There is nothing left !!

[PieOHmy]

For the enterprising hardwoking anesthesiologist.
Seriously, I took a look at gaswork for the first time in about 1 year and
the groups that i thought would never sell out to corporate have done so
very very very disheartening that physicians are selling the profession out.

Were done.
Thank god ive god less than 10 years left

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[deleted941485]

For the enterprising hardwoking anesthesiologist.
Seriously, I took a look at gaswork for the first time in about 1 year and
the groups that i thought would never sell out to corporate have done so
very very very disheartening that physicians are selling the profession out.

Were done.
Thank god ive god less than 10 years left

Yeah man...they are gonzo. Hilariously bad timing for new grads seriously.

I’m not in the field but I mean I check gasworks just to see what’s going on outside my area. Not a lot of movement overall. Kind of the same employees posting the same jobs day in and day out.

 

[PieOHmy]

You would literally be better off if you went to trade school and learned heating and a/c for 1 year then moved on to plumbing and pipefitting for one year then moved on to electrical and advanced electrical, then welding . You would be NEVER unemployed and prob if you had your own business your phone would never stop ringing

 

[Planktonmd]

If you want to be an owner or entrepreneur then medicine (all specialties) is not the right choice, it's a different world and a different economy.

 

[Pharmado]

It’s not all doom and gloom, but management companies and good groups selling out have definitely hurt the field. There are areas of the country where good opportunities may are severely limited. That said, good PP groups like the job Lurch posted for MAP in Minneapolis still exist (I will admit to being biased as I am joining the practice).

 

[Mikkel]

There are good groups out there still, you just have to look and relocate.


The good news though is even if you don't find a great group, you can find a job in a desirable area easily, even if it means getting underpaid. It's great for docs with sociopathic laziness tendency, since these AMCs always need fresh meat to keep the gears turning. Delay cases, cancel cases, refuse cases. What's the AMC gonna do?

 

[deleted941485]

If you want to be an owner or entrepreneur then medicine (all specialties) is not the right choice, it's a different world and a different economy.

And the sad thing is even 10 years ago that wasn’t the case! Seriously terrible all around. Even if you call your local ASA chapter they literally will just shrug their shoulders. The AMCs and hospitals now have the power. And now they all want residency programs!

Seriously worst time in history to be a physician

 

[nimbus]

And the sad thing is even 10 years ago that wasn’t the case! Seriously terrible all around. Even if you call your local ASA chapter they literally will just shrug their shoulders. The AMCs and hospitals now have the power. And now they all want residency programs!

Seriously worst time in history to be a physician

Several ASA officers and at least one former ASA president started the AMC trend.

 

[AdmiralChz]

That said, good PP groups like the job Lurch posted for MAP in Minneapolis still exist (I will admit to being biased as I am joining the practice).

Might be good. For as negative as this forum is on PP posting people have been oddly slobbering over this job which is still 8 months away from even existing. So what if the other hospitals the group sort of has are lucrative - this is a new contract they hadn’t even been ironed out yet. Props to those willing to take the jump, but a healthy skepticism is fully warranted.

Corporatization is hitting ALL medicine and if you think it’s bad in our specialty go ask everyone’s favorite alternative EM how it is for them.

People saying this is the “worst time” to be a physician probably lack some experience/perspective or weren’t around during the very lean times in the 1990s when the field was in very dire straights. I wasn’t around, but my personal PP has never done better than it is now.

 

[Lurch]

Might be good. For as negative as this forum is on PP posting people have been oddly slobbering over this job which is still 8 months away from even existing. So what if the other hospitals the group sort of has are lucrative - this is a new contract they hadn’t even been ironed out yet. Props to those willing to take the jump, but a healthy skepticism is fully warranted.

Corporatization is hitting ALL medicine and if you think it’s bad in our specialty go ask everyone’s favorite alternative EM how it is for them.

People saying this is the “worst time” to be a physician probably lack some experience/perspective or weren’t around during the very lean times in the 1990s when the field was in very dire straights. I wasn’t around, but my personal PP has never done better than it is now.

Actually the job exists. We took over a portion of the contract early and are on location now. Minnesota isn’t for everyone but this job should be. Geographic arbitrage!

 

[DirtDocMD]

Hospitals are littered with jackazz administrators, on the 2-3 year “corporate ladder” plan, just LOOKING for a way to cut costs. They have no ties to the community, so are more than happy to bring in corporate medical groups to save money, with no regard for quality of care.


Anybody thinking about ANY of the hospital-based medical specialties should keep this in mind, and realize that their life is subject to the whims of some idiot administrator who is looking to impress “corporate” with their cost-cutting prowess, so they can move up the corporate ladder or to a nicer locale....

 

[Stank811]

Many groups exist such as lurch’s.

 

[BLADEMDA]

Many groups exist such as lurch’s.

True. But some of them are no longer offering partnership tracks while others have a tiered track.

Lurch’s group is fair and equitable in addition to high income as a partner.

 

[Stank811]

True. But some of them are no longer offering partnership tracks while others have a tiered track.

Lurch’s group is fair and equitable in addition to high income as a partner.

I was referring to groups that are fair and equitable with high income as a partner.

 

[deleted941485]

True. But some of them are no longer offering partnership tracks while others have a tiered track.

Lurch’s group is fair and equitable in addition to high income as a partner.

I remember the anesthesia PP at our shop at the end was basically tiering their “profit centers” and keeping them away from the junior people for longer. So they make partner but have no voting rights and only get to be a part of tangent break even and money losing part of the organization.

 

[Stank811]

I remember the anesthesia PP at our shop at the end was basically tiering their “profit centers” and keeping them away from the junior people for longer. So they make partner but have no voting rights and only get to be a part of tangent break even and money losing part of the organization.

And does anyone wonder why you made the statement “at the end”. So I would assume the business model of shuffling profits in a non equitable way was one factor in them failing. And I consider selling to an AMC failing.

 

[dannyboy1]

There are good groups out there still, you just have to look and relocate.


The good news though is even if you don't find a great group, you can find a job in a desirable area easily, even if it means getting underpaid. It's great for docs with sociopathic laziness tendency, since these AMCs always need fresh meat to keep the gears turning. Delay cases, cancel cases, refuse cases. What's the AMC gonna do?

Exactly. THIS is really the only way to fight it. Do as little as possible to cash the paycheck and avoid being sued. I can think of quite a few times where I could have gone the extra mile to help out the surgeon, hospital, and who knows possibly even the patient. Then my saner self prevailed when I reminded myself that any extra effort will not benefit me in the slightest. Just punching a clock....

 

[deleted941485]

T

And does anyone wonder why you made the statement “at the end”. So I would assume the business model of shuffling profits in a non equitable way was one factor in them failing. And I consider selling to an AMC failing.

They had been hurting for a few years and had made all these people partnership tract. The writing was on the wall like many tactics they use it’s futile and they ultimately got hospital employed

 

[TrojanGopher]

Exactly. THIS is really the only way to fight it. Do as little as possible to cash the paycheck and avoid being sued. I can think of quite a few times where I could have gone the extra mile to help out the surgeon, hospital, and who knows possibly even the patient. Then my saner self prevailed when I reminded myself that any extra effort will not benefit me in the slightest. Just punching a clock....

I don't blame you for having this mentality given your situation, but man it would suck to go into work everyday and feel that way. There is a great benefit in private practice knowing everything you do at work, including going that extra mile, goes back to you and your partners, rather than to some corporation.

 

[Pharmado]

I’ve been going the extra mile in my practice as an employee because it’s both the right thing to do and in the best interest of my patients. Then I look at my colleagues, some of whom don’t share my work ethic, and I realize that I may actually pay the price for being better. If there is something more to be done, an extra case, an extra block etc, those who are the most willing are the first to be asked. Those who drag their feet and complain end up with less work and equal pay. There is no incentive in an AMC or hospital employed role to do more cases, turn over rooms faster or work harder. This is the very essence of why the private practice model works better. If a group works harder, more efficiently and provides better service, they make more money, improve care and establish a better relationship with the hospital. It seems like eventually the best hospitals should realize this and get rid of the management companies and we should end up with a 2 tiered system:

Private practice: Best hospitals/ payer mix
Hospital or AMC employed: rural hospitals, poor payer mix

 

[rightonn_dude]

Child Psych is the secret goldmine. No overhead. Outpatient. Cash practice some charge 1-2k/hr in my area.

 

[dhb]

Cash practice some charge 1-2k/hr in my area.

 

[nimbus]

Child Psych is the secret goldmine. No overhead. Outpatient. Cash practice some charge 1-2k/hr in my area.

Yep for learning disability/IEP evaluations for well to do parents.

 

[narcotics999]

Yep for learning disability/IEP evaluations for well to do parents.

Not at all. Most of these evaluations are paid by government or private insurance. In CA, I don't know how much Sacramento pays, but I know bcbs pays a whopping 600$ for 2 hour with 4 person staff (one MD, 3 therapists).

There are always rich clients in every field. Rumor said the late MJ paid his cardiologist 150k/month.

Sent from my moto g(6) using SDN mobile

 

[nimbus]

Not at all. Most of these evaluations are paid by government or private insurance. In CA, I don't know how much Sacramento pays, but I know bcbs pays a whopping 600$ for 2 hour with 4 person staff (one MD, 3 therapists).

There are always rich clients in every field. Rumor said the late MJ paid his cardiologist 150k/month.

Sent from my moto g(6) using SDN mobile

I know going rate for some developmental psychologists in the DC suburbs is $5k. That is probably the high end. Worth it to the parents though.

 

[chocomorsel]

Child Psych is the secret goldmine. No overhead. Outpatient. Cash practice some charge 1-2k/hr in my area.

Who the hell can afford that? Sounds to me like rich people problem kids who just need a belt or a switch. Lol
Don’t spare the rod. It’s in the Bible.

 

[chocomorsel]

I know going rate for some developmental psychologists in the DC suburbs is $5k. That is probably the high end. Worth it to the parents though.

Again. Rich people problems. Hell I will google that **** and charge you 500 bucks an hour. Whip your kids occasionally that’s my advice.
Are you kidding me?
That is not the Majority of your patients. Maybe 5% to 10% of them. But ain’t enough to pay the bills.
I personally would not be OK catering to rich little spoiled ass kids. There are there who really need help and can not afford thousands an hour.

 

[GravelRider]

Again. Rich people problems. Hell I will google that **** and charge you 500 bucks an hour. Whip your kids occasionally that’s my advice.
Are you kidding me?
That is not the Majority of your patients. Maybe 5% to 10% of them. But ain’t enough to pay the bills.
I personally would not be OK catering to rich little spoiled ass kids. There are there who really need help and can not afford thousands an hour.

I would have no problem taking money from rich parents raising maladjusted little twerps. Tell them they have ADD, prescribe some Ritalin, and collect a check...see you next week.

Is it any different than when someone pays $500 a session for a math tutor when all the little brat needs to do is put the phone down for an hour and read a book? Teachers in rich suburbs can do nicely running a little Saturday tutoring clinic at the local library.

 

[chocomorsel]

I would have no problem taking money from rich parents raising maladjusted little twerps. Tell them they have ADD, prescribe some Ritalin, and collect a check...see you next week.

Is it any different than when someone pays $500 a session for a math tutor when all the little brat needs to do is put the phone down for an hour and read a book? Teachers in rich suburbs can do nicely running a little Saturday tutoring clinic at the local library.

Seriously? Teachers in rich districts getting this but the ones in poor districts and states need two jobs?
That ain’t right.

 

[Twiggidy]

Seriously? Teachers in rich districts getting this but the ones in poor districts and states need two jobs?
That ain’t right.

Clientele Choco....clientele.

 

[pgg]

There are always rich clients in every field. Rumor said the late MJ paid his cardiologist 150k/month.

If only he'd hired an anesthesiologist instead the King Of Pop would still be around.

 

[LineAndBerry]

I’ve been going the extra mile in my practice as an employee because it’s both the right thing to do and in the best interest of my patients. Then I look at my colleagues, some of whom don’t share my work ethic, and I realize that I may actually pay the price for being better. If there is something more to be done, an extra case, an extra block etc, those who are the most willing are the first to be asked. Those who drag their feet and complain end up with less work and equal pay. There is no incentive in an AMC or hospital employed role to do more cases, turn over rooms faster or work harder. This is the very essence of why the private practice model works better. If a group works harder, more efficiently and provides better service, they make more money, improve care and establish a better relationship with the hospital. It seems like eventually the best hospitals should realize this and get rid of the management companies and we should end up with a 2 tiered system:

Private practice: Best hospitals/ payer mix
Hospital or AMC employed: rural hospitals, poor payer mix

Another real life example of Corporate Socialism vs. Free Market economics

 

[VA Hopeful Dr]

Seriously? Teachers in rich districts getting this but the ones in poor districts and states need two jobs?
That ain’t right.

That Saturday tutoring is their 2nd job.

I live in a small SC city, even our teachers are getting $50/h minimum for private tutoring. 4 hours of that once/week will snag you an extra $800/month tax free. That can be a mortgage on a decent house in a good neighborhood here.

 

[medgator]

Child Psych is the secret goldmine. No overhead. Outpatient. Cash practice some charge 1-2k/hr in my area.

Couldn't pay me enough to do that.

Like peds, dealing with the parents is sometimes the biggest problem with the specialty

 

[AdmiralChz]

Couldn't pay me enough to do that.

Like peds, dealing with the parents is sometimes the biggest problem with the specialty

Totally agreed, and if someone is really raking that much in (certainly nowhere approaching that around here) you’ll essentially be bought by the parents and you’ll have to do whatever they want - prescribe meds, provide a diagnosis, write letters, etc... basically you’d be a ridiculous sell out and doing nothing to better your patients. Not what most of us got into medicine for.

 

[TheLoneWolf]

Totally agreed, and if someone is really raking that much in (certainly nowhere approaching that around here) you’ll essentially be bought by the parents and you’ll have to do whatever they want - prescribe meds, provide a diagnosis, write letters, etc... basically you’d be a ridiculous sell out and doing nothing to better your patients. Not what most of us got into medicine for.

Sounds like PP pain management..
Coming from a pain guy

 

[MoMoGesiologist]

If only he'd hired an anesthesiologist instead the King Of Pop would still be around.

Imagine the music and dance moves we could’ve born witness to... RIP

 

[deleted162650]

Imagine the music and dance moves we could’ve born witness to... RIP

Not to mention the child molestation.

 

[Twiggidy]

If only he'd hired an anesthesiologist instead the King Of Pop would still be around.

Yep......would still be Moonwalking and playing with Bubbles right now

 

[Twiggidy]

Totally agreed, and if someone is really raking that much in (certainly nowhere approaching that around here) you’ll essentially be bought by the parents and you’ll have to do whatever they want - prescribe meds, provide a diagnosis, write letters, etc... basically you’d be a ridiculous sell out and doing nothing to better your patients. Not what most of us got into medicine for.

Exactly. I imagine Big Little Lies on steroids

 

[MoMoGesiologist]

Not to mention the child molestation.

Was that a for sure thing? I thought he never had a childhood so tried living vicariously through children, weird as that is

 

[medgator]

Was that a for sure thing? I thought he never had a childhood so tried living vicariously through children, weird as that is

Finding Neverland seemed fairly compelling for me...

 

[deleted162650]

so tried living vicariously through children

In the most literal sense.

 

[Twiggidy]

Finding Neverland seemed fairly compelling for me...

I'm a big fan of Kate Winslet myself. (sorry, doing my best SaltyDog impression)

It was Leaving Neverland.......and personally I'm 50/50 of what I believe in that documentary. Do I think Michael Jackson did some weird stuff with kids? Probably. Do I think he did it Wade? I'm not sure.

 

[Consigliere]

The anesthesia job market is just a vast wasteland of garbage jobs right now.

 

[medgator]

I'm a big fan of Kate Winslet myself. (sorry, doing my best SaltyDog impression)

It was Leaving Neverland.......and personally I'm 50/50 of what I believe in that documentary. Do I think Michael Jackson did some weird stuff with kids? Probably. Do I think he did it Wade? I'm not sure.

Even 50% of that movie is too much for me, personally. I like his music but he was one ****ed up dude

 

[Twiggidy]

Even 50% of that movie is too much for me, personally. I like his music but he was one ****ed up dude

Yep. F'd up dude with a VERY f'd up life, that's even if "The Jacksons: An American Dream" was even somewhat accurate. Joe Jackson was a crazy man and it at least gives some insight into Jackson's mental state. As you said, dude could still make some amazing music.

 

[narcotics999]

Yep. F'd up dude with a VERY f'd up life, that's even if "The Jacksons: An American Dream" was even somewhat accurate. Joe Jackson was a crazy man and it at least gives some insight into Jackson's mental state. As you said, dude could still make some amazing music.

It takes a crazy mind to make amazing music.

Some people think MJ is autistic (or Aspergers)

Many of the most talented people (genius) were believed to be abnormal or autistic, including the two greatest Physicists (Isaac Newton and Albert Eistein).

 

[PieOHmy]

Child Psych is the secret goldmine. No overhead. Outpatient. Cash practice some charge 1-2k/hr in my area.

And... they are booked months and months ahead of time