Sound in arizona?

[amyl]

Looks like sound has some new contract - old envision contract? In Phoenix ? What’s going on In Phoenix and Tucson these days? Arizona seems like a mess

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[Ashers]

Sound took over some of envision's contracts. I know they got banner university in Phoenix, but valley anesthesia had still around and hiring (I've been getting recruiters contacting me). Phoenix is a cluster. I barely work here now occasionally helping out friends' groups as an independent. But now i do locums.

 

[GassYous]

Sound took over some of envision's contracts. I know they got banner university in Phoenix, but valley anesthesia had still around and hiring (I've been getting recruiters contacting me). Phoenix is a cluster. I barely work here now occasionally helping out friends' groups as an independent. But now i do locums.

Yeah because the pay for valley is way lower since they sold out and a bunch of people left

 

[Arantius]

I actually just interviewed for the sound program in Phoenix- I’m looking for somewhere sunny with golf. Anyway, I liked the group- nice people and seemed to work well together. Pay was awesome (like over 500k), and hospital looks like a hotel. Cons are in house call at night and covering airways in the hospital but that is any big university hospital/trauma center... BUT the locums rates are so good I think I may just continue being a nomad for awhile...

 

[GassYous]

I actually just interviewed for the sound program in Phoenix- I’m looking for somewhere sunny with golf. Anyway, I liked the group- nice people and seemed to work well together. Pay was awesome (like over 500k), and hospital looks like a hotel. Cons are in house call at night and covering airways in the hospital but that is any big university hospital/trauma center... BUT the locums rates are so good I think I may just continue being a nomad for awhile...

How are you going to golf in 115 weather? As it is like 1/4 of the year?

 

[chessknt]

How are you going to golf in 115 weather? As it is like 1/4 of the year?

How are those golf courses going to exist when they run out of water?

 

[nimbus]

How are you going to golf in 115 weather? As it is like 1/4 of the year?

I used to live in the desert. I never golfed but the golfers got up REAL early.

 

[Ashers]

How are you going to golf in 115 weather? As it is like 1/4 of the year?

From what I hear, you get good rates... my friends take lots of water. The tennis courts are empty right now too. Stand up paddle/kayaking/tubing is still pretty popular even on the hot days -- lakes and rivers.

 

[sevoflurane]

Pretty sure USAP has exited AZ market entirely.

 

[Ashers]

Pretty sure USAP has exited AZ market entirely.

Oh, just checked their website; it no longer lists AZ. One of my friends who works for them in FL was telling me I should join the AZ group. Didn't even talk to them at that point. My friend at Valley tells me Envision is still having major issues too.

 

[amyl]

Pretty sure USAP has exited AZ market entirely.

I think so too - but sometimes I don’t know the whole story. This is what Ive heard- Years ago I think USAP pitched those groups and they picked envision. USAP took a less desirable contract there just to get a foothold in the market. Eventually became a waste of resources I think so USAP is out.
Crazy that it’s such a tough market - you would think Phoenix and Tucson would have good payor mixes

 

[zizzer]

Sound wasn't able to cover everything so certain services are still covered by Valley. I hear it's a temporary agreement right now and it's unclear whether Banner will continue it, replace Valley with Sound entirely in the future, or go back to Valley.

 

[GassYous]

Sound wasn't able to cover everything so certain services are still covered by Valley. I hear it's a temporary agreement right now and it's unclear whether Banner will continue it, replace Valley with Sound entirely in the future, or go back to Valley.

And by Valley you mean envision

 

[mmag]

Seems like Sound is willing to put up some big bucks when they start contracts. Very likely that the first contract is going to be the best one though.

 

[GassYous]

Seems like Sound is willing to put up some big bucks when they start contracts. Very likely that the first contract is going to be the best one though.

View attachment 357295

Valley just pulled out of there

I'm sure they are very short and you will get worked

Once they get their hands on you I'm sure there will be some reason for why you don't get the full 600

 

[DirtDocMD]

Seems like Sound is willing to put up some big bucks when they start contracts. Very likely that the first contract is going to be the best one though.

View attachment 357295

That was the old Northstar tactic. TONS of locums for the first two years (at the Hospital’s expense), to keep other folks around (make the job cushy to attract permanents). At the end of the two years, it’s time for the “come to Jesus” meetin’, where they tell all the permanents how much harder they’re gonna be working (cause the hospital money for locums is gone).

As mentioned, the first couple years are usually the “best” of these gigs (assuming they can find plenty of locums, which is NOT a given in today’s market, even at high pay). Don’t go buying that massive house until that first contract has passed. The end of that “honeymoon” period can be a real beeyotch, sometimes....

 

[narcotics999]

That was the old Northstar tactic. TONS of locums for the first two years (at the Hospital’s expense), to keep other folks around (make the job cushy to attract permanents). At the end of the two years, it’s time for the “come to Jesus” meetin’, where they tell all the permanents how much harder they’re gonna be working (cause the hospital money for locums is gone).

As mentioned, the first couple years are usually the “best” of these gigs (assuming they can find plenty of locums, which is NOT a given in today’s market, even at high pay). Don’t go buying that massive house until that first contract has passed. The end of that “honeymoon” period can be a real beeyotch, sometimes....

Why would anyone ever entertain a permeant job for AMC?

 

[zizzer]

And by Valley you mean envision

Yes, Valley is an Envision company now, although according to must accounts seems to maintain more autonomy than most other Envision groups.

Seems like Sound is willing to put up some big bucks when they start contracts. Very likely that the first contract is going to be the best one though.

View attachment 357295

Exactly

 

[gasresident1]

Sound also took over Tri city in SD right? LOL

 

[Arantius]

Wait so envision is valley, but valley doesn’t cover all of envision in phoenix? There’s other envision groups right?

 

[marr65]

That was the old Northstar tactic. TONS of locums for the first two years (at the Hospital’s expense), to keep other folks around (make the job cushy to attract permanents). At the end of the two years, it’s time for the “come to Jesus” meetin’, where they tell all the permanents how much harder they’re gonna be working (cause the hospital money for locums is gone).

As mentioned, the first couple years are usually the “best” of these gigs (assuming they can find plenty of locums, which is NOT a given in today’s market, even at high pay). Don’t go buying that massive house until that first contract has passed. The end of that “honeymoon” period can be a real beeyotch, sometimes....

Also, the PTO will be prorated if you were to leave early so if you left with 1/2 year left then your max pto is only 4 weeks. Also, they might not let you take pto when you during your 90 days resignation notice. The best bet is to have in your contract states that your pto is a full 8 weeks taken anytime even when you have given notice to leave.

Relocation and sign on bonus are taxable so best bet is to have them pay it out to you as salary so that you don’t have to pay it back if you leave. Less of a headache for you tax wise.

 

[zizzer]

Wait so envision is valley, but valley doesn’t cover all of envision in phoenix? There’s other envision groups right?

A better way to put it is that Valley Anesthesiology Consultants is Envision because Envision (formerly known as Sheridan) is in many other states, also owning Emergency Medicine groups. Valley Anesthesiology Consultants in Phoenix is one of the largest private practice groups they acquired (over 300 physicians with several different divisions across Phoenix). Even though Valley is now owned by Envision, they're referred to across Phoenix as Valley Anesthesiology Consultants still.

 

[stormn12]

Obviously Valley jobs aren't quite as lucrative as in the recent past with the buyout, but from talking to a current employee at the Scottsdale division it still sounds like a pretty sweet gig. The combination of salary plus after-hours units sounds like a good balance. For something that's primarily a solo-MD practice, is there anywhere else in Phoenix I should be looking? I'm currently a fellow on the east coast so I'm pretty out of touch with the market.

 

[GassYous]

Obviously Valley jobs aren't quite as lucrative as in the recent past with the buyout, but from talking to a current employee at the Scottsdale division it still sounds like a pretty sweet gig. The combination of salary plus after-hours units sounds like a good balance. For something that's primarily a solo-MD practice, is there anywhere else in Phoenix I should be looking? I'm currently a fellow on the east coast so I'm pretty out of touch with the market.

Phoenix is 110 degrees 6 months of the year with no water why would you want to live there

 

[Ashers]

Obviously Valley jobs aren't quite as lucrative as in the recent past with the buyout, but from talking to a current employee at the Scottsdale division it still sounds like a pretty sweet gig. The combination of salary plus after-hours units sounds like a good balance. For something that's primarily a solo-MD practice, is there anywhere else in Phoenix I should be looking? I'm currently a fellow on the east coast so I'm pretty out of touch with the market.

Phoenix is a really weird market. Valley is a good job if you don't mind the call (from talking to a bunch of people in Valley). I moved there in 2020 to be closer to family, and I'm a Wildcat. I left the group I was with, and I'm doing locums now.

Phoenix is 110 degrees 6 months of the year with no water why would you want to live there

Summer's not that long. I love the weather, and there are lakes. I've used my SUP board a few times. I'm sad that locums has taken me out of PHX in the summer. Granted, it's not like where I grew up (HI), but it's better than so many other places!

 

[nimbus]

Looks like Sound is recruiting for their own internal “travel team” “ambassadors”….ie internal locums. I discourage anyone from taking these positions. If you’re working locums assignments, might as well get paid locums rates.

 

[Ashers]

Looks like Sound is recruiting for their own internal “travel team” “ambassadors”….ie internal locums. I discourage anyone from taking these positions. If you’re working locums assignments, might as well get paid locums rates.

They've got regular locums too there. I may pick up a few shifts when I'm in town from my out of town assignments. I hadn't heard of this ambassador things, but I'm staying away from it!

 

[IMGASMD]

Looks like Sound is recruiting for their own internal “travel team” “ambassadors”….ie internal locums. I discourage anyone from taking these positions. If you’re working locums assignments, might as well get paid locums rates.

Hahaha. Sounds like robing Peter to pay Paul if you ask me.

We have these within system “traveling” nurse. You take a hospital that’s already short, “travel” them to another hospital that’s even shorter.

 

[amyl]

USAP doing this too. On call anesthesia is the new company. So far have hired mostly crnas but hiring doctors too. I’m not personally involved so don’t know details.

 

[GravelRider]

NAPA has been doing internal locums for a while now. It’s usually advertised as a “SWAT” team. It’s a terrible deal…you get paid 50k more W2 than a regular employee, but you can be assigned wherever they need/want you.

 

[amyl]

NAPA has been doing internal locums for a while now. It’s usually advertised as a “SWAT” team. It’s a terrible deal…you get paid 50k more W2 than a regular employee, but you can be assigned wherever they need/want you.

Yea this is a good example of the business guys not understanding the nature of the business if anesthesia… or maybe they don’t care and they were all planning to have a monopoly on the business and be able to set the business. No one does locums for an extended period of time. It’s either that they want a little extra money from their regular job that has lots of vacation or someone transitioning in life. No one is going to sign up to be the permanent locums person especially in this day and age where Life outside of work takes more precedence than it ever has before. Alll they see is that locums companies are getting a huge amount of money and have to pay a middle man…. Well they think keep the $ cut out the middleman. It’s not that simple and I do not think these ventures will be successful.
Even for USAP - I don’t know any one of my partners that would do this for 50k plus expenses more. And USAP is only in a few cities so there’s only a few places to go.
Anyone interested in locums is going to be attracted to the set your own schedule life…. And will sometimes wait until a place gets really desperate and will put a super big number up in the short term.
The idea may look good on paper but falls flat when it hits the road….

 

[IMGASMD]

NAPA has been doing internal locums for a while now. It’s usually advertised as a “SWAT” team. It’s a terrible deal…you get paid 50k more W2 than a regular employee, but you can be assigned wherever they need/want you.

50K at our income bracket, is probably close to 30. I hope they also get some sort of hourly compensations too.

It’s always cheapest to pay higher rate in house first, but I find it perplex sometimes (often) AMCs don’t try that first, and piss off their loyal employees, after they find out how much more locums are getting paid.

 

[CubsDynasty]

Academics is the same way though. Don’t want to pay their FTE more to pick up the extra shifts and go with locums. Must be something they teach in business school.

 

[IMGASMD]

Academics is the same way though. Don’t want to pay their FTE more to pick up the extra shifts and go with locums. Must be something they teach in business school.

My SO was just telling me that the company “actual” cost is 4x employees salary…. So it makes sense not to hire more full timers. But, these are already hired and benefits paid FTEs, let them work!

 

[amyl]

50K at our income bracket, is probably close to 30. I hope they also get some sort of hourly compensations too.

It’s always cheapest to pay higher rate in house first, but I find it perplex sometimes (often) AMCs don’t try that first, and piss off their loyal employees, after they find out how much more locums are getting paid.

From the gossip I hear this was the Final blow for phymed

 

[amyl]

My SO was just telling me that the company “actual” cost is 4x employees salary…. So it makes sense not to hire more full timers. But, these are already hired and benefits paid FTEs, let them work!

How is the actual cost 4x the salary? I don’t understand how that math works?

 

[IMGASMD]

How is the actual cost 4x the salary? I don’t understand how that math works?

Just a lot of insurance, development, trainings and other supporting resources.

This is more for the corporate world though. They take their “team building” and “training” much more serious than we do.

 

[amyl]

Oh yea for us I don’t think malpractice or benefits are anywhere near even a quarter of our income. But the point remains, it’s cheaper to keep ‘em.
Hiring and credentialing more expensive than retention

 

[IMGASMD]

Oh yea for us I don’t think malpractice or benefits are anywhere near even a quarter of our income. But the point remains, it’s cheaper to keep ‘em.
Hiring and credentialing more expensive than retention

By and large, we are very self sufficient. We carry around our skills and knowledge; typically don’t bother anybody.

They have three “team retreat” within the last two months, which requires people to be flown in and out of the destinations. They also require different software and hardwares that the team wants. When they were in the office, a lot of their food is also subsidized by the company….. and other stuff that I am probably not accounting for. All those stuff is part of the “cost” to the company.

You’re absolutely right, it’s always much cheaper to keep what you have rather than pissing away money to get new ones.

 

[Howard888]

These are all plays to survive a bad environment. Might prolong life but won’t stop the end result….unless they can find a way to up reimbursement. Expenses are going up and will always continue to do so. Without increases in Revenue this is a dead model. I don’t see how any PE group will get substantial rate increases with no surprises act. That means no increases revenue to cover the expenses and no return for them

 

[Arantius]

Looks like Sound is recruiting for their own internal “travel team” “ambassadors”….ie internal locums. I discourage anyone from taking these positions. If you’re working locums assignments, might as well get paid locums rates.

Interestingly I just talked to a sound recruiter about this because I’m on their locums list. It’s not a bad gig and I end up ahead of where I am now on an hourly basis. It’s like $15k a week. Downside is I don’t know where I’d go BUT I can put in preferences. I don’t know. I’m liking the current locums market. How long will it last?

 

[aneftp]

Most “internal locums” is base W2 salary PLUS $300-325/hr w2 that I know of. That’s what my friend does at an AMC

His base is 500k/11 weeks (have to take full week off) 40-43 hours a week at amc. He is the lead there so showed me his numbers and average hours of all the guys there. Plus internal locums. Beeper rare call backs after 10pm. No ob. No hearts. No peds. He got a good deal. But the payor mix is ridiculously good so the AMC is still making a boatload.

So he will cover internal locums on his post call day off once in a while. Or his week off. But he prefers 1099 so will hustle at another side gig 1099 1 hour away for $8500 for 24 hours as opposed to covering local w2 at $300/hr.

 

[anes12]

Valley just pulled out of there

I'm sure they are very short and you will get worked

Once they get their hands on you I'm sure there will be some reason for why you don't get the full 600

Heard that Valley did no pull out of there and that on the contrary, Valley is still very present.

 

[nimbus]

Heard that Valley did no pull out of there and that on the contrary, Valley is still very present.

So mixed staff with 2 groups working side by side? Or was Sound unable to recruit quickly enough to staff it and Valley stayed with new terms?

 

[Arantius]

So mixed staff with 2 groups working side by side? Or was Sound unable to recruit quickly enough to staff it and Valley stayed with new terms?

I’m a locums at banner and sound takes over the whole thing in April. Valley can’t staff a lot of cases so they get put on other groups. I’m thinking envision is sinking... but there are 6 groups here alone soooo I don’t know what’s going to happen

 

[amyl]

Wow sounds like a great big mess - has sound been able to get enough people to fill that contract for April? I hear they are struggling hard in dfw but it’s gossip and not from anyone who would necessarily know.

 

[nimbus]

I’m a locums at banner and sound takes over the whole thing in April. Valley can’t staff a lot of cases so they get put on other groups. I’m thinking envision is sinking... but there are 6 groups here alone soooo I don’t know what’s going to happen

6 groups in one hospital? How do they split the cases? Surgeon request or some other system?

 

[Katheudontas parateroumen]

I heard that the transplant/cardiac surgeons want to keep their Valley anesthesiologists. The Sound team is taking the gen surg/trauma cases/call. And there's another CRNA mil group doing endo etc. It's a giant mess there is seems like.

 

[Arantius]

6 groups in one hospital? How do they split the cases? Surgeon request or some other system?

its insane that's the answer. No one group can cover it all is the issue, I think. And it seems like everyone I run into in PHX has an envision non-compete.

 

[CubsDynasty]

Sounds like Sound/Envision covers 99% of cases and other MD only groups come in for only a few surgeons that originated when envision couldn’t fulfil their obligations