That is correct. Vituity is a partnership without 501c3 tax status. About the only places I know of that physicians (especially EM) can do PSLF is academic medical centers. You can have more options in an outpatient setting ie working at a community health center but be sure and check carefully. Whatever you do, if you are looking at PSLF be sure to submit your certification paperwork yearly to be sure it is accepted and approved so you don't put in a decade of work and get surprised later.
Teamhealth vs EMcare/Envision vs Schumacher vs USACS vs Vituity
- Thread starter cyanide12345678
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"partnership"
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deleted941485
Kind of like USAP for gas. I’ve seen those “partnerships”. They are a joke. They use to rope these wide eyed poor residents in...I don’t even think they bother anymore
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Vituity is a scam too just a different kind. They have a bunch of Level 5 "partners" who see 1 pt/hour and do nothing. They collect their 80K annual "partner bonus". Best of all it's salary not RVU so people can get away with doing minimal work. They over-hire at all their sites, making it hard to get enough hours in to advance partnership. Gotta keep the ranks of high level partners thin I guess.
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The Vituity scam reminds me of the USACS scam. Huge pyramid scheme.
"Partnership" blah blah blah
I think you just started a position with them? I think there is a lot of site to site variation so I wouldn't extrapolate too much to the national group. Perhaps I just got lucky with my local group but I'm ok with the Vituity setup personally. There is a 20% bonus for full partner (level 5) on earned income. I always thought you have 2 choices: Work as locums and get a fixed rate that can be pretty good if you find a nice job, or work in a partnership and take a lower hourly to start and once you make full partner you start to get a bonus that makes up for it and usually exceeds locums rates within your general area. With Vituity and all other other private places I interviewed at you take a lower hourly for your first few years with the group and then it gets to be really good after 4+ years with the group. For a 20-30 year career that math ended up looking pretty attractive to me. Add in paid sabbatical, parental leave plan etc and it actually works out reasonably well to commit to the group for a longer period of time. Friends working in SF, LA, Vegas are also looking at partner bonuses, but theirs are into the 100-200k range with an even steeper sweat equity buy in. It does take a leap of faith for those first few years and you do get a little screwed if you only work for a short time at a site and move on to another group. At least with Vituity you can move states and have some amount of location flexibility if you stay in the partnership.
Our sites have had an ebb and flow of staffing and I can't imagine it's specific to Vituity, but rather to EM in general. We hold a group vote on all hires and determined that we wanted to staff to 110% of desired hours at the time. Our group prioritized lifestyle so for parental leave, sickness, unexpected retirements you don't have to get killed with extra hours. I'm only a few years out of residency, no kids, and am usually the one looking for extra hours so I occasionally have regretted that philosophy. So far in my 2 years working for them we have had about 6 months where we were overstaffed and I got about 10 hours less than I wanted, about a year where it was perfect, and now we are in a 3-4 month stretch of being understaffed with one person retiring, several sabbaticals and parental leaves over the summer and I'm getting killed with shifts about 10-20 hours over what I requested. I feel like it all balances out.
The gripe about level 5 partners coasting at 1 pph sounds more like a site specific issue. We work a lot of single coverage at a smaller community site so you don't have a lot of places to hide and have to see the patients. I would like to see our site incorporate more of a production based incentive to our surplus payouts to encourage better documentation and reward the extra effort. We have had votes on that, but unsurprisingly the slower and night shift docs with lower volume voted it down. Other Vituity sites have implemented this option though.
I'm sure that there are some people in Vituity central office that make far more than the value they provide to the partnership however I've been quite impressed by the majority I've run into. Like many admin positions I think it varies a lot and with any larger organization you'll find those who advocate well and carve out a niche for themselves can get a pretty sweet gig. Also consider, if the admin spots pay so well, you can always advance up that ladder yourself with some initiative and diversify out from a pure clinical position. Overall I'm happy with my current spot. Nowhere is perfect. I interviewed around the country and there were 3-4 other places with private SDGs that seemed much better from a financial perspective however I went at least 50% for location/geography and have been pleased with Vituity so far.
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I did just start with them about 8 months ago. My frustration is that they have way over-hired and recruited a bunch of doctors to move to the local area, without first asking us local doctors what our maximum number of shifts are. As a consequence, most of our "full time" docs are getting 80-90 hours per month. Since it takes 1500 hours to make level I partnership, I'm looking at nearly 2 years just to make level I! At this rate it would be almost 10 years to make level 5! That's not a time committment I think is reasonable. Maybe it's not malicious and intentional, and perhaps it's just poor site management, but I'm not terribly impressed by it.
When the contract started, they brought in a bunch of these 70+ year-old grandpa doctors from California who were either on the board or level 5 partners. I'm not kidding you when I say they could barely see 1 pt/hr even with a scribe! The consequence was that the rest of us had to pick up the slack and work extra hard to compensate for them. Worst of all I got no increased RVU production for picking up the slack.
Fortunately the Grandpa doctors are mostly gone, but in my opinion if you are leadership in the company and getting a huge bonus every year, you should be able to work at least to a minimum level. In my mind that's at least 2 pt/hr. It's simply not fair or reasonable to give these guys huge bonuses when they are physically unable to do the work, or just lazy.
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Would love to hear how you'd argue for that...the key is to beat them at their own game. But that involves physicians getting involved w/ hospital admin and politics, something CMG's do better. The groups that get taken over, many of them have themselves to blame for the free-rider problem where only a couple people in the "democratic" group carry the whole group, until they can't any more.
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As in, limited and limiting prospects.
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In the end the issue with vituity is scale. It harms them. Scale can be a blessing and a curse. For most CMGs it is a curse when they hit a certain size. For vituity the lack of an “equal” partnership is an issue. Bottom line is I am sure it is a good deal in some markets and likely crappy in most. If you aren’t at 250/hr fairly quickly you are getting screwed as a full partner you should be at $300 otherwise why bother with all the extra stuff you have to do?
i have spoken with an helped a few folks start SDGs and there is a slow movement to that again thankfully. I am unsure if it is outpacing the purchasing of groups but that surely has slowed down from the 2014-2018 highs.
i have spoken with an helped a few folks start SDGs and there is a slow movement to that again thankfully. I am unsure if it is outpacing the purchasing of groups but that surely has slowed down from the 2014-2018 highs.
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Also has Apollo fallen so far so fast they aren’t even in this discussion anymore? Throw in APP and their plethora of trash contracts to the chess pool of CMGs.
When I finished residency Apollo was going to take over the world. The reality hit? I know some on here work for them and the new Kennestone residency is theirs but whats the deal?
When I finished residency Apollo was going to take over the world. The reality hit? I know some on here work for them and the new Kennestone residency is theirs but whats the deal?
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Let me be me.
I interviewed with two SDGs down here in my metro area.
The only two real players down here at the time, by the way.
It was CLEAR to me that they were bull$hit pyramid schemes by halfway thru the interview.
"Let me see the books?"
No. Those are closed to partners only.
"How many docs have made partner over their buy-in period?"
We don't keep track of those statistics.
Hmm.
Here came the effing vulcan death-grip...
Is "Dr. McDickerson still here? I met him/her when I was taking my boards. What happened to him or her?"
"Uhh. Err. Uhh. Dr. McDickerson wanted to say something about robbledy robbledy robble and sowing wild oats and the four horseman ride at midnight, so he or she isn't with us anymore."
*** Dr. McDickerson ratted these fux out when we took our boards. If you didn't work 15 nightshifts in a row, you wouldn't make partner. We didn't work 15 nightshifts in a row during residency, mind you. ***
I was quickly shown the door after mentioning Dr. McDickerson.
Psst. Hey.... SDGs...
If you want to be a good guy, and save EM... then don't be worse than the CMGs.
Dr. McDickerson and I are still good friends, living and working in the same city for the local CMGs. He or she has the real dirt on the "local SDG". He or she calls me and asks me to cover a shift when his/her kid has a softball game and wants to leave early.
Its funny.... a lot of the 'old codgers' that I work with were once employed by that same local SDG, and are "out".
They have nothing positive to say about that SDG. I had one fellow doc (when I moved, just across town) show up to my home with a big flat-bed truck and a crew because he was being a good buddy to me. He was spurned by that same SDG. He now has a side-gig that makes him even more money .
Dr. ObiWan: "Yes. Once upon a time... I used to work for the empire. I have not heard that name in a long, long, time."
This guy is my own personal Han Solo.
Hey... SDGs....the heat is on you.
Be good, or be gone.
I interviewed with two SDGs down here in my metro area.
The only two real players down here at the time, by the way.
It was CLEAR to me that they were bull$hit pyramid schemes by halfway thru the interview.
"Let me see the books?"
No. Those are closed to partners only.
"How many docs have made partner over their buy-in period?"
We don't keep track of those statistics.
Hmm.
Here came the effing vulcan death-grip...
Is "Dr. McDickerson still here? I met him/her when I was taking my boards. What happened to him or her?"
"Uhh. Err. Uhh. Dr. McDickerson wanted to say something about robbledy robbledy robble and sowing wild oats and the four horseman ride at midnight, so he or she isn't with us anymore."
*** Dr. McDickerson ratted these fux out when we took our boards. If you didn't work 15 nightshifts in a row, you wouldn't make partner. We didn't work 15 nightshifts in a row during residency, mind you. ***
I was quickly shown the door after mentioning Dr. McDickerson.
Psst. Hey.... SDGs...
If you want to be a good guy, and save EM... then don't be worse than the CMGs.
Dr. McDickerson and I are still good friends, living and working in the same city for the local CMGs. He or she has the real dirt on the "local SDG". He or she calls me and asks me to cover a shift when his/her kid has a softball game and wants to leave early.
Its funny.... a lot of the 'old codgers' that I work with were once employed by that same local SDG, and are "out".
They have nothing positive to say about that SDG. I had one fellow doc (when I moved, just across town) show up to my home with a big flat-bed truck and a crew because he was being a good buddy to me. He was spurned by that same SDG. He now has a side-gig that makes him even more money .
Dr. ObiWan: "Yes. Once upon a time... I used to work for the empire. I have not heard that name in a long, long, time."
This guy is my own personal Han Solo.
Hey... SDGs....the heat is on you.
Be good, or be gone.
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Glad I'm in a good one...as far as I know.
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I echo RustedFox's disdain for these groups. Before my first job I too looked at FEP which was a SDG then. They are essentially using the same bait and switch that CMGs are using to get new grads, and rely on the financial ignorance of these young physicians
I'm okay with a 1-2 year buy-in, but there can be no monetary contribution, and there needs to be only one level of "partner". Bonuses should be given out based on hours worked in the year and productivity, not just because you've been part of the group since before the earth cooled. Partners who can't meet metrics and produce at least a minimal amount of work should be warned, then shown the door if they don't improve.
There also needs to be a clear and achievable path in writing to partnership, not some nebulous time frame and vote by the other partners.
I'm okay with a 1-2 year buy-in, but there can be no monetary contribution, and there needs to be only one level of "partner". Bonuses should be given out based on hours worked in the year and productivity, not just because you've been part of the group since before the earth cooled. Partners who can't meet metrics and produce at least a minimal amount of work should be warned, then shown the door if they don't improve.
There also needs to be a clear and achievable path in writing to partnership, not some nebulous time frame and vote by the other partners.
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It's amazing how region/site specific EM can be.
Local community-academic hybrid wanted to pay me $170ish/hr to work more hours. Yeah ok.
Another small group about an hour from home wanted to pay 160 for almost no schedule control. Nope.
Why work for them when the CMG will pay me 100 more?
The CMGs have negotiating power with the insurance industry that the small groups just don't.
They're like the Klingons of the EM world. Not quite your friend, not quite your enemy, but when the Borg (insurance companies, government, hospitals) invade, they are (kinda) on your side.
Local community-academic hybrid wanted to pay me $170ish/hr to work more hours. Yeah ok.
Another small group about an hour from home wanted to pay 160 for almost no schedule control. Nope.
Why work for them when the CMG will pay me 100 more?
The CMGs have negotiating power with the insurance industry that the small groups just don't.
They're like the Klingons of the EM world. Not quite your friend, not quite your enemy, but when the Borg (insurance companies, government, hospitals) invade, they are (kinda) on your side.
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Same for me when I was job hunting. The local sdg paid $150/hr for partnership track, the track was 5 years long, and a few people wouldn't make it in the end.
The non partnership track was $200/hr for 2.5 patients per hour with a scribe. Most of their sites were staffed much worse than the CMG gigs.
I eventually signed for a cmg at 265/hr for roughly 1.6-1.7 pts per hour myself and 2.1 per hour with a MLP. (20k volume place with 24 hr physician and 12 hour MLP).
The non partnership track was $200/hr for 2.5 patients per hour with a scribe. Most of their sites were staffed much worse than the CMG gigs.
I eventually signed for a cmg at 265/hr for roughly 1.6-1.7 pts per hour myself and 2.1 per hour with a MLP. (20k volume place with 24 hr physician and 12 hour MLP).
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What does the Florida market look like for 2-3 year commitments with sign-on bonus/hourly? I see lots of openings with different CMGs.
Sounds like it was a new site for Vituity. I can't believe they would be paying their reservist rates (plus the 20% bonus to full partners) while letting a new level 1 partner get less hours. Sounds like a real missed opportunity for the group and super frustrating. At least with the general meetings they are always talking about trying to pull Reservists out as fast as possible since they cost a TON of money but I'm sure there is some self dealing going on from time to time.
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Florida seems to be hurting for emergency physicians. A quick look through TeamHealth and Envision's websites indicate that you can land in just about any area. The going rate in my neck of the woods is about $250/hour.
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I wonder why? Liability? High pph? **** location?
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Florida has a lot of HCA hospitals though so beware
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Teamhealth vs EMcare/Envision vs Schumacher vs USACS vs Vituity - Which one is worse?
This question is like asking which STD is worse?
Gonorrhea vs chlamydia vs herpes vs syphilis vs trichomonas vs pubic lice vs HPV
This question is like asking which STD is worse?
Gonorrhea vs chlamydia vs herpes vs syphilis vs trichomonas vs pubic lice vs HPV
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BTW, this whole buy-in feature of groups. We are going under our hospital foundation at my site, and dumping the CMG. We decided that seniority will be paid as an hourly bonus. The longer you stay there, the more you make....but we aren't taking money away from new hires. it's $10/hr per 5 years of service. Seems pretty fair.
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How can the more senior people make higher pay without reducing the pay of new grads? Is your hospital subsidizing your salary over and above your collections?
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Sounds like they are becoming hospital employees, so they aren't getting paid based on collections at all.
My wife's old hospitalist group worked that way - more money the longer you were there.
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Apt analogy. They all suck. USACS with seemingly the most sucker koolaid drinkers.
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Yes....hospital is going to pay us a hybrid model of base + RVU (or all RVU with a minimum guaranteed base)...and they are taking on the risk of collections. So it is conceivable that some years they might lose money on our group, and some years they might make money on our group. Really puts the onus on the hospital to bring in the money.
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Is there a maximum pay? Say after 10 years?
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I think it goes to 20 years. Or maybe more. We have one guy who will be making an extra $40/hr because he's been there for > 20 years. That is a ton of money
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It depends. Is it significantly more than a a group like Vituity? After 5 years you are making $50/hr more than the new grad.
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That I really don't know. Our hospital is paying for research to determine what regional salaries are in our area and going to make ours competitive. That's what they say and I believe them.
At the end of the day it's all about the total value of the compensation package, and whether it's easy to attain, right?
$50/hr is sizable...I worked about 1500 hrs last year.
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$50 can be sizable....but it all depends on your starting rate. $5/year increase in pay isn't much. 20 years to attain that seems like an awful long time, especially if the starting pay isn't competitive.
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Malignant medmal climate takes states like Florida off the radar for me. I wouldn't work there even if they paid me 25-30% more income. It's just completely not worth the stress.
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See, I will take polite disagreement.
Sure, the med-mal climate is contentious, but that's primarily the Miami area.
I have been thru a "jackpot!" lawsuit in Florida.
Didn't pay a dime.
Don't be afraid of the big, bad wolf.
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Sure, having been through one myself...I'm no longer afraid of them, but that doesn't mean I go looking for them either. The statistics don't lie...If I were to transplant myself from where I'm at to FL and practice in the exact same way that I do here...I would probably get sued 2-3x as often throughout my career simply due to the environment. Each suit would also be much more likely to result in significant payout. I'm not really worried about money ever coming out of my assets. Most physicians shouldn't really be worried about that, but if I can have a negligible payout or under state reporting requirements (if applicable), I'd much rather have that than something substantial. (Better yet...dropped from the suit entirely...much less likely to occur in Florida though.)
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Don't get me wrong, FL seems like an awesome place to live and work, but I think if I moved there I'd probably do locums in a nearby state or something.
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deleted859535
Did you ever post that story? Thought I remembered seeing mention of that somewhere.
I'm with Groove myself. Not in a horrible malpractice place, and running into someone wanting to sue is an occupational risk for us, but I sleep better at night knowing I'm not in, say, Illinois. (Sorry, Illinois docs.)
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I thought IL was much higher and IN much lower. Where and when is this data from?
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I will post soon. Too many other things going on in life right now.
I can't commit to the process when I need to do other things for other people.
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I'd have no problem with higher malpractice states if the pay was a lot more. Interestingly the worst malpractice states, NY, NJ, IL have also among the lowest pay for physicians.
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deleted859535
Also interested.
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Malpractice Statistics - True Cost of Healthcare
My new book The Great American Healthcare Scam: How Kickbacks, Collusion and Propaganda have Exploded Healthcare Costs in the United States Can now be purchased on Amazon. Here are the links: Paperback eBook Most of the information provided on this page is based on data taken from the National...
truecostofhealthcare.org
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deleted547339
Ummmmm - herpes. Herpes is the worst. You can’t cure it and it physically hurts. It’s clearly the worst.
Please note, this isn’t from personal knowledge.
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deleted859535
Yeah, and your avatar isn't a selfie. We know better, buddy.
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Actually it's pregnancy. Causes massive financial loss, and premature aging and 20% end up with substance abuse.
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deleted547339
I always find it amusing when I see pregnancy listed under medical problems.
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Have you SEEN the movie Alien? That is DEFINITELY a problem.
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Avoid USACS at all cost.
In the last 2 years they have done the following:
- Cut hours significantly. Staffing physician hours around 2.25-2.4 pt/hr.
- Cut 401k contributions from 34k to 27k. Rate from 13% to 10%.
- Eliminated the 401k max over pay. (Once you maxed out the 401k contribution they provided, you got a small chuck of extra pay)
- Suddenly and without notification dropped the employer provided life insurance from 750k to 500k.
- Cut the business expenses account from 8k to 4k. Starting this year, they will no longer pay you out the difference you didn't use.
- No profit sharing since 2016.
In the last 2 years they have done the following:
- Cut hours significantly. Staffing physician hours around 2.25-2.4 pt/hr.
- Cut 401k contributions from 34k to 27k. Rate from 13% to 10%.
- Eliminated the 401k max over pay. (Once you maxed out the 401k contribution they provided, you got a small chuck of extra pay)
- Suddenly and without notification dropped the employer provided life insurance from 750k to 500k.
- Cut the business expenses account from 8k to 4k. Starting this year, they will no longer pay you out the difference you didn't use.
- No profit sharing since 2016.
