Sound Physicians

[mmag]

Just saw a job posting for the Mass Ear and Eye Infirmary from Sound. When/how did Sound manage to get that contract? The pay is 475k, 36 hours/wk, 10 weeks off, no call. Weird to me that you can be working at a shiny Harvard hospital and still be a Sound employee.

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[Dr. Rude]

Just saw a job posting for the Mass Ear and Eye Infirmary from Sound. When/how did Sound manage to get that contract? The pay is 475k, 36 hours/wk, 10 weeks off, no call. Weird to me that you can be working at a shiny Harvard hospital and still be a Sound employee.

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[ambiturner]

Just saw a job posting for the Mass Ear and Eye Infirmary from Sound. When/how did Sound manage to get that contract? The pay is 475k, 36 hours/wk, 10 weeks off, no call. Weird to me that you can be working at a shiny Harvard hospital and still be a Sound employee.

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That’s weird, back in the day they were employees of the hospital but they were never an academic group hooked up with BWH or MGH. Maybe sound is just running part of the rooms and some of the others will be teaching rooms with a different group?

Either way I maintain sound is a major threat to our field, or at least a job that I would want to have in our field.

 

[Arantius]

Just saw a job posting for the Mass Ear and Eye Infirmary from Sound. When/how did Sound manage to get that contract? The pay is 475k, 36 hours/wk, 10 weeks off, no call. Weird to me that you can be working at a shiny Harvard hospital and still be a Sound employee.

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I’ve gotten a LOT of academic job ads lately. My theory is they can’t staff their ORs because they either refuse to go to care team and incorporate CRNAs or they can’t keep their docs because well, academic culture. So they are contracting with companies like envision or sound hoping they can recruit or bring in care teams.

Do you get an academic appointment and the perks that come with it?! Like tuition breaks for kids, etc? Might make it worth it

 

[Coffee PRN]

Maybe I'm speaking to the wrong demographic here...but it's always been humorous to me that Sound shares a name with the main antagonist village in a certain animated series

 

[kidthor]

I’ve gotten a LOT of academic job ads lately. My theory is they can’t staff their ORs because they either refuse to go to care team and incorporate CRNAs or they can’t keep their docs because well, academic culture. So they are contracting with companies like envision or sound hoping they can recruit or bring in care teams.

Do you get an academic appointment and the perks that come with it?! Like tuition breaks for kids, etc? Might make it worth it

Yes, and many of them are very, VERY slow to change - it'll take them years to make a basic salary adjustment to a level that's still way under market. While in the past people might hold out for certain benefits, those benefits now are essentially gone or are just not worth it when considering that a non-academic job with the same workload may pay 100-300K more. Academia can do the slow hand-wavey delay deal only so much, and certainly not at all in this hot market.

I'm still in academics and happy with the way my group is managing the current market. We don't have any staffing shortages because it's still a good place to work.

But I have friends at big name places who're now working along-side locums who're making much more than they are, while their departments refuse to increase their academic salaries. It's a morale crusher and signals that their leadership has no viable path forward with their current salary structure. Most of these places are already in a care team model - some of them even already staffing rooms 1:4.

As for those Harvard hospitals, many of them had serious benefits deterioration. A friend of mine ejected from one because some of the older members had a great sweetheart deal with maxed 401K plus a cash benefit plan, but the younger underlings got instead a paltry partial 401K match with a long 5 year vesting scheme.

Another thing - a lot of academic places are short and hiring but "too good" to post a job ad, and instead are relying on word of mouth.

 

[ambiturner]

I’ve gotten a LOT of academic job ads lately. My theory is they can’t staff their ORs because they either refuse to go to care team and incorporate CRNAs or they can’t keep their docs because well, academic culture. So they are contracting with companies like envision or sound hoping they can recruit or bring in care teams.

Do you get an academic appointment and the perks that come with it?! Like tuition breaks for kids, etc? Might make it worth it

Mass eye and ear has lots of CRNAs and almost all other academic places do too, it’s much less common to see attendings do their own cases at most academic hospitals. I think this is more a way to get some of the low acuity work done (ophtho is boring).

As kidthor said, academics are resistant to change and most of the good benefits are drying up or have an obnoxious grandfathering scheme. Most of these jobs don’t even give you protected research or admin time anymore so what reason is there then to take them?

 

[IMGASMD]

Mass eye and ear has lots of CRNAs and almost all other academic places do too, it’s much less common to see attendings do their own cases at most academic hospitals. I think this is more a way to get some of the low acuity work done (ophtho is boring).

As kidthor said, academics are resistant to change and most of the good benefits are drying up or have an obnoxious grandfathering scheme. Most of these jobs don’t even give you protected research or admin time anymore so what reason is there then to take them?

Hahaha. Now you’re clinical staff without any academic duties, but you can still use their good names around town….

I’ve seen Yale with some bull community hospital gig. Also SF with something like “clinical track” position.

AMN and/or CompHealth has a academic division which peddles some of these prestigious jobs.

 

[GassYous]

You can only handle getting shafted on pay and cases for so long before all the clinicians leave. My residency was letting nurses do blocks and lines so that they don't leave but they left for greener pastures anyway. It's all about the benjamins.

 

[Maz777]

I’ve gotten a LOT of academic job ads lately. My theory is they can’t staff their ORs because they either refuse to go to care team and incorporate CRNAs or they can’t keep their docs because well, academic culture. So they are contracting with companies like envision or sound hoping they can recruit or bring in care teams.

Do you get an academic appointment and the perks that come with it?! Like tuition breaks for kids, etc? Might make it worth it

It's nearly impossible to hire in academics. Your only shot is to convince a few desperate fellows that came from elsewhere to stick around. The residents are usually too smart to actually stay on.

There are no perks in academics. Unless you consider taking a pay cut a perk. You get paid less, usually don't get any significant protected time, and use your off hours to publish garbage research that no one actually cares about. It's such a sham.

 

[amyl]

2 of my same year co-residents are working with sound in fort worth. it's basically signing charts.

Wonder what they think of their job security.

I heard the same about sound in ft worth

 

[circleK]

You do all know that Sound is owned by United, right? I value my time as much as the next guy but I’ll be damned if I ever give it up in service of the devil no matter the price

 

[amyl]

Well aware that United owns sound. They failed at running their playbook at USAP so this was plan b.
No doubt that United and sound are 100% the devil.
I guess everyone has their price to sell out. 🤷‍♀️

 

[Howard888]

Not sure USAP is any better than United or Sound. Both are about money. United/Sound controlling cost/expense of anesthesia to profit on insurance side and icing is to even profit on staffing anesthesia side too. USAP wants 20+% return and used quasi monopolies to bully insurance into higher rates, unsustainable rates, that led to the no surprises act (not just USAP)- all private equity. Some USAP sites really struggling just as some Sound sites are.

Latest rumor I heard is that USAP is starting to pivot into either crna only or supervision in Montana and take over traditional MD only contracts. Haven’t seen that 100% substantiated yet though.

Maybe one is slightly lesser evil for anesthesia as a specialty???? But not by much

 

[nimbus]

Not sure USAP is any better than United or Sound. Both are about money. United/Sound controlling cost/expense of anesthesia to profit on insurance side and icing is to even profit on staffing anesthesia side too. USAP wants 20+% return and used quasi monopolies to bully insurance into higher rates, unsustainable rates, that led to the no surprises act (not just USAP)- all private equity. Some USAP sites really struggling just as some Sound sites are.

Latest rumor I heard is that USAP is starting to pivot into either crna only or supervision in Montana and take over traditional MD only contracts. Haven’t seen that 100% substantiated yet though.

Maybe one is slightly lesser evil for anesthesia as a specialty???? But not by much

USAP is heavily recruiting SRNAs on their social media which appears professionally run.

 

[LivetoTell]

Not sure USAP is any better than United or Sound. Both are about money. United/Sound controlling cost/expense of anesthesia to profit on insurance side and icing is to even profit on staffing anesthesia side too. USAP wants 20+% return and used quasi monopolies to bully insurance into higher rates, unsustainable rates, that led to the no surprises act (not just USAP)- all private equity. Some USAP sites really struggling just as some Sound sites are.

Latest rumor I heard is that USAP is starting to pivot into either crna only or supervision in Montana and take over traditional MD only contracts. Haven’t seen that 100% substantiated yet though.

USAP won the contract for the Billings Clinic, in Billings and is expanding. I believe the Billings Clinic is the largest hospital system in Montana.

 

[kidthor]

USAP won the contract for the Billings Clinic, in Billings and is expanding. I believe the Billings Clinic is the largest hospital system in Montana.

Was that recent??? Did they oust the private group there?

 

[amyl]

I heard they couldn’t recruit… so made a deal w USAP. I’m not sure of the details - we may just be consultants there. I’ve heard mixed things -

 

[LivetoTell]

I heard they couldn’t recruit… so made a deal w USAP. I’m not sure of the details - we may just be consultants there. I’ve heard mixed things -

I hear Billings isn’t the greatest place to live. Fairly flat, cold, and dirty? Loved Big Sky.

 

[nimbus]

I heard they couldn’t recruit… so made a deal w USAP. I’m not sure of the details - we may just be consultants there. I’ve heard mixed things -

That sounds plausible.

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[MirrorTodd]

I tried to do some locums up there as my wife and I are fairly interested in moving someplace north after Texas and they were kinda squirrly about providing pay details etc etc. I didn't get a good impression from the group.

I heard they couldn’t recruit… so made a deal w USAP. I’m not sure of the details - we may just be consultants there. I’ve heard mixed things -

 

[amyl]

I tried to do some locums up there as my wife and I are fairly interested in moving someplace north after Texas and they were kinda squirrly about providing pay details etc etc. I didn't get a good impression from the group.

They were likely squirrelly because they don’t know the pay details yet…. Not sure the final plan for up there is finalized - but maybe I don’t have the latest

 

[NeedleJockey]

Has anyone seen a scenario where Sound or another AMC reduced pay after Initial fantastic numbers? Apparently their contracts state they may change comp with 90 days notice…
I could see a strategy of hooking with big promise and big sign-on then drop pay due to …reasons , and then the individual is on the hook for sign-on repayment should they disagree.

 

[CCM-MD]

Has anyone seen a scenario where Sound or another AMC reduced pay after Initial fantastic numbers? Apparently their contracts state they may change comp with 90 days notice…
I could see a strategy of hooking with big promise and big sign-on then drop pay due to …reasons , and then the individual is on the hook for sign-on repayment should they disagree.

Not an anesthesia specific example but this is personal experience with a Sound run intensivist group. Few months after I joined, they went from 2 daytimes Intensivists covering 12 hours daytime shifts to one intensivist working only 8 hour day shifts (with the other continuing to work 12 hour shifts, so single coverage for 4 hours of the day). They did simultaneously increased the night shift pay, and reduced the wRVU threshold for daytime shift to make up for the change with productivity bonuses. Overall a net slight decrease in pay for most of us, the intensivists that work only nights got a decent sized pay increase. The pay is decent - 500k base for mostly daytime ICU coverage in a Southwest metro - but all the disadvantages of working for a corporation cannot be overstated.

They pull more shenanigans with our hospitalists and ER colleagues. Most often it is by reducing the amount of physician coverage, rather than by directly reducing the pay itself. And yes, if someone wants to leave within the "payback period", they would have to return the sign on.

 

[GravelRider]

Has anyone seen a scenario where Sound or another AMC reduced pay after Initial fantastic numbers? Apparently their contracts state they may change comp with 90 days notice…
I could see a strategy of hooking with big promise and big sign-on then drop pay due to …reasons , and then the individual is on the hook for sign-on repayment should they disagree.

Many employment contracts are structured that way. You basically are on a 90 day contract perpetually. That would be the period of notice they would have to give you to terminate you without cause. If an employer were to change your salary, I would imagine that you would be offered a new contract to sign. If you decided not to sign then you would either continue with your current contract or the 90 days would expire and you would no longer be employed. The real question in the scenario of a non-renewal of contract is if any non-compete is enforceable.

Most employer cost cutting is usually more insidious than they saying “hey, we’re cutting your salary.” It’s usually in the form of staff cutting, workload increases, non-contractual “bonuses” being taken away, etc. They maintain the contract you sign, but things like lifestyle and other perks slowly degrade.

 

[kidthor]

Many employment contracts are structured that way. You basically are on a 90 day contract perpetually. That would be the period of notice they would have to give you terminate you without cause. If an employer were to change your salary, I would imagine that you would be offered a new contract to sign. If you decided not to sign then you would either continue with your current contract or the 90 days would expire and you would no longer be employed. The real question in the scenario of a non-renewal of contract is of any non-compete is enforceable.

Most employer cost cutting is usually more insidious than they saying “hey, we’re cutting your salary.” It’s usually in the form of staff cutting, workload increases, non-contractual “bonuses” being taken away, etc. They maintain the contract you sign, but things like lifestyle and other perks slowly degrade.

A previous employer of mine engaged in a similar move. They said we were getting a ~30K raise to meet market demands and showed a bunch of confusing charts and graphs. The short of it was that we were getting a 30k "raise" that was really a "salary target" that included a bunch of overtime on top of newly devalued call shifts... the base salary for equivalent work was actually decreased. Yet they had the nerve to sell it as a raise. But we couldn’t do much about it because of a similar 90 day perpetual contract with entirely undefined work and pay requirements within the actual contract itself. A bunch of people drank the Kool-Aid to my dismay. Rest assured, I got a new job.

 

[GravelRider]

A previous employer of mine engaged in a similar move. They said we were getting a ~30K raise to meet market demands and showed a bunch of confusing charts and graphs. The short of it was that we were getting a 30k "raise" that was really a "salary target" that included a bunch of overtime on top of newly devalued call shifts... the base salary for equivalent work was actually decreased. Yet they had the nerve to sell it as a raise. But we couldn’t do much about it because of a similar 90 day perpetual contract with entirely undefined work and pay requirements within the actual contract itself. A bunch of people drank the Kool-Aid to my dismay. Rest assured, I got a new job.

Ah, the ol’ raise that’s not a raise trick.

I still maintain that basic high school math is one of the most important tools in navigating life. Every contract should be scrutinized with some simple algebra even before you spend $500 for a lawyer to look at it.