OC/LA Groups (Sanitized Version)

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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.

EVERY system can be gamed. In an eat-what-you-kill model it’s by monkeying with the schedule/case distribution as stated above. That’s why it is so important to ask who makes the schedule and how it’s done if you are considering a practice like this.

The most important thing is finding a group full of high quality individuals - not douchebags, and that’s why it pays to have connections.

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Just saw this one on Gaswork. They pay $120/hour for 24-hour OB coverage! What a shame! Who works at this rate in California?
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Have avoided working for Somnia, team health , envisions for greater than 5 Years. The market rate is 3 k plus billing (productivity). Usually make 5k even with bad insurance mix. Next day it is paid off. Otherwise you won’t be making what the average anesthesiologist makes.
There are anesthesiologists who have a primary job(main source of income) or govt employed physicians who take up these offers in vacation time.
The reason one should not accept these offers is that as a group of anesthesiologists, our bargaining power is simply being eroded. Why stop at 120$/hr, soon it can be 80,60 20?.
Low ball offers are deflationary to income and even full timers should refrain from taking these offers as it will definitely decrease the bargaining power of all and lead to further decreases in salary. Locums should get a higher rate as they are the first to be laid off when there is now work. Have lost 20 weeks of work due to Covid. Locums
company are obligated to give only 30 days notice and cut the contract. Getting another job in Covid era takes 3-4 months.
 
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Have avoided working for Somnia, team health , envisions for greater than 5 Years. The market rate is 3 k plus billing (productivity). Usually make 5k even with bad insurance mix. Next day it is paid off. Otherwise you won’t be making what the average anesthesiologist makes.
There are anesthesiologists who have a primary job(main source of income) or govt employed physicians who take up these offers in vacation time.
The reason one should not accept these offers is that as a group of anesthesiologists, our bargaining power is simply being eroded. Why stop at 120$/hr, soon it can be 80,60 20?.
Low ball offers are deflationary to income and even full timers should refrain from taking these offers as it will definitely decrease the bargaining power of all and lead to further decreases in salary. Locums should get a higher rate as they are the first to be laid off when there is now work. Have lost 20 weeks of work due to Covid. Locums
company are obligated to give only 30 days notice and cut the contract. Getting another job in Covid era takes 3-4 months.

I asked the question a few months before.

So what’s a 24hour ob rate that’s acceptable for you? So ~5000? With next day off and paid for? Close to ~7500 for two days? Have you personally gotten that rate?
 
I asked the question a few months before.

So what’s a 24hour ob rate that’s acceptable for you? So ~5000? With next day off and paid for? Close to ~7500 for two days? Have you personally gotten that rate?
That would be my question as well. Who gets paid $2500 the next day for not working, assuming a productivity based model?
 

Just saw this one on Gaswork. They pay $120/hour for 24-hour OB coverage! What a shame! Who works at this rate in California?

 
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That would be my question as well. Who gets paid $2500 the next day for not working, assuming a productivity based model?

Or even just straight hourly/per diem model.

I definitely think it’s possible and acceptable. Because at end of the day, you’re getting ~200/hr. I want to know how you could/would negotiate that kind of rate. 24+8=32 hours of pay.

What tactic did you use to make them see it your way? To say hey, you need to pay for the next day off, that’s what you do for your full timer.
 
Or even just straight hourly/per diem model.

I definitely think it’s possible and acceptable. Because at end of the day, you’re getting ~200/hr. I want to know how you could/would negotiate that kind of rate. 24+8=32 hours of pay.

What tactic did you use to make them see it your way? To say hey, you need to pay for the next day off, that’s what you do for your full timer.
I'm confused. So it's 24hr call plus 8hr call that next day? If so then fine, but if you're off the next day you shouldn't be paid. I think people should only be paid if they're working/on-duty (that includes sitting around waiting for something to happen)
 
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I'm confused. So it's 24hr call plus 8hr call that next day? If so then fine, but if you're off the next day you shouldn't be paid. I think people should only be paid if they're working/on-duty (that includes sitting around waiting for something to happen)

I meant 24hrs.

Since @inquisitiveanes mentioned getting paid next day, so I just assumed being paid for another 8 hours. So technically the practice will be paying you for 32 hours of your time. For about $7500.
 
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That would be my question as well. Who gets paid $2500 the next day for not working, assuming a productivity based model?
Why would you take night calls ,for a total of 5k more when you can make 4000 working 8 hrs each day for 2 days. In other words just 1000 is not sufficient to make someone do night calls. Hospitals want anesthesiologists just to work 7pm to 7 am like night float. How do you think that needs to be priced? Remember when you do night float you let the regular anesthesia members to have high Productivity and therefore the higher The MGMA income Bracket. The bottom line is the dollar is worthless and has no saving grace.
I dont have next day off. Next day you are given the shortest room and you are the first to go home with 8 hrs guaranteed pay.
 
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Why would you take night calls ,for a total of 5k more when you can make 4000 working 8 hrs each day for 2 days. In other words just 1000 is not sufficient to make someone do night calls. Hospitals want anesthesiologists just to work 7pm to 7 am like night float. How do you think that needs to be priced? Remember when you do night float you let the regular anesthesia members to have high Productivity and therefore the higher The MGMA income Bracket. The bottom line is the dollar is worthless and has no saving grace.
I dont have next day off. Next day you are given the shortest room and you are the first to go home with 8 hrs guaranteed pay.
At least in my system you can always request to work the next day, but after an OB call most don’t want to. The hospital should pay you something for parking in the hospital overnight and everything on top of that is money you make. Some places the night call person always works during the day. So really the money that some people make “the next day” at some places they make it “the same day”. I just could never support paying someone for not working or being on duty. I understand what your saying about “the risk of taking call at the expense of not working cases the next day” My answer to that would be to heavily weigh the night call stipend.
 
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Why would you take night calls ,for a total of 5k more when you can make 4000 working 8 hrs each day for 2 days. In other words just 1000 is not sufficient to make someone do night calls. Hospitals want anesthesiologists just to work 7pm to 7 am like night float. How do you think that needs to be priced? Remember when you do night float you let the regular anesthesia members to have high Productivity and therefore the higher The MGMA income Bracket. The bottom line is the dollar is worthless and has no saving grace.
I dont have next day off. Next day you are given the shortest room and you are the first to go home with 8 hrs guaranteed pay.

Most of us take call because we have to. It’s part of the deal. We try to make it less painful by making sure we don’t lose money for doing it.
 
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.


That "group" is really two guys and a couple of stringers. They work at SCA facilities throughout Orange County and as far inland as Murrieta/Temecula. I think they share a medical directorship at one of the SCA facilities, but just fill in extra rooms at the other three or four. I can't speak to their payer mix, but since it's all outpatient work, I should hope the surgeons are weeding out the bad cases. Then again, my limited experience with SCA facilities leads me to believe they don't court surgeon/owners and private insurance patients as aggressively as other ASCs.

I know of at least three of their stringers have left within the last twelve months. Whether that's because they found more stable work elsewhere or some other reason, I can't say. Maybe that explains why the other poster heard they were adding to their ranks (or "poaching anesthesiologists," as the poster put it).

On the other hand, I also heard that SCA is closing the facility where they do most of their work, effective at the end of the month, which would help to explain why they are rumored to by trying to pick up ("poach") contracts.

All in all, it sounds like a retirement gig. I'm not surprised they don't advertise. The anesthesiology world is pretty small. The SDAMG guys "get around," so they are likely fill whatever needs they have by word of mouth. Good for them.
 
At one time, SDAMG was a larger group based out of a hospital. The bulk of it (and the hospital work) was absorbed into an even larger group but a few of members elected to continue as SDAMG doing outpatient work.
 
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Silver lining: At least you get to work in the heart of the ghetto.

Lol I do resent this comment since I grew up down the street from this hospital but you're not wrong. This hospital's campus does a good job of "walling off" though and cars are parked in highly secured garage so you don't really interact with the outside world. My father who worked here, along with other physicians, would routinely bring their bmws, benzs, rolls-royces and even ferraris and leave it in the garage for the weekend.

Also their OB census is a joke with 1-2 epidurals during the day, 4-5 vaginals and maybe 2 c-sections a week. Obviously no high-risk. If you asked me to take OB call here, and they didn't require in-house for epidurals (which they usually don't) then I'd do it for $2800. I have not been here since 2016 though fwiw.

CA insurance pays for all patients to choose their birthing locale, so most go to Cedars or the nicer LA hospitals. This explains why those OB groups in LA make so much money and are impossible to get in to.
 
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I read these threads with great interest, being a pp mid-late career guy in suburban LA in a hospital group looking for top tier candidates to be equal partners after 1 year. I am new to this site and just saw the section for posting openings, we will get on it
 
I read these threads with great interest, being a pp mid-late career guy in suburban LA in a hospital group looking for top tier candidates to be equal partners after 1 year. I am new to this site and just saw the section for posting openings, we will get on it

5 dollars says this is that ****ty allied anesthesia nonsense
 
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LOL what a joke. U cant even afford to buy a shack in that part of LA with that salary. Maybe california anesthesiologists live in the homeless encampments all over LA?
 
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Or a retired person collecting retirement income from some other job
 
It says full time. I would presume it’s M-F 7-3.... not a gig I want if I was retired.
It's 90% eyes. It's basically sitting there, giving 1mg of versed, and charting. Not terrible if you're in the twilight of your career, kids have graduated college, and you own your home. Horrible if you're a new grad or mid career.
 
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It's 90% eyes. It's basically sitting there, giving 1mg of versed, and charting. Not terrible if you're in the twilight of your career, kids have graduated college, and you own your home. Horrible if you're a new grad or mid career.

I just can’t imagining being “retired” and working 40 hours a week.
 
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I just can’t imagining being “retired” and working 40 hours a week.
I'd look at it more as doing quasi-locums and using it to pay for all the fun stuff in retirement instead of spending retirement savings. Also, you can set you kids up even better. Probably do it for 5 years if you hang in there until you're 70 and that's an extra million.
 
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I'd look at it more as doing quasi-locums and using it to pay for all the fun stuff in retirement instead of spending retirement savings. Also, you can set you kids up even better. Probably do it for 5 years if you hang in there until you're 70 and that's an extra million.
Even if you just tread water and pay your living expenses for five years, you would let your retirement accounts keep rolling up over that time.

If you had 5 mill socked away and averaged 6% per year returns you’d have 6.6 mill after 5 years.
 
Even if you just tread water and pay your living expenses for five years, you would let your retirement accounts keep rolling up over that time.

If you had 5 mill socked away and averaged 6% per year returns you’d have 6.6 mill after 5 years.
It’s very trendy to trash jobs on here without examining the fact that some jobs may be targeted to a specific demographic. Not every Gasworks post is for the new grad with bills to pay and a family to raise.
 
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I'd look at it more as doing quasi-locums and using it to pay for all the fun stuff in retirement instead of spending retirement savings. Also, you can set you kids up even better. Probably do it for 5 years if you hang in there until you're 70 and that's an extra million.

I’d much rather just work my normal gig 1/2 time, than this one full time in “retirement.”
 
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I never understood why some of my colleagues actively choose to do the eyeball room. Mind numbing.
It's probably one of the closest rooms in anesthesia to where your entire anesthetic is doing nothing. I'm not saying I'd want that but I'm sure there's a handful of people who just want to avoid any sniff of drama
 
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It's probably one of the closest rooms in anesthesia to where your entire anesthetic is doing nothing. I'm not saying I'd want that but I'm sure there's a handful of people who just want to avoid any sniff of drama

I had an ophthalmologist dictate the whole anesthetic regimen. Sure, I will give as much versed as you think your 80 yo old needs. GFY.
 
I had an ophthalmologist dictate the whole anesthetic regimen. Sure, I will give as much versed as you think your 80 yo old needs. GFY.
It's all about picking battles. Think about how much that battle is worth versus how much you get paid to sit and surf the net during that case. Pick your battles.
 
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I think it has been mentioned, but I suspect there are a ton of great ASC jobs in LA area, or office based jobs that pay well.

I moonlight for a gig for LA County system. It pays $220/hr. I was offered $250 for a per diem job further up north.

But I think the best bet is get a job at Kaiser. Or go further south to ASMG in San Diego.
 
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