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[TheLoneWolf]

Pp group leaving hospital and AMC coming in to cover a small community hospital, 6 ORs, bread and butter cases, low OB volume. Home call with call in cases <250 in last year.

Full benefits with the AMC, compensation 550ish, w2. Setup is 3 physicians and 6 CRNAs. Schedule is 1 week on call from home, 1 week of work with no call, and third week is vacation. Rinse and repeat.

Poverty population with poor payor mix so I'm not sure why an AMC would get involved with this facility. Nice and wealthy neighborhoods within a half hour of the hospital.

Honestly can't tell if this could be a hidden gem or to run in the other direction.

Anyone have experience with one week long calls as the norm? Current shop gig call is 1:3 and working pre and postcall.

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[aneftp]

You are working 7 days (call week) with no post call day off.

Than working 5 days (daytime)

Than one week off

So 17 weeks off ish.

It’s ok.

It all comes down to acuity level. When are cases done? 4pm? Or 7pm? Makes a huge difference. How often are call backs?

Low ob volume to me mean less than 2 a day (less than 800 deliveries a year). So what exactly is the ob volume?

Funny how some places define low ob as less than 1500 a year.

 

[sevoflurane]

How many days straight w/o a day off?
12? 14?

How many weekends per month on average 1.33? I don’t think this type of job is for me, but it can be good depending on how much work you are actually doing.

 

[DirtDocMD]

The AMC is taking it because they can skim enough off the subsidy to make a profit AND they likely have a “guarantee” from the hospital, at least for the first one/two years, to cover any/all locums costs.

Point being, it COULD be a good job, at least for the first couple of years, assuming:

1) The hospital IS providing the pay to get those locums

2) The place isn’t woefully understaffed, despite pay being available to provide those locums

3) You’re not getting dragged in EVERY, or nearly every, night with either a case or an epidural. They may be easy, but losing sleep 5/6/7 nights out of 7 is no good. Anything more than 2 (with a handful of 3x a year), isn’t good, if you’re working post-call.

You MIGHT (depending on getting PERMANENT Docs there) be able to work out an “every other night” call schedule with the other Doc that is in town. (Realize that AMC’s sometimes have schedules like you mentioned above, KNOWING that they may start off with only 1-2 perm Docs, and they can easily insert a locums no-call Doc to do the daytime week. Therefore, the other “in-town”/non-vacation (probably locums) Doc isn’t getting paid or available to cover any call).

You should make sure that the contract contains some language regarding maximum hours/call, and provides extra pay if department is not “fully staffed”.

Also realize that sometimes these jobs go south, in a hurry, when the hospital locums money runs out. The AMC gets the heck out, or the hospital CEO will fall for another “too good to be true” sales pitch from another AMC, at the 2 year mark.

If you’re already in the area, it may be worth a shot. If you’re packing up family to move to a job like this, make sure you cover your bases (contract language and making sure there are other available jobs in town).

You’re currently working 1:3 call AND working pre and post call??? Ouch…

 

[pgg]

Home call with call in cases <250 in last year.

So more often than not when on call, you get called in. Sounds like that could be brutal when on for 7 straight nights while working during the day.

 

[TheLoneWolf]

You are working 7 days (call week) with no post call day off.

Than working 5 days (daytime)

Than one week off

So 17 weeks off ish.

It’s ok.

It all comes down to acuity level. When are cases done? 4pm? Or 7pm? Makes a huge difference. How often are call backs?

Low ob volume to me mean less than 2 a day (less than 800 deliveries a year). So what exactly is the ob volume?

Funny how some places define low ob as less than 1500 a year.

Things close out at 5
Ob<500 deliveries per year

 

[TheLoneWolf]

How many days straight w/o a day off?
12? 14?

How many weekends per month on average 1.33? I don’t think this type of job is for me, but it can be good depending on how much work you are actually doing.

12 days straight followed by 9 off

Hadnt done math on weekends but yeah 17 weekends per year = 1.33

 

[TheLoneWolf]

The AMC is taking it because they can skim enough off the subsidy to make a profit AND they likely have a “guarantee” from the hospital, at least for the first one/two years, to cover any/all locums costs.

Point being, it COULD be a good job, at least for the first couple of years, assuming:

1) The hospital IS providing the pay to get those locums

2) The place isn’t woefully understaffed, despite pay being available to provide those locums

3) You’re not getting dragged in EVERY, or nearly every, night with either a case or an epidural. They may be easy, but losing sleep 5/6/7 nights out of 7 is no good. Anything more than 2 (with a handful of 3x a year), isn’t good, if you’re working post-call.

You MIGHT (depending on getting PERMANENT Docs there) be able to work out an “every other night” call schedule with the other Doc that is in town. (Realize that AMC’s sometimes have schedules like you mentioned above, KNOWING that they may start off with only 1-2 perm Docs, and they can easily insert a locums no-call Doc to do the daytime week. Therefore, the other “in-town”/non-vacation Doc isn’t getting paid or available to cover any call).

You should make sure that the contract contains some language regarding maximum hours/call, and provides extra pay if department is not “fully staffed”.

Also realize that sometimes these jobs go south, in a hurry, when the hospital locums money runs out. The AMC gets the heck out, or the hospital CEO will fall for another “too good to be true” sales pitch from another AMC, at the 2 year mark.

If you’re already in the area, it may be worth a shot. If you’re packing up family to move to a job like this, make sure you cover your bases (contract language and making sure there are other available jobs in town).

You’re currently working 1:3 call AND working pre and post call??? Ouch…

wow. Some real solid points I hadn't really considered. Will look into it. I think the potential for being called in 7 days in a row would wear anyone who isnt living across the street out pretty quickly.

 

[PpfSuxTube]

On call 7 days straight. Next.

 

[Guillemot]

Dont mean to hijack this thread, but please rate my job also:

Pay is generous per interval of time (assigned in time units) given the market conditions (MGMA percentile) and I do a variety of different things. The hospital is close to a medium sized lake. There is no buy in per se, but you make 50% of maximum salary from day 0 and it gradually increases over the period of 5 years. Call is also randomly distributed and is generally distributed every 72-96 hours. All units are given a weighted average of 1.06 - 1.075 depending upon case frequency. IE. If case frequency drops the weighted average follows along frequency curve.

 

[dchz]

There is no buy in per se

Yes there is, per se:

you make 50% of maximum salary from day 0 and it gradually increases over the period of 5 years.

Dont mean to hijack this thread, but please rate my job also:

3.8 out of 10*(weighted average of 1.06-1.075, depending on frequency)

 

[Volatile]

Dont mean to hijack this thread, but please rate my job also:

Pay is generous per interval of time (assigned in time units) given the market conditions (MGMA percentile) and I do a variety of different things. The hospital is close to a medium sized lake. There is no buy in per se, but you make 50% of maximum salary from day 0 and it gradually increases over the period of 5 years. Call is also randomly distributed and is generally distributed every 72-96 hours. All units are given a weighted average of 1.06 - 1.075 depending upon case frequency. IE. If case frequency drops the weighted average follows along frequency curve.

A 5yr partnership track is pretty rough. I think for a good PP job a 2yr track can still be worth it but a lot can happen in that amount of time.

 

[Guillemot]

A 5yr partnership track is pretty rough. I think for a good PP job a 2yr track can still be worth it but a lot can happen in that amount of time.

There is no buy in though and one is never made partner

 

[DocVapor]

There is no buy in though and one is never made partner

The enormously discounted salary is your "buy-in." If you think about the potential compounding interest you could earn on that money you're not getting, it will be an enormous number.

 

[anbuitachi]

Pp group leaving hospital and AMC coming in to cover a small community hospital, 6 ORs, bread and butter cases, low OB volume. Home call with call in cases <250 in last year.

Full benefits with the AMC, compensation 550ish, w2. Setup is 3 physicians and 6 CRNAs. Schedule is 1 week on call from home, 1 week of work with no call, and third week is vacation. Rinse and repeat.

Poverty population with poor payor mix so I'm not sure why an AMC would get involved with this facility. Nice and wealthy neighborhoods within a half hour of the hospital.

Honestly can't tell if this could be a hidden gem or to run in the other direction.

Anyone have experience with one week long calls as the norm? Current shop gig call is 1:3 and working pre and postcall.

if no non commpete and contract for certain duration, id consider it. but what to do if they LIE or things change? that 1:3 can change to 1:4. etc

 

[Southpaw]

There is no buy in though and one is never made partner

For 5 years you made less than partners. Where did all that money go, and how much was it? That was your buy-in.

 

[Burned_Out]

With every AMC I've been associated with, all of them are lying through their teeth when they say they will staff according to a certain level. You will find out that they understaff on purpose and squeeze every ounce of productivity out of you because....what is stopping them?

 

[UnoMas]

This goes to show how piss poor of a job residency programs do when it comes to educating their graduates about the business side of anesthesia. I got none from my program, learned 100% what I know from here, reddit, wci forum.

50% reduction first year and gradual increase over 5 years, assuming 50% first year, 60% 2nd year, 70% 3rd, 80% 4th 90% 5th, you are giving up 1.5x partner salary for this track. That’s a alot of money and very very abusive track. And who knows where the group will be in 5 years…

 

[UscGhost]

Sounds like you would be taking 7 calls per month, with only 7 days off per month.

Reasonable schedule is 2-3 calls per months, postcall off, 5-6 weekend days off. Which would give you 3 calls and 9 days off per month

 

[Hoya11]

Pp group leaving hospital and AMC coming in to cover a small community hospital, 6 ORs, bread and butter cases, low OB volume. Home call with call in cases <250 in last year.

Full benefits with the AMC, compensation 550ish, w2. Setup is 3 physicians and 6 CRNAs. Schedule is 1 week on call from home, 1 week of work with no call, and third week is vacation. Rinse and repeat.

Poverty population with poor payor mix so I'm not sure why an AMC would get involved with this facility. Nice and wealthy neighborhoods within a half hour of the hospital.

Honestly can't tell if this could be a hidden gem or to run in the other direction.

Anyone have experience with one week long calls as the norm? Current shop gig call is 1:3 and working pre and postcall.

good compensation and vacation

bad combination of a lot of home call plus probably small little easy cases

i would not be into that. i would rather cover a serious hospital if i am going to be giving up my nights

 

[NitroS]

Pp group leaving hospital and AMC coming in to cover a small community hospital, 6 ORs, bread and butter cases, low OB volume. Home call with call in cases <250 in last year.

Full benefits with the AMC, compensation 550ish, w2. Setup is 3 physicians and 6 CRNAs. Schedule is 1 week on call from home, 1 week of work with no call, and third week is vacation. Rinse and repeat.

Poverty population with poor payor mix so I'm not sure why an AMC would get involved with this facility. Nice and wealthy neighborhoods within a half hour of the hospital.

Honestly can't tell if this could be a hidden gem or to run in the other direction.

Anyone have experience with one week long calls as the norm? Current shop gig call is 1:3 and working pre and postcall.

Compensation not too bad especially if the benefits are good.

7 days on call w/ ~65-70% call back rate can be brutal. All it takes is 1 lap chole case at 2am to completely disrupt your sleep and you don't have postcall days off. I personally can't get good night sleep when I'm home call at night....especially if you live like 30+ min from the hospital. Always dreading having to drive back in.

You said you have 6 CRNAs too. How are they utilized? Is it mostly supervision? or are they solo independent in room?

 

[teacher2md]

Dude, run away. 14 days in a row, with 7 of those days being on call? Hell no.

The unpredictable schedule and sleep disruption aren't worth it. Like the other poster said, it only takes one 2:00am lap choley or epidural to ruin your circadian rhythm. Also think about all the times you're woken up for BS phone calls: "Hey...so Dr. OBGYN is thinking about maybe sectioning this lady in a few hours..."

I can't imagine doing that for a week in a row, every three weeks. You only get 7 days off per month? I wouldn't take this job for $1M/yr.

 

[Burned_Out]

With every AMC I've been associated with, all of them are lying through their teeth when they say they will staff according to a certain level. You will find out that they understaff on purpose and squeeze every ounce of productivity out of you because....what is stopping them?

Another thing I forgot to mention is that the weeks of vacation they give you is NOT guaranteed. One AMC in the past told me you can have your vacation only if there is enough people on-duty to staff. Which there never was. Another one told me you have to work a certain amount of weeks before you can take a vacation. Those bastards even tried to not grant me vacation because they claim not enough staff on hand to cover hospital.

You cannot trust any AMC. They will change terms of contract at will. Expect to work much harder than they claim.

 

[IMGASMD]

Another thing I forgot to mention is that the weeks of vacation they give you is NOT guaranteed. One AMC in the past told me you can have your vacation only if there is enough people on-duty to staff. Which there never was. Another one told me you have to work a certain amount of weeks before you can take a vacation. Those bastards even tried to not grant me vacation because they claim not enough staff on hand to cover hospital.

You cannot trust any AMC. They will change terms of contract at will. Expect to work much harder than they claim.

Everyone (should) know this. But no one follows this advice, especially when you HAVE TO stay…..
a better way to do it would be working from them as contractors, then you’d have some control of your own schedule.
Math doesn’t lie.
300/hr * 40hrs * 40 weeks = 480K.
12 weeks of vacation to boot.

I will also take a few overnight/pager calls once every 2 weeks. And get my post call off. @ 2400/call. This would be awash. But you’d have a week day off to do whatever.

Weekend calls every 2 weeks.
20 @ 3600 (let’s assume they low ball you and you don’t get any call back….) =72K

480+72K = a lot of money. (552K) For those who needs to solve the equation.
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2 calls a month; 2 weekend (24 hour pager) @ 40weeks a year. It ain’t bad. If you truly believe this is what you are worth right now……