To those of you have gone PP --> AMC

[deleted162650]

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So I'm pretty sure there are a few on this board whose successful PP groups have become AMC owned recently. I'm curious to hear how working conditions have changed with the new management. I don't care as much about the salary side of things, but more so have the changes we assume the AMC would make been implemented? Have supervision ratios increased? Have worse hours been imposed? More forced call? Benefits reduced?

Anyone whose initial contract with the AMC has expired and got (even more) shafted on the second round of contract negotiations?

As the AMC buy-out movement continues to gain steam, it would be nice to know what sort of things to actually expect post-sell-out from those that have been there and done that.

 

[Consigliere]

If I had to go PP--> AMC I wouldn't; I'd go PP--> McDonalds.

 

[sevoflurane]

They are learning their lessons is my understanding. Implementing big changes in a group that has history can cause them to loose their contracts if they are not able to play nice in the sandbox. This has happened and they are wising up. In the end however, your contract with the amc will be your shield and enforcer to avert any negative changes.

 

[Mman]

So I'm pretty sure there are a few on this board whose successful PP groups have become AMC owned recently. I'm curious to hear how working conditions have changed with the new management. I don't care as much about the salary side of things, but more so have the changes we assume the AMC would make been implemented? Have supervision ratios increased? Have worse hours been imposed? More forced call? Benefits reduced?

Anyone whose initial contract with the AMC has expired and got (even more) shafted on the second round of contract negotiations?

As the AMC buy-out movement continues to gain steam, it would be nice to know what sort of things to actually expect post-sell-out from those that have been there and done that.

I haven't, but have a close friend from residency that has and was not a partner and didn't get a buyout. He finds it not too bad. Hours and supervision ratios haven't changed at all since they are all determined locally.

 

[sevoflurane]

Remember... These guys make a ton from day one based on negotiated insurance rates. There is an impetuous to keep homeostasis at the group level. Disturbing that balance can prove very costly to any AMC- think of Valleys buyout. Say they muck things up and then loose all their contracts. Now they are out of a lot of $$$ that was given to those partners... while those partners are free to walk away.

 

[Mman]

Remember... These guys make a ton from day one based on negotiated insurance rates. There is an impetuous to keep homeostasis at the group level. Disturbing that balance can prove very costly to any AMC- think of Valleys buyout. Say they muck things up and then loose all their contracts. Now they are out of a lot of $$$ that was given to those partners... while those partners are free to walk away.

agreed.

Their contract is where they make mega bucks. Bickering about work hours and supervision ratios is mere pennies relatively speaking. Long term they might squeeze those last few drops out but it's irrelevant in the short term.

 

[IkeBoy18]

I haven't, but have a close friend from residency that has and was not a partner and didn't get a buyout. He finds it not too bad. Hours and supervision ratios haven't changed at all since they are all determined locally.

less money, same hours?

 

[Mman]

less money, same hours?

No. Same money, same hours. He wasn't a partner so he didn't get a buyout, but his current salary is better than what he made on a partner track and a little less than what the partners were making pre buy out. Their benefits dropped significantly, however.

 

[Ezekiel2517]

This should be no surprise but one thing I've heard from more than one group that's sold is that there was enormous turnover of anesthesiologists afterward. The majority of people who didn't have to stay will leave . It led to nurses and surgeons complaining and going to administration. It also results in being relatively short staffed and this caused an increase in work hours and calls. It also leads to changes in hiring practices. Given the relatively "portable" nature of the specialty, it's not hard to leave a job if there isn't incentive to stay

 

[caligas]

This should be no surprise but one thing I've heard from more than one group that's sold is that there was enormous turnover of anesthesiologists afterward. The majority of people who didn't have to stay will leave . It led to nurses and surgeons complaining and going to administration. It also results in being relatively short staffed and this caused an increase in work hours and calls. It also leads to changes in hiring practices. Given the relatively "portable" nature of the specialty, it's not hard to leave a job if there isn't incentive to stay

What is the penalty for leaving the group if things get bad after getting money for a buyout? I assume it's a financial penalty or maybe just a non compete clause?

 

[aneftp]

No. Same money, same hours. He wasn't a partner so he didn't get a buyout, but his current salary is better than what he made on a partner track and a little less than what the partners were making pre buy out. Their benefits dropped significantly, however.

Who's benefit dropped significantly? The former partners who sold out? Or your friends benefits?

 

[Mman]

Who's benefit dropped significantly? The former partners who sold out? Or your friends benefits?

Everybody's. Partners, non-partners, AMCs pay decent enough money but they really scrounge on the benefits.

 

[Ezekiel2517]

What is the penalty for leaving the group if things get bad after getting money for a buyout? I assume it's a financial penalty or maybe just a non compete clause?

Not sure about that. I was referring to the non partners leaving , they can leave whenever they want. I'm sure the buyout people who aren't happy with the situation will leave as soon as the contract allows

 

[Man o War]

What is the penalty for leaving the group if things get bad after getting money for a buyout? I assume it's a financial penalty or maybe just a non compete clause?

There was an article posted here not too long ago about this- American took over a big private practice up in Michigan at Beaumont. If I remember it right, one of the docs took the buy out and left to go work for another group in town. It violated the non compete he signed when he signed on with American and they're going after him legally. The doctor is fighting back. There was a link to the complete legal document with all the details. The non competes these AMCs impose are the real issue, because they will often write it in such a way that you really can't work anywhere close, forcing you to either move or keep working for them. It will be interesting to see if the courts side with the doctor or AMC on this one.

 

[aneftp]

There was an article posted here not too long ago about this- American took over a big private practice up in Michigan at Beaumont. If I remember it right, one of the docs took the buy out and left to go work for another group in town. It violated the non compete he signed when he signed on with American and they're going after him legally. The doctor is fighting back. There was a link to the complete legal document with all the details. The non competes these AMCs impose are the real issue, because they will often write it in such a way that you really can't work anywhere close, forcing you to either move or keep working for them. It will be interesting to see if the courts side with the doctor or AMC on this one.

Well that situation was a little different.

I read the entire document.

This dude was a partner so got a buyout. He got cash and wanted to have his cake and eat it too.

He's pushing the limits of non compete. Since American anesthesiology gave him X amount. And he was trying to work for an outpatient place within the 30 mile radius or so.

I think he can give the cash they gave him for selling out and he can take the job with better hours!

So it's not like some new guy trying to leave Americans anesthesiology with no financial profit from the buyout. This was a former partner trying to leave after getting his cash

 

[deleted162650]

So as a partner, could you take the buy-out money and then bail as long your new job was outside the non-compete radius? Or are you locked in to working for a set period of time in exchange for the buy-out money? (I know contracts will vary, but just curious what the norm is).

 

[Mman]

So as a partner, could you take the buy-out money and then bail as long your new job was outside the non-compete radius? Or are you locked in to working for a set period of time in exchange for the buy-out money? (I know contracts will vary, but just curious what the norm is).

Yes, you can. The AMC doesn't care if you leave because they will replace you with another MD at the same salary. The issue is with each group the buyout money is a lump sum and some groups might want to set up an agreement that says you can't walk until you've fulfilled the contract or you have to pay back some of the buyout.


Think about it this way, the group gets bought out with 5 year contracts and a lump sum buyout. Not exactly fair to the partners that stay for somebody to walk after 1 year because they just got their buyout on the assumption they'd be there 5 years. The AMC doesn't care because a salary is a salary. If they knew the doc would walk after a year they'd have given them a smaller buyout and kept more for everybody else. I've seen groups that set up "claw back" agreements within themselves so if somebody left early there was recourse for the group to recoup some buy out money.

 

[lakersbaby]

Yes, you can. The AMC doesn't care if you leave because they will replace you with another MD at the same salary. The issue is with each group the buyout money is a lump sum and some groups might want to set up an agreement that says you can't walk until you've fulfilled the contract or you have to pay back some of the buyout.


Think about it this way, the group gets bought out with 5 year contracts and a lump sum buyout. Not exactly fair to the partners that stay for somebody to walk after 1 year because they just got their buyout on the assumption they'd be there 5 years. The AMC doesn't care because a salary is a salary. If they knew the doc would walk after a year they'd have given them a smaller buyout and kept more for everybody else. I've seen groups that set up "claw back" agreements within themselves so if somebody left early there was recourse for the group to recoup some buy out money.

I have heard from a friends group that the buyer did require a 5 year contract. It is not as easy as you say to just hire a bunch of people if people quit. The AMC is not only about paying out and then wiping their hands they still want to keep hospitals happy and have some group stability.

 

[Mman]

I have heard from a friends group that the buyer did require a 5 year contract. It is not as easy as you say to just hire a bunch of people if people quit. The AMC is not only about paying out and then wiping their hands they still want to keep hospitals happy and have some group stability.

I know they sign a contract. I'm just saying the AMC doesn't really care if they walk away sooner. They obviously don't want everyone to leave but they aren't sweating a doc leaving.