'm happy to be corrected.

The group I'm talking about is headed by WT. Their "flagship" hospital is Orange County Global Medical Center, now owned by KPC. In the last 15 years it--and three other hospitals in Orange County--have had as many corporate owners. Tenet, Integrated Health Holdings, and KPC.

(To give you an idea just how terrible those four hospitals are, in one of the very most affluent counties in the world, those four private hospitals together sold for $70M, and the "turnaround" did so poorly that they had to be rescued by KPC which--in case you didn't know--is a poor man's version of Prime Healthcare. (Dr. Prem Reddy owns Prime Healthcare and is in dozens of states and owns 40 or 50 truly terrible, terrible hospitals. Dr. Kali Chaudhuri owns KPC with seven hospitals and is in three counties in a single state. In addition to the four fire-sale Orange County hospitals, he also extended his empire into Hemet, Victorville, and Menifee. Of course, bigger isn't always better...but Victorville, Hemet, and Menifee? I think I'd prefer Otisburg. ().)

According to OCA's own website, they also serve hospitals in Glendale and Victor Valley Global Medical Center, 15248 Eleventh St., Victorville, CA 92395.

With great fanfare, NAPA just announced they had entered Orange County, by way of purchasing the group in question. (North American Partners in Anesthesia expands to West Coast with new acquisition of Orange Coast Anesthesia, Southern California's fastest-growing anesthesia group) I had always called it Orange Coast Anesthesia. It might possibly be a different place than where tecumseh works. Or, maybe WT retired, took his loathsome toady with him, and virtually overnight performed a turnaround that would make Iacocca proud--though the third rate press release/salespitch quotes WT in a word salad of meaningless drivel, so I find that theory far-fetched. Or, maybe WT's therapist worked a miracle, in which case we owe it to humanity to divulge the recipe of the therapist's secret sauce.

I'll send tecumseh a private message and try to clarify the whole mess. If he works for a good group that is being confused with OCA, that's too bad for him and his group. If OCA is the same outfit tecumseh works for, we'll have to chalk it up to different strokes for different folks, and agree that no one job is perfect for everybody, anymore than one anesthesiologist is perfect for every job.

 

[dchz]

Well, the problem with NAPA is that they don't pay enough for how thin they stretch their employees.

What if they didn't do that and everything stayed the same? Then it shouldn't be a big deal, right?

 

[eahhh]

Orange Coast Medical Center (Memorial Care) is not staffed by the group known as “Orange Coast Anesthesia.” That is where the confusion comes from. Orange Coast Anesthesia was purchased by NAPA and is affiliated with OC Global and a number of other “hospitals.” The group at Orange Coast Medical Center from all accounts I’ve heard is reputable, though their blended unit value is subpar.

 

[narcotics999]

Orange Coast Medical Center (Memorial Care) is not staffed by the group known as “Orange Coast Anesthesia.” That is where the confusion comes from. Orange Coast Anesthesia was purchased by NAPA and is affiliated with OC Global and a number of other “hospitals.” The group at Orange Coast Medical Center from all accounts I’ve heard is reputable, though their blended unit value is subpar.

See how important it is to have a distinct name, for example, Scope anesthesia.

 

[Twiggidy]

Ben Carson

Update: Candace Owens

 

[deleted162650]

Update: Candace Owens

How ‘bout this one:

What do you call a black guy flying an airplane?









A pilot you f’in racist.

 

[IMGASMD]

How ‘bout this one:

What do you call a black guy flying an airplane?









A pilot you f’in racist.

Wow.

 

[Twiggidy]

How ‘bout this one:

What do you call a black guy flying an airplane?









A pilot you f’in racist.

Our cardiac surgeon dropped that one on me my first day on the job.

 

[Tony C anesthesia]

Anyone knows anything new about Providence hospitals in LA? St. John's and Tarzana in particular!

 

[Peterluger]

Anyone knows anything new about Providence hospitals in LA? St. John's and Tarzana in particular!

I know a lot about the santa monica one. The attendings cant afford to even live in fking santa monica in a respectable house. You’ll work hard to make over $300k as a 1099 with no benefits for a few years, as u are paid per hour, less than $200. And by paid by the hour, i mean anesthesia start to anesthesia stop. Meaning you don’t get paid per hour youre at the hospital. The time it takes for nurses to mop the floor and set up sht for the surgeon-you’re basically there working for free, exactly like slavery.
the benefits are that its in a nice city (that you wont afford a 3 bedroom house with the money they give you). Also its lifestyle oriented from what i understand.

 

[nimbus]

I know a lot about the santa monica one. The attendings cant afford to even live in fking santa monica in a respectable house. You’ll work hard to make over $300k as a 1099 with no benefits for a few years, as u are paid per hour, less than $200. And by paid by the hour, i mean anesthesia start to anesthesia stop. Meaning you don’t get paid per hour youre at the hospital. The time it takes for nurses to mop the floor and set up sht for the surgeon-you’re basically there working for free, exactly like slavery.
the benefits are that its in a nice city (that you wont afford a 3 bedroom house with the money they give you). Also its lifestyle oriented from what i understand.

Then who gets all the money? The guys at the top must be making millions.

 

[deleted697127]

I know a lot about the santa monica one. The attendings cant afford to even live in fking santa monica in a respectable house. You’ll work hard to make over $300k as a 1099 with no benefits for a few years, as u are paid per hour, less than $200. And by paid by the hour, i mean anesthesia start to anesthesia stop. Meaning you don’t get paid per hour youre at the hospital. The time it takes for nurses to mop the floor and set up sht for the surgeon-you’re basically there working for free, exactly like slavery.
the benefits are that its in a nice city (that you wont afford a 3 bedroom house with the money they give you). Also its lifestyle oriented from what i understand.

Comparing being paid $200 an hour to be an anesthesiologist in one of the most desirable regions to live in the world to slavery...smh

 

[rakotomazoto]

You’ll work hard to make over $300k as a 1099 with no benefits for a few years, as u are paid per hour, less than $200.

For those unfamiliar with 1099 salaries, I really want to emphasize that this is trash money. Subtract from $300k your taxes, malpractice, medical/dental insurance, and other overhead expenses. Especially since you live in LA, so there are hefty state taxes on top of federal. And Santa Monica real estate prices will make your head spin. Besides, if you are just carrying a reasonable caseload on your own, your annual billing far exceeds $300k. Who pockets the difference? Senior partners, the hospital, or whoever your boss is.

Is partnership available after you have sold yourself for a few years? Is there any reason to believe that things would get better at some point?

 

[Peterluger]

Comparing being paid $200 an hour to be an anesthesiologist in one of the most desirable regions to live in the world to slavery...smh

No... i compared working for free to being a slave. Working for free is slavery. You dont get paid for the hours you are at work that dont fall within anesthesia start and anesthesia stop. And you DONT make $200 an hour there. Its closer to $180 per hour. Read my post before shaking your head.

 

[Peterluger]

For those unfamiliar with 1099 salaries, I really want to emphasize that this is trash money. Subtract from $300k your taxes, malpractice, medical/dental insurance, and other overhead expenses. Especially since you live in LA, so there are hefty state taxes on top of federal. And Santa Monica real estate prices will make your head spin. Besides, if you are just carrying a reasonable caseload on your own, your annual billing far exceeds $300k. Who pockets the difference? Senior partners, the hospital, or whoever your boss is.

Is partnership available after you have sold yourself for a few years? Is there any reason to believe that things would get better at some point?

All im gonna say is, when even the actual partners cant afford to live in the city they work in, something is off. Whatever the pay is when they become partner, its still not enough for them to be able to afford to live in the city they work in. Which is sad. That’s a very working class/blue collar problem to have.

 

[Lashler9054]

You dont get paid for the hours you are at work that dont fall within anesthesia start and anesthesia stop.

This is true for ALL productivity based models. You work around this by being in an environment where the cases are fairly distributed. However, 300k 1099 is AWFUL, especially because there are no other benefits. I find it hard to believe that SOCAL is THAT bad

 

[nimbus]

This is true for ALL productivity based models. You work around this by being in an environment where the cases are fairly distributed. However, 300k 1099 is AWFUL, especially because there are no other benefits. I find it hard to believe that SOCAL is THAT bad

St. John’s is in a wealthy area with a great payor mix and Bayside is still a non-AMC PP. The only reason they can offer that is because the partnership income is above average.


This site is a great resource for payor mix information.

Resource has moved | Redirect

OSHPD Application

oshpd.ca.gov

 

[Twiggidy]

St. John’s is in a wealthy area with a great payor mix and Bayside is still a non-AMC PP. The only reason they can offer that is because the partnership income is above average.


This site is a great resource for payor mix information.

Resource has moved | Redirect

OSHPD Application

oshpd.ca.gov

I see that job post make it's way to Gaswork about once a year I feel like. That says something in my book. All of us with a CA license would probably love to work in Santa Monica but if they're posting on Gaswork then something is up. The big question I would have is "How many people they take on for the "pre-employee/junior partner" track actually end up making partner?"

 

[narcotics999]

St. John’s is in a wealthy area with a great payor mix and Bayside is still a non-AMC PP. The only reason they can offer that is because the partnership income is above average.


This site is a great resource for payor mix information.

Resource has moved | Redirect

OSHPD Application

oshpd.ca.gov

Thanks for info.

 

[Tony C anesthesia]

Any update on Good Samaritan in Downtown LA? Have they changed or same as before?

 

[likewhatevs]

Sorry. I have no updates on Good Samaritan. I know the hospital changed ownership, and the new corporate bosses switched radiology groups, but I have not heard anything about the anesthesia department being impacted.

As long as we are asking for more information, can anybody say anything one way or another about California Anesthesia Associates (CAAMG)? I see they have lately been running ads on Gaswork. I asked a colleague who has been around the proverbial block, and he had absolutely nothing bad to say about them. It's such a sad commentary on the back-biting nature of anesthesiologists, that not having anything bad to say is immediately interpreted as high praise. I guess they are centered at two hospitals (Saddleback and Long Beach Memorial), and also have a smattering of GI centers, as well. That has to be a better situation that Envision or Somnia. No question about that.

I see another ad on Gaswork for "job near Los Angeles" that is Valencia Anesthesia, up by Santa Clarita. I have had two separate recruiters spam me about the same job. The job sounds great--not an AMC, no CRNAs, fair and equitable treatment. I don't know why they are having such difficulty filling the position...though resorting to Gaswork and recruiters raises an immediate red flag.

I have heard rumblings of a small outpatient-only "group" that calls itself SDAMG. The SD does not stand for San Diego, though they do work in South Orange County. They have been accused of trying to poach contracts and anesthesiologists from other outpatient surgical centers. I don't mean to flavor the conversation one way or another--SDAMG seems to be "growing," and is doing so by word-of-mouth (and not recruiters/Gaswork)--so maybe they are an upper tier partnership that unsatisfied docs in lesser groups might aspire to. I don't know. I do know that two well-above-average outpatient surgical centers in South OC have closed their doors because of Covid. Those cases will have to go somewhere--as will the doctors and staffs who used to work there. So if SDAMG is not only surviving, but expanding...good for them.

Another group on Gaswork calls itself the fastest growing outpatient group in LA/OC. Them calling themselves that is the only thing I've ever heard about them. Maybe it's just one guy who hired another guy and then can say with a straight face that over the last quarter his group has grown by 100%. I don't know. Their ad says no call and they are only looking for the best, so those are two things in their favor and maybe deserving of an inquiry. Maybe they are simply so big that they don't even need to mention their real name in their ad. If I come across as very skeptical, that is by design.

Finally, there's a "group" that calls itself Talbert Anesthesia Group, and they've also been advertising on Gaswork. Their ad says "no call," but also "some weekends." I made an official inquiry with them over two years ago--when they were just two guys with the same last name--and at the time the weekend work was exclusively at a fertility clinic. Their more recent ad makes refers to Fountain Valley Medical Center, so if they have taken over the lowest-paying hospital in the country, then their weekend obligations have become more regular and less remunerative. Their website now lists six anesthesiologists, so they are small, but growing. They do deserve high marks for mentioning in their ad that you must be "presentable with great bedside manner" for cosmetic cases. Not to put too fine a point on it, but that is certainly not the kind of demand that the guy who used to run Fountain Valley Hospital could have made.

 

[deleted162650]

California Anesthesia Associates (CAAMG)

Solid practice. One of the more popular gigs with UCLA grads. Aside from a shared business/billing office, Long Beach and Saddleback completely separate groups. I’m surprised they need to advertise on gaswork.

SDAMG

Small group of almost exclusively UCSD grads. All outpatient. They drive all over the place from OC to Temecula. Very good payer mix but work can be sporadic.

 

[GassYous]

Solid practice. One of the more popular gigs with UCLA grads. Aside from a shared business/billing office, Long Beach and Saddleback completely separate groups. I’m surprised they need to advertise on gaswork.




Small group of almost exclusively UCSD grads. All outpatient. They drive all over the place from OC to Temecula. Very good payer mix but work can be sporadic.

Probably due to everyone escaping from the fires/covid/taxes before the market crashes again.

 

[deleted682700]

Small groups in California don’t reveal a number of facts about fee for service practice. First is how many cases are you going to be doing per day. If it is one case at 7.30, one at noon and one case at 5 pm, you won’t make enough units. Rest of the time you are sitting idle.
Second is the cases being uniformly distributed among all or just a select few get preferential treatment in getting the most productive OR line up?
Third the societal insurance, except in some locales, most of the Central Valley 90% is govt insurance, which means that unless the hospital assures a sizable subsidy, collection at end of 6 months to year will be disappointing.
The worst is some of these groups don’t pay and keep the last few months of collections as ransom.