Phoenix job market?

[CubsDynasty]

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I wouldn’t say it’s a malignant state for anesthesiologists. I bet there’s more docs doing their own cases then supervising actually. It’s just that it’s an opt out state, with no real residency program to supply physicians, and therefore the massive demand for anesthesia comes in the form of independent CRNA practice. It’s actually a tremendous job market for anesthesiologists with most making 600-800. But there are a lot of smaller hospitals that are CRNA only.

 

[ans2021]

Wow. That is good to know as I don't live in Arizona so I am not familiar with the anesthesia dynamics in Phoenix or any AZ cities. I am just looking for jobs in Phoenix area and saw a Gaswork ad for Guide Anesthesia (AzAS) and they had a "Dr" listed as the head anesthesiologist. Maybe they consider this "Dr" a CRNA Dr. I just assumed that chief Dr. is an MD/DO not DNP. I have worked with awesome CRNAs in medical direction and medical supervision models in the past. But no way would I want to go work in a place that vocalizes hostility and disdain for physicians. It's trickery for DNPs calling themselves "anesthesiologist nurse" and confusing people who are MD/DOs and patients. There have been a couple of online ads and groups which are CRNA DNP which one would not know they are CRNAs since they just have the title of "Dr" with no letters behind their last name. Trickery and Sham.

What about Gilbert and other Phoenix anesthesia groups? Banner? Are they malignant places to work at?

I interviewed with Gilbert group a few years back. DM me and I can give you what I learned back then.

 

[zizzer]

Arizona sounds like a malignant state for anesthesiologists. I don't follow or know the national lead CRNAs who have hatred for anesthesiologists, so I didn't know that some of the nation's most vocal anti-anesthesiologist movements are coming from Arizona. Had no clue. I'll probably pass on Phoenix for a job

I haven't found the state or any of the hospitals (including Banner hospitals) malignant towards anesthesiologists. To the contrary, surgeons have a lot of respect for anesthesiologists, who usually do cases themselves without residents or CRNAs. DM me if you want to hear more about a job where you do your own, sometimes high acuity cases and have the flexibility to work harder and make a lot of money or work less with more vacation and still make decent money with a great work-life balance.

 

[Dawkter]

The VA, Maricopa County (Valleywise), Indian Health Services offer lower salaries with the perk being time off, schedule flexibility, and the benefits package. It is easier to climb the ladder and have a voice at one of these institutions.

Mayo Clinic, St. Joe's, Honor Health, Banner remain competitive with salaries if you are employed by them or work for a group that covers one of these hospitals.

In the past the benefits used to make up the salary difference with locums. In the current market going 1099 + paying for your own health insurance seems to make a lot of sense while still offering the flexibility.

 

[IVdoc]

Any input about the work conditions for the Phoenix groups? Banner Health, Honor Health (Envision), other anesthesia groups? Is there a group/hospital system to avoid due to malignancy in work environment such as high workload, low pay or high supervision ratios? Someone mentioned that Guide Anesthesia is CRNA owned and operated which might be OK if it's a respectful work environment. What about Banner or Envision in Phoenix? Chandler Anesthesia use to advertise for years but I don't see their ads anymore so maybe they are no longer in existence or are fully staffed. I'm looking into multiple cities for potential FT and possible locums jobs.

 

[amyl]

Any input about the work conditions for the Phoenix groups? Banner Health, Honor Health (Envision), other anesthesia groups? Is there a group/hospital system to avoid due to malignancy in work environment such as high workload, low pay or high supervision ratios? Someone mentioned that Guide Anesthesia is CRNA owned and operated which might be OK if it's a respectful work environment. What about Banner or Envision in Phoenix? Chandler Anesthesia use to advertise for years but I don't see their ads anymore so maybe they are no longer in existence or are fully staffed. I'm looking into multiple cities for potential FT and possible locums jobs.

Guide anesthesia is not a respectful work environment. An acquaintance works for them and hates it… she’s treated like a crna equivalent… no one recognizes the difference between the drs and independent Crnas. She only works there because she has scheduling issues with her custody battle. Joe (the head of guide) is a famous crna influencer pushing for independence… they only employ anesthesiologists because they were forced too by some of their hospital contracts.
I hear banner is trying to go in house - but their offers are really really low. Heard their plans were to put crna only in peripheral sites and mix solo doc and crna independents at the main hospital.
Envision supposedly loosing their footprint in town. Hospitals aren’t happy with them. They’ve had difficulty recruiting mostly bc they are envision… I get the impression that envision might be an okay job for someone that really wants to work hard and lots with good $ … for now…. 150k sign on is concerning - note many of these sign on bonuses are actually start date bonuses - gotta read the fine print
Most of what I know is second hand from friends so if someone has other information please correct me if I’m wrong

 

[POW16]

Look into Mayo.

 

[amyl]

Look into Mayo.

Mayo doesn’t have near enough vacation to be considered desirable imho

 

[Burned_Out]

I work with a guy who is a long-time partner within Chandler Anesthesia. He says they are fully staffed. Sound Anesthesia has a few contracts within the valley including at Banner. I am getting mixed signals from those whom work at Sound about their job satisfaction.

 

[zizzer]

Envision supposedly loosing their footprint in town. Hospitals aren’t happy with them. They’ve had difficulty recruiting mostly bc they are envision… I get the impression that envision might be an okay job for someone that really wants to work hard and lots with good $ … for now…. 150k sign on is concerning - note many of these sign on bonuses are actually start date bonuses - gotta read the fine print
Most of what I know is second hand from friends so if someone has other information please correct me if I’m wrong

In my experience, Valley Anesthesiology Consultants via Envision has been the most reliable with hospitals and hospitals prefer them. The limiting factor is not hospitals wanting to work with them, but them being able to hire enough people, hence the $150k sign-on bonus. For those of us eager to work, $1MM a year is possible. That's not too popular for new grads now though.

VAC has a solid contract for now for exclusive coverage with Banner Estrella and Banner Thunderbird, all of Honor Health, and certain service lines at Banner University Medical Center and St. Joseph's Hospital. They also just took over the contract for cardiac surgery at St. Joseph's hospital, which is expanding. On the other hand, Sound's footprint at Banner University seems to be decreasing. Sound (the corporation) seems to overpromise and underdeliver.

I work with a guy who is a long-time partner within Chandler Anesthesia. He says they are fully staffed. Sound Anesthesia has a few contracts within the valley including at Banner. I am getting mixed signals from those whom work at Sound about their job satisfaction.

I'm not sure about the docs at Sound, but the CRNAs seem very unhappy. Sound seems to prioritize new contract sites and then forget about the old ones.

 

[aneftp]

In my experience, Valley Anesthesiology Consultants via Envision has been the most reliable with hospitals and hospitals prefer them. The limiting factor is not hospitals wanting to work with them, but them being able to hire enough people, hence the $150k sign-on bonus. For those of us eager to work, $1MM a year is possible. That's not too popular for new grads now though.

VAC has a solid contract for now for exclusive coverage with Banner Estrella and Banner Thunderbird, all of Honor Health, and certain service lines at Banner University Medical Center and St. Joseph's Hospital. They also just took over the contract for cardiac surgery at St. Joseph's hospital, which is expanding. On the other hand, Sound's footprint at Banner University seems to be decreasing. Sound (the corporation) seems to overpromise and underdeliver.


I'm not sure about the docs at Sound, but the CRNAs seem very unhappy. Sound seems to prioritize new contract sites and then forget about the old ones.

Workload matters more than pure income. How much time off are you taking making 1 million. A min 7 plus weeks off in my opinion and 50 hrs a week. Anyone can make 1 million these days. Just need to pace yourself.

 

[zizzer]

Workload matters more than pure income. How much time off are you taking making 1 million. A min 7 plus weeks off in my opinion and 50 hrs a week. Anyone can make 1 million these days. Just need to pace yourself.

We get 10 and can sell some back. Last year I took about 7 off. Hours a week is highly variable but I don't think I'm averaging much more than 50. Not bad for a big city rather than having to go rural. Regardless, your opinion can really only apply to you since it's an individualized matter of preference.

 

[amyl]

We get 10 and can sell some back. Last year I took about 7 off. Hours a week is highly variable but I don't think I'm averaging much more than 50. Not bad for a big city rather than having to go rural. Regardless, your opinion can really only apply to you since it's an individualized matter of preference.

Everyone gets 10 to start? Thought envision started at 8. Is everyone getting stuck at 50h/week average or is that your choice?

If envision would put a number on 40-45h/week and 10 weeks vacation with over time of you go over hours - if that number was 600 they’d get people….

People want some control over their hours… I used to bank 800 at my old job but I bet I’d be really really pissed off if I worked out what I made per hour

 

[Burned_Out]

From what I can tell of the Envision Valley guys & gals at one facility, they are always there late at night, weekends and holidays covering the hearts, transplants, cranis, and complex spines. They are stuck there until they're done with no relief. I'm not doubting that you can make big $ at Envision, but you will inherit the complex cases in doing so.

 

[agammaglobulin]

Avoid Envision in Phoenix metro at all costs.

(1) Corporate structure is horrible. They have 20 year old, non medical people remotely running the OR anesthesia staffing. This person is not on site and have no idea what’s going on. Fortunately, the senior people, “managers”, often get out early/have a light day to help “run the board” but they just go home. So around 2:30-5 everyday no one knows what’s going on.

(2) Envision is short everywhere so while you apply for one location, or region, they’ll tell you during recruiting you “mostly” stay at one place but may help out “time to time” if other sites are short. Reality: you often cover other hospitals, driving all over, to cover places no one wants to go. You show up to a brand new place, get thrown in the OR, another 20 year old texting you where to go and what to do. Super safe.

(3) They pay a big “sign on” but it’s not a sign on bonus, it’s a retention bonus. You have to pay it back, prorated, if you leave within 2 years. (For example, if you leave after 6 months you’ve only completed 25% of a 2 year commitment so you only keep 25% of the bonus). Don’t forget, you get taxed highly on the retention bonus so if you have to pay it back you could actually LOSE money as the pay back amount is not post tax, but pre tax. (Example: 100k sign on bonus, post tax is roughly $65k. If you leave after 6 months you owe back 75k, more than you ever received.)

(4) the way some employees make decent money for this place is working on vacation (like person above “selling back” 3 weeks of vacation). They’ll give you extra pay for working vacation days. So senior people accumulate more vacation the longer they’ve been there, and then work many of their vacation weeks. You’d make WAY more if you just did locums, or had a decent job that pays more, but that is how these “high earners” at Envision are doing it. Next time the recruiter or someone tells you they’re making a high amount, ask directly how much of their vacation they are selling back and working.

If you interview with Envision, I’d strongly recommend talking to many non-managers during interviewing. Make sure you talk to many people without managers standing there and ask pointed questions. Think of it like applying to residency but the program director following around everywhere you go…no one is going to give you the truth.

I’d recommend Chandler Group, Mayo or SWAP (ASCs) highly over Envision.

 

[D4C]

Avoid Banner and Avoid Envision. You’re better off in a private group or different town.

 

[zizzer]

Everyone gets 10 to start? Thought envision started at 8. Is everyone getting stuck at 50h/week average or is that your choice?

If envision would put a number on 40-45h/week and 10 weeks vacation with over time of you go over hours - if that number was 600 they’d get people….

People want some control over their hours… I used to bank 800 at my old job but I bet I’d be really really pissed off if I worked out what I made per hour

Good point. Corporate starts people out at 8 and graduates them up, which is stupid. That said, it's more than offset by the $100K to $150K (depending on division) sign-on bonus.

There's flexibility with how much to work, and many people are happy to work less and make less. It's all personal preference (with limits because there's some mandatory call for everybody).

From what I can tell of the Envision Valley guys & gals at one facility, they are always there late at night, weekends and holidays covering the hearts, transplants, cranis, and complex spines. They are stuck there until they're done with no relief. I'm not doubting that you can make big $ at Envision, but you will inherit the complex cases in doing so.

It's definitely the higher-acuity stuff at some places like downtown, but there's a lot of variability with the different divisions, as it's a large group. Cardiac anesthesiologists have their own deal. The expectation is that you're relieved by a call person when not on call. As with anywhere, that's not always possible, but updated contracts with hospitals means we can enforce our room obligations and not start rooms at 1500 when we don't have a call person to take over. That has been a welcome change. On the off chance one does get stuck late, not on call, they're always earning more for it and it usually balances out with preferential treatment with the next day's schedule.

Avoid Envision in Phoenix metro at all costs.

(1) Corporate structure is horrible. They have 20 year old, non medical people remotely running the OR anesthesia staffing. This person is not on site and have no idea what’s going on. Fortunately, the senior people, “managers”, often get out early/have a light day to help “run the board” but they just go home. So around 2:30-5 everyday no one knows what’s going on.

(2) Envision is short everywhere so while you apply for one location, or region, they’ll tell you during recruiting you “mostly” stay at one place but may help out “time to time” if other sites are short. Reality: you often cover other hospitals, driving all over, to cover places no one wants to go. You show up to a brand new place, get thrown in the OR, another 20 year old texting you where to go and what to do. Super safe.

(3) They pay a big “sign on” but it’s not a sign on bonus, it’s a retention bonus. You have to pay it back, prorated, if you leave within 2 years. (For example, if you leave after 6 months you’ve only completed 25% of a 2 year commitment so you only keep 25% of the bonus). Don’t forget, you get taxed highly on the retention bonus so if you have to pay it back you could actually LOSE money as the pay back amount is not post tax, but pre tax. (Example: 100k sign on bonus, post tax is roughly $65k. If you leave after 6 months you owe back 75k, more than you ever received.)

(4) the way some employees make decent money for this place is working on vacation (like person above “selling back” 3 weeks of vacation). They’ll give you extra pay for working vacation days. So senior people accumulate more vacation the longer they’ve been there, and then work many of their vacation weeks. You’d make WAY more if you just did locums, or had a decent job that pays more, but that is how these “high earners” at Envision are doing it. Next time the recruiter or someone tells you they’re making a high amount, ask directly how much of their vacation they are selling back and working.

If you interview with Envision, I’d strongly recommend talking to many non-managers during interviewing. Make sure you talk to many people without managers standing there and ask pointed questions. Think of it like applying to residency but the program director following around everywhere you go…no one is going to give you the truth.

I’d recommend Chandler Group, Mayo or SWAP (ASCs) highly over Envision.

Nothing there is false, with the possible exception of the subjective schedule-maker favoritism claim, which I haven't experienced, but there are many divisions and managers I'm not too familiar with.

That said, the other stuff is transparently explained. Some do indeed choose to use their PTO to work locums. The sign-on bonus is also a retention bonus in the manner you described. Applicants are shown everybody's daily schedules over several weeks, as well as pay stubs. This transparent approach actually helps with recruiting. "Base salary is <$400K but you can make $1MM just trust me" doesn't land many recruits.

 

[aneftp]

Everyone gets 10 to start? Thought envision started at 8. Is everyone getting stuck at 50h/week average or is that your choice?

If envision would put a number on 40-45h/week and 10 weeks vacation with over time of you go over hours - if that number was 600 they’d get people….

People want some control over their hours… I used to bank 800 at my old job but I bet I’d be really really pissed off if I worked out what I made per hour

Correct. I never pay attention to gross income worked. While 800k is solid high full time (not locums) number but without context how much you are working or time off. Or beeper time. 800k without context means little.

There are many places with Envison in Florida where they dangle enough overtime and extra pay shifts etc where you can probably hit 650k-700k w2 with Envison (which are solid numbers for Florida). Just a lot of extra hours to get to there number.

 

[IVdoc]

What about doing locums with Envoy/Envision in Phoenix? Would those who live in Phoenix say that's an OK option? I have worked at places where the "secretary" or some non-medical person is running the anesthesia board and calling me and telling me where to go for my next cases and it was awful. These secretary board-runner (non-medical) were clueless about how the ORs/anesthesia cases run. All these secretaries knew would be "GI added a case to your room. Or this case moved out of your room and now this case is in your room" and these secretaries were clueless as to the complexity of the case, the complexity and sickness of the patients but they just changed all the rooms of the patients you already looked up the day before and dumped someone on the verge of death who has no work-up in your room. Major stress in these types of situations with secretaries being the board-runner

 

[amyl]

Avoid Banner and Avoid Envision. You’re better off in a private group or different town.

Sounds familiar - the valley setup working late not on call…. My old dallas gig was like this. I guess AMCs dominate big cities… Indianapolis and Reno have solid options but many wouldn’t consider them big cities (I love Indy- not throwing any shade. Ive never been to Reno).
Please someone correct me if I’m wrong and tell me if there are “big-ish cities” with good jobs…. Doesn’t seem like it to me

 

[Ashers]

What about doing locums with Envoy/Envision in Phoenix? Would those who live in Phoenix say that's an OK option? I have worked at places where the "secretary" or some non-medical person is running the anesthesia board and calling me and telling me where to go for my next cases and it was awful. These secretary board-runner (non-medical) were clueless about how the ORs/anesthesia cases run. All these secretaries knew would be "GI added a case to your room. Or this case moved out of your room and now this case is in your room" and these secretaries were clueless as to the complexity of the case, the complexity and sickness of the patients but they just changed all the rooms of the patients you already looked up the day before and dumped someone on the verge of death who has no work-up in your room. Major stress in these types of situations with secretaries being the board-runner

This is how the private groups i worked for in Phoenix were. I refused to work for Banner/Envision dating back over 10 years when i was looking at UofA in Tucson (go cats!). I left to do locums and eventually moved back to where I did med school/residency even though my family is in Phoenix because I couldn't stand working in Phoenix.

 

[amyl]

This is how the private groups i worked for in Phoenix were. I refused to work for Banner/Envision dating back over 10 years when i was looking at UofA in Tucson (go cats!). I left to do locums and eventually moved back to where I did med school/residency even though my family is in Phoenix because I couldn't stand working in Phoenix.

Ditto but with dallas…