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Partnership track in eastern, NC

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racerx

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For a July 1, 2017 start. My small, private group has a need for a general anesthesiologist at an UNC Affiliated Health Center. This is a bread and butter position. Surgical services include general, vascular, neuro (no complex heads), ortho, gyn, healthy peds. OB call-backs generally light. Regional anesthesia skills a plus. No hearts, and very limited trauma, as most are referred to a tertiary care center.

Two years to partner

Starting salary $300K + benefits; salary increased second year. In addition, benefits include Healthcare, Maximum 401k, HSA, CME allowance, etc.
Profit/dividend sharing upon becoming partner increases total income substantially.

Position is medical direction of CRNAs

MD anesthesiologists place and manage labor epidurals.

Home call 1:5, first out post-call.

7 weeks vacation, plus 1 week CME meeting time per year, to start. This increases upon becoming partner.

Paid Malpractice 3M/5M

Located in Eastern, NC. 45 minutes from Raleigh, 60-90 minutes from the beach (depending on what beach). Low cost of living.

If interested, please feel free to PM me and I'll give you my email address where you can send your CV.

Not an AMC, and not an agency. Agencies, please do not contact regarding this post.
 
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chocomorsel

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How often are you supervising CRNAs verses doing your own cases? Or is it all Medical Direction unless on call? Also, what is the ratio of MD:CRNA during supervision?
 

racerx

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Always medically directing hospital employed CRNAs. Even on call, we medically direct. We do our own Epidurals, spinals, regional procedures. max is 1:4 for us, so we don't get into a medical supervision situation. As our group doesn't employ the CRNAs, our RVUs would drop to 3 for each case in all 5 directed rooms, with no time adder. IF we took on the CRNAs, we could ad a "QZ" modifier and realize more RVUs, but the headache of a small group taking on the CRNAs (and their assorted issues) is more than we want.

I will say, we work hard, but the income is pretty good for the area, and f-ing excellent once someone makes partner. I had no idea until making partner exactly what the difference would be. I thought I did, but wow! I was wrong.

We also give an annual year-end 401k disbursement at the max allowed by law ($>50k). Also, even non-partners get a small "token" of appreciation at year end in addition to regular salary. And no, it's not a frozen turkey. LOL

Anyhow, I can't give up too much info on this forum. Gotta save some information!
 
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Gaseous Clay

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Sounds like a solid job, thanks for posting rather than trying to use a recruiter. I don't think you'll have too much difficulty filling the position.
 
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chocomorsel

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Good job for someone who likes supervising. I personally can't supervise 100% of the time. When I supervise, I feel like I am running around like a chicken with my head cut off. Plus, I feel like I would lose out on some skills. I need to do and sit my own cases.
 

racerx

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Good job for someone who likes supervising. I personally can't supervise 100% of the time. When I supervise, I feel like I am running around like a chicken with my head cut off. Plus, I feel like I would lose out on some skills. I need to do and sit my own cases.
We routinely do aspects of the case ourselves to keep our clinical skills up. I do all difficult and/or fiberoptic intubations myself, all lines, handle all urgent/emergent physiologic derangements -- the CRNAs don't unilaterally treat without our input. We decide what and when to give, how, etc. When on call, I still occasionally sit the case while the call CRNA hangs in the lounge. That way, if I get called to labor and delivery, they can come in and sit. Keeps my skills up.

That being said, I completely understand where you're coming from on this. Different folks like practicing in different ways.
 
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BLADEMDA

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My small, private group has a need for a general anesthesiologist at an UNC Affiliated Health Center. This is a bread and butter position. Surgical services include general, vascular, neuro (no complex heads), ortho, gyn, healthy peds. OB call-backs generally light. Regional anesthesia skills a plus. No hearts, and very limited trauma, as most are referred to a tertiary care center.

Two years to partner

Starting salary $300K + benefits; salary increased second year. In addition, benefits include Healthcare, Maximum 401k, HSA, CME allowance, etc.
Profit/dividend sharing upon becoming partner increases total income substantially.

Position is medical direction of CRNAs

MD anesthesiologists place and manage labor epidurals.

Home call 1:5, first out post-call.

7 weeks vacation, plus 1 week CME meeting time per year, to start. This increases upon becoming partner.

Paid Malpractice 3M/5M

Located in Eastern, NC. 45 minutes from Raleigh, 60-90 minutes from the beach (depending on what beach). Low cost of living.

If interested, please feel free to PM me and I'll give you my email address where you can send your CV.

Not an AMC, and not an agency. Agencies, please do not contact regarding this post.

this is a good job. The type you want to pursue imho.
 
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racerx

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Can you elaborate on this please?
Sure. At year end, we each (partners and anyone in partnership track) get a check of around $54k +/- to invest.

Those who are partners are free to invest as they please, anyone in their first two years uses an investment firm here in town. This has to do with being an "S" corp., and employee vs shareholder status. Technically, as a qualifying retirement plan for employees status folks, we shareholders are technically trustees of the retirement accounts of employees. In reality, we don't know, and don't really care in what the employee invests in.

The in-town investment firm did such a good job while I was an employee, once I became shareholder/partner, I stayed with them.

Another roundabout way we have of investing is via our HSA accounts. If anyone doesn't use all of their HSA account money that is put in every year, it accrues. Anything over our health plan deductible for a year can be invested as well.

Again, I don't know how much my partners would want me to elaborate, so I'm gonna stop there. (Gotta have a few secrets, LOL)

Racerx
 

Scotty_G

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It's good that you are still Private in an area dominated by AMC's.
 

racerx

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It's good that you are still Private in an area dominated by AMC's.
Yeah. Not many left around here. MEDNAX pretty much has a monopoly on NC, with Providence taking the southern piedmont and Sentara the extreme northeastern parts as consolation scraps.

I would think with MEDNAX taking such a large portion of every region they enter, it may skirt the edges of monopoly, as they become essentially the single seller of a service in a region. I'm not a business major nor lawyer, so I don't know. However, it sure sucks if you're looking for a job in anesthesiology where MEDNAX exists.
 

GravelRider

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Yeah. Not many left around here. MEDNAX pretty much has a monopoly on NC, with Providence taking the southern piedmont and Sentara the extreme northeastern parts as consolation scraps.

I would think with MEDNAX taking such a large portion of every region they enter, it may skirt the edges of monopoly, as they become essentially the single seller of a service in a region. I'm not a business major nor lawyer, so I don't know. However, it sure sucks if you're looking for a job in anesthesiology where MEDNAX exists.

I wonder if the fact that you are surrounded by MEDNAX makes people wary about signing a partnership track job and is making your recruiting more difficult? People may assume it is only a matter of time before you are part of MEDNAX.

This is actually an interesting point because I was recently talking to a few classmates and some other recent or soon-to-be grads and the prevailing notion was that signing a partnership track job was for suckers. The thinking was that "partnership track" is synonymous with scam. Every single person I was talking to has been or knows someone who was screwed over by a private practice who promised a partnership. Now, I'm not saying your group is looking to scam someone or even that a majority of private practices are looking to scam someone, but the stories about the screw jobs are far and wide. In the end, I guess it's all about risk tolerance. People with high debt loads and minimal personal wealth are more likely to take a "devil that you know" approach. The AMCs are winning the game because of the amount of uncertainty they've created in the market (among other reasons).
 

racerx

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I wonder if the fact that you are surrounded by MEDNAX makes people wary about signing a partnership track job and is making your recruiting more difficult? People may assume it is only a matter of time before you are part of MEDNAX.

This is actually an interesting point because I was recently talking to a few classmates and some other recent or soon-to-be grads and the prevailing notion was that signing a partnership track job was for suckers. The thinking was that "partnership track" is synonymous with scam. Every single person I was talking to has been or knows someone who was screwed over by a private practice who promised a partnership. Now, I'm not saying your group is looking to scam someone or even that a majority of private practices are looking to scam someone, but the stories about the screw jobs are far and wide. In the end, I guess it's all about risk tolerance. People with high debt loads and minimal personal wealth are more likely to take a "devil that you know" approach. The AMCs are winning the game because of the amount of uncertainty they've created in the market (among other reasons).

Fair points.

I can tell you that three things work in our group's favor. One, we are a small group where the potential income:headache ratio for a large AMC (they who shan't be named. . .cough, cough) isn't attractive. Second, we were told in the most recent contract renewal the new (and current) administration felt AMCs were not willing to provide the level of service we do without needing stipending. Third, we are able to make a very good living without needing additional funds from the hospital. We are currently taking no stipends, whereas all of the AMCs in NC seem to request stipends. Our group essentially costs the hospital no money.

We are secure, and have been praised by admin for seamlessly taking on additional services. Now that we're much busier, we need to expand our FTE coverage with another anesthesiologist.

Our group has only refused partnership to one in its 30+ year history, due to the doc developing a common "problem." I am the most recent person to become partner, and was initially worried (needlessly, as it turned out) about being "scammed." The more I got to know the others in the group, I came to realize they were all straight shooters who were only concerned with good patient care and keeping the reputation of the group stellar.

I have to say, you guys here have all given me good insight into the possible thinking of potential candidates. Thank you all.
 
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Arch Guillotti

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    Sure. At year end, we each (partners and anyone in partnership track) get a check of around $54k +/- to invest.

    Those who are partners are free to invest as they please, anyone in their first two years uses an investment firm here in town. This has to do with being an "S" corp., and employee vs shareholder status. Technically, as a qualifying retirement plan for employees status folks, we shareholders are technically trustees of the retirement accounts of employees. In reality, we don't know, and don't really care in what the employee invests in.

    The in-town investment firm did such a good job while I was an employee, once I became shareholder/partner, I stayed with them.

    Another roundabout way we have of investing is via our HSA accounts. If anyone doesn't use all of their HSA account money that is put in every year, it accrues. Anything over our health plan deductible for a year can be invested as well.

    Again, I don't know how much my partners would want me to elaborate, so I'm gonna stop there. (Gotta have a few secrets, LOL)

    Racerx


    Ok, thanks.

    I understand the $54,000 as this is easily found in the IRS guidelines (20% of the 2017 annual compensation limit. It's unclear to me how the amount can be higher that $54,000 though as this is the limit set by the IRS. It's pretty generous of your group to make this contribution for non-shareholders.

    My bigger question is why wait until the end of the year to deposit the money? Say there are 5 of you in the group - over the course of a year you have over a quarter of a million dollars accumulating what is probably a paltry interest rate. Where is this money invested? I think it makes much more sense to contribute throughout the year on each paycheck up to the maximum - for 2017 this is $1500 a check if you are paid monthly if you are under the age of 50. If you wait until the end of the year your last paycheck might be pretty puny if such a large amount is all going straight to retirement.

    What fees does the intern investment firm charge? Bogleheads abound around here and most are aghast at paying any more fees that they have to.

    Finally, if you are a partner, shareholder and trustee then I would imagine that you could request a year end report from the 401K detailing holdings, assets, etc. I am astounded at some of the crap my partners are invested in.
     

    racerx

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    Ok, thanks.

    I understand the $54,000 as this is easily found in the IRS guidelines (20% of the 2017 annual compensation limit. It's unclear to me how the amount can be higher that $54,000 though as this is the limit set by the IRS. It's pretty generous of your group to make this contribution for non-shareholders.

    My bigger question is why wait until the end of the year to deposit the money? Say there are 5 of you in the group - over the course of a year you have over a quarter of a million dollars accumulating what is probably a paltry interest rate. Where is this money invested? I think it makes much more sense to contribute throughout the year on each paycheck up to the maximum - for 2017 this is $1500 a check if you are paid monthly if you are under the age of 50. If you wait until the end of the year your last paycheck might be pretty puny if such a large amount is all going straight to retirement.

    What fees does the intern investment firm charge? Bogleheads abound around here and most are aghast at paying any more fees that they have to.

    Finally, if you are a partner, shareholder and trustee then I would imagine that you could request a year end report from the 401K detailing holdings, assets, etc. I am astounded at some of the crap my partners are invested in.


    All great questions.

    For now, I'm going to defer answering the questions for two reasons: First, some of the answers I do not have as I am fairly new to this and am not business-minded. Second, I am not sure what additional information my partners would want being discussed on an internet forum. I'm sure you understand. Especially as it is currently very easy to determine who/where we are.

    You have brought up some great points, though, and I will be discussing this with the group shareholders. Monthly payroll contributions may have been onerous for our founder to manage, as he did a large portion of the financials himself, with input/assistance from a CPA firm. Now that he has retired, he is in process of training our new practice manager. Maybe now is a good time to make a few tweaks to the process.

    Thank you.
     
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    pjl

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    For residents:
    As a PP attending, if I was looking for a new job in the south, this is the type of job I would look for. The partnership track is a blink of an eye, and the job sounds decent (although I personally prefer sitting at least some of my own cases).
    Vacation, working post call, and partner salary would be my questions/hangups. Partner pay would have to be decent to get me to work postcall with only 7 weeks off.

    Sent from my iPad using SDN mobile app
     
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    racerx

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    For residents:
    As a PP attending, if I was looking for a new job in the south, this is the type of job I would look for. The partnership track is a blink of an eye, and the job sounds decent (although I personally prefer sitting at least some of my own cases).
    Vacation, working post call, and partner salary would be my questions/hangups. Partner pay would have to be decent to get me to work postcall with only 7 weeks off.

    Sent from my iPad using SDN mobile app

    Once a partner, vacation is more than 7 weeks. In addition, we have an another week of CME, which can be used as vacation. . . if you already do audio digest, or ACE, SEE, etc. throughout the year. We don't really nitpick that week.

    With the addition of another person, post call will be much shorter. Mainly just coming in to get the first starts rolling.

    Partner salary is the same. Where we get the increase in income is the dividend/profit distributions every quarter. I am not at liberty to give any numbers here, but suffice it to say the partners here make approx. 1.75X the regular W2 salary they receive from the S-corp (on a "bad year." Good years have seen up to 2X.
     

    racerx

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    I encourage anyone who is interested in this position to send their CV, even if they're not available until 2018. We anticipate even more expansion of services. In addition, the new OR suite being built will start coming online in 2018, so we are anticipating the need for yet a second additional FTE then.

    For my email address, send me a PM.
     

    WholeLottaGame7

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    How far are you from Charlotte?

    Raleigh's about 2 hours from Charlotte, and if the beach is only 60min away, he's on the eastern side of Raleigh, so figure about 3hours-ish, give or take. Plus traffic on 40 can be a bitch depending on the time of day.

    I can't figure out exactly which city he's in, but based on the clues, I'm thinking somewhere like Goldsboro or maybe Rocky Mount?

    NC is a great place to live, but keep in mind those towns are on the smaller side, so don't go in there expecting a place like Charlotte, Raleigh, or even Greensboro/Winston-Salem.

    The job sounds decent, though.
     
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    racerx

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    Some of you have PMed me asking if we are still looking for another Anesthesiologist. The short answer is yes. As it stands now, we are planning to interview a couple of folks soon, and are still accepting CVs from anyone interested. Those of you who have enquired, please send your CV. I'm still waiting on a few folks who have said they were going to send me one. If you need my email address, PM me.
     

    racerx

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    You should ask the regional AMC. :p
    Not really sure what you mean by this. We just renewed our contract with the hospital for a long term deal.

    The "regional AMC" in Eastern NC has found it isn't as easy at the smaller community hospitals. They consistently ask for stipends to ensure they make money for a "for profit" corp. We do not, and run as an S-Corp, with no carryover profit from year to year. Their weakness is the need to keep growing via acquisitions, thereby having to maintain a certain amount of liquid capital/debt, while paying external shareholders.

    The stipends turn off hospitals that run on slim margins here; especially when we currently cost the hospital nothing.
     
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    racerx

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    What's the potential of needing someone July, 2020?

    ;)

    When you get to the fall of your CA3 year, send me a CV. Don't know if we'll have an opening, but it can't hurt to try.
     
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    Stank811

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    Your groups structure is set up very similar to the majority of PP groups that I am familiar with....great opportunity for those interested in your geographical area.
     

    Stank811

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    I wonder if the fact that you are surrounded by MEDNAX makes people wary about signing a partnership track job and is making your recruiting more difficult? People may assume it is only a matter of time before you are part of MEDNAX.

    This is actually an interesting point because I was recently talking to a few classmates and some other recent or soon-to-be grads and the prevailing notion was that signing a partnership track job was for suckers. The thinking was that "partnership track" is synonymous with scam. Every single person I was talking to has been or knows someone who was screwed over by a private practice who promised a partnership. Now, I'm not saying your group is looking to scam someone or even that a majority of private practices are looking to scam someone, but the stories about the screw jobs are far and wide. In the end, I guess it's all about risk tolerance. People with high debt loads and minimal personal wealth are more likely to take a "devil that you know" approach. The AMCs are winning the game because of the amount of uncertainty they've created in the market (among other reasons).


    Umm taking a job with AMCs is for suckers...apply for racerx group and if you get the job I would love to get your perspective in 3 yrs. If you have high debt loads and minimal personal wealth you are willing to take a job that pays 100K more for 1 yr? My guess is the partners make around 600-800k a yr in his group. I would say the 2 yr partnership is more than worth the risk. I paid of my 300K in loans within 3 yrs by joining a group like Racerx. If you have options the AMC should be last on everyones list and if the AMC is your only option then there isn't much you can do.
     
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    nimbus

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    Umm taking a job with AMCs is for suckers...apply for racerx group and if you get the job I would love to get your perspective in 3 yrs. If you have high debt loads and minimal personal wealth you are willing to take a job that pays 100K more for 1 yr? My guess is the partners make around 600-800k a yr in his group. I would say the 2 yr partnership is more than worth the risk. I paid of my 300K in loans within 3 yrs by joining a group like Racerx. If you have options the AMC should be last on everyones list and if the AMC is your only option then there isn't much you can do.


    It's simple...AMC---->20-30% of top line gross practice revenues goes to sinkhole. Forever.
     

    Mad Jack

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    I might still win the lottery before that. Or have some relative Nigerian prince die and leave me lots of money. Or have some barista spill scalding hot coffee all over my groin and leave me disabled.
    I would rather be broke than have the sort of burns the woman in the McDonald's case ended up with on her groin. Full thickness, 3rd degree burns to the genitalia and legs requiring hospitalization, regular debridement, and reconstruction of over 16% of her body.

    Choosing between that and working for an AMC might be difficult though.
     

    GravelRider

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    Umm taking a job with AMCs is for suckers...apply for racerx group and if you get the job I would love to get your perspective in 3 yrs. If you have high debt loads and minimal personal wealth you are willing to take a job that pays 100K more for 1 yr? My guess is the partners make around 600-800k a yr in his group. I would say the 2 yr partnership is more than worth the risk. I paid of my 300K in loans within 3 yrs by joining a group like Racerx. If you have options the AMC should be last on everyones list and if the AMC is your only option then there isn't much you can do.

    Yup. The majority of physicians are suckers. I think we hit a point a few years ago where >50% of all physicians are employed by someone else. That number grows every year.
     

    Stank811

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    Yup. The majority of physicians are suckers. I think we hit a point a few years ago where >50% of all physicians are employed by someone else. That number grows every year.


    I said working for an AMC not employed. AMC have the worse total package deal out of any employed contract I have heard of.
     

    GravelRider

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    I said working for an AMC not employed. AMC have the worse total package deal out of any employed contract I have heard of.

    I don't like AMCs. I would prefer to work in a partnership like mentioned in this thread, BUT...

    It's not necessarily true that the AMC offer is the worst in a region. A fake partnership and many hospital employed positions can be worse.
     

    racerx

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    At this time, we have offered the position to a candidate. Thank you to all who applied and offered advice.

    That being said:

    Due to the new OR construction and expansion of services, there is a strong possibility of another position opening in the Summer of 2018. If you are interested in this position, please PM me for my email address, so you may send your CV. (Including 2018 residency grads)

    Again, thank you.
     
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    Leonard McCoy

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    At this time, we have offered the position to a candidate. Thank you to all who applied and offered advice.

    That being said:

    Due to the new OR construction and expansion of services, there is a strong possibility of another position opening in the Summer of 2018. If you are interested in this position, please PM me for my email address, so you may send your CV. (Including 2018 residency grads)

    Again, thank you.


    PM sent
     

    rockRT

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    For a July 1, 2017 start. My small, private group has a need for a general anesthesiologist at an UNC Affiliated Health Center. This is a bread and butter position. Surgical services include general, vascular, neuro (no complex heads), ortho, gyn, healthy peds. OB call-backs generally light. Regional anesthesia skills a plus. No hearts, and very limited trauma, as most are referred to a tertiary care center.

    Two years to partner

    Starting salary $300K + benefits; salary increased second year. In addition, benefits include Healthcare, Maximum 401k, HSA, CME allowance, etc.
    Profit/dividend sharing upon becoming partner increases total income substantially.

    Position is medical direction of CRNAs

    MD anesthesiologists place and manage labor epidurals.

    Home call 1:5, first out post-call.

    7 weeks vacation, plus 1 week CME meeting time per year, to start. This increases upon becoming partner.

    Paid Malpractice 3M/5M

    Located in Eastern, NC. 45 minutes from Raleigh, 60-90 minutes from the beach (depending on what beach). Low cost of living.

    If interested, please feel free to PM me and I'll give you my email address where you can send your CV.

    Not an AMC, and not an agency. Agencies, please do not contact regarding this post.

    Can
    For a July 1, 2017 start. My small, private group has a need for a general anesthesiologist at an UNC Affiliated Health Center. This is a bread and butter position. Surgical services include general, vascular, neuro (no complex heads), ortho, gyn, healthy peds. OB call-backs generally light. Regional anesthesia skills a plus. No hearts, and very limited trauma, as most are referred to a tertiary care center.

    Two years to partner

    Starting salary $300K + benefits; salary increased second year. In addition, benefits include Healthcare, Maximum 401k, HSA, CME allowance, etc.
    Profit/dividend sharing upon becoming partner increases total income substantially.

    Position is medical direction of CRNAs

    MD anesthesiologists place and manage labor epidurals.

    Home call 1:5, first out post-call.

    7 weeks vacation, plus 1 week CME meeting time per year, to start. This increases upon becoming partner.

    Paid Malpractice 3M/5M

    Located in Eastern, NC. 45 minutes from Raleigh, 60-90 minutes from the beach (depending on what beach). Low cost of living.

    If interested, please feel free to PM me and I'll give you my email address where you can send your CV.

    Not an AMC, and not an agency. Agencies, please do not contact regarding this post.
     

    rockRT

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    Hey, can you please offer more details regarding the location of your practice? thanks!
     

    racerx

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    Hey, can you please offer more details regarding the location of your practice? thanks!

    Sure, we're located about 45 minutes southwest of Greenville, in Goldsboro. I see you went to Brody, so I'm sure you are familiar with the area.

    We will likely need yet another for July 2018, so please PM, I'll PM back my email, and you send me a CV if you're interested. We're getting an earlier start on it this tome around. Hopefully, there will be more interest if we start earlier.

    Racerx
     
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