The best gigs in anesthesia

[2win]

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I think it is informative to share some info....regarding the best anesthesia groups. I will start with Barrington Anesthesia Associates, Chicago.
I mean great gigs (I had to edit..) - real money for your work, respect, good call schedule, freedom to take a day off when you need it (family).
I remember with sadness when I had a family emergency - my employees ( I wasn't a partner at that time) refused my days off.
I worked and what a price I paid...
So, I think it is extremely important to be treated fair and respect from the beginning.
I know for sure that on this forum are Doctors (the real ones...) that could advise better than me about this subject. Their input will be really appreciated. Thank you,
2win

 

[maceo]

I think it is informative to share some info....regarding the best anesthesia groups. I will start with Barrington Anesthesia Associates, Chicago.
I mean great gigs (I had to edit..) - real money for your work, respect, good call schedule, freedom to take a day off when you need it (family).
I remember with sadness when I had a family emergency - my employees ( I wasn't a partner at that time) refused my days off.
I worked and what a price I paid...
So, I think it is extremely important to be treated fair and respect from the beginning.
I know for sure that on this forum are Doctors (the real ones...) that could advise better than me about this subject. Their input will be really appreciated. Thank you,
2win

honestly never heard of a fair group. Ive been practicing about 8 years and never heard of one.. even my group now sucks.

 

[2win]

honestly never heard of a fair group. Ive been practicing about 8 years and never heard of one.. even my group now sucks.

I got it....Tell us about some good gigs you know about it.

 

[maceo]

I got it....Tell us about some good gigs you know about it.

i dont know of any. The only fair groups are the ones that allow you to bill on your own or who equitably distribute the billings of which there are prolly none left of those groups. Next fairest is prolly if you have a contract with a group and spell out exactly what you want including days off with no hope for partnership is prolly fair i suppose but very little security.

 

[desflurane]

agree with above. too much greed in medicine for fairness. The only fair employer you'll find is yourself. Unfortunately that is not all that easy to do in anesthesia, unless you are a pain doc.

In your case I would find a group whose books are open, and pools units and you eat what you kill minus administrative costs. That is the only way to get close to fairness.

 

[UTSouthwestern]

There are still fair groups out there, even if your definition of fair is extreme. They don't advertise because they don't need to. You find them by word of mouth and reputation. If you rely on the recruiters and gaswork, etc. only, you will get what you get.

 

[maceo]

There are still fair groups out there, even if your definition of fair is extreme. They don't advertise because they don't need to. You find them by word of mouth and reputation. If you rely on the recruiters and gaswork, etc. only, you will get what you get.

if there are fair groups they are few and far between. This is what the people going into anesthesia need to be aware of.

Give me an example (no names) of a fair group and what makes them fair. Any groups with a buy in or x years to partnership is crossed off the list. Inherently partnership tracks are not fair. no matter the length.

 

[kmurp]

Umm... Maceo, you have rather stringent standards as to what is fair. If a group owns real property do you not think that it is fair to pay your fair share to gain ownership of it? Similarly, what group would want to grant immediate partnership with voting rights on important group matters to someone they hardly know who knows nothing of the local lay of the land. How is a group to pay a departing members' accounts receivable unless they pay the new guy less than parity for a couple of years? And just what other professions bring new people in at parity from day one with those who have been around for decades working though thick and thin?
I do not agree with groups who exploit new hires, but jeez, your position seems a bit extreme.

 

[UTSouthwestern]

Presence of a partnership track is not inherently unfair. I went through one and worked equal if not less than the oldest partners in my group. It was a time for them to evaluate my fit into the practice and my skill level and a time for me to evaluate the group and its philosophies and whether or not it fit my goals and ideals.

I knew by the end of year one that I was going to make partner and that allowed me to invest in business interests locally, get a home, put down firm roots, etc.

I could have joined any number of groups with equal partnership from day 1 in a subsidized or exclusive setting, taking call in house Q4-6, $350-$450/year, benefits, etc. If you feel that is more fair than joining a group like mine that does have a partnership track then so be it. Groups like mine don't dangle the golden carrot and pull it back at the end of your track. You know if you are going to make it by the end of the first year on the track. While on the track, you don't take any more call, work any more hours, or do any administrative stuff whatsoever (which consumes a ton of my free time now) than even the most senior partners.

 

[Noyac]

Don't listen to maceo, he's jaded.

My group is about as fair as it gets. Everyone gets the same vacation, pay, and cases from day one. The only difference is new grads are paid about 20K less for one year (because of the administrative duties which take additional time) and that is beans with our pay.

Maceo's personality is why he hasn't found a fair group.

 

[maceo]

Don't listen to maceo, he's jaded.

My group is about as fair as it gets. Everyone gets the same vacation, pay, and cases from day one. The only difference is new grads are paid about 20K less for one year (because of the administrative duties which take additional time) and that is beans with our pay.

Maceo's personality is why he hasn't found a fair group.

your group is fair because you are a hospital employee.

 

[Noyac]

"fair", meaning comparable pay, time off, distribution of cases and voting rights with above average packages do exist, but they are less common than they used to be. They will be even less common going forward, unless you count being a hospital employee treated equal to other employees fair. There are plenty of "fair" below average jobs.

We will all be hospital employees sooner or later. So will the General Surgeons.

But that is not a bad thing. Unless you call 75th percentile of MGMA income with a great vacation package and malpractice covered along with all other benies a bad deal.

 

[maceo]

No. That is a very good deal. But in general hospital employee packages are below average. There is a reason that hospital employment has been traditionally shunned by docs and forced upon groups.

I do disagree with your contention that "we will all be hospital employees sooner or later" implying that we should all acquiesce. Later may be an entire career.

the government does not want you to make a lot of money. Neither does the hospital. So anesthesiologists are the perfect people to pick on since we rely on the hospital, we cant do anything without the hospital. If the present group doesntcrumble under pressure the administration gets rid of them.. Most of these contracts that groups have with hospital, the hospital has a right to end it without cause at anytime. Does that sound like job security to you? Is that something you would buy into? three years at sub par wages.

 

[Noyac]

the government does not want you to make a lot of money. Neither does the hospital. So anesthesiologists are the perfect people to pick on since we rely on the hospital, we cant do anything without the hospital. If the present group doesntcrumble under pressure the administration gets rid of them.. Most of these contracts that groups have with hospital, the hospital has a right to end it without cause at anytime. Does that sound like job security to you? Is that something you would buy into? three years at sub par wages.

You make some good points. My administration did get rid of the previous group and the experience was so distasteful for everyone involved that they have vowed not to do that again (we'll see). The previous group was a private group though. So job security isn't necessarily any better with a private group. When I joined this current group the intention was for us to be private within 3-5 years but things are going smoothly and nobody seems to want to change it. As far as letting one of us go without cause, we have a clause in the contract that protects us. It would cost them a pretty penny to do that. But it is possible just as with a private group. My previous PP group let a 20 yr partner go without cause. We are all venerable.

 

[2win]

There are many valid points in the above post. But I would not consider it true 100% of the time. Just more often than not. The risk of deferring income for a few years in the pursuit of a partnership has never been higher.

I would point out that some groups don't crumble and administration doesn't get rid of them-administration perceives the risk of non renewal of the groups contract as too big a risk to take. Hospital CEOS lose their jobs for the consequences that follow anesthesia group blowups. They are significant.

Although I agree with you, I have to say that more and more anesthesiologists find attractive the hospital employee setting. For somebody that had the good taste of private practice it is not the best way to go...
As Noy pointed out there are some benefits but what is coming with them is not so palatable. So give us some private group names to take a glance at them.

 

[foxtrot]

There are still fair groups out there, even if your definition of fair is extreme. They don't advertise because they don't need to. You find them by word of mouth and reputation. If you rely on the recruiters and gaswork, etc. only, you will get what you get.

This is exactly why we need a thread like this (either here or the private forum). If you come from a small program and you want to practice in another state it is tough to find the good groups via "word of mouth." So where does one look?--gasworks. But I agree with UT, most of the jobs on gaswork are garbage. So what is your next option--cold calling (which isn't the greatest way either).

 

[bogatyr]

This is exactly why we need a thread like this (either here or the private forum). If you come from a small program and you want to practice in another state it is tough to find the good groups via "word of mouth." So where does one look?--gasworks. But I agree with UT, most of the jobs on gaswork are garbage. So what is your next option--cold calling (which isn't the greatest way either).

If you had a good gig, why would you need to post it on this website? My guess is that any job that recruits through SDN is probably just half a step up from gaswork.

 

[BLADEMDA]

We will all be hospital employees sooner or later. So will the General Surgeons.

But that is not a bad thing. Unless you call 75th percentile of MGMA income with a great vacation package and malpractice covered along with all other benies a bad deal.

If some version of Obamacare is SHOVED through the Senate on a party line vote using the reconciliation clause what do you think 75th percentile will be in 5 years? 200K? 250k?

Make no mistake about it the Obamacare is a death sentence to this specialty and HE Will get something passed this year. The 2 billion dollar question is how much "govt run" insurance survives the Senate?

 

[BLADEMDA]

If you had a good gig, why would you need to post it on this website? My guess is that any job that recruits through SDN is probably just half a step up from gaswork.

Here is my advice. Wait until the ObamaCare passes the Senate and Obama signs the actual bill. Then, you will have a good idea how many pesos this field will generate in 5 years. If the govt option is part of the plan my advice is "take the money and run" upfront. Get the highest paying job possible Years 1-3 because by year 5 partnership will likely be 250K.

Blade

 

[BLADEMDA]

There are still fair groups out there, even if your definition of fair is extreme. They don't advertise because they don't need to. You find them by word of mouth and reputation. If you rely on the recruiters and gaswork, etc. only, you will get what you get.

Dallas is a fantastic city and UT's Group sounds fair. Dallas has a lot of primo insurance cases and one can do very well there. If I was graduating today I would call/PM UT for advice. Dallas is the place to be.

Blade

 

[Bertelman]

You make some good points. My administration did get rid of the previous group and the experience was so distasteful for everyone involved that they have vowed not to do that again (we'll see). The previous group was a private group though. So job security isn't necessarily any better with a private group. When I joined this current group the intention was for us to be private within 3-5 years but things are going smoothly and nobody seems to want to change it. As far as letting one of us go without cause, we have a clause in the contract that protects us. It would cost them a pretty penny to do that. But it is possible just as with a private group. My previous PP group let a 20 yr partner go without cause. We are all venerable.

I'm not doubting your venerability, but perhaps you meant vulnerable?

 

[2win]

Hey Noy - if it isn't a conflict - what do you think about Vail Valley Anesthesia?
They have a position on GasWork ...
The place is awesome.
Thanks,
2win

 

[Sammich81]

Hey guys..not sure if you remember me...I posted a lot when I was a 2nd-4th year in med school but then got busy with getting married and doing, you know, residency.

I'm in my CA-2 year, now looking at fellowships and jobs in DC. Am fortunate to have a close family friend who is the head of a private practice group so he's kind of my in, I think, but if he doesn't have a position that's appealing and available for me do you know of any groups that are good, or to stay the hell away from?

It sounds like you're saying I should look for:
1. Equal sharing of call
2. Comparable pay (except maybe the first year when they're still training me)
3. REasonable time to being a partner (1-2 years is what I saw on gaswork mostly)
4. Reasonable flexibility in terms of taking a day off for emergencies, etc

What else?

Also I graduate in 2011. When should I start sending out cover letters and CVs? Also other than through my contact in DC how do I figure out who is hiring (aside from gaswork)?

Finally, there is a possibility that I may have to do a fellowship for a year because my husband graduates from his urology residency at the same time and may be doing 1 yr fellowship here. What would be the best fellowship be? I can't stomach pain, it kills my soul. Am thinking about a fellowship in ambulatory, regional, or maybe designing my own fellowship at my current program with 1/3 ICU, 1/3 regional, 1/3 cardiac or peds.

Advice? Thoughts? You served me well when i was trying to decide between anesthesia and urology.

 

[Pilot Doc]

Am thinking about a fellowship in ambulatory, regional, or maybe designing my own fellowship at my current program with 1/3 ICU, 1/3 regional, 1/3 cardiac or peds.

Advice? Thoughts? You served me well when i was trying to decide between anesthesia and urology.[/QUOTE]

The more I see/hear/read/think, what I have decided is important in a group is transparency. Whatever the situation is - you know what it is, everyone else knows what it is - no one is getting screwed with a blindfold on. I think that's worth a lot more than "fairness."

As for fellowship, will your program hire you for a year? In that case, you should only do a fellowship if you can find a reason to give up $200K. I think the roll your own combo fellowship is a horrible idea. You don't get any extra pieces of paper and your skillset will not be markedly better than the experienced partners in any group you join - which is the edge you want a fellowship to give you!

 

[bigdan]

Doze -

It's posts like this that make SDN worth it.

Kudos.

Nice thread, guys. Keep it up.

dc

 

[foxtrot]

PM me if anyone knows of any fair group in or near Seattle. I love the area but I am not particularly thrilled with the job that has been offered to me.

 

[2ndyear]

Hey guys..not sure if you remember me...I posted a lot when I was a 2nd-4th year in med school but then got busy with getting married and doing, you know, residency.

I'm in my CA-2 year, now looking at fellowships and jobs in DC. Am fortunate to have a close family friend who is the head of a private practice group so he's kind of my in, I think, but if he doesn't have a position that's appealing and available for me do you know of any groups that are good, or to stay the hell away from?

It sounds like you're saying I should look for:
1. Equal sharing of call
2. Comparable pay (except maybe the first year when they're still training me)
3. REasonable time to being a partner (1-2 years is what I saw on gaswork mostly)
4. Reasonable flexibility in terms of taking a day off for emergencies, etc

What else?

Also I graduate in 2011. When should I start sending out cover letters and CVs? Also other than through my contact in DC how do I figure out who is hiring (aside from gaswork)?

Finally, there is a possibility that I may have to do a fellowship for a year because my husband graduates from his urology residency at the same time and may be doing 1 yr fellowship here. What would be the best fellowship be? I can't stomach pain, it kills my soul. Am thinking about a fellowship in ambulatory, regional, or maybe designing my own fellowship at my current program with 1/3 ICU, 1/3 regional, 1/3 cardiac or peds.

Advice? Thoughts? You served me well when i was trying to decide between anesthesia and urology.

I have always been interested in the Kaiser system. I'm sure a lot of people will say Kaiser sucks and so on, but it does seem like a sustainable model for uncertain times. I know they are recruiting in metro DC right now too.

 

[mille125]

if there are fair groups they are few and far between. This is what the people going into anesthesia need to be aware of.

Give me an example (no names) of a fair group and what makes them fair. Any groups with a buy in or x years to partnership is crossed off the list. Inherently partnership tracks are not fair. no matter the length.

I can talk from the prospective of an employer and an employee as I have occupied both positions (currently I am an employer). Everyone wants to be fair but many times as is the case above you are only looking at it from a fairness to the employee perspective. Every group started from one individual or one group of individuals. That person took a considerable risk and now reaps the rewards of that hard work. Why should someone be allowed to walk into an established group with much less perceived risk and have the same compensation/voting rights.

Let me give you another example: Lets say that I create a company. This involves dedicating a GREAT deal of time and capital with a risk of total bankruptcy. After 5 years of hard work, my company is now worth millions. If a prospective partner comes along would he expect to pay the amount that I put in or a figure that is much higher.

When speaking on fairness, look at both sides. With all of that said, these groups that are trying to exploit people with 4 yr partnerships and $500000 buy ins are corrupt. However, to expect to have total partnership status and voting rights from day one is not fair to the group.

 

[Noyac]

I'm not doubting your venerability, but perhaps you meant vulnerable?

that was a mental slip but it still holds true.

 

[Sammich81]

Yup, Kaiser is hiring in dc. I saw the posting on gaswork. I emailed a recruiter and she said I didn't need to send out my cv until I was 6-8 months from graduation.

 

[Sammich81]

As for fellowship, will your program hire you for a year? In that case, you should only do a fellowship if you can find a reason to give up $200K. I think the roll your own combo fellowship is a horrible idea. You don't get any extra pieces of paper and your skillset will not be markedly better than the experienced partners in any group you join - which is the edge you want a fellowship to give you![/QUOTE]

It would be difficult to find anyone to hire me for a year. Also I would have to pay a big malpractice tail (like I think $10-20K) if I'm only there for a year. Also if I do fellowship with my program there are a ton of moonlighting opportunities.

 

[Pilot Doc]

The tail after only 1 year is typically closer to 5K.

That will vary widely by location. That said, most university programs have a self-funded occurence basis malpractice coverage for which you would have no tail. And even "a ton" of moonlighting opportunities still leave you with a substantial opportunity cost for completing a fellowship, even if you have to pay a $20K tail.

To the OP - I'm not saying don't do a fellowship, but "I can't afford to be an attending for a year" is not a good reason.

 

[Narcotized]

maybe designing my own fellowship at my current program with 1/3 ICU, 1/3 regional, 1/3 cardiac or peds.

I would think if you didn't narrow it down a bit, it just looks like you did a second year as a CA-3. Just my opinion, but I think those seeking fellowship trained physicians are looking for someone highly skilled in a subspecialty, not a jack of all trades. But of course, any additional training of whatever kind certainly won't hurt you either.

 

[BLADEMDA]

Am thinking about a fellowship in ambulatory, regional, or maybe designing my own fellowship at my current program with 1/3 ICU, 1/3 regional, 1/3 cardiac or peds.

Advice? Thoughts? You served me well when i was trying to decide between anesthesia and urology.

The more I see/hear/read/think, what I have decided is important in a group is transparency. Whatever the situation is - you know what it is, everyone else knows what it is - no one is getting screwed with a blindfold on. I think that's worth a lot more than "fairness."

As for fellowship, will your program hire you for a year? In that case, you should only do a fellowship if you can find a reason to give up $200K. I think the roll your own combo fellowship is a horrible idea. You don't get any extra pieces of paper and your skillset will not be markedly better than the experienced partners in any group you join - which is the edge you want a fellowship to give you![/QUOTE]

Agree.👍