Say NO to NAPA

[gasoflife]

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I don't mean to engage in bashing a group, but I feel this forum is for regular anesthesiologists to know the "inside story" so they can protect themselves. NAPA is not a group anyone should work for- not anesthesiologists or even CRNAs. In 2012 their founder, Peter Walker, sold 50% of NAPA to a financial firm, Moelis Capital for $150 million.

http://moelisassetmanagement.com/moelis-capital-partners/SitePages/news-feed-details.aspx?feedId=143

Shortly thereafter, the yearly pensions for NAPA physicians which was $30K was decreased to $20K, and a similar decrease was made for CRNAs. Additionally, NAPA docs work on a "bonus" where they make a below market salary but then receive bonuses based on "how their site did." Ofcourse no one is ever shown the books so this is all done on faith. Well, after this acquisition with Moelis, all the bonuses shrank. Some people left, new people weren't hired and the remaining people did more call, worked longer hours. Many people were "cross credentialed" so that a site with full capacity would have to send docs to other hospitals where docs had left to do a day shift here and there to prevent hiring of more staff.
As people left, there was no desire to wish them well, thank them for their service, or even say good luck. They were simply told "ok." Now, this group, Moelis, has driven much of these changes with NAPA partners tacit blessing. The firm wants to sell NAPA to another group at a profit. So, whereas they bought it for $150 million, they want to now sell for $600 million.

http://pevc.dowjones.com/Article?an...FLBO0120150109eb19brjhb&cid=32135002&ctype=ts

The new buyer will likely want to make their money back and sell for even higher. So, in the era of shrinking reimbursements how do you keep making millions in profit? Cut salary, benefits, personnel. Would any anesthesiologist want to be part of this??
Additionally, one may say that Mednax, Sheridan, etc are just as bad but these groups atleast have some structure in place for overtime pay. NAPA has NO STRUCTURE for this and THEY DON'T CARE. The partners already cashed out and will keep cashing out while the hundreds that have help build the practice and squeezed more and more.
PLEASE, do not trust your career with NAPA. This is a horrible vortex to get caught up in. There are better groups out there and Mednax and sheridan are better. Look at the details of what you are being offered and make sure there is a provision for "overtime pay." Do not rest your career on the thinking that "as a partner/call taker" you have to own the work and do whatever they say.

Go on gasworks and you will see they have recently had an exodus from their sites as Syosset and Franklin and NOBODY is looking to join. These ads have been up for over a year and paint the job as rosy as possible. Those jobs are atrocious and will likely never get filled unless some innocent fool signs up. Do NOT trust NAPA!

 

[Trisomy13]

If you do a search you will find that my experiences with NAPA have not reflected the sentiment in this post. Quite the opposite. I don't work for below market salary, nor do I depend on bonuses, and my 401K contribution was not reduced. I do think this happened at some sites, but not all, because it didn't happen to our group.

I'm not going to retype all the reasons I feel that NAPA is actually a cut above some other AMCs, as you can search for my replies in other threads, but I think you're somewhat misguided. If anything, the feedback I get from my peers who attend the chief meetings is that their is a strong and focused commitment to patient safety and quality care, and we tend to stay ahead of the impending changes in healthcare and associated requirements. So, take it for what it's worth. I read all the AMC threads too, and took this position several years ago, with no regrets.

 

[fiveccsyringe]

If you do a search you will find that my experiences with NAPA have not reflected the sentiment in this post. Quite the opposite. I don't work for below market salary, nor do I depend on bonuses, and my 401K contribution was not reduced. I do think this happened at some sites, but not all, because it didn't happen to our group.

I'm not going to retype all the reasons I feel that NAPA is actually a cut above some other AMCs, as you can search for my replies in other threads, but I think you're somewhat misguided. If anything, the feedback I get from my peers who attend the chief meetings is that their is a strong and focused commitment to patient safety and quality care, and we tend to stay ahead of the impending changes in healthcare and associated requirements. So, take it for what it's worth. I read all the AMC threads too, and took this position several years ago, with no regrets.

Trisomy, how can you say that gasforlife is "misguided" if you yourself in your acknowledge that pensions were reduced at "some sites." Perhaps gasforlife is from one of those sites? Also, since you are a "chief" (you mentioned chief's meeting so Im assuming you are one yourself), perhaps you have a better deal than the masses who that post will apply to? Maybe you are one of the "core" founders who benefited from sales mentioned in the links.

I'm just trying to clarify your comments. Can you please comment on the articles?

 

[deleted126335]

The general consensus on this board (that I agree with) is that working for a management company is less desirable. It is also becoming less avoidable. Most individual docs have worked for 1-2 of these companies at most. Usually at one site only. I suspect but don't know for certain that there is a decent level of variability within one company at different sites. Also, some level of variability between management companies.

Unfortunately it is in nobody's interest to survey anesthesiologists on their experiences with management companies so all data is anecdotal. Might I suggest a sub forum in the private forum dedicated to AMCs where people in GENERAL terms could post their experiences with AMCs?
Name of AMC/hours per week/rural vs suburban vs desirable metro area vs BFE/ percentile income/ description of working conditions/benefits/level of security/types of cases/type of group,e.g., mostly AMG/lots of fellowship trained, age demographic of the group, MD-only, ACT-medical direction/medical supervision/collaborative model/etc, etc.

 

[Trisomy13]

Trisomy, how can you say that gasforlife is "misguided" if you yourself in your acknowledge that pensions were reduced at "some sites." Perhaps gasforlife is from one of those sites? Also, since you are a "chief" (you mentioned chief's meeting so Im assuming you are one yourself), perhaps you have a better deal than the masses who that post will apply to? Maybe you are one of the "core" founders who benefited from sales mentioned in the links.

I'm just trying to clarify your comments. Can you please comment on the articles?

I'm saying he's misguided because he made a blanket statement that sounded like all 401ks were reduced, and some were not. I'm not a chief but I am friends with a few at various sites, and have heard positive feedback from their meetings. I'm certainly not one of the "core" founders. If anything, I'm biased because this is my first gig out of residency (about six years now), so I was not part of the "golden age of gas". I never said working for an AMC is ideal, but from what I've heard from colleagues, and what I have witnessed with my own eyes and experiences, NAPA was a huge positive change for this hospital.

 

[Trisomy13]

I suspect but don't know for certain that there is a decent level of variability within one company at different sites. .

I believe this as well.

 

[fiveccsyringe]

The general consensus on this board (that I agree with) is that working for a management company is less desirable. It is also becoming less avoidable. Most individual docs have worked for 1-2 of these companies at most. Usually at one site only. I suspect but don't know for certain that there is a decent level of variability within one company at different sites. Also, some level of variability between management companies.

Unfortunately it is in nobody's interest to survey anesthesiologists on their experiences with management companies so all data is anecdotal. Might I suggest a sub forum in the private forum dedicated to AMCs where people in GENERAL terms could post their experiences with AMCs?
Name of AMC/hours per week/rural vs suburban vs desirable metro area vs BFE/ percentile income/ description of working conditions/benefits/level of security/types of cases/type of group,e.g., mostly AMG/lots of fellowship trained, age demographic of the group, MD-only, ACT-medical direction/medical supervision/collaborative model/etc, etc.

I thought the purpose of this forum was for clinicians to post on topics they believe is relevant. We post on board review materials, what fellowships to use, what salaries to look for, what companies to work for. If someone is giving their take, why do we need to set up a seperate "forum" on the corner of the website for ONLY that topic. We have had a lively discussion on mednax and american anesthesiology going on for weeks. I for one would like to know if an AMC is about to sell because i intend to bring that up during my interview if i apply for a job and see what the response is.

Also, while its true both academic centers and AMCs experience "exodus," its always good to have inside info on this because if you join during tumultuous times, you're putting your career on the line. The people interviewing you aren't obligated to tell you the whole story. I would encourage anyone applying to big groups to search the forum for experiences. Should u base your decision ONLY on whats posted here? No. However, it is an additional bit of info that is worth looking into. I still would like trisomy to comment on the articles quoted because they are in my opinion relevant; and no I am not looking for a belligerent frivolous response, but a genuine answer as to whether he/she knew this was happening and what do the little folks in NAPA think about this. Has their been any discussion on the inside? If so, that is great and deserves to be known. If not, well then I would like to know that because this will effect everyone's bottom dollar.

Trisomy, keep working hard for NAPA, don't let anyone get u down. But, please know some of us are on the fence with a bunch of AMC offers and while it may hurt ur sentiment to hear people bash your company, their viewpoint is also welcome.

 

[fiveccsyringe]

BTW, I have seen those "syosset" and franklin ads on gaswork. They have been there for a LONG LONG time. I always wonder what is the deal with the people who work there...do they know their employers are hiring and no one wants the job? Do the chiefs there do something extra to prevent the folks who are there from leaving? Who r the chiefs anyway??

 

[Trisomy13]

I'm not sure what you expect me to comment about the articles. They are pretty clearly stated, and I don't have an MBA to expound on the economic underpinnings. I do know that Tim Dowd, named in the first article, is no longer part of NAPA. There was a leadership change a few years back, for the better IMHO. I did hear about the sale from Moelis but honestly I don't know how/if that impacts my day-to-day life at all. We shall see. I do know that I'm part of a large great group here and goes a long way to making my career fulfilling on a daily basis. If it all blows up tomorrow, I'll find somewhere else. That's part of having an "F U" account and portable skills. It's probably different at smaller sites. I think having a large group with similar minded docs makes for a good situation regardless of whether it's part of an AMC or otherwise.

 

[gasoflife]

Tim Dowd did leave and apparently there was such a falling out that NAPA lost a ton of money while he laughed all the way to the bank, likely kicked back to the employees in the form of shrinking bonuses and declining pensions. Like I said, ever since Peter Walker left and John Dicapua took over, it has been utter chaos.

In terms of syosset, and franklin the chiefs are fabiano and marino I think. they both have a tough time earning the respect of their staff and were planted there back when NAPA took over. Neither lifts a finger to actually sit in a room to do a case, and the rest of the departments suffer, or so I here. How they enjoy true partner salaries I have no idea.

Bronx lebanon has been a mess. Their chief left after being frustrated by weak corporate leadership and now they have someone else. This is a "revolving door" institution. Anyone that has good things to say about NAPA is somehow in cahoots with the upper eschalon, of which most of the people on this forum will not be in. They also recently lost NY Downtown and Westchester.

Say NO to NAPA. This is not a group you want to work for.

 

[Trisomy13]

Tim Dowd did leave and apparently there was such a falling out that NAPA lost a ton of money while he laughed all the way to the bank, likely kicked back to the employees in the form of shrinking bonuses and declining pensions. Like I said, ever since Peter Walker left and John Dicapua took over, it has been utter chaos.

In terms of syosset, and franklin the chiefs are fabiano and marino I think. they both have a tough time earning the respect of their staff and were planted there back when NAPA took over. Neither lifts a finger to actually sit in a room to do a case, and the rest of the departments suffer, or so I here. How they enjoy true partner salaries I have no idea.

Bronx lebanon has been a mess. Their chief left after being frustrated by weak corporate leadership and now they have someone else. This is a "revolving door" institution. Anyone that has good things to say about NAPA is somehow in cahoots with the upper eschalon, of which most of the people on this forum will not be in. They also recently lost NY Downtown and Westchester.

Say NO to NAPA. This is not a group you want to work for.

So it sounds like you have more personal experience with NAPA than you let on initially and maybe an axe to grind? Did you just join SDN to vent about NAPA? Are you disgruntled at Bronx Lebanon?

It very well could be that we just don't see the "utter chaos" of which you speak at our site, but we have been remarkably stable for over five years now. If anything, Dicapua is a strong leader and dedicated to patient safety.

And I take offense that you would assume I am somehow in "cahoots with the upper echelon" just because I have a rosier experience with NAPA than you. Am I friends with our chief here? Sure. He joined a couple months after I did. Do I know another chief in the system? Yeah, we studied for oral boards together.

I'll happily provide a counterpoint to all the negativity, while accepting that maybe my site is an anomaly.

 

[criticalelement]

Trisomy, how can you say that gasforlife is "misguided" if you yourself in your acknowledge that pensions were reduced at "some sites." Perhaps gasforlife is from one of those sites? Also, since you are a "chief" (you mentioned chief's meeting so Im assuming you are one yourself), perhaps you have a better deal than the masses who that post will apply to? Maybe you are one of the "core" founders who benefited from sales mentioned in the links.

I'm just trying to clarify your comments. Can you please comment on the articles?

1) WHy would anyone voluntarily work for an AMC. They are SCUM. THe minute you walk into the hospital they have a hand in your pocket.
2) WHy would you think you are getting a fair deal when you are not privvy to the financials.
3) The AMCs are a house of cards. and the corporate scum know it.
4) How can anyone one is better than the other. They are all corporate scum.

 

[deleted126335]

1. Fewer options to choose from.
2. hope springs eternal.
3. They have been around for over thirty years. Bigger than ever.
4. Walmart v. Costco. They do the same jobs but the workers have vastly different experiences on average. http://www.vizettes.com/perspectives/tc/walmart/walmart-vs-costco.htm

 

[criticalelement]

The point of my last post was you are getting screwed every which way when you work for any of them. In fact, if you work for ANYONE as an anesthesia doc you are getting exploited because your license is what is generating the revenue not the ingenuity of any bureaucrat.

 

[lilzelda2]

The group I work for appears to be in the situation where they'll taken over by an AMC. In NY, NJ and CT it seems to be the way everything is headed.

It would be helpful as posted above to have a forum going through the different AMCs

 

[criticalelement]

I think there should be one central anesthesiology depository. All of our names and credentials are on there. Everyone refuses to work for AMC. If they want our services on a hourly/perdiem basis consult the central depository... AMCs are desperately afraid of something like this happening.

 

[fiveccsyringe]

What you're talking about is a physician's union and yes they will be the end of AMCs, which is why they oppose it

 

[fiveccsyringe]

What I still can't understand is all the huffing-and-puffing by trisomy. I mean...lay off a little man...gasoflife is just giving his opinion. i went back and looked at your other posts...you're constantly defending NAPA no matter what the issue. I'm happy you are having such a great time with them but if others aren't being treated as well as they treat you (i.e. getting pensions cut, being forced to work at multiple places, cutting bonus) then obviously they are gonna be pissed and if they want to tell others about what NAPA did to them, why is it a personal attack on you?

BTW, i dont know this dicapoa guy, but after having met a lot of these AMC guys they couldn't care less about patients or their safety...they just care about the bottom line. I think guys like you probably care about patients and do right by them and your bosses just ride the wave. Just my general opinion not knowing the guy

 

[Trisomy13]

What I still can't understand is all the huffing-and-puffing by trisomy. I mean...lay off a little man...gasoflife is just giving his opinion. i went back and looked at your other posts...you're constantly defending NAPA no matter what the issue. I'm happy you are having such a great time with them but if others aren't being treated as well as they treat you (i.e. getting pensions cut, being forced to work at multiple places, cutting bonus) then obviously they are gonna be pissed and if they want to tell others about what NAPA did to them, why is it a personal attack on you?

BTW, i dont know this dicapoa guy, but after having met a lot of these AMC guys they couldn't care less about patients or their safety...they just care about the bottom line. I think guys like you probably care about patients and do right by them and your bosses just ride the wave. Just my general opinion not knowing the guy

My apologies if it comes across as huffing and puffing. When you say I'm constantly defending NAPA no matter the issue, it's really because I've had no issues working for them. It might sound hard to believe based on all the negativity on this forum, so I feel compelled to share my positive opinion. I don't think I'm being overly harsh on gasoflife when he clearly is speaking without all the facts. To the best of my knowledge nobody is being "forced to work at multiple places". Some people can volunteer to be credentialed at multiple sites and lend support. In my case I'm credentialed at another site but have yet to be asked to cover there, and if I do, I make extra pay. In fact, I've turned it down a few times.

Look, I'm fully aware I sound like an AMC cheerleader, and I hope I don't have to eat my words someday, and although it's not ideal compared to some groups, it's not all gloom doom and paranoia in every situation. If I had depended on this forum I never would have taken my current gig and would have missed out on a good opportunity.

 

[Scotty_G]

Trisomy would you be comfortable telling us which NAPA hospital you work for? Or at least give us the area? Ie is it on Long Island? If not could you PM me? I agree with the majority of the senior guys here and argue against NAPA. I grew up on Long Island and saw the beginning of NAPA (North-Shore-LIJ hospital), and I'm familiar with the majority of the "main hospitals". I had a few friends who interviewed with NAPA in recent times and the contract is not worth it. I also still don't understand how they could start an anesthesia residency that is based with an AMC. I thought that was illegal?

 

[Trisomy13]

Not Long Island. More Midwestern/Pennsylvania. Perhaps that plays into things. I can imagine things might be different closer to the metaphorical ground zero.

 

[fiveccsyringe]

Trisomy I don't mean to be rude but how can you vouch for an organization that is 80% located hundreds of miles away? I mean most people know NAPA is mainly a long island AMC with some pockets in other states. Even dicapoa, the head honcho, is based in long island as per their website and their headquarters are in melville, long island. How then can you rely on your "friends who are chiefs" to give you a broad overview of what's going on in their main hub?

Perhaps you should ask some of your non-chief colleagues in long island if gasforlife has any substance to his claims before you tell us all to disregard his/her comments

 

[Trisomy13]

Trisomy I don't mean to be rude but how can you vouch for an organization that is 80% located hundreds of miles away? I mean most people know NAPA is mainly a long island AMC with some pockets in other states. Even dicapoa, the head honcho, is based in long island as per their website and their headquarters are in melville, long island. How then can you rely on your "friends who are chiefs" to give you a broad overview of what's going on in their main hub?

Perhaps you should ask some of your non-chief colleagues in long island if gasforlife has any substance to his claims before you tell us all to disregard his/her comments

That's not rude, and you make a very valid point. Perhaps I have not done it on this thread, but I usually try to make the disclaimer that admittedly, my site is not near NYC, quite larger than most of the sites, and we tend to have more autonomy in our day-to-day affairs, scheduling, etc. Maybe we are the lone anomaly. Things might be different on LI, but I can still butt in when I see a thread imploring "SAY NO TO NAPA" when maybe in a couple of years we might be recruiting to replace our old-timers here. It doesn't help our cause locally, and I like to provide a counterpoint to the general vibe on this board. Does that make any sense?

 

[Man o War]

If you do a search you will find that my experiences with NAPA have not reflected the sentiment in this post. Quite the opposite. I don't work for below market salary, nor do I depend on bonuses, and my 401K contribution was not reduced. I do think this happened at some sites, but not all, because it didn't happen to our group.

I'm not going to retype all the reasons I feel that NAPA is actually a cut above some other AMCs, as you can search for my replies in other threads, but I think you're somewhat misguided. If anything, the feedback I get from my peers who attend the chief meetings is that their is a strong and focused commitment to patient safety and quality care, and we tend to stay ahead of the impending changes in healthcare and associated requirements. So, take it for what it's worth. I read all the AMC threads too, and took this position several years ago, with no regrets.

@Trisomy13 what is your supervision ratio? This was the biggest gripe I had with the AMC I moonlit for a few times (not NAPA). It was 4:1, and in my opinion it was unsafe that way they did it. CRNAs had too much autonomy because we as docs were so busy we couldn't properly review their anesthetic plan and supervise the rooms during the cases. After some near misses because of bad case management and the CRNA not calling in time, I did not moonlight there anymore.

 

[gasoflife]

Not Long Island. More Midwestern/Pennsylvania. Perhaps that plays into things. I can imagine things might be different closer to the metaphorical ground zero.

Ok, so now that we know that the sole advocate for NAPA is really on the periphery of the AMC, I would like to re-focus on the initial comment, which is that the core of NAPA, which is in long island, is rotten. The sites I am referring to (in no particular order) are Bronx Lebanon, Brooklyn Hospital, Franklin Hospital, Plainview, Syosset, Glen Cove, and LIJ. I don't know about the deal employees have at Manhasset.

These folks had their pensions cut by 33% from 30K, to 20K. Their bonuses were cut by more than 50%, they were told they HAVE to go to other hospitals to work (sometimes 3 in a week) with NO EXTRA PAY or even gas money reimbursement. If you weren't happy, you were told you could leave.

Now, I've heard a lot of discussion about how AMCs provide stability and job security and are the future, but here is the reality: your base with NAPA will be more or less entry level ($250-280) and that's after you've made "partner." The remainder is usually a bonus (~$75-$80K). Add to that your pension and your take home is supposedly above $400K. Not bad, eh? Well, what if they slash the bonus to only $25K for the year because "you made no money this year at your site." And when people left you were made to take their calls and not receive additional per diem rates for the extra calls? Then is this "stable" job any better than getting up and starting somewhere else? My point is that yes you will always have a job with NAPA, but the pay will be so low that you would not take a pay hit if you started at the bottom elsewhere. Thus, this isn't much security is it?

Mednax and Sheridan are bigger and deal with non-anesthesia fields also. They have thus a better handle on how to retain physicians. Who knows who is in charge of NAPA; is it John Dicapua the CMO, Lloyd Strauss the CEO, the partners at Moelis? Go on their website and they have several board members. Is the board in charge? What about the managing partner, Dale Anderson? Is he in charge?

This is an organization that has no desire to improve quality or retain physicians. The mantra is "make as much and pay as little as you can get away with." This is y I am posting this...it isn't to vent, I have my husband for that. Until physicians are kept in the dark, NAPA and grps like it will thrive. Those considering careers with NAPA need to know that they are looking to sell to the highest bidder and the new owner may change everything (even from you trisomy 13). They also need to know that the base you negotiate better be higher than they say bec your bonus can disappear very fast. Finally, their contract has a clause about how they can change anything unilaterally anytime. DONT sign that like I did!!! No one tells you these things. You deserve to be informed!

 

[Trisomy13]

@Trisomy13 what is your supervision ratio? This was the biggest gripe I had with the AMC I moonlit for a few times (not NAPA). It was 4:1, and in my opinion it was unsafe that way they did it. CRNAs had too much autonomy because we as docs were so busy we couldn't properly review their anesthetic plan and supervise the rooms during the cases. After some near misses because of bad case management and the CRNA not calling in time, I did not moonlight there anymore.

Usually 3:1, sometimes 2:1. Very rarely 4:1 under extreme circumstances (multiple people on vacation, every offsite wanting a case that day, and an emergent heart - you get the idea).

And I'll agree with gasoflife, if my hours/salary/work expectations etc. were anything like he described, I might not have signed that contract. There is obviously variability between sites.

 

[Scotty_G]

Gasoflife which LI hospital did you work at? Trisomy it's good you are in PA 🙂 If you were in NY things would be worse. The worst part of NAPA is the noncompete. You literally will not be able to work in the tristate area/LI if you decide to quit. (Unless you want to go far east) There are rumblings that some of the hospitals including the main hub (Manhasset) are tired of NAPA. I would not be surprised if they take a hit soon, hence the reason they are shopping it around.

 

[Arch Guillotti]

Might I suggest a sub forum in the private forum dedicated to AMCs where people in GENERAL terms could post their experiences with AMCs? Name of AMC/hours per week/rural vs suburban vs desirable metro area vs BFE/ percentile income/ description of working conditions/benefits/level of security/types of cases/type of group,e.g., mostly AMG/lots of fellowship trained, age demographic of the group, MD-only, ACT-medical direction/medical supervision/collaborative model/etc, etc.

It would be helpful as posted above to have a forum going through the different AMCs

The private forum as it stands should suffice for this.

 

[criticalelement]

Ok, so now that we know that the sole advocate for NAPA is really on the periphery of the AMC, I would like to re-focus on the initial comment, which is that the core of NAPA, which is in long island, is rotten. The sites I am referring to (in no particular order) are Bronx Lebanon, Brooklyn Hospital, Franklin Hospital, Plainview, Syosset, Glen Cove, and LIJ. I don't know about the deal employees have at Manhasset.

These folks had their pensions cut by 33% from 30K, to 20K. Their bonuses were cut by more than 50%, they were told they HAVE to go to other hospitals to work (sometimes 3 in a week) with NO EXTRA PAY or even gas money reimbursement. If you weren't happy, you were told you could leave.

Now, I've heard a lot of discussion about how AMCs provide stability and job security and are the future, but here is the reality: your base with NAPA will be more or less entry level ($250-280) and that's after you've made "partner." The remainder is usually a bonus (~$75-$80K). Add to that your pension and your take home is supposedly above $400K. Not bad, eh? Well, what if they slash the bonus to only $25K for the year because "you made no money this year at your site." And when people left you were made to take their calls and not receive additional per diem rates for the extra calls? Then is this "stable" job any better than getting up and starting somewhere else? My point is that yes you will always have a job with NAPA, but the pay will be so low that you would not take a pay hit if you started at the bottom elsewhere. Thus, this isn't much security is it?

Mednax and Sheridan are bigger and deal with non-anesthesia fields also. They have thus a better handle on how to retain physicians. Who knows who is in charge of NAPA; is it John Dicapua the CMO, Lloyd Strauss the CEO, the partners at Moelis? Go on their website and they have several board members. Is the board in charge? What about the managing partner, Dale Anderson? Is he in charge?

This is an organization that has no desire to improve quality or retain physicians. The mantra is "make as much and pay as little as you can get away with." This is y I am posting this...it isn't to vent, I have my husband for that. Until physicians are kept in the dark, NAPA and grps like it will thrive. Those considering careers with NAPA need to know that they are looking to sell to the highest bidder and the new owner may change everything (even from you trisomy 13). They also need to know that the base you negotiate better be higher than they say bec your bonus can disappear very fast. Finally, their contract has a clause about how they can change anything unilaterally anytime. DONT sign that like I did!!! No one tells you these things. You deserve to be informed!

With this post you may have saved many people heartache and for that I am thankful for your post.

Every single AMC is SCUM. I dont care how big they are or how much they smile at me.. THey are fu cking scum and treat them as such. DOnt trust any of em. Until they say criticalelement if you work for us... you will have zero liability. You wont answer ANY phone calls or letters from lawyers NONE. We take ALL OF THE LIABILITY. Until they say that or show me all of the accounts receivables. they are ****ing scum

 

[deleted171991]

Unfortunately, that applies to most medical employers. You take most of the risks and liability, while they take most of the profits. That's why one had better practice in a state with malpractice caps, to somewhat limit the downside.

 

[powermd]

Is NAPA still trying to sign docs up for the seven year 'partner' track?

 

[risnwb]

Is NAPA still trying to sign docs up for the seven year 'partner' track?

I've more recently heard 5 years (I believe at LIJ)
And other sites in New Jersey, never heard 7.... That's insane. Actually 5 is insane.

 

[Man o War]

Why would anyone do a 5 year buy in anywhere, much less an AMC? That is crazy.

 

[caligas]

Why would anyone do a 5 year buy in anywhere, much less an AMC? That is crazy.

Why would anyone go into obstetrics? Why would anyone argue with Blade? Why would anyone move to Florida?

...people make bad decisions.

 

[Shouldawouldacouldas]

Gasoflife, what are we all to do? I remember when new anes MD's, during the mid and late 90's, were being offered 75-100K to start by small groups owned by MD's. So...back in those days, the anes docs were screwing over the new anes grads. Now, the AMC's are screwing over all the anes docs.

I am too late in my career to change, unless I go into pain management. I wish medical students and residents really knew how the world works. Unfortunately, I don't think I would have believed anyone telling me all the bad stuff about anesthesia or medicine.

My group is about to hit a big transition -- either to become hospital employees or an employee of an AMC. I get depressed whenever I think about it.

 

[GaseousClay]

Apparently the biggest anesthesia group in California (which will remain nameless) is planning to sell. This will be a nightmare for those younger partners while the greedy old partners collect and ruin a great group who used to attract the best and brightest. sad times we are in....

 

[deleted162650]

I'll be a little surprised if they sell. Keep in mind only the rotators get screwed as you're up for "partner" after only a year. At least they didn't have to sacrifice any "buy-in" money. The fact that there are essentially at least 210 partners out of 260 docs tells me the buy out amount wouldn't be that large per doc and I think the group is too young as a whole for the req'd 80% vote to pass. We shall see though.

 

[teeva]

Why should it remain nameless. How am I supposed to figure out if I'm in that AMC?

 

[GaseousClay]

I'll be a little surprised if they sell. Keep in mind only the rotators get screwed as you're up for "partner" after only a year. At least they didn't have to sacrifice any "buy-in" money. The fact that there are essentially at least 210 partners out of 260 docs tells me the buy out amount wouldn't be that large per doc and I think the group is too young as a whole for the req'd 80% vote to pass. We shall see though.

Its actually 2 years before you can buy a share is what I am told. So there are still some people out there besides rotators that get screwed. The momentum for the buy-out is starting to increase which I am told means that it could be a multi-million dollar payout to each shareholder which is hard to believe (4-600 million???!?) but thats really the only way it will sell....

 

[Ezekiel2517]

The momentum for the buy-out is starting to increase which I am told means that it could be a multi-million dollar payout to each shareholder which is hard to believe (4-600 million???!?).

I'm willing to bet it won't be close to those figures

 

[Arch Guillotti]

Closing. TOS violation.