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2 years ago yes but market it back. 300/hr+ is easy to come by now in Locum ER
Orange County Market
Started by gaslearnt
Last time I checked there was still a 3 year buy-in. Yes, there's no state income tax, but the "mountain tax" is real.
Examples: Fresno, Bakersfield, Riverside, Fontana, Chino
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How much is Matrix offering these days? They used to be the most competitive group in the area, but haven’t heard much about them in a long while.
deep into poway, escondido, el cajon are basically desert climates lol
In the Bay Area you don’t even have to go that far out. Concord/Martinez and you might as well be in Death Valley.
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deleted87051
Probably 1% live in those areas because they are too far from the hospitals we service although a few live in Poway and more in Scripps ranch. There are nice homes there but both are admittedly too hot for my taste. Poway is pushing it because traffic is bad. Carmel Valley is by far the most popular area because of convenient location and good public schools. Many younger folks without kids live downtown. Don’t know anyone in El Cajon or Escondido.
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Majority of physicians live within 30 to 40 minutes of the hospitals they work out of.
Geez. The hate for California is something else.
I can't think of any physician in my circle (surgeons, OBs, internists, peds, anesthesia) who live more than 30 minutes from the hospital where we function out of ( mid size community hospital in LA county). I know of one orthopod who lives near the beach and commutes against traffic to operate here but that's the exception. Probably an hour drive or so for him.
Quality of life is good in the surrounding areas with good schools, outdoor stuff, etc. Ethnically diverse with great restaurants. Weather is better than the rest of the country.
I'm visiting family in Illinois and it's 90+ degrees with decent humidity. Miserable weather outside. Not to mention cicadas.
Meanwhile, my hometown is 75 max and this is considered a more inland part of Southern California.
Most physicians can purchase a decent house in large segments of Los Angeles, Orange county. Can they purchase in Malibu ? No. But that goes for a lot of super high end parts of the country.
Taxes are terrible. I won't deny that but at this point I've sucked it up. A lot of people have family here and pay the taxes as the cost of staying close to family. Myself included.
Geez. The hate for California is something else.
I can't think of any physician in my circle (surgeons, OBs, internists, peds, anesthesia) who live more than 30 minutes from the hospital where we function out of ( mid size community hospital in LA county). I know of one orthopod who lives near the beach and commutes against traffic to operate here but that's the exception. Probably an hour drive or so for him.
Quality of life is good in the surrounding areas with good schools, outdoor stuff, etc. Ethnically diverse with great restaurants. Weather is better than the rest of the country.
I'm visiting family in Illinois and it's 90+ degrees with decent humidity. Miserable weather outside. Not to mention cicadas.
Meanwhile, my hometown is 75 max and this is considered a more inland part of Southern California.
Most physicians can purchase a decent house in large segments of Los Angeles, Orange county. Can they purchase in Malibu ? No. But that goes for a lot of super high end parts of the country.
Taxes are terrible. I won't deny that but at this point I've sucked it up. A lot of people have family here and pay the taxes as the cost of staying close to family. Myself included.
carmel valley is definitely unaffordable for any young attending sadly but great place to live for sure
I'm in socal and we have to be within 30 min of my hospital when on call - I happen to be well under that. Colleagues who aren't will stay in the hospital... luckily we're only on call about 2 times per month, so it really isn't too bad. Some people live an hour away due to life choices and their spouse's job.
I can't comfortably afford a house in socal because I don't want to be bound to a 1.5 - 2.5 million dollar handcuff. I could probably buy, but with the crazy home valuations I just think it's a bad idea. But I'd much rather live where I am in socal as a renter (which ends up being a relative good deal) than to live somewhere else just because COL and house prices are lower elsewhere. The lifestyle I have in socal is great - perfect weather, tons to do all the time, great culture, nice people, and most of my family is here... With rents much lower than mortgage payments, I'm just stashing away money into index funds and watching them grow.
That said I could definitely picture living somewhere else that has an overall nice setup, like where @sevoflurane is.
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deleted87051
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deleted1183938
So what’s a 4BR 2.5/3 Bath 2500 SF gonna run you?
Oh come on, you complain about cicada? It is one in 221 year event. My neighborhood has none.
3million but people say the value will double every 5-10 years. Let say 6 million in 7 years, lol
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Depends but at least 1.3 million depending on location, lot size and school district.
Better public school district is $$$. Asian people here put that at a high priority and will aggressively bid on these houses solely for the school district.
I live in the OC, have a primary residence and a rental house here, and have a real estate license (mostly as a tool for investing). I am also dorky enough to web-scrape real estate listings to analyse the market (again: investing tools). I have a rental house in coastal OC and can give you actual numbers. It has historically been cheaper to rent than to own in coastal OC--unless you bought during a great recession of just before a pandemic. The rental house is a 3/2.5 located 1 kilometer from the beach in a walkable town. Pretty nice but nothing special. We get $5000 in rent and could probably charge more but we have good tenants. If you wanted to buy this house it would close around $1,500,000. You would need at least 10% down and your monthly expense (mortgage/property taxes) will be ~$10,300/month. You should conservatively have an income of $450,000/year . This doesn't count the opportunity cost when you put down 10% rather than invest elsewhere. In our case our tenants are living for about 50% the cost of owning. Historically around here it has been about 60%.
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deleted1183938
Insanity.
Although it’s probably about $8500 after tax incentives.
Here’s a 4BR 3 bath 3000 sqft house in a pretty nice family friendly neighborhood in SF. 2.3M.
3058 Paseo Granada, Pleasanton, CA 94566 | Zillow
3058 Paseo Granada, Pleasanton CA, is a Single Family home that contains 3027 sq ft and was built in 1990.It contains 4 bedrooms and 3 bathrooms.This home last sold for $2,250,000 in July 2024. The Zestimate for this Single Family is $2,073,100, which has decreased by $17,797 in the last 30...
www.zillow.com
Which segments do you have in mind? Currently house hunting and eyeing Irvine. 4 bed 4 bath 3000 sqft in Irvine is usually 2.5-3M.
It really depends on the area and school district. You’re probably looking at about $600/sqft in less desirable OC cities (so $1.5 million) and over $1,000/sqft in areas like Newport, Laguna Beach or Irvine (so over $2.5 million).
Open Zillow and look around if you’re really curious what it would get you.
If you want more mountains etc, Claremont, San Dimas, Diamond Bar, Walnut. All good school districts and safe with houses under 2 million.
Chino hills is technically in San Bernardino county but rated highly but on the border to Orange and LA county.
For Orange county, Yorba Linda, Brea, Fullerton, Cypress, Costa Mesa, Tustin.
I know physicians and nurses who live in all of these areas.
You can find around 3000 sq ft for under 2.5 million in those areas.
Irvine is definitely inflated. I see some of the great Park homes from Toll Brothers going for $3 million plus.
I don't do much in the San Fernando Valley or Westside so don't know much about those areas.
I grew up in Walnut. Good school district indeed but it does feel like the baby boomers are keeping and staying in their homes, so it's harder to find young-ish couples with kids in their 30-40's. Similar with Diamond Bar
Why would they sell? They enjoy very low property tax. When they die, pass it down to children with step-up basis.
True. Why sell and move if you don't have to? Reasonable property taxes that are locked in. I don't plan on selling my house ever, even if I did move.
Walnut is building on its last piece of open land. Decent size gated community with single family homes. Will be a great opportunity for a family with kids to get into the school district.
Irvine is also absurdly boring. But people do love to live there...
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deleted87051
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You’re living the dream!!!
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There were pros and cons to this. Before having kids, I liked a lot of that kind of stuff, and because of my academic involvement and productivity, I did a lot of it. But it's true, it ain't time off. I can't speak for every university, but we had a calculation of how much non-clinical time you'd get for certain administrative or leadership activities, and the work, to do it well, always took more time than you were given. Having now transitioned out of that role to a strictly clinical, PP group, I can tell you that even though I work more hours, I am way less stressed not doing all the other "homework."
Uh, that's at least an hour from SF without undue traffic.Here’s a 4BR 3 bath 3000 sqft house in a pretty nice family friendly neighborhood in SF. 2.3M.
3058 Paseo Granada, Pleasanton, CA 94566 | Zillow
3058 Paseo Granada, Pleasanton CA, is a Single Family home that contains 3027 sq ft and was built in 1990.It contains 4 bedrooms and 3 bathrooms.This home last sold for $2,250,000 in July 2024. The Zestimate for this Single Family is $2,073,100, which has decreased by $17,797 in the last 30...
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deleted87051
Timely report about housing markets. Hong Kong, Sydney, and Vancouver are least affordable. Don’t see Zurich or Singapore so they may have stuck to English speaking cities.
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Not to mention Pleasanton is an armpit. All the downsides of the Bay Area with none of the upsides.
Some OC Real Estate Metrics
Generational real estate wealth - the American way
Going to have a landed gentry in this country soon enough.
My experience is fairly similar. I did a good handful of administrative roles in the recent past and the amount of work they entailed was soul-crushing - and they never give you even half the time, resources, or pay to make it worth it. A lot of the administrative work in fact was associated with zero time and zero money (and yet tons of people signed up for it).
Going to meetings is fun sometimes, as you can meet with others in the field and see what they're up to. Plus I feel like giving an academic talk here and there has a nice intrinsic reward of advancing the field and disseminating knowledge. But ultimately academic busy work is just not well rewarded these days. The old model of putzing around long enough to be able to think big thoughts in your important professor corner office with a nice pension are long gone.
It's nice to just do a good job clinically, not worry about all the hospital's inner machinations and needs, and then go home to your family/hobbies.
Who considers Pleasanton SF? I would be so depressed paying 2.3mil for that. That might be a 2 hour commute home in rush hour from SF proper.Here’s a 4BR 3 bath 3000 sqft house in a pretty nice family friendly neighborhood in SF. 2.3M.
3058 Paseo Granada, Pleasanton, CA 94566 | Zillow
3058 Paseo Granada, Pleasanton CA, is a Single Family home that contains 3027 sq ft and was built in 1990.It contains 4 bedrooms and 3 bathrooms.This home last sold for $2,250,000 in July 2024. The Zestimate for this Single Family is $2,073,100, which has decreased by $17,797 in the last 30...
How do you guys feel about private practice places chiefs getting not only the usual 50k chief salary but in some cases 150k medical director titles. Essentially 3 non clinical days a week as well. Private practice with certain AMCs.
I’m finding that a common trend. The first is to ask for one non clinical day. Than 2. Than sometimes 3 days non clinical.
The dumbs chiefs ones take advantage of it. Fail to show up and be “seen” on physical location as non clinical days. Two of them have been fired (one in Florida , one in Massachusetts) that I know.
The “smart” chiefs know the game. They will “show” up at the front OR board even for just 20-30 min. They are “seen”. They may shoot off emails are certain business times to make it appear they are doing things.
Don’t hate the player, hate the game?
Why don't you just sit your own cases and correct this issue once and for all. Stop creating a job market for CRNAS
While SF gets the limelight (especially from tourists), it is not the end all be all of the Bay Area. The bay area is a massive place. Pleasanton is not SF (obviously), but it is bay area. Locals here would generally consider it to be a desirable wealthy suburb to live. The folks who are buying in Pleasanton now don't commute to SF. Families choose a town like Pleasanton bc they can still commute to their tech jobs in the south bay or on the peninsula while being able to get more house for their money and send their kids to top notch schools. The heavy hitters as far as $ goes aren't in SF, they are in the south bay and the peninsula ("silicon valley"). Like Apple, Google, Oracle, Nvidia, Facebook, Microsoft, Cisco, Intel, Tesla, etc... This is why homes in Pleasanton are expensive, not to mention there are some beautiful and massive homes/estates there. I mean, it's not as if Los Gatos, Los Altos, Cupertino, Mountain View, Palo Alto, Fremont, etc are quick drives into SF. But they are all incredibly expensive places to live bc they are where all the highest paying tech jobs are. I've basically lived in the bay area my entire life. I'd actually say the east bay is underrated and often overlooked by tourists. There is a lot going on in the east bay. Cities like Oakland and Berkeley have a lot of culture and tons to do. Great food and drink scene in many places. The east bay parks system is amazing. There are so many hills, trails, hiking, views, etc throughout that are beautiful. Top notch school systems in many parts. Great golfing and country clubs if you're into that. Many smaller towns outside of Oakland/Berkeley have pretty cool and clean downtowns, like Walnut Creek, Danville, Lafayette, Alameda, Pleasanton, Albany to name a few
I do sit my own cases. We are losing crnas left and right at my regular job. We probably lost 5 full time crnas in the last 9 months. Losing another crna next month. 2-3 more may leave in the next few months as well. All but one crnas leaving are either going prn w2 or 1099.
The only crna making a lateral w2 move (w2 to w2) for same pay to different practice is because the work load is easier (no trauma , no high risk cases aka bread and butter) plus it’s 5 min commute for him vs 30 min commute. So he saves close to 4 hr commute time each week (he works 4 days a week)
So we have gone from 5-10% medical direction to 40% solo these days at my main gig
There is simply not enough bodies to cover all the cases.
I did have a long talk with one of the old timer crnas in the locker room yesterday. He’s afraid crnas are pricing themselves out of the market soon and that docs will just pickup the slack along with AA willing to work
But I told him AAs are leaving many places as well especially crappy trauma centers. The new AAs go to trauma one. Learn the job for a year or two than leave as well.
It’s just the way things are going these days.
Honestly. I’m close to leaving my full time job as well. I can work 10 days a month 1099 and make twice as much plus stay on as prn w2 at my current job and keep the generous healthcare plus have access to
457b/401a/403b on days I want to work. It’s like the best of all worlds.
The entire anesthesia market is becoming unstablized. Once the docs get with the same mindset as the crnas to work hourly. There is nothing hospital admin can do. They have no choice but to cut elective cases after hours with they hate to do.
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This is why you never want to employ the CRNA's. Too much of a headache. Let it be the hospital's problem.
What do you do? Just shut down multiple rooms?
I’m not anesthesia but watching this play out at a hospital I cover:
Hospital system has decided to kick out all independent groups. The only service specialty group that is hanging on is the one that employs the CRNAs themselves.
That might be the biggest leverage an anesthesia group could have when going up against hospital MBA psychos.
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Looks like even some of the desirable groups in socal are having to advertise nowadays.
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deleted1183938
Tell us more. Is this because the hospital doesn’t want to pay the CRNAs and sees them as a cost expenditure that someone else should handle?
And what doe you mean “service specialty group”? You mean all independent physicians in general are getting kicked out or all independent anesthesia groups?
Yes.
It’s happening to rads, anesthesia, path, and ER.
Either leave or be employed.
Only the anesthesia group with their own CRNAs has fended this off. My guess is the hospital wouldn’t pay the CRNAs enough and they’d all leave.
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deleted1183938
Are the doctors leaving? Why do you think it’s the CRNAs and not the anesthesiologists who aren’t getting enough? Are there other non CRNA dependent groups there who’ve left or agreed to employment?
So all the specialties who aren’t bringing their own patients to the hospital are being asked to leave.
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deleted87051
Looks like even some of the desirable groups in socal are having to advertise nowadays.
True but they’ve advertised in the past.
