Profit sharing practice looking for General/Cardiac Anesthesiologists. Top 10% MGMA in Florida ! Starting @400, Low Covid census!

[dr.vvb]

Anesthesiology Associates of Tallahassee (AAOT) is seeking a Board Certified/Board Eligible Anesthesiologist for a full-time position with in Tallahassee, Florida. This group provides anesthesia services at Tallahassee Memorial Hospital, Capital Regional Medical Center and several ASCs.

Highlights of this opportunity include:

• Excellent compensation plan with significant profit sharing eligibility after year 2 (Top 10 % MGMA)
• Anesthesia Care team is comprised of 30 physicians and 80 allied health providers ( CAAs and CRNAs)
• Cases include: General Surgery, Trauma, OB, Orthopedics, Hearts, Endo, Pediatrics, Neuro
• Physician must be cardiac proficient. TEE certification not required, but should be willing to do cardiac w/echo
• Physicians medically direct 99% of the time, 1:2 - 1:3 most of the time but occassionally 1:4
• In house call 2-3x a month and this is the same for our cardiac fellows as we do not have cardiac call.

8 Weeks PTO

W2 position that starts at 425k the first year with significant profit sharing opportunity beginning year 3.


Envision Physician Services offers a competitive compensation and benefits start day one with no waiting period! Package includes medical, dental, vision, short/long-term disability, life insurance, FSA and HSA, 401(k) with Company match and paid malpractice with tail coverage.


Community Description:
Best known as Florida's capital city, Tallahassee holds a deep-rooted history and culture with unparalleled natural adventure and an upbeat vitality. Tallahassee’s year-round appeal enjoys some seasonal flavoring from the pageantry of college football (FSU and Florida A&M University), a sparkling array of lights during the holiday season, a glorious blanket of springtime color and celebrations of music, cuisine, nightlife and distinctive local attractions interactive water fountain, discovery playscape and numerous historical markers. Arts, culture and heritage are an integral part of the capital city's lifestyle. From galleries and public art to stage performances and music festivals, the region is filled with one of-a-kind experiences for all ages.

Tallahassee is 30 mins from the coast, 2hrs from some of the best beaches in the US (30a, Destin) and is the fastest growing economy per capita in Florida. We have great schools and it is an excellent place to raise a family. Please send me a PM if you're interested! We are looking forward to hearing from you.

---

Members don't see this ad.

 

[dr.vvb]

You can argue what envision did was improper but they were placed in difficult situation supporting 100s of practices with little or no revenue for an unknown period of time. My colleagues in other private practices cut their own pay by a larger amounts to support paying their employees. For us the pay cuts were short lived (3 pay periods) and Tallahassee has low covid numbers. We are confident that we will be allowed to manage our practice locally and and that this was a relatively isolated experience. We had been with envision in the past and for the last 10 years didn't have a single issue. Thanks for commenting.

 

[GandalfTheWhite]

You can argue what envision did was improper but they were placed in difficult situation supporting 100s of practices with little or no revenue for an unknown period of time. My colleagues in other private practices cut their own pay by a larger amounts to support paying their employees. For us the pay cuts were short lived (3 pay periods) and Tallahassee has low covid numbers. We are confident that we will be allowed to manage our practice locally and and that this was a relatively isolated experience. We had been with envision in the past and for the last 10 years didn't have a single issue. Thanks for commenting.

Couldve sold institutional shares or cut executive board salaries, comps, and stocks. Instead they screwed the doctors.
400K is top 10% MGMA in Florida?

 

[caveat87]

Couldve sold institutional shares or cut executive board salaries, comps, and stocks. Instead they screwed the doctors.
400K is top 10% MGMA in Florida?

Yeah that sounds like some #fakenews. I’m part of a roughly 50-75% mgma practice in NE and 400k seems low (unless that is base before distributions). From my understanding of reading salary trends anesthesiologists in the southeast are making more than the northeast...

 

[GandalfTheWhite]

Yeah that sounds like some #fakenews. I’m part of a roughly 50-75% mgma practice in NE and 400k seems low (unless that is base before distributions). From my understanding of reading salary trends anesthesiologists in the southeast are making more than the northeast...

For sure. I would say its 50% MGMA, definitely not 90.

 

[dr.vvb]

For sure. I would say its 50% MGMA, definitely not 90.

LOL Must of missed all this hate. 400 k is our starting base prior to being eligible for profit share and not including distributions. The job is definitely real.

 

[dr.vvb]

Yeah that sounds like some #fakenews. I’m part of a roughly 50-75% mgma practice in NE and 400k seems low (unless that is base before distributions). From my understanding of reading salary trends anesthesiologists in the southeast are making more than the northeast...

Your right that is the base prior to being eligible for profit share and doesn’t include distributions.

 

[Ronin1]

Envision pays market rate in the area. In my area of South Florida that means 325k and there are plenty of applicants. They did handle the Covid crisis badly from a payroll perspective but this was handed down from the KKR team. This was really our first bump in the road in the past 15 years with Sheridan/Amsurg/Envision. It is a different company now though so buyer beware.

 

[sevoflurane]

Profit sharing under AMC terms is very different than profit sharing in a true PP group situation. The “sharing” is often tied to metrics that are difficult to meet and always after the AMC/private equity cut.

 

[sevoflurane]

Don’t know anything about this group. All I know is that if I were to move to Florida there better be a beach within 30 minutes.

 

[sevoflurane]

But if the $ is good enough.... then maybe it’s worth it to some.

 

[IMGASMD]

Profit sharing under AMC terms is very different than profit sharing in a true PP group situation. The “sharing” is often tied to metrics that are difficult to meet and always after the AMC/private equity cut.

So you will be “profit sharing” after a few years. It’s something like, you have to make X million for the corporate. If you make it, then they get to keep %, the group gets (1-%).
Obviously, you’d have to make the matrix for compliance, completion of paperwork and whatever they want you to do.
When everyone is making their marks, it is good; when you don’t make your share for the corporate, you will start hating people. And corporate don’t care about your feelings.

Edit: for those who (residents/students) don’t understand marginal tax, here’s a good example.

Let’s say your share back to the AMC is cool $5M a year. This year you made $6M. So the $1M is the profit. And you’d be naive to think that’s all coming to you. Usually the corporate keeps 60%, and you get the keep the rest. So 400K you get to keep and divide. If there are 10 of you, you get 40K “bonus”. When there are 20 of you, you get 20K.

If I was the old partners, who sold originally to AMC, I’d keep the pool as small as possible. And I’d work as little as possible. Since everyone is salaried and I will get my “profit sharing” amount higher. What’s my drive to work harder?

I digress......

 

[dr.vvb]

So you will be “profit sharing” after a few years. It’s something like, you have to make X million for the corporate. If you make it, then they get to keep %, the group gets (1-%).
Obviously, you’d have to make the matrix for compliance, completion of paperwork and whatever they want you to do.
When everyone is making their marks, it is good; when you don’t make your share for the corporate, you will start hating people. And corporate don’t care about your feelings.

Edit: for those who (residents/students) don’t understand marginal tax, here’s a good example.

Let’s say your share back to the AMC is cool $5M a year. This year you made $6M. So the $1M is the profit. And you’d be naive to think that’s all coming to you. Usually the corporate keeps 60%, and you get the keep the rest. So 400K you get to keep and divide. If there are 10 of you, you get 40K “bonus”. When there are 20 of you, you get 20K.

If I was the old partners, who sold originally to AMC, I’d keep the pool as small as possible. And I’d work as little as possible. Since everyone is salaried and I will get my “profit sharing” amount higher. What’s my drive to work harder?

I digress......

This is a largely incorrect assumption about our practice, all the physicians are in the profitshare pool and equal and we clear our hurdle easily. We always make our profit and have a 12 year history of doing so and will make it again this year despite Covid.

 

[IMGASMD]

My bad. You are right.

 

[spike7585]

This is a largely incorrect assumption about our practice, all the physicians are in the profitshare pool and equal and we clear our hurdle easily. We always make our profit and have a 12 year history of doing so and will make it again this year despite Covid.

How many physicians are in the profitshare pool?

 

[BLADEMDA]

For clarification purposes, the OP is stating that after the 2 year track is completed and the new hire makes partner total income will be in the 90th% MGMA. There are only a few practices in Florida that will offer any new hire that type of deal regardless of whether PP or AMC. The opportunity to earn 90th% should not be scoffed at even if the AMC is taking a big cut of the profits.

 

[dr.vvb]

How many physicians are in the profitshare pool?

We have 24 in the pool currently with 3 additional joining by the end of the year (2 years have been completed)

 

[dr.vvb]

For clarification purposes, the OP is stating that after the 2 year track is completed and the new hire makes partner total income will be in the 90th% MGMA. There are only a few practices in Florida that will offer any new hire that type of deal regardless of whether PP or AMC. The opportunity to earn 90th% should not be scoffed at even if the AMC is taking a big cut of the profits.

Thanks, the reality is this is one of the best opportunities in Florida with a great group of guys/gals and nice hospitals. If you're CT fellow, or a good generalist with TEE skills, you should definitely inquire. You may find a job that really works for you.

 

[vector2]

How many pump cases and how many structural heart cases are you guys doing? How many MDs in the practice do cardiac? Frequently I've noticed that some of places which do mostly community hearts and are not looking for exclusively fellowship trained folks have pretty low cardiac volume split amongst too many docs, which means no one is really getting enough volume to keep up their proficiency...

 

[1234567654321]

First time poster - and I'm in the group above.

Why does everyone assume the worst? Why is there so much hate towards the poster, rather than asking a neutral question (or assuming you know the answer - of which no one above has been correct)?

I thought the first post made it pretty clear - "after year 2 (Top 10 % MGMA)."

It's over 400 for the first 2 years, then top 10% MGMA after. If you want more information based on that alone, please follow up.

Both the structure of the "profit share" above and the general figures that people are guessing are way off, just as an aside.

All the partners are participating or in the first 2 years (see post #1 for the # of physicians in the practice). There is no intent to not offer this to any new hire who is clinically good and works as a team player.

Being an Envision employee has its benefits and risks, but the major benefit comes from their ability to get a good reimbursement from insurance.

Does Envision make money as well? Yes. Do you think maybe the people here have run the numbers and seen that the benefit of staying with Envision and the rates they get are better than going private and trying to be a small fish in a big pond when negotiating with large insurance companies as a small group? Yes.

As for the cardiac, multiple hospitals are covered with >1000 pump cases a year, and that doesn't include multiple days of structural hearts each week - TAVR's with sedation and GA (our group covering 3D valve sizing for the patients with high Cr and no prep CTA), mitraclips, watchman, triluminate, PVL closure, BAV, etc.

Some of the folks on the heart team will do close to 100 open cases a year plus structural (more than some cardiac folks in academics with "non-clinical" time who do one case a day...).

While some people do more hospital, or blocks/ortho, or Peds, or surgery center, or whatever - that's part of the appeal of this group. You get to do a lot of what you want, as well as a little of everything to keep your skills up.

 

[spike7585]

Does Envision make money as well? Yes. Do you think maybe the people here have run the numbers and seen that the benefit of staying with Envision and the rates they get are better than going private and trying to be a small fish in a big pond when negotiating with large insurance companies as a small group? Yes.

Are you claiming that your group has that option to simply leave envision if it wasn't financially beneficial? Doesn't envision own the contracts with the hospital and have a non compete with the employees/partners?

Most groups owned by an AMC lose the ability to simply "part ways" with the AMC that just spent millions of dollars purchasing that private group, but please correct me if I'm wrong.....

 

[IMGASMD]

First time poster - and I'm in the group above.

Why does everyone assume the worst? Why is there so much hate towards the poster, rather than asking a neutral question (or assuming you know the answer - of which no one above has been correct)?

I thought the first post made it pretty clear - "after year 2 (Top 10 % MGMA)."

It's over 400 for the first 2 years, then top 10% MGMA after. If you want more information based on that alone, please follow up.

Both the structure of the "profit share" above and the general figures that people are guessing are way off, just as an aside.

All the partners are participating or in the first 2 years (see post #1 for the # of physicians in the practice). There is no intent to not offer this to any new hire who is clinically good and works as a team player.

Being an Envision employee has its benefits and risks, but the major benefit comes from their ability to get a good reimbursement from insurance.

Does Envision make money as well? Yes. Do you think maybe the people here have run the numbers and seen that the benefit of staying with Envision and the rates they get are better than going private and trying to be a small fish in a big pond when negotiating with large insurance companies as a small group? Yes.

As for the cardiac, multiple hospitals are covered with >1000 pump cases a year, and that doesn't include multiple days of structural hearts each week - TAVR's with sedation and GA (our group covering 3D valve sizing for the patients with high Cr and no prep CTA), mitraclips, watchman, triluminate, PVL closure, BAV, etc.

Some of the folks on the heart team will do close to 100 open cases a year plus structural (more than some cardiac folks in academics with "non-clinical" time who do one case a day...).

While some people do more hospital, or blocks/ortho, or Peds, or surgery center, or whatever - that's part of the appeal of this group. You get to do a lot of what you want, as well as a little of everything to keep your skills up.

I think you guys are looking for someone who’s not local.

Being FL has been known as Sheridan country, so you should have a big recruitment machine. The fact that you’re posting here, means there is some difficulty recruiting.

So the “only” good reason for someone who is not local to join the practice is the pay. I think it’s fair to ask all the questions about compensation, especially if that’s the “only” draw for people to join.

If you have to make a new account to defend the practice.... it doesn’t inspire confidence.

But yes, haters always hate.

 

[abolt18]

Are you claiming that your group has that option to simply leave envision if it wasn't financially beneficial? Doesn't envision own the contracts with the hospital and have a non compete with the employees/partners?

Most groups owned by an AMC lose the ability to simply "part ways" with the AMC that just spent millions of dollars purchasing that private group, but please correct me if I'm wrong.....

I think they were asserting that someone can MOVE and get another job.

 

[1234567654321]

About18 is correct - my claim is that I interviewed at multiple other private groups of similar size and in comparable locations (and this I am aware of their reimbursement). I am also aware of our reimbursement and the amount given to Envision each year. I am stating that for our group, there is a financial benefit to stay with Envision over being private. I was reading some of the other threads here and realize that this is heresy on this forum.

Since this is a private group (and not academic with home residents)... by definition we are not looking for "local". You are correct we see a lot of applications by being with Envision, but we don't just want any application or warm body.

We are a completely fair group. 8 weeks vacation given day 1 or year 20. We are given the same number of daily calls, relief benefit, and call weekends (less than 1 per month). I'm saying it's a fair and equal group.

We do interesting open hearts, structural hearts (both to warrant cardiac fellows), thoracic, Peds, trauma, ortho with blocks/catheters, etc. We do a lot of interesting cases, cover multiple surgery centers, etc without a lot of the terrible stuff like transplant in the middle of the night.

We believe we are an outstanding, fair, well-compensated group with good work-life balance and partners always willing to help out.

We want outstanding candidates - and believe because of what has been posted above - that we can get them. We want cardiac fellows, we want chief residents, we want regional fellows to help expand our regional services. These are examples of what we want.

I've been reading this forum where people are complaining about the job market. You finally get a great one posted and people do nothing but criticize. "haters gonna hate" is an understatement.

And hopefully it's obvious, but great groups with low turnover tend to not need to recruit often, so we're open to where else we should be looking.

 

[BLADEMDA]

Remember the rule about 2/3? The job above has 2/3 and after you visit I think you will agree with me. That said, I recommend anyone interested in making 90th percentile + MGMA with a fellowship at least go interview. How many jobs out there are offering new grads 90th+ percentile MGMA these days? The track is very fair as is the distribution of work.

 

[Gaseous Clay]

I never understand the job bashing. If I was looking and especially if I was a graduating resident I would’ve been all over this. Thanks for posting and good luck.

BTW, I believe one of my colleagues interviewed there a few years ago and almost pulled the trigger.

 

[GandalfTheWhite]

About18 is correct - my claim is that I interviewed at multiple other private groups of similar size and in comparable locations (and this I am aware of their reimbursement). I am also aware of our reimbursement and the amount given to Envision each year. I am stating that for our group, there is a financial benefit to stay with Envision over being private. I was reading some of the other threads here and realize that this is heresy on this forum.

Since this is a private group (and not academic with home residents)... by definition we are not looking for "local". You are correct we see a lot of applications by being with Envision, but we don't just want any application or warm body.

We are a completely fair group. 8 weeks vacation given day 1 or year 20. We are given the same number of daily calls, relief benefit, and call weekends (less than 1 per month). I'm saying it's a fair and equal group.

We do interesting open hearts, structural hearts (both to warrant cardiac fellows), thoracic, Peds, trauma, ortho with blocks/catheters, etc. We do a lot of interesting cases, cover multiple surgery centers, etc without a lot of the terrible stuff like transplant in the middle of the night.

We believe we are an outstanding, fair, well-compensated group with good work-life balance and partners always willing to help out.

We want outstanding candidates - and believe because of what has been posted above - that we can get them. We want cardiac fellows, we want chief residents, we want regional fellows to help expand our regional services. These are examples of what we want.

I've been reading this forum where people are complaining about the job market. You finally get a great one posted and people do nothing but criticize. "haters gonna hate" is an understatement.

And hopefully it's obvious, but great groups with low turnover tend to not need to recruit often, so we're open to where else we should be looking.

Im poor. Whats 90% MGMA? 800k?

 

[dchz]

What is the supervision ratio for your CPB cases?

 

[2Fast2Des]

And what are the CRNAs like there? They fighters or team players? That will make or break work life experience

 

[D P356]

And what are the CRNAs like there? They fighters or team players? That will make or break work life experience

To piggy back on your question everyone is replaceable, but....
How easily can challenging employees be replaced, and who makes that call?

 

[dchz]

And what are the CRNAs like there? They fighters or team players? That will make or break work life experience

To piggy back on your question everyone is replaceable, but....
How easily can challenging employees be replaced, and who makes that call?

To be fair, these questions are very subjective and cannot be verified even if the answer is truthful...

 

[D P356]

To be fair, these questions are very subjective and cannot be verified even if the answer is truthful...

I agree. Everyone will put their best foot forward on an interview.

If a group has a hard time staffing up, they will tolerate a lot of irritating crap just to meet contractual obligations to the hospital.

 

[dr.vvb]

Sorry I missed a couple of questions and will try to answer the last 2-3 here.

1. What is the supervision ratio for your CPB cases?

When doing a heart we are usually supervising 2-3 rooms.

2. And what are the CRNAs like there? They fighters or team players? That will make or break work life experience

We have a very collegial group that consists of about 50 % AA and 50% Crna. While any group may have a couple difficult personalities, we have had most of those leave. We have training programs and tend to hire grads that we know that have rotated with us and I think it probably helps.

3. How easily can challenging employees be replaced, and who makes that call?

Short answer: We try not to hire people that will be a serious problem, of course you eventually may run into someone that requires correction or termination. I would say that we do our best to give each individual chances to correct their behavior and do not take letting folks go lightly. Each individual circumstance is different and thus the decision to terminate employees is done by the MD board of the directors in conjunction with envision HR.

 

[Endee]

I worked here as an AA from 2011 to 2016 and I just want to say it was an incredible place to work. It's like a family. I would come back in a heartbeat.

 

[abolt18]

Sorry I missed a couple of questions and will try to answer the last 2-3 here.

1. What is the supervision ratio for your CPB cases?

When doing a heart we are usually supervising 2-3 rooms.

2. And what are the CRNAs like there? They fighters or team players? That will make or break work life experience

We have a very collegial group that consists of about 50 % AA and 50% Crna. While any group may have some difficult personalities, we have had most of those leave. We have training programs and tend to hire grads that we know that have rotated with us.

3. How easily can challenging employees be replaced, and who makes that call?

Short answer: We try not to hire people that will be a serious problem, of course you eventually may run into someone that requires correction or termination. I would say that we do our best to give each individual chances to correct their behavior and do not take letting folks go lightly.

Just wanted to say that your third answer did not in any way answer the questions.

 

[dr.vvb]

Just wanted to say that your third answer did not in any way answer the questions.

Edited.

 

[dr.vvb]

Just an update on our situation, we have made a couple of hires and are still looking for another for this year and 1-2 for the following year due to expected retirements. If your interested please send me a private message.