Toofscum said:
I just started my CA3 year and am beginning to think about plans for next year. I've got some general questions for the private practice anesthesiologists out there.
1) When you sign a contract, how long do you commit to work with a particular group? What are the penalties for breaking the contract?
2) How are anesthesiologists who change jobs frequently looked upon? What are the repercussions if I want to go somewhere for a year, work, and then move somewhere else?
3) How difficult is it getting a job in a location where you have no contacts? i.e. residency in Philadelphia but really want to live in Seattle
4) I keep hearing about this whole "tail" thing, regarding malpractice coverage. Is it true that every time you leave a group, you have to pay an exorbitant sum for tail coverage? Does this mean that most anesthesiologists do not change jobs very frequently?
I'm overwhelmed how to start this whole process. I have no specific preferences as to where I want to live, so where do I begin? What's the best way to go about starting this job search?
Thanks!!
Step One) Relax. You're in good shape. You picked a specialty that is well liked by the people in it. Jobs are plentiful and the CRNA threat is overblown. I havent worked in a hospital yet that would come close to considering all CRNA anesthesia.
2)Most groups dont make you sign a time commitment, since its to their advantage if you leave, they sign another newbie, and they protect their partnership paychecks.
One of the most important parts of a contract, ironically, is not how you get in, but
how you get out of the contract.. An eight week notice is probably standard. Anything over that is undesirable for you. Not to say you wouldnt sign a contract with a 6 month exit clause if its a great contract, but then you have to tell another group you're looking at that you cant start for six months. So keep this in mind.
Most groups dont offer sign on bonuses since the salaries are so high, but underserved areas may, and this is where you may see a time commitment clause of say 2 years...and if you leave before that, you have to pay your signing bonus back.
3)Anesthesiologists who change jobs frequently....depends on your definition of frequent. Its not uncommon for an MD to change jobs within seven years of employment after finishing residency....but if you changed jobs five times in seven years I'd consider that a red flag.
3)It may or may not be difficult to get a job where you have no contacts, depending on where the location is. Some areas are saturated (even in this unsaturated market) so its totally dependent on where you want to live. Having a specific place you wanna be makes it harder....if you say to yourself "I want a job with the potential to make 450K plus" but you dont have a preference to location, your list would be long. But geographically limiting yourself may limit your income potential.
If you dont have contacts where you want to live when you're done, I'd start calling NOW and start making contacts. Cold call the ORs in the city, ask for an anesthesiologist, and tell them when you're finishing. Stop by the ORs. Meet the anesthesiologists. The squeeky wheel often gets the oil.
4)Tail coverage is complicated. Many times if you are relocating, the group you are going to may use the same insurance company, or the new insurance company may elect to pick up your tail coverage.
If not, your tail price is commensurate with your years in practice. Counterintuitively, your malpractice insurance costs less when you first start, and goes up incrementally until it caps at industry standard about five years out. So if you left after 2 years in practice, your tail wouldnt be as much as if you left 7 years later.
My initial gig was with a private practice group. My new (since May 2004) is a Chief of Anesthesia gig at a hospital where about 6 years ago they cancelled the private groups contract and hired anesthesiologists as hospital employees, so now I'm a hospital employee, which has its plusses and minuses, but the money/lifestyle is great which makes up for all the bueracratic BS I have to put up with as HMFIC of the department.
Anyway, the hospital I work at is self insured, so I had to pay a tail when I left my first gig...27K
😱 .
Not having a specific place where you want to live works to your advantage. If you wanna live in a boon-dock town for a while you can really optimize your earnings. Many partners in groups that cover hospitals in small towns are in the 500-600K range, at least in the southeast.
Metropolitan areas are a little more dicey since most big cities have a plethora of hospitals, all competing for patients and surgeons. The dudes making the big bucks in these areas have highly coveted jobs not easily attained unless you have a connection.
I'd start looking about 4-6 months from now, which is close enough chronologically to your end date, but further enough away so you don't feel rushed.
Good luck, and congrats on being almost finished.
👍
