Protecting your private anesthesia group from AMC's such as Northstar

[hypnosMD]

To the private practice groups out there, if your no-compete is in place to protect yourself and your business, it needs to have an established amount per person for a "buyout" (such as 500k each, etc) in writing. Without this, the AMC's will argue that enforcing a no-compete is a danger to the community and courts will have no monetary amount to value it at. You need to price yourselves out of the market so you are not the lowest hanging fruit for a hostile takeover.
Hypocritically, the same AMC's that argue against the validity of your no-compete will themselves place a no-compete on your head once they take over. Be warned.

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[aneftp]

Issue is hospitals have super veto power that will super sede anything.

Remember when the group negotiated with hospitals. Doctors are really just contractors. And hospital is free to drop the contract as they please.

Now hospitals are taking it to another level in some states. Cause my sister is in all MD private practice and hospital administrators have specifically stated if aneshesia practice sells out. Hospital has right to veto any sell out of anesthesia practice because their authority supersedes any anesthesia contracts.

 

[B-Bone]

Issue is hospitals have super veto power that will super sede anything.

Remember when the group negotiated with hospitals. Doctors are really just contractors. And hospital is free to drop the contract as they please.

Now hospitals are taking it to another level in some states. Cause my sister is in all MD private practice and hospital administrators have specifically stated if aneshesia practice sells out. Hospital has right to veto any sell out of anesthesia practice because their authority supersedes any anesthesia contracts.

This is great in theory, but can not matter at all in practice. Recently happened in my town. Anesthesia group (~40 MD, 100 CRNA) sells out to national corporation. Hospital system is blindsided and opposes "merger", saying they don't have a contract with the national corporation, only with the local group. Local group no longer "exists". Hospital system can, in theory, say "screw 'em" and open the contract up to whomever they want. In practice, however, there is no other entity in town large enough to take on the contract with short/no notice, and the hospital system begrudgingly signs contract with national corporation (which now employs all the docs that screwed over the hospital system in the first place). Hospital system very unhappy with the situation, but has no coverage options in the short-term. It appears that this debacle has left a bad AMC taste in the mouth of the hospital system, so hopefully this will dissuade them from further dealings with this or other AMCs, but who knows.

 

[caligas]

This is great in theory, but can not matter at all in practice. Recently happened in my town. Anesthesia group (~40 MD, 100 CRNA) sells out to national corporation. Hospital system is blindsided and opposes "merger", saying they don't have a contract with the national corporation, only with the local group. Local group no longer "exists". Hospital system can, in theory, say "screw 'em" and open the contract up to whomever they want. In practice, however, there is no other entity in town large enough to take on the contract with short/no notice, and the hospital system begrudgingly signs contract with national corporation (which now employs all the docs that screwed over the hospital system in the first place). Hospital system very unhappy with the situation, but has no coverage options in the short-term. It appears that this debacle has left a bad AMC taste in the mouth of the hospital system, so hopefully this will dissuade them from further dealings with this or other AMCs, but who knows.

Sounds like what happened in Asheville

 

[Southpaw]

Sounds like what happened in Asheville

In Asheville the hospital kicked the AMC out as the contract was up for renewal and created their own hospital-employed Anesthesia group. AMCs are bad news.

 

[caligas]

In Asheville the hospital kicked the AMC out as the contract was up for renewal and created their own hospital-employed Anesthesia group. AMCs are bad news.

So did the partners get their buyout money?

If so, raw deal for the AMC!

 

[Southpaw]

So did the partners get their buyout money?

If so, raw deal for the AMC!

I'd guess they did since my understanding was the AMC held them to their non-competes when the hospital started recruiting anesthesiologists. I don't know for sure though.

 

[Arch Guillotti]

In Asheville the hospital kicked the AMC out as the contract was up for renewal and created their own hospital-employed Anesthesia group. AMCs are bad news.

My understanding was that it was a private group, not an AMC.

 

[Southpaw]

My understanding was that it was a private group, not an AMC.

As in the hospital kicked out the private group to form a hospital group? You could be right - dunno. The hospital recruited heavily on gaswork for about 6 months prior to the previous groups contract expiring. It was discussed on the forum when it all went down. I recall the private group (which was setup like junior partners, seniors, supers) trying to sell to an AMC and the hospital saying 'not happenin'. But sure I could be wrong. Perhaps some others will chime in.

 

[Arch Guillotti]

As in the hospital kicked out the private group to form a hospital group? You could be right - dunno. The hospital recruited heavily on gaswork for about 6 months prior to the previous groups contract expiring. It was discussed on the forum when it all went down. I recall the private group (which was setup like junior partners, seniors, supers) trying to sell to an AMC and the hospital saying 'not happenin'. But sure I could be wrong. Perhaps some others will chime in.

I think what actually happened is a bit murky:

Mission may end agreement with anesthesia services provider

The end result is that members of the group were forced to become hospital employees.

 

[hypnosMD]

I will add that you should also have a clause (in addition to the 500K per person buyout cost) stating that anyone meeting with the AMC (much less verbally or contractually committing), whether it be for dinners, job fairs, phone calls, etc., could be held liable for the 500K in damages to the company and to their business.
Any hospital that awards a contract to an AMC will do so ONLY contingent upon them showing that they have acquired the staff beforehand, and it will have to be 30-60 days before. No hospital can risk losing coverage. If you shut down allowing any conversations (or even shut them down up until the last week), it will paralyze the AMC. Long live the (fair and equitable) private practice of medicine.

 

[Consigliere]

I will add that you should also have a clause (in addition to the 500K per person buyout cost) stating that anyone meeting with the AMC (much less verbally or contractually committing), whether it be for dinners, job fairs, phone calls, etc., could be held liable for the 500K in damages to the company and to their business.
Any hospital that awards a contract to an AMC will do so ONLY contingent upon them showing that they have acquired the staff beforehand, and it will have to be 30-60 days before. No hospital can risk losing coverage. If you shut down allowing any conversations (or even shut them down up until the last week), it will paralyze the AMC. Long live the (fair and equitable) private practice of medicine.

That exists?!?

 

[deleted126335]

Here are the animals that are sadly going to depart from this world soon.

• Northern Hairy Nosed Wombat. ...
• Pygmy Three Toed Sloth. ...
• Red Crested Tree Rat. ...
• Angel Shark (also known as Squatina Squatina) ...
• Elephant Shrew (now known as Boni Giant Sengi) ...
• Southeast Asia's Javan Rhino. ...
• Ploughshare Tortoise (also known as Angonoka)
• Fair and Equitable Private Practice Groups in Desirable Locations. May persist in overlooked ecosystems of BFE.

 

[deleted162650]

It's a shame about those Javan Rhinos. They're delicious.

 

[Bru]

I think what actually happened is a bit murky:

Mission may end agreement with anesthesia services provider

The end result is that members of the group were forced to become hospital employees.

Anyone have updates on that situation btw? That article is from 2015 and I always wanted to know how things ended up. In part b/c I still think about practicing in NC at some point.

 

[pastafan]

Anyone have updates on that situation btw? That article is from 2015 and I always wanted to know how things ended up. In part b/c I still think about practicing in NC at some point.

Anyone know final outcome? Were all the docs replaced?

 

[Mman]

I believe everybody is a hospital employee at this point.

 

[skypilot]

Here are the animals that are sadly going to depart from this world soon.

• Northern Hairy Nosed Wombat. ...
• Pygmy Three Toed Sloth. ...
• Red Crested Tree Rat. ...
• Angel Shark (also known as Squatina Squatina) ...
• Elephant Shrew (now known as Boni Giant Sengi) ...
• Southeast Asia's Javan Rhino. ...
• Ploughshare Tortoise (also known as Angonoka)
• Fair and Equitable Private Practice Groups in Desirable Locations. May persist in overlooked ecosystems of BFE.

Ha

 

[hypnosMD]

Added point. If you personally do any work for an AMC, you should see that your notice period is sufficiently long (6 months+) that you will have plenty of time to find an alternative when they attempt to "renegotiate" your contract.