sheridan

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militarymd

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anyone spend some time on the second floor at the asa resource center for jobs and talk to the chick at the Sheridan desk?

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to go along with my thoughts in the other thread I started.

So according to this attractive young lady with pretty eyes ....i think the color was 34C.....many of the new young docs don't want to deal with practice management....they just want to be employees...and let THEM, Sheridan, deal with the hassles.

I asked where they went....she said to hospitals where the anesthesia department is in "crisis" ....where the people there can't get their game together to provide "coverage"....

I asked how much I would be paid....she said an "above average" salary.

I asked how that is possible when the people already there can't do it.

She said through a hospital subsidy and through a better negotiated rate with the commercial payers.

And I said...and the "owners" takes a bit off the top...and she said yes....


My question to YOU all, is WHY can't WE do that?

Why do WE allow departments to GO INTO "CRISIS"?

If WE did what Sheridan DOES, we would either GET PAID more, or COST the system (hospitals, payers, etc) less.

My thoughts and observations.....what are yours?
 
to go along with my thoughts in the other thread I started.

So according to this attractive young lady with pretty eyes ....i think the color was 34C.....many of the new young docs don't want to deal with practice management....they just want to be employees...and let THEM, Sheridan, deal with the hassles.

I asked where they went....she said to hospitals where the anesthesia department is in "crisis" ....where the people there can't get their game together to provide "coverage"....

I asked how much I would be paid....she said an "above average" salary.

I asked how that is possible when the people already there can't do it.

She said through a hospital subsidy and through a better negotiated rate with the commercial payers.

And I said...and the "owners" takes a bit off the top...and she said yes....


My question to YOU all, is WHY can't WE do that?

Why do WE allow departments to GO INTO "CRISIS"?

If WE did what Sheridan DOES, we would either GET PAID more, or COST the system (hospitals, payers, etc) less.

My thoughts and observations.....what are yours?

the anesthesia management companies take advantage of the dis unity among physicians. plus they have power in numbers.. about 5 years ago I worked for a hospital that sheridan ran. They were paying me an arm and a leg. I stayed there for 8 months. that year I made more money than i have made heretofore . I spoke to their billing guy a few months later because he wanted my npi number and the sorts, and he was telling me what they paid me was a fraction of what they billed out. I couldnt believe it. He at the time told me they have a great relationship with the insurers. So it is power in numbers.. I didnt find them horrible people to deal with but I then again I was an independent contractor. And the hospitals dont have to be in crisis.. that chick doesnt know what she is talking about. Sheridan actively seeks to BUY out anesthesia departments from the partners. and if the partners are willing. they can sell and pretty much b e sitting pretty for retirement
 
the anesthesia management companies take advantage of the dis unity among physicians. plus they have power in numbers.. about 5 years ago I worked for a hospital that sheridan ran. They were paying me an arm and a leg. I stayed there for 8 months. that year I made more money than i have made heretofore . I spoke to their billing guy a few months later because he wanted my npi number and the sorts, and he was telling me what they paid me was a fraction of what they billed out. I couldnt believe it. He at the time told me they have a great relationship with the insurers. So it is power in numbers.. I didnt find them horrible people to deal with but I then again I was an independent contractor. And the hospitals dont have to be in crisis.. that chick doesnt know what she is talking about. Sheridan actively seeks to BUY out anesthesia departments from the partners. and if the partners are willing. they can sell and pretty much b e sitting pretty for retirement

if they paid you so well, then why did you move on?
 
to go along with my thoughts in the other thread I started.

So according to this attractive young lady with pretty eyes ....i think the color was 34C.....many of the new young docs don't want to deal with practice management....they just want to be employees...and let THEM, Sheridan, deal with the hassles.

I asked where they went....she said to hospitals where the anesthesia department is in "crisis" ....where the people there can't get their game together to provide "coverage"....

I asked how much I would be paid....she said an "above average" salary. On average, this translates into abour $300K for a generalist, or approximately $340K for a cardiac guy (benefits get subtracted from above numbers and there is no such thing as partnership bouses or say-so into how the "practice" runs.)

I asked how that is possible when the people already there can't do it.

She said through a hospital subsidy and through a better negotiated rate with the commercial payers. This means that they approach the hospital admin and promise the world when it comes to coverage (it's a really fancy powerpoint presentation that sells itself to the dept of surgery and the admin). Being the second group in, you can "command" more value (i.e. subsidy) for the promises that you bring. You, ofcourse, come on board by first demonizing the practices of the prior "failed group" and promise to "change the culture." You bring any warm body CRNA and a dumb enough MD to saff such entity, then the rest is history....

And I said...and the "owners" takes a bit off the top...and she said yes.... You do the math: average billing for a hard working anesthesiologist can be anywhere from $400k-$500K (depends on location and subspecialty, ofcourse). Subtract from that the menial salary that they pay you, then that translates into a handsome sum from all the MD's who sign with them (this, ofcourse, gets piled on top of the subsidy).


My question to YOU all, is WHY can't WE do that? If you do not give a rat's ***** about the quality of the anesthetic that you deliver, then sure, you can easily perpetuate their care model (similar to the Cash for Clunkers program: they will hire any train wreck CRNA/MD).

Why do WE allow departments to GO INTO "CRISIS"? simple answer on this one: $$$ and ego.

If WE did what Sheridan DOES, we would either GET PAID more, or COST the system (hospitals, payers, etc) less. Inefficient care does not cost the hospital less money (may actually cost more). You may get paid more because you are the second group in and can possibly command a bigger subsidy, only if you promise the world.... (but that's all it is, a promise....)

My thoughts and observations.....what are yours?

p.s., this response applies to all AMC's.
 
Departments go into crisis because of money. There may be other reasons in addition but money is the biggest.
 
Mil,

I work at a Sheridan Practice. What that young lady expressed to you is the basic formula. Troubled group, hospital admin. tired of "anesthesia" issues! Sheridan promises the world but for a hefty premium and Im talkin "BIG" subsidy! Viola OR anesthesia issues fixed! Until the administration realizes they are being taken for a gravy train!

I have talked with Drozdow and Sheridan spent and continues to spend big bucks to fight insures for not only better rates but timely pay! This is on of the reasons he tells hospitals he is adding value!

The problem in medicine is everyone is trying to eat off everyone elses back! This is especially true in Anes. Locums agency eat off you, your "partners", AMC's!!!! I'm not even sure how many non-MD's work for Sheridan or similar organization that generate 0 revenue but I know it's a lot. This is what is killing all of us financially! The government isn't helping the situation either.

Imagine if ALL aneshesiology groups gave just 0.25% of billing to a small group of lobbyist to fight the insurance companies on everyones behalf across all 50 states. This is what we really need not Sheridan or Any other AMC skimming in orders of magnitude greater than that.

For the record Im ok with my job but am always looking at better opportunities!
 
yes, but Sheridan costs the hospitals EVEN MORE.

Absolutely.

It's a viscous circle. And nobody ever accused the hospital administrators of being very intelligent in this area either.

Anesth dept can't get there **** together, they fight with the hospital about money and among each other, surgeons start complaining about anesth, and then the hospital folds under the pressure of the surgeons and hires the AMC. Things are good for a few months and then the AMC pulls their more talented providers and the quality drops off. Surgeons start complaining again. and it all starts over. Obviously, there are other scenarios but this is a common one.
 
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the other thing a large company like sheridan has going for it is the ability to negotiate better reimbursement from insurance companies. Sheridan has many more providers (and takes care of more patients) than your average small private practice group. Therefore they have more negotiating power, and more importantly, more resources devoted to this.
 
Agreed, but none of this impacts that little foot soldiers who are taking all the liability. This is done to deepen the pockets of those who own the corporation; none of this trickles down to the worker bees....






the other thing a large company like sheridan has going for it is the ability to negotiate better reimbursement from insurance companies. Sheridan has many more providers (and takes care of more patients) than your average small private practice group. Therefore they have more negotiating power, and more importantly, more resources devoted to this.
 
Agreed, but none of this impacts the little foot soldiers who are taking all the liability. This is done to deepen the pockets of those who own the corporation; none of this trickles down to the worker bees....






the other thing a large company like sheridan has going for it is the ability to negotiate better reimbursement from insurance companies. Sheridan has many more providers (and takes care of more patients) than your average small private practice group. Therefore they have more negotiating power, and more importantly, more resources devoted to this.
 
This link has been posted on this forum before, but I think it is worth posting again. Below is a link to a large PDF file that contains a book about the "rape" of emergency medicine. It took me several nights on OB night float as a CA2 to get through it, but it is a great story and illustrates many of the problems that come with medical management companies.


http://www.aaem.org/rem/The_Rape_of_Emergency_Medicine.pdf
 
Your arguments would be stronger if senior partners didn't f- over new employees. At least with AMCs you know what you are getting. With a lot of groups you are subject to being used worse than an AMC then dropped without ever becoming a partner. If you guys lose your contracts because we go work for an AMC, you are pretty much getting what's coming to you. (This doesn't apply to all groups obviously, and is based on the rumor mill not personal experience.)
 
I would completely disagree with your bolded statement. you have no idea as to what sort of liability nightmare you are getting into. I am not defending the bad PP groups either.... But know one thing: you are nothing more than a mere body when it comes to these AMC's and you will be worked to death and promised the world--only to end up with a world of liability and no promise whatsoever of partnership, say-so into how the practice runs, or even relatively knowing your daily work hours. Again, I am not defending bad PP groups, just saying that odds are you would fair much better staying away from AMC's.



Your arguments would be stronger if senior partners didn't f- over new employees. At least with AMCs you know what you are getting. With a lot of groups you are subject to being used worse than an AMC then dropped without ever becoming a partner. If you guys lose your contracts because we go work for an AMC, you are pretty much getting what's coming to you. (This doesn't apply to all groups obviously, and is based on the rumor mill not personal experience.)
 
I would completely disagree with your bolded statement. you have no idea as to what sort of liability nightmare you are getting into. I am not defending the bad PP groups either.... But know one thing: you are nothing more than a mere body when it comes to these AMC's and you will be worked to death and promised the world--only to end up with a world of liability and no promise whatsoever of partnership, say-so into how the practice runs, or even relatively knowing your daily work hours. Again, I am not defending bad PP groups, just saying that odds are you would fair much better staying away from AMC's.

I don't have experience with this stuff so correct me if I'm wrong.
What I was trying to say was that if an AMC offers you a given salary, that's pretty much what you are going to get, and you can keep making that for as long as you are willing to work for the AMC. I'm not saying you don't get the shaft in other ways, but you get hired at a salary and you get what you agreed to.

With some groups, you will get a salary that is much worse than the AMC with the expectation of making up for lost income 2-5 years in the future when you get income parity in the group. You are willing to sacrifice current income for future income. The problem comes when 5 years down the road you still don't get income parity. They just hire some other new guy that they can underpay or whatever.

I know everyone is familiar with this scenario and that I'm not telling you something you don't know.

My point is that f--- those guys in the group. I'd rather help an AMC replace them than let them keep screwing people over. At least with the AMC you are paid fairly (relative to some private groups) when you work there. You might hate working for the AMC, but at least you haven't lost hundreds of thousands of dollars in potential income to some private practice partners just because they graduated a few years before you an have monopolized the practice of anesthesia in that city.

Don't get me wrong. I know most groups probably aren't like this, but those that are need to be taken down. If it takes an AMC to do so then fine. The enemy of my enemy is my friend. ?
 
I agree with 99% of what you are saying. I also am no big fan of PP groups that screw the younger guy. But, as a patient advocate, I cannot find it in me to advocate the uprooting of any PP group for replacement by an AMC. Why? Because the anesthesia care from an AMC is scary! You need to see how they provide anesthesia to fully agree with me. I am familiar with malignant groups, they certainly are out there. But from a patient safety perspective, you really do not want to be on board with an AMC....



I don't have experience with this stuff so correct me if I'm wrong.
What I was trying to say was that if an AMC offers you a given salary, that's pretty much what you are going to get, and you can keep making that for as long as you are willing to work for the AMC. I'm not saying you don't get the shaft in other ways, but you get hired at a salary and you get what you agreed to.

With some groups, you will get a salary that is much worse than the AMC with the expectation of making up for lost income 2-5 years in the future when you get income parity in the group. You are willing to sacrifice current income for future income. The problem comes when 5 years down the road you still don't get income parity. They just hire some other new guy that they can underpay or whatever.

I know everyone is familiar with this scenario and that I'm not telling you something you don't know.

My point is that f--- those guys in the group. I'd rather help an AMC replace them than let them keep screwing people over. At least with the AMC you are paid fairly (relative to some private groups) when you work there. You might hate working for the AMC, but at least you haven't lost hundreds of thousands of dollars in potential income to some private practice partners just because they graduated a few years before you an have monopolized the practice of anesthesia in that city.

Don't get me wrong. I know most groups probably aren't like this, but those that are need to be taken down. If it takes an AMC to do so then fine. The enemy of my enemy is my friend. ?
 
It's a viscous circle. And nobody ever accused the hospital administrators of being very intelligent in this area either.

Like lidocaine, or like Pennzoil? It's a vicious question.

(Just bustin' chops, Mikey! Maybe one too many foul tips to the mask? Eh, even then, you're still smarter than me!)
 
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