OC/LA Groups (Sanitized Version)

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Uhhh, excuse me but this thread is for LA/OC group discussion. Let’s try to keep to keep it on topic. ;)
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So what do the good LA/OC jobs offer/pay, etc (call, hours)?
Just curious. I am an hour up the coast from LA, got this job out of residency 1.5 years ago. I am from socal but did med school and residency out of state, so didn't have any connections in medicine to get back.
MD only, 13 in the group, 1:5 weekend call, malpractice paid, no other benefits, 1099. Units are flat fee reimbursement at $32, but there are different stipends as well for certain shifts. I am pretty happy where I am (near family and friends, beach, in a smaller city) so I guess I am just wondering what makes the great jobs great.
 
NoTalentGasClown said:
So what do the good LA/OC jobs offer/pay, etc (call, hours)?
Just curious. I am an hour up the coast from LA, got this job out of residency 1.5 years ago. I am from socal but did med school and residency out of state, so didn't have any connections in medicine to get back.
MD only, 13 in the group, 1:5 weekend call, malpractice paid, no other benefits, 1099. Units are flat fee reimbursement at $32, but there are different stipends as well for certain shifts. I am pretty happy where I am (near family and friends, beach, in a smaller city) so I guess I am just wondering what makes the great jobs great.
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I would venture to guess more than $32 a unit.
But money isn’t everything.
 
chocomorsel said:
I would venture to guess more than $32 a unit.
But money isn’t everything.
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Actually, lots of of LA area jobs are around there per unit and many are slightly lower (a friend makes 29 a unit!!). And many have you sit around doing nothing, then you do your $32/ blended unit case, then you sit around doing nothing.

So your job sounds OK. Nothing wildly better in LA unless you're lucky. The grass is not greener, rather a different shade of meh.
 
kidthor said:
Actually, lots of of LA area jobs are around there per unit and many are slightly lower (a friend makes 29 a unit!!). And many have you sit around doing nothing, then you do your $32/ blended unit case, then you sit around doing nothing.

So your job sounds OK. Nothing wildly better in LA unless you're lucky. The grass is not greener, rather a different shade of meh.
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Apparently Salty is making much more than that. I was working in Vegas making $27 to $$35 an hour.
I left and glad I did. I was making not much money I later realized.
 
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chocomorsel said:
I would venture to guess more than $32 a unit.
But money isn’t everything.
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Yeah but the stipends actually make up for that quite a bit. I made a lot in my first year, granted I only took 3 weeks of vacation. Are there some jobs in LA or OC where people make 750+ etc? I always thought that was only in the less desirable locale. Or maybe once you have been a partner for a while.
 
chocomorsel said:
Apparently Salty is making much more than that. I was working in Vegas making $27 to $$35 an hour.
I left and glad I did. I was making not much money I later realized.
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Hopefully you mean per unit! :) is salty in OC?
 
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Blended unit value of 30 to low 40s in Socal is normal. Expect most groups to take 1/2 of your case start units for group run expenses. You will not find much better than that unless you go further east or further north. I work in SD and did residency in LA and know this for a fact.

Source: Dude, trust me.
 
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NoTalentGasClown said:
So what do the good LA/OC jobs offer/pay, etc (call, hours)?
Just curious. I am an hour up the coast from LA, got this job out of residency 1.5 years ago. I am from socal but did med school and residency out of state, so didn't have any connections in medicine to get back.
MD only, 13 in the group, 1:5 weekend call, malpractice paid, no other benefits, 1099. Units are flat fee reimbursement at $32, but there are different stipends as well for certain shifts. I am pretty happy where I am (near family and friends, beach, in a smaller city) so I guess I am just wondering what makes the great jobs great.
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Maybe you could find a better job if you weren’t such a no talent gas clown.;)

Your gig actually doesn’t sound too terrible assuming your call stipends are decent, and you have the case mix/volume to turn a respectable number of units/year.


chocomorsel said:
Apparently Salty is making much more than that.
Click to expand...

Well I’m definitely not one of those 99% MGMA with 20 weeks of vacation guys. We are just blessed with an above average payer mix (for the region) that allows us to make in the 75th-ish MGMA income range for 50th-ish MGMA workload range. That’s with about 6ish weeks of vacation if you work an even 1 FTE.

What others have said regarding typical unit values for SoCal is pretty spot on. Beyond that it’s about finding fair groups with the right schedules so you can make the most of the blah unit values.
 
Can someone explain the rationale of what seems to be a large amount of 1099 jobs in SoCal? Is that just a smoke screen and there are a fair amount of W2 jobs or it just a thing for the region
 
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Twiggidy said:
Can someone explain the rationale of what seems to be a large amount of 1099 jobs in SoCal? Is that just a smoke screen and there are a fair amount of W2 jobs or it just a thing for the region
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I think it’s mostly a relic at this point from a time when most “groups” were still loose collections of more or less independent guys. MD only on a blended unit makes it pretty easy to just continue as 1099.

Bottom line is that 1099 v W2 is basically a moot point when you are a partner in an MD only PP. Would you rather deal with deductions on your own return, or expense everything through the group is what it comes down to. Unless you have some side gig, there really isn’t any benefit to 1099 and you are much more audit prone.
 
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propadex said:
Thanks to everyone contributing. The honest assessments of groups to avoid is invaluable to residents like me without connections or experience.

Hoping to come home in a year and a half to the Glendale area and am not picky. Appreciate all the info so far about groups nearby. Curious if anyone is willing to share any knowledge about the reputations of:

-Glendale Adventist
-Verdugo Hills (besides what has already been mentioned in this thread)
-Huntington Hospital

Appreciate you all.
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You want the group that contracts with Huntington.
 
nimbus said:
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
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This group takes the advantage of new grads dreaming about Santa Monica location. Good luck on affording a small house with super low salary. Many docs have left the group after a year or two.
 
Just wanted to chime in on the discussion because our group was mentioned earlier in this thread regarding our gaswork post... the poster had mentioned, "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"

All of the above is true. We have a really happy group of anesthesiologists. We all work equally hard, share equally in call, and divide all the money that comes in equally. This is the first time in our group's existence that we've even had to post a job on gaswork. Turnover is very rare in our group and when we do have to recruit, we normally use our regular word-of-mouth channels. It just so happens that mid-2020 coincided with retirements of a few of our older anesthesiologists which were accelerated due to the Covid pandemic.

We are an all-physician group and as you may recognize it's not easy to recruit a physician to the outskirts of Los Angeles, let alone a few physicians all at the same time. So I just want to say that although a post on gaswork "raises an immediate red flag" it is not always the case. And once you post on gaswork, ALL the recruiters start coming out of the woodwork and spamming the entire database of ASA, ABA, AMA email addresses - not something that we endorse.

All that said, if you're still looking for a job I'd be happy to chat with you about details. We are a very fair and equitable group in a community hospital setting where you're respected as a physician and not just a warm body to cover an operating room. The area has an excellent payor mix of mostly white-collar employed residents who have insurance through their workplaces. Very little Medicare/Medi-Cal. Feel free to PM me here or just respond to our gaswork ad under "VAMG"
 
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How are these groups compared to socal Kaiser?
 
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While this thread has recently been bumped (and Riverside has recently been discussed in another thread SoCal Anesthesiology Residencies), I thought I'd ask if anybody knows anything about Landmark, which seems to straddle LA/OC and the Inland Empire.

Landmark used to be headquartered at St. Francis in Lynwood. KPC (a wannabe Prime Healthcare) bought St. Francis, before recently selling it to Prem Reddy. Blech.

KPC's "flagship" turned its anesthesia department over to NAPA, which was discussed above in this thread. Also, blech. But as bad as NAPA is, it has to be better than IAMG.

Landmark has been running ads for positions in Pomona, Chino Hills, and Murrieta. Are they with Prime? KPC? Somebody else??

So, Landmark, anyone? Bueller?
 
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All I know is that Napa originated in Long Island and are currently getting muscled out of their home base hospital system by the hospital system itself. They were recently kicked out of nymc because they were terrible and the guy at Orange Coast who sold out his group is now one of their VPs, probably making a lot off the backs of his "partners".
 
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GassYous said:
All I know is that Napa originated in Long Island and are currently getting muscled out of their home base hospital system by the hospital system itself. They were recently kicked out of nymc because they were terrible and the guy at Orange Coast who sold out his group is now one of their VPs, probably making a lot off the backs of his "partners".
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They’re being kicked out of North Shore and LIJ?
 
Peterluger said:
They’re being kicked out of North Shore and LIJ?
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They have not. But northwell now is in the picture. Which I find hard to understand when LIJ is a Northwell hospital, but their flagship hospital is staffed by another group, when NW is actively taking over all other sites.
 
Northwell's in house anesthesiologist group is relatively new and they are actively recruiting as they take over more hospitals in Long Island in their expansion to the south and east. Good Samaritan lost a hospital to them recently. Good riddance because a 5 year track with no guarantee of partnership is just predatory, especially in this environment. As an aside, it seems that a hospital with the name Good Samaritan is basically a red flag no matter where you are.

Both Napa and Northwell are now offering 50k sign on bonuses (there are practices offering 100k sign on bonuses and immediate financial parity to one year partnership tracks throughout the country at this moment btw).

GasWork.com - Reference #288575

Reference #288575
www.gaswork.com www.gaswork.com

Napa is even offering a position with 450k now, 500k next year. As far as I know, the hours are maybe mid 40s-mid 50s with call maybe twice a week.
 
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GassYous said:
Northwell's in house anesthesiologist group is relatively new and they are actively recruiting as they take over more hospitals in Long Island in their expansion to the south and east. Good Samaritan lost a hospital to them recently. Good riddance because a 5 year track with no guarantee of partnership is just predatory, especially in this environment. As an aside, it seems that a hospital with the name Good Samaritan is basically a red flag no matter where you are.

Both Napa and Northwell are now offering 50k sign on bonuses (there are practices offering 100k sign on bonuses and immediate financial parity to one year partnership tracks throughout the country at this moment btw).

GasWork.com - Reference #288575

Reference #288575
www.gaswork.com www.gaswork.com

Napa is even offering a position with 450k now, 500k next year. As far as I know, the hours are maybe mid 40s-mid 50s with call maybe twice a week.
Click to expand...

Good Samaritan was run by Ramapo, and they also had some association with westchester medical center at some point. Is that the group you’re talking about?

Ps. Also 450 is attractive with whatever the sign on is. BUT you’re working for Napa, probably 1:3 most of the time, on a bad day 1:4. And you work for Napa. You’re not a partner, no voting rights. And you work for Napa. Just to reiterate, you work for Napa.
 
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GassYous said:
Northwell's in house anesthesiologist group is relatively new and they are actively recruiting as they take over more hospitals in Long Island in their expansion to the south and east. Good Samaritan lost a hospital to them recently. Good riddance because a 5 year track with no guarantee of partnership is just predatory, especially in this environment. As an aside, it seems that a hospital with the name Good Samaritan is basically a red flag no matter where you are.

Both Napa and Northwell are now offering 50k sign on bonuses (there are practices offering 100k sign on bonuses and immediate financial parity to one year partnership tracks throughout the country at this moment btw).

GasWork.com - Reference #288575

Reference #288575
www.gaswork.com www.gaswork.com

Napa is even offering a position with 450k now, 500k next year. As far as I know, the hours are maybe mid 40s-mid 50s with call maybe twice a week.
Click to expand...

IMGASMD said:
Good Samaritan was run by Ramapo, and they also had some association with westchester medical center at some point. Is that the group you’re talking about?

Ps. Also 450 is attractive with whatever the sign on is. BUT you’re working for Napa, probably 1:3 most of the time, on a bad day 1:4. And you work for Napa. You’re not a partner, no voting rights. And you work for Napa. Just to reiterate, you work for Napa.
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The listing is for director of liver transplant anesthesia. Hopefully one is not directing 1:3 or 1:4 during a liver transplant.
 
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nimbus said:
The listing is for director of liver transplant anesthesia. Hopefully one is not directing 1:3 or 1:4 during a liver transplant.
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True. It’s also a directorship position (for 450k)hmmmm.
It’s first posted in 2019, and want a fellowship trained person.

Doubt they will let you not be clinical while there are no liver going on. I will admit, I don’t even know how many they do a year.

You still work for napa.
 
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IMGASMD said:
True. It’s also a directorship position (for 450k)hmmmm.
It’s first posted in 2019, and want a fellowship trained person.

Doubt they will let you not be clinical while there are no liver going on. I will admit, I don’t even know how many they do a year.

You still work for napa.
Click to expand...

Yes I’m sure you’ll be kept busy.
 
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How's Cedars? Tough to get in and busy as hell? I'm looking to come down to Slow Cal in the near future, but jobs look **** compared to the Bay Area.
 
IMGASMD said:
They have not. But northwell now is in the picture. Which I find hard to understand when LIJ is a Northwell hospital, but their flagship hospital is staffed by another group, when NW is actively taking over all other sites.
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Hard to staff an 800 bed hospital due to non-compete?
 
Allied is now offering signing bonuses if you'll agree to help them at St. Joseph's. St. Joseph's is their single best hospital, and it's not even close. I knew things were bad for Allied, but I didn't know they were that bad.

Landmark (formerly of St. Francis, now with Prime Healthcare hospitals, though I understand Landmark is not to be confused with IAMG/Pacific) has let it be known that they are planning on moving into Orange County. That probably means Landmark will be taking over West Anaheim and/or Garden Grove.

Does anybody know anything about Landmark, other than what the OP said? I know they can't possibly be worse than IAMG, but are they any better?
 
true_dat said:
Allied is now offering signing bonuses if you'll agree to help them at St. Joseph's. St. Joseph's is their single best hospital, and it's not even close. I knew things were bad for Allied, but I didn't know they were that bad.

Landmark (formerly of St. Francis, now with Prime Healthcare hospitals, though I understand Landmark is not to be confused with IAMG/Pacific) has let it be known that they are planning on moving into Orange County. That probably means Landmark will be taking over West Anaheim and/or Garden Grove.

Does anybody know anything about Landmark, other than what the OP said? I know they can't possibly be worse than IAMG, but are they any better?
Click to expand...

A lot of groups are offering signing bonuses right now. Not to take away from your assessment of allied.
 
GassYous said:
A lot of groups are offering signing bonuses right now. Not to take away from your assessment of allied.
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I'm always skeptical of sign on bonuses. I know its doesn't apply to every case, but I feel like those bonuses are a way to lock people in to possible bad situation. I think I saw someone suggest this elsewhere, but I would take that bonus and put into an interest bearing account and don't touch until you know you're satisfied that way you can just give it back if the situation isn't optimal.
 
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Twiggidy said:
I'm always skeptical of sign on bonuses. I know its doesn't apply to every case, but I feel like those bonuses are a way to lock people in to possible bad situation. I think I saw someone suggest this elsewhere, but I would take that bonus and put into an interest bearing account and don't touch until you know you're satisfied that way you can just give it back if the situation isn't optimal.
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Yep I feel you and that's definitely something to keep in mind. But I also think that a lot of places need help, either cause of the covid backlog or cause a lot of people are retiring into this red hot market. A lot of cases I'm doing now were scheduled months ago.
 
Twiggidy said:
I'm always skeptical of sign on bonuses. I know its doesn't apply to every case, but I feel like those bonuses are a way to lock people in to possible bad situation. I think I saw someone suggest this elsewhere, but I would take that bonus and put into an interest bearing account and don't touch until you know you're satisfied that way you can just give it back if the situation isn't optimal.
Click to expand...

GassYous said:
Yep I feel you and that's definitely something to keep in mind. But I also think that a lot of places need help, either cause of the covid backlog or cause a lot of people are retiring into this red hot market. A lot of cases I'm doing now were scheduled months ago.
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What are usually the terms of these kind of bonuses? They give you the cash up front when you start but you have to return it if you leave within a year or something? 2 yrs?
 
vector2 said:
What are usually the terms of these kind of bonuses? They give you the cash up front when you start but you have to return it if you leave within a year or something? 2 yrs?
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Depends. It can be as large as 100K. Five years. Prorated. The “problem” is that, it will be taxed as income, so technically, you get 70K in your pocket.

When you return the money, they want full 100K, or 100K minus however long you worked. So you lost that 30K to taxes right off the bat.
 
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IMGASMD said:
Depends. It can be as large as 100K. Five years. Prorated. The “problem” is that, it will be taxed as income, so technically, you get 70K in your pocket.

When you return the money, they want full 100K, or 100K minus however long you worked. So you lost that 30K to taxes right off the bat.
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Maybe you can request to be paid yearly to spread out the tax. When the group is so desperate, it will probably agree (written in contract).
 
true_dat said:
Allied is now offering signing bonuses if you'll agree to help them at St. Joseph's. St. Joseph's is their single best hospital, and it's not even close. I knew things were bad for Allied, but I didn't know they were that bad.

Landmark (formerly of St. Francis, now with Prime Healthcare hospitals, though I understand Landmark is not to be confused with IAMG/Pacific) has let it be known that they are planning on moving into Orange County. That probably means Landmark will be taking over West Anaheim and/or Garden Grove.

Does anybody know anything about Landmark, other than what the OP said? I know they can't possibly be worse than IAMG, but are they any better?
Click to expand...
Does St. Joseph still have a 5-6 year partner track? Do the partners play the schedule that they get the bulk of the units and the new ones are the fillers?

I talked with landmark a couple years ago before St. Francis was sold to KPC. The group was relatively fair, but extremely hard working. It was probably related to the poor payor mix of St. Francis and the stingy subsidy from the hospital. It paid you 100 or 120$/hr (can't remember exactly) if you work post call. I knew nothing about the situation after KPC and Prime transition.

Prime makes money from government in ER. It usually drops all private insurance. So if some unlucky emergency PPO/HMO pts were sent there, the bills would be gigantic. A while ago Kaiser had a lawsuit with Prime on it and Kaiser lost.

Most of the Prime hospitals have very few cases and only one anesthesiologist is assigned there. The majority of the cases are medicaid. A stipend is provided. You take a lot of calls. If you live nearby, are semi-retired, have nothing to do other than SDN, gardening, stock trading, it may be tolerable.
 
narcotics999 said:
Maybe you can request to be paid yearly to spread out the tax. When the group is so desperate, it will probably agree (written in contract).
Click to expand...

You would probably think so right?! Recently tried to negotiate with a national group to make the “sign on” bonus as a “retention” bonus. You would think it’s all the same; same money to the same account, you’d be surprised. At end of the day, they just want to feel they have the upper hand. Whatever your ask is, the answer is always no, or we will get back to you. It’s literally pulling teeth to get it done.

Maybe it’s a little different with the smaller groups, but let’s just say the national group would rather pay locum who they can get rid of at will, than retaining people.

Or it’s just like that everywhere.

¯\_(ツ)_/¯
 
propadex said:
Any general consensus/generalizations regarding working in LA vs OC? For example - groups on average in LA or OC work harder? Or groups on average in LA or OC make more money? Or LA or OC as a whole is a better place to practice as an anesthesiologist (not accounting for external factors like location, culture, things to do, etc.)? Just trying to get some opinions - thoughts?
Click to expand...

LA has better food. OC has better beaches. The traffic can be soul crushing in both locations.
 
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It seems the market is terrible for all specialties in the SoCal area unless you're some old established plastic surgeon or subspecialty ortho. Every one I know that has tried to get a job down there says pay is much less than the Bay Area for more work.
 
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Long time reader, first time caller, posting under a pseudonym for obvious reasons

Now that the job search is done, I feel comfortable writing this up. I want to acknowledge everyone who has posted as the free exchange of information here has been an invaluable resource and allows everyone to know what is out there and have a basis for comparison. For disclosure and liability purposes, this may just be a dream and the information is worth to you as much as you paid for it.

I'm a CA-3 at a top (1-10) program on the east coast. Strong resident with strong CV (D1 athlete, full ride to top med school, AOA,>20 1st author pubs in Anesthesiology, A&A, RAAPM, JCVA etc, recs from names you've heard of who vouch for skillset that is quick, efficient and personable and matched to a very competitive fellowship program). Decided wanted to do general, partner pushing for So Cal since we have a strong connection to the area so I did my due diligence and interviewed with the following groups. Phone calls were made to get my foot in the door. Here's my experience:

Hoag (NHAC)- many consider it the "best" job out there in So Cal, extremely in-bred with in-house referral system from the top LA and SD program (notice no plural there). They considered it was "lucky" for me to have someone I knew and strongly referred me. 3 year partner track, production based. No lucrative or easy cases before partner. Most lucrative cases are at ortho institute but you're banned until later in your career (why?) despite my strong connection to the surgeons and them requesting for it. They wavered with possibly having to be per-diem for first 6 months as audition. Pre-partner income is skimmed with a unit value that is above average. Total package before partner is less than starting CRNA pay at my current institution with much more hours than our CRNAs. Imagine busting your ass and striving to be nothing but the best all so you can make less than a nurse anesthetist. And that is a best case scenario for socal. This group also prides themselves on only hiring cardiac or chief residents though they have not stuck to that lately.

MV - Chill group, seemingly fair, have a line of people working as per-diem waiting for a full time position. Per diem hourly rate (why not ASA unit based?!) made me have to mute the phone so they couldn't hear me laugh. There was someone whose been there almost 12 months as per diem, bless their heart. ICU RNs in covid units make more (this isn't a knock on them, they deserve it). 2 or 3 years to partner IIRC. Associate pay is production based, claimed fair scheduling but who knows. Benefits are standard, can't believe paid vacation is rare in CA. Partner comp package isn't anything to write home about but seemed to be great people to be around.

Kaiser SD - wanted people to work per-diem, they're "expanding" with new facility that will need 10 additional providers. Per diem rate is laughable if you're a reasonable person. Then consider that you have to fund your own benefits until you get the privelege of being full time. 5 year track IIRC. Pension is sweet though if you're not an idiot, could outpace those dividends saving up your own money over 30 years. Standard kaiser package, lifestyle seems great once partner compared to other CA gigs. Very nice to have integrated EMR and patients actually set up well for surgery. Before I even got the chance to tell them I'm not interested, they had called references and texted around asking people who knew me. This would be a long term option if you have the patience and a trust fund to live off.

Allied Anesthesia - Did this as a courtesy interview. Did my best to not hang up mid-call. They also wanted to do a mock oral boards as part of the interview. Three regional branches - 1 is extremely malignant, 1 is malignant and 1 is semi-malignant. 5 year track, production based, lowest unit value that I saw on the trail. Did not want to discuss numbers and kept defaulting to "you'll be compensated well". Apparently well is pediatrician salary working neurosurgeon hours for 5 years.

ASMG - just quick call, seemingly fair, 1 year of "match" which means driving around everywhere and them assigning you somewhere people liked you. Heavy collections and skimming. Huge group and huge geographic area. Lots of driving. Probably most lucrative and best benefits package as well as least malignant track.

So Cal seems like a race to the bottom. Good luck negotiating because if you don't really want what they offer you, there's someone who is willing to work for less. It sucks to be replaceable but that's the market here. Combine this with a litigous population, huge patient entitlement, a liberal environment (nothing wrong with the politics but when a nurse reports a doctor or a bad patient outcome occurs, good luck facing the jury or judge), high medicare+medi-cal population (read lower reimbursements) along with a seemingly endless supply of people who want to live/work in So Cal. This is one of the rare places where it seems like the academic gigs are a better value than playing these silly games and racing to the bottom of the reimbursement scale in private practice. Money may not be everything but financial security for your investment in yourself is a long way off. We have cRNAs who make more than some of the partner gigs here while working 40 hours and never taking call and not assuming the liability.
 
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