Updated Kaiser Southern California (2022) thread

[nimbus]

Is that St. John’s? Hmm are you sure that’s a good long term gig with a fair and transparent partnership track? Or are we talking about just independent contracting? Cuz I heard from a graduating senior the contract had some major red flags. (Also heard bad things regarding partnership there from a guy who left there when I was graduating. He came to academia after 4 years there. But hey, things might be different right now).

250-300/hr gigs are everywhere now. I’m talking about a promised, defined, reasonable (<3yrs) partnership track that treats the new guy relatively fairly with cases. Isn’t that what defines a good PP on this forum???

Furthermore, I heard some places only offer 300/hr ONLY for OR time. Huge difference.

Seems like the practices that are fair and transparent have mediocre unit values. The places with the best unit values and highest income potential still tend to be less fair and less transparent in terms of length of partnership track, call assignments, case picking etc.

I posed the question above about Kaiser’s payor mix because from the outside, it seems like they have a very good payor mix. They should have above average income.

Does anybody know about Long Beach Memorial? 2 decades ago it was a very busy, very desirable place to work but they had a long partnership track with a “potential to become partner after 4 yrs”. Nowadays I hear they offer offer financial parity from the beginning. Is that true?

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[GassmanMD]

You anticipate that the $250/hr kaiser per diem rate will drop next fall? Would make sense, the jump from precovid $150/hr seemed unsustainable for the long term. Especially if departments fill out, and the per diems are no longer needed.

The Kaiser per diem rates, IMHO, should drop back otherwise why would any partner accept a pay cut to take call, work nights, weekends, holidays, do harder cases, stay past 3 when necessary, etc. I’ve got my resignation letter and per diem application resume ready for the day I vest into the pension. If the rates are still $250/hr, I’m switching and I’ve told my area medical director this to their face. They offered to cut the per diem rate immediately to appease us but we said keep the rates high until the market corrects.

 

[nimbus]

The Kaiser per diem rates, IMHO, should drop back otherwise why would any partner accept a pay cut to take call, work nights, weekends, holidays, do harder cases, stay past 3 when necessary, etc. I’ve got my resignation letter and per diem application resume ready for the day I vest into the pension. If the rates are still $250/hr, I’m switching and I’ve told my area medical director this to their face. They offered to cut the per diem rate immediately to appease us but we said keep the rates high until the market corrects.

The per diem rate is set by the market. They can only lower the per diem rate if they don’t really need the per diem docs.

 

[GassmanMD]

The per diem rate is set by the market. They can only lower the per diem rate if they don’t really need the per diem docs.

My department won’t have that big of a need come August. Ymmv.

 

[ucladoc2b]

Seems like the practices that are fair and transparent have mediocre unit values. The places with the best unit values and highest income potential still tend to be less fair and less transparent in terms of length of partnership track, call assignments, case picking etc.

I posed the question above about Kaiser’s payor mix because from the outside, it seems like they have a very good payor mix. They should have above average income.

Does anybody know about Long Beach Memorial? 2 decades ago it was a very busy, very desirable place to work but they had a long partnership track with a “potential to become partner after 4 yrs”. Nowadays I hear they offer offer financial parity from the beginning. Is that true?

Yes that is true. 2 year track, but 100% partner income for new hires.

 

[Coffee PRN]

Yes that is true. 2 year track, but 100% partner income for new hires.

What are their salaries and hours like?

 

[kidthor]

What are their salaries and hours like?

I’d love to know this too.

 

[nimbus]

My department won’t have that big of a need come August. Ymmv.

Then you’ll probably drop per diem rates in August

I remember not too long ago when EM docs were commanding 300-400/hr. What happened to them could happen to anesthesia too.

 

[nimbus]

One big difference is that we have real case requirements that you can't farm out as easily as EM can.

For every HCA residency, there is a requirement for a large number of cardiac, vascular, thoracic, pediatric, neuro, and life threatening cases.

There is already some difficulty meeting these requirements even at top residencies. It isn't trivial to find these cases consistently enough to create a residency, the way people here seem to think. Just ask any residency program director about how hard it can be to meet case numbers.

Agree with you. Still there are new residencies in Stockton, Visalia, and Thousand Oaks. A small DO residency in Riverside recently became ACGME and expanded. EM was also victim to the rising proliferation of APPs. We are also vulnerable to APP risk.

 

[ucladoc2b]

Agree with you. Still there are new residencies in Stockton, Visalia, and Thousand Oaks. A small DO residency in Riverside recently became ACGME and expanded. EM was also victim to the rising proliferation of APPs. We are also vulnerable to APP risk.

We already have new CRNA schools popping up. They have high demand, as well, and cost savings isn’t much if any. EM APP have much lower barriers to entry. The economics are different.

 

[soccerboy2288]

Then you’ll probably drop per diem rates in August

I remember not too long ago when EM docs were commanding 300-400/hr. What happened to them could happen to anesthesia too.

My department won’t have that big of a need come August. Ymmv.

I think rates will continue to depend on socal market (demand/supply) as a whole, or SoCal kaiser's back log/anesthesia shortage as a whole. If anything, shifts/days/hours given to PD will be cut first at specific departments who have enough people. Once the market cools overall, then rates will start to go down. This probably applies to all groups out there aside from partners and permanent employees (academia/county).

I think the big question is how long this will last, if not permanent.

 

[thinkorswim]

Some misinformation here.

You can find more details on income in other kaiser threads but as a first year associate (Socal) I definitely cleared the upper range of that salary with somewhere between 5-5.5 weeks of vacation. (There's a caveat to this vacation days depending on which kaiser you work for. So you're kinda right but not rly... It's a lot to type out. You can probably find it on other kaiser threads). Obviously income also varies depending on how much you wanna work but I didn't work any crazy hours. With the 150k bonus this year, I guess new hires will clearing 550k !

As a second year I had 6-6.5 weeks. Now as a partner after 3 years I have 7.5 week. Starting next year 8.5 weeks (Again doesn't exactly apply to all kaisers). Not including paid sick days. And with each year came a bump in income, with the biggest obviously being partnership.


Yes, everyone contributes to their 401k + Keogh Plan as well (totaling 66k of tax deductible money for 2023). I save money in addition to this towards retirement.

Keep in mind... we don't pay anything into the Kaiser's pension. NOTHING is taken out of our pay check.

I'm curious how you get to 7.5 weeks vacation after just 3 years. The benefits handbook says years 1-4 get 18 days of vacation and 5 day educational leave, so about 4.5 weeks vacation.

So you're saying new hires make about $400k? How hard are they working and how much more call do they need to pick up for that? And how much does it go up to once you become partner?

 

[thinkorswim]

By my estimate I make a little more than 300 per hr (not locums or per diem). But no benefits like health, malpractice, pension. Safe to assume this is better than kaiser partners? Not trying to start a pissing contest. There are so many downsides to private practice. Terrible lifestyle. Always on call. Really have to earn that money. Self inflicted though. I have a lot of debt. But if my pay and lifestyle are both worse than kaiser, well than I need to change jobs

I'm in the same boat. On occasion I will calculate my hourly income and find that I am generating anywehere from low $200s to $500+ per hour, with the average coming in at over $300 per hour. There's a Kaiser only a couple miles from my house which I drive by on my commute to work, so I do sometimes get the "grass is greener" itch. But every time I crunch the numbers using my back of the napkin math, it just doesn't make sense and I don't think my lifestyle will improve significantly, if it does at all.

 

[blackbolt]

As posted above, I beg the question: where/what are these good private practices that exist specifically in los angeles that is being compared to kaiser? Or are people just voting for these "theoretical" private practices that are theoretically good? Are people voting for the "thought" of practicing in a good PP? From when I was applying, there really weren't any private groups that offered a true partnership with a reasonable track, fair, transparent, and well paying in the los angeles area. With the hot market, this may be different now cuz everyone wants to fill spots. However, when I was graduating 4 years ago, I was faced with the dilemma of going academia/county/kaiser to stay in LA, or moving out of LA to join a good PP gig.

We aren't comparing apples to apples if geography isn't taken into account in a location like socal/los angeles. Many people take kaiser due to its accessibility from desirable parts of LA: West LA, South bay, Downey, LAMC, Woodland Hills. Its one of the better options in a ****ty market.

There's a lot of detail about Kaiser's forum, and it's easy to say "oh yeah, I would take a good PP over that." But the reality is, there aren't many (or any great ones) in LA. These are located outside of LA: OC, SB, Ventura. By no means am I saying Kaiser is the best in the area, but things have to be put in context. I'm sure there are a few decent PP out there (I heard decent things about Long Beach memorial, northridge, Tarzana but have no details. But even those are in the periphery geographically). But as far as I can see no one has posted any details about a great PP gig in Los Angeles. Again, not trying to start a pissing contest, but I'm genuinely curious myself. Shill me a great PP in LA?

(Also, I didn't even vote for the poll haha)

I know of at least 2 groups (~20ish mins from DTLA) that pay partners ~300 or more per hour. One of them is that 290/hr group, which pays for time in house (not just anes start to stop time). And they give stipends for overnight call. The other group gets to that level via stipends and a pretty good insurance mix.

In terms of whether Kaiser or pp is better, its hard to say. I think the biggest advantage of Kaiser is the predictability. That predictability is the ability to know ahead of time, exactly what time during the day you'll be done. The other aspect is the pay: you will always know how much each shift pays and you never have to worry about billing issues. And if you can stick it out for 30 years, Kaiser probably pays more as you continue to get raises, more benefits for the same amount of work, and that pension. I also dont get why ppl on this board are so against supervising. I think suping 1:2-3 seems to be generally less taxing than solo MD work, where you constantly have to prep the room for each case and have to time ur meals/pee breaks with room turnover or just skip meals all together.

PP you probably get more control over how the group is run and maybe some more flexibility in being able to work half days or ask for random days off. But I absolutely hate how unpredictable it can be. Yes, you can make much higher $/hr than Kaiser, but you're gonna be working for it, taking lots of home call. In addition, that $300/hr is dependent on the cases you have for the day. If the case gets delayed for OR equipment issues, pt shows up late, or the case is cancelled, now you have a big gap that you arent getting paid for and your day will likely end later than anticipated. And top of that, you have to keep track of the billing and make sure your billing team doesnt put the wrong code or misses a block. Plus, you cant keep working like a dog forever. Eventually you'll slow down and your pay is gonna drop. Or insurance reimbursements will continue to drop or the hospital decides to cut your stipend.

So I guess if you want to work really hard and retire by your 50, PP may be the way to go to maximize the money. Otherwise, Kaiser probably better if you dont wanna go balls to the wall and keep passing gas till whenever the pension is fully funded.

 

[propadex]

I'm in the same boat. On occasion I will calculate my hourly income and find that I am generating anywehere from low $200s to $500+ per hour, with the average coming in at over $300 per hour. There's a Kaiser only a couple miles from my house which I drive by on my commute to work, so I do sometimes get the "grass is greener" itch. But every time I crunch the numbers using my back of the napkin math, it just doesn't make sense and I don't think my lifestyle will improve significantly, if it does at all.

Let's see if our thoughts are the same:

Kaiser Associate: 55 hrs/wk, 6 wk vacation, 450k + malpractice (10k) + pension (32k assuming 30 years) + disability (6k) + health (3.5k; variable, changes if you have family) = 501.5k total value
PP: 55 hrs/wk, 6 wk vacation, 275-300/hr = 696-790k total value

PP 1099 so have to pay employer taxes but with deductions it's a wash. Kaiser has a keogh that matches the benefits of a solo 401k.

The math is much closer for kaiser partners however:
Kaiser Partner: 55 hrs/wk, 9 wk vacation, 550k + malpractice (10k) + pension (32k) + disability (6k) + health (3.5k; variable, changes if you have family) = 601.5k total value
PP: 55 hrs/wk, 9 wk vacation, 275-300/hr = 650-710k total value

Anyone see any incorrect assumptions in my math?

 

[NitroS]

I'm curious how you get to 7.5 weeks vacation after just 3 years. The benefits handbook says years 1-4 get 18 days of vacation and 5 day educational leave, so about 4.5 weeks vacation.

So you're saying new hires make about $400k? How hard are they working and how much more call do they need to pick up for that? And how much does it go up to once you become partner?

that should be including sick days I think (which people use as vacation). Partners get 22 sick days (it rolls over if not used up to 44 days)....so 23 vacation days+5 days educational leave+22 sick days so about 10 weeks

New hires can make 400k working 40-50 hours. I'm one of the new hires and I'm on pace to make 550-600k this year and thats not including the sign on bonus. But I do work a lot tho (by choice). Taking some extra calls...probably working 60+ hours.

 

[ucladoc2b]

that should be including sick days I think (which people use as vacation). Partners get 22 sick days (it rolls over if not used up to 44 days)....so 23 vacation days+5 days educational leave+22 sick days so about 10 weeks

New hires can make 400k working 40-50 hours. I'm one of the new hires and I'm on pace to make 550-600k this year and thats not including the sign on bonus. But I do work a lot tho (by choice). Taking some extra calls...probably working 60+ hours.

That’s pretty good. If that’s cash comp (excluding any benefits) that’s better than most places. Care to share what your call burden is like?

 

[aneftp]

My brother and a couple of friends are in southern (LA proper like downtown LA) and Northern California (real Bay Area) $300/hr is the base line on both areas. Place in San Diego further down was $350/hr with sound I think.

The market is the market. Crna’s aren’t taking less than $175/hr east or west coast. Many making $225/hr already in mid size cities all over the country.

So our “competition” isn’t getting cheaper. I don’t see MD locums rates below $250/hr anywhere near future.

Recruiters will try to say $250/hr. U counter with $350/hr. And some how magically they come back one week later at $300/hr.

 

[soccerboy2288]

I'm curious how you get to 7.5 weeks vacation after just 3 years. The benefits handbook says years 1-4 get 18 days of vacation and 5 day educational leave, so about 4.5 weeks vacation.

that should be including sick days I think (which people use as vacation). Partners get 22 sick days (it rolls over if not used up to 44 days)....so 23 vacation days+5 days educational leave+22 sick days so about 10 weeks

New hires can make 400k working 40-50 hours. I'm one of the new hires and I'm on pace to make 550-600k this year and thats not including the sign on bonus. But I do work a lot tho (by choice). Taking some extra calls...probably working 60+ hours.

No this does NOT include the paid sick days we have. I have 38 days of actual vacation days on top of the sick days; As a partner we get an additional 5 days relative to that table. FYI the actual compensation handbook is like over hundred pages long....

nitros: In our department we don't get the weekly ED you guys get. We instead get additional EL days

So you're saying new hires make about $400k? How hard are they working and how much more call do they need to pick up for that? And how much does it go up to once you become partner?

As a first year yes. New hires this year will make 550k with the sign on bonus. As a1st year partner, clear 500k. (straight cash not including benefits). More as older partners

Check out this thread, your questions have been discussed in like the first 2 pages (even went back and edited one post I posted as update).

Southern California Kaiser Anesthesiology

Anyone have any info on SoCal Kaiser Anesthesiology jobs? specifically, San Diego Kaiser? Ex: practice model, base pay, call, and any other useful information would be awesome.

forums.studentdoctor.net

 

[blackbolt]

Let's see if our thoughts are the same:

Kaiser Associate: 55 hrs/wk, 6 wk vacation, 450k + malpractice (10k) + pension (32k assuming 30 years) + disability (6k) + health (3.5k; variable, changes if you have family) = 501.5k total value
PP: 55 hrs/wk, 6 wk vacation, 275-300/hr = 696-790k total value

PP 1099 so have to pay employer taxes but with deductions it's a wash. Kaiser has a keogh that matches the benefits of a solo 401k.

The math is much closer for kaiser partners however:
Kaiser Partner: 55 hrs/wk, 9 wk vacation, 550k + malpractice (10k) + pension (32k) + disability (6k) + health (3.5k; variable, changes if you have family) = 601.5k total value
PP: 55 hrs/wk, 9 wk vacation, 275-300/hr = 650-710k total value

Anyone see any incorrect assumptions in my math?

Ur forgetting the 150k sign on bonus for new hires. So thats an extra 50k a year for them if the track is 3 years.

Also partners seem to get annual raises and production/holiday bonuses? So their pay for 55hrs is probably higher than 550k. 9 weeks vacation also seems low, probably closer to 10-11 weeks if u include sick days and cme etc.

 

[soccerboy2288]

Kinda want to point out that people wanna know details about kaiser but when people talk about other/their own PP groups that are supposedly better, no one drops names… “I know a place…” “my place…..” “a place in LA…”

I get people don’t like to disclose specifics of their practice. But kinda makes certain claims less credible. (Also makes me feel silly being transparent about kaiser and will probably stop doing so in the future).

Just curious why this is. Not a single name drop in this entire thread with details regarding partnership. People just dropping rates. (Not saying it’s a lie nor am I instigating anything. Genuinely curious what’s out there). Or am I naive to ask this since I’m not in PP?

(And I keep pointing out rates don’t mean anything if we aren’t talking about partnership offers. Apples to apples…)

 

[NitroS]

That’s pretty good. If that’s cash comp (excluding any benefits) that’s better than most places. Care to share what your call burden is like?

Yeah cash comp. I take about 6 calls/month. it’s in house 24hr call…but the call is light since it’s 1:1 supervision doing bread&butter stuff

 

[propofabulous]

Kinda want to point out that people wanna know details about kaiser but when people talk about other/their own PP group, no one drops names… “I know a place…” “my place…..” “a place in LA…”

I get people don’t like to disclose specifics of their practice and the name. But kinda makes certain claims less credible. Anyone can spit numbers out. Also makes me feel silly being transparent about kaiser and will probably stop doing so in the future

Just curious why this is. Not a single name drop. I’m probably naive since I’m not in PP

It's frustrating and hypocritical, I agree. But I can think of two reasons.

1) Anonymity: With kaiser you have the protection of there being multiple locations. I've never seen someone come right out and say I work at Kaiser "X", which would be the equivalent of publicly identifying your PP group, revealing exactly where you work, who you potentially are, etc. There are what, 10+ socal kaiser locations? I would feel more comfortable saying that I am in one of the following 10 private practice groups, due to fear of being doxxed or bringing bad press/unwanted attention to my group, etc.

2) "Trade secrets": A lot of kaiser info is public. Benefits for example. And working at kaiser, despite being a partner, is actually more like the traditional employee situation - pay is standardized across locations with subtle differences among different departments. If you know someone who works at a kaiser then you know what the baseline rates, call multipliers, etc. are. PP tend to hold their compensation pretty close to their chest, kind of like "trade secrets". The good ones don't want to be flooded with bad applicants or become targets. The bad ones want to hide the fact they aren't great. It's the same reason that most groups won't tell you their exact unit value until you get an offer. Does it make sense? Not really. I would feel comfortable disclosing all my information but feel that it's not up to me. What if someone from my group finds out I'm posting here and takes issue?

 

[blackbolt]

It's frustrating and hypocritical, I agree. But I can think of two reasons.

1) Anonymity: With kaiser you have the protection of there being multiple locations. I've never seen someone come right out and say I work at Kaiser "X", which would be the equivalent of publicly identifying your PP group, revealing exactly where you work, who you potentially are, etc. There are what, 10+ socal kaiser locations? I would feel more comfortable saying that I am in one of the following 10 private practice groups, due to fear of being doxxed or bringing bad press/unwanted attention to my group, etc.

2) "Trade secrets": A lot of kaiser info is public. Benefits for example. And working at kaiser, despite being a partner, is actually more like the traditional employee situation - pay is standardized across locations with subtle differences among different departments. If you know someone who works at a kaiser then you know what the baseline rates, call multipliers, etc. are. PP tend to hold their compensation pretty close to their chest, kind of like "trade secrets". The good ones don't want to be flooded with bad applicants or become targets. The bad ones want to hide the fact they aren't great. It's the same reason that most groups won't tell you their exact unit value until you get an offer. Does it make sense? Not really. I would feel comfortable disclosing all my information but feel that it's not up to me. What if someone from my group finds out I'm posting here and takes issue?

I agree w the anonymity and trade secrets parts. But if a good group releases their data publically, how does that attract more bad applicants than good ones? I assume they would attract more good applicants as well and can weed out the really bad ones through the vetting/interview process.

I also dont get the “make them a target.” Are you saying other anesthesia groups will try to bring down other groups unit values? Obviously this is naive on my part, but i always think what if all the pp groups in an area band together and negotiate against insurance companies together? Surely they would get more bargaining power? Definitely an oversimplification im sure

 

[secretasianman]

I agree w the anonymity and trade secrets parts. But if a good group releases their data publically, how does that attract more bad applicants than good ones? I assume they would attract more good applicants as well and can weed out the really bad ones through the vetting/interview process.

I also dont get the “make them a target.” Are you saying other anesthesia groups will try to bring down other groups unit values? Obviously this is naive on my part, but i always think what if all the pp groups in an area band together and negotiate against insurance companies together? Surely they would get more bargaining power? Definitely an oversimplification im sure

Fear of appearing weak leads to secrecy, even if it may be irrational. On the flip side, CEO salaries are disclosed in the shareholder report. This transparency allows for competition and their ballooning packages we see everywhere.

 

[nimbus]

I agree w the anonymity and trade secrets parts. But if a good group releases their data publically, how does that attract more bad applicants than good ones? I assume they would attract more good applicants as well and can weed out the really bad ones through the vetting/interview process.

I also dont get the “make them a target.” Are you saying other anesthesia groups will try to bring down other groups unit values? Obviously this is naive on my part, but i always think what if all the pp groups in an area band together and negotiate against insurance companies together? Surely they would get more bargaining power? Definitely an oversimplification im sure

If it gets back to hospital administration and insurance companies that a particular group is making significantly above market income, it can sabotage their negotiations with those parties. “Target on their back” means inviting competition from other groups that will try to take over their practice by undercutting them. That is why this information is generally kept confidential.

 

[blackbolt]

If it gets back to hospital administration and insurance companies that a particular group is making significantly above market income, it can sabotage their negotiations with those parties. “Target on their back” means inviting competition from other groups that will try to take over their practice by undercutting them. That is why this information is generally kept confidential.

This doesnt really make sense to me. Insurance companies already know how much they are paying each group. If anything, its in their best interest for anesthesia groups to keep those a secret so they dont know what the average is and are happy being below market values.

As for the hospital admins, i feel like you could make the reverse argument as well. If group A knows group B is paying more, people will leave group A to join group B. Then hospital A admins are gonna have to raise stipends to keep group A happy if they still want keep the OR money flowing.

In terms of groups undercutting each other, that seems like a bad long term move to tell the hospital they are happy to work for less money.

 

[thinkorswim]

Anyone see any incorrect assumptions in my math?

Yes, you’re assuming that I want to actually work 55 hours per week consistently and that I’m not willing to make less for home call, regardless of how light the call may be.

I’m still early in my career but one thing I’ve found is that I feel terrible if I am working over 50-55 hours in a week. I absolutely hate it when I don’t see my spouse and kids for almost 48 hours sometimes and even if I do manage to see them everyday, I find myself giving up work at the end of a brutal week because I want to spend more time with them. I also hate sleeping in hospital call rooms, no matter how quiet the call can be.

No this does NOT include the paid sick days we have. I have 38 days of actual vacation days on top of the sick days; As a partner we get an additional 5 days relative to that table. FYI the actual compensation handbook is like over hundred pages long....

nitros: In our department we don't get the weekly ED you guys get. We instead get additional EL days


As a first year yes. New hires this year will make 550k with the sign on bonus. As a1st year partner, clear 500k. (straight cash not including benefits). More as older partners

Check out this thread, your questions have been discussed in like the first 2 pages (even went back and edited one post I posted as update).

Southern California Kaiser Anesthesiology

Anyone have any info on SoCal Kaiser Anesthesiology jobs? specifically, San Diego Kaiser? Ex: practice model, base pay, call, and any other useful information would be awesome.

forums.studentdoctor.net

Interesting. So your division uses the administrative days as vacation instead? And setting income and vacation aside, what does the typical schedule look like in terms of hours and number of calls per month? Are all Kaisers in house calls?

 

[thinkorswim]

I know of at least 2 groups (~20ish mins from DTLA) that pay partners ~300 or more per hour. One of them is that 290/hr group, which pays for time in house (not just anes start to stop time). And they give stipends for overnight call. The other group gets to that level via stipends and a pretty good insurance mix.

In terms of whether Kaiser or pp is better, its hard to say. I think the biggest advantage of Kaiser is the predictability. That predictability is the ability to know ahead of time, exactly what time during the day you'll be done. The other aspect is the pay: you will always know how much each shift pays and you never have to worry about billing issues. And if you can stick it out for 30 years, Kaiser probably pays more as you continue to get raises, more benefits for the same amount of work, and that pension. I also dont get why ppl on this board are so against supervising. I think suping 1:2-3 seems to be generally less taxing than solo MD work, where you constantly have to prep the room for each case and have to time ur meals/pee breaks with room turnover or just skip meals all together.

PP you probably get more control over how the group is run and maybe some more flexibility in being able to work half days or ask for random days off. But I absolutely hate how unpredictable it can be. Yes, you can make much higher $/hr than Kaiser, but you're gonna be working for it, taking lots of home call. In addition, that $300/hr is dependent on the cases you have for the day. If the case gets delayed for OR equipment issues, pt shows up late, or the case is cancelled, now you have a big gap that you arent getting paid for and your day will likely end later than anticipated. And top of that, you have to keep track of the billing and make sure your billing team doesnt put the wrong code or misses a block. Plus, you cant keep working like a dog forever. Eventually you'll slow down and your pay is gonna drop. Or insurance reimbursements will continue to drop or the hospital decides to cut your stipend.

So I guess if you want to work really hard and retire by your 50, PP may be the way to go to maximize the money. Otherwise, Kaiser probably better if you dont wanna go balls to the wall and keep passing gas till whenever the pension is fully funded.

I don’t think there’s a right answer whether Kaiser is better or worse than private practice. No job is perfect and it really just comes down to what you want in your career, not just in terms of income but also lifestyle. The things you dislike about private groups are totally understandable, but there are many who are willing to accept those downsides for other advantages.

For me personally, the reasons I think private practice is a better fit are:
- No supervision. I’ve never done it, but I am very satisfied doing my own cases and have no reason to change that.
- Home call only once or twice a month with a relatively low call back rate. I have no desire to sleep in a hospital again for the rest of my career.
- The mix of busy and light days. I don’t mind a day with less work and being home before noon, allowing me to run errands or just relax.
- The ability to pick my own benefits and contribute to a cash balance plan. I can put away over $150k per year into tax-deferred retirement accounts.
- The fear that golden handcuffs that is the pension may affect my decisions later should I want to change jobs.
- The potential to go part time on the back end of my career. Not sure if Kaiser would accommodate this.

 

[blackbolt]

I don’t think there’s a right answer whether Kaiser is better or worse than private practice. No job is perfect and it really just comes down to what you want in your career, not just in terms of income but also lifestyle. The things you dislike about private groups are totally understandable, but there are many who are willing to accept those downsides for other advantages.

For me personally, the reasons I think private practice is a better fit are:
- No supervision. I’ve never done it, but I am very satisfied doing my own cases and have no reason to change that.
- Home call only once or twice a month with a relatively low call back rate. I have no desire to sleep in a hospital again for the rest of my career.
- The mix of busy and light days. I don’t mind a day with less work and being home before noon, allowing me to run errands or just relax.
- The ability to pick my own benefits and contribute to a cash balance plan. I can put away over $150k per year into tax-deferred retirement accounts.
- The fear that golden handcuffs that is the pension may affect my decisions later should I want to change jobs.
- The potential to go part time on the back end of my career. Not sure if Kaiser would accommodate this.

Those are all great points. I do see a lot of the older partners taking half days or only working part time and are fine w taking a pay cut for it. The flexibility of pp is hard to match vs kaiser where the shifts are pretty set in stone and its almost impossible to end days at noon unless your post call I imagine.

And having more money now is always preferable to having more money later (ie pension).

 

[propofabulous]

- The ability to pick my own benefits and contribute to a cash balance plan. I can put away over $150k per year into tax-deferred retirement accounts.

Is there any type of age restriction regarding when you can start using a cash balance plan?

 

[Arch Guillotti]

Is there any type of age restriction regarding when you can start using a cash balance plan?

Don’t think so although contributions are limited.

 

[propofabulous]

Keep in mind... we don't pay anything into the Kaiser's pension. NOTHING is taken out of our pay check.

Does qualifying time for the pension start as an associate or as a partner?

 

[thinkorswim]

Is there any type of age restriction regarding when you can start using a cash balance plan?

Not sure about age restrictions but the maximum contribution amount does increase with age. It starts around $60k in your early 30s and goes up to over $300k in your late 60s. This amount is in addition to your 401k contribution.

 

[nimbus]

Not sure about age restrictions but the maximum contribution amount does increase with age. It starts around $60k in your early 30s and goes up to over $300k in your late 60s. This amount is in addition to your 401k contribution.

Contribution limits by age are in this link.

Contribution Limits » Cash Balance Design

Contributuion limits table: Age401(k) only, 401(k) with Profit Sharing, Cash Balance, Total. To view our 2018 Retirement Plan Limits Postcard, click here.

www.cashbalancedesign.com

Age​	401(k) only​	401(k) with Profit Sharing​	Cash Balance​	Total​
70​	$30,000​	$73,500​	$398,000​	$471,500​
69​	$30,000​	$73,500​	$381,000​	$454,500​
68​	$30,000​	$73,500​	$365,000​	$438,500​
67​	$30,000​	$73,500​	$350,000​	$423,500​
66​	$30,000​	$73,500​	$335,000​	$408,500​
65​	$30,000​	$73,500​	$321,000​	$394,500​
64​	$30,000​	$73,500​	$328,000​	$401,500​
63​	$30,000​	$73,500​	$335,000​	$408,500​
62​	$30,000​	$73,500​	$341,000​	$414,500​
61​	$30,000​	$73,500​	$325,000​	$398,500​
60​	$30,000​	$73,500​	$309,000​	$382,500​
59​	$30,000​	$73,500​	$294,000​	$367,500​
58​	$30,000​	$73,500​	$280,000​	$353,500​
57​	$30,000​	$73,500​	$266,000​	$339,500​
56​	$30,000​	$73,500​	$253,000​	$326,500​
55​	$30,000​	$73,500​	$241,000​	$314,500​
54​	$30,000​	$73,500​	$229,000​	$302,500​
53​	$30,000​	$73,500​	$218,000​	$291,500​
52​	$30,000​	$73,500​	$207,000​	$280,500​
51​	$30,000​	$73,500​	$197,000​	$270,500​
50​	$30,000​	$73,500​	$188,000​	$261,500​
49​	$22,500​	$66,000​	$178,000​	$244,000​
48​	$22,500​	$66,000​	$170,000​	$236,000​
47​	$22,500​	$66,000​	$161,000​	$227,000​
46​	$22,500​	$66,000​	$154,000​	$220,000​
45​	$22,500​	$66,000​	$146,000​	$212,000​
44​	$22,500​	$66,000​	$139,000​	$205,000​
43​	$22,500​	$66,000​	$132,000​	$198,000​
42​	$22,500​	$66,000​	$126,000​	$192,000​
41​	$22,500​	$66,000​	$120,000​	$186,000​
40​	$22,500​	$66,000​	$114,000​	$180,000​
39​	$22,500​	$66,000​	$108,000​	$174,000​
38​	$22,500​	$66,000​	$103,000​	$169,000​
37​	$22,500​	$66,000​	$98,000​	$164,000​
36​	$22,500​	$66,000​	$93,000​	$159,000​
35​	$22,500​	$66,000​	$89,000​	$155,000​
34​	$22,500​	$66,000​	$85,000​	$151,000​
33​	$22,500​	$66,000​	$80,000​	$146,000​
32​	$22,500​	$66,000​	$77,000​	$143,000​
31​	$22,500​	$66,000​	$73,000​	$139,000​
30​	$22,500​	$66,000​	$69,000​	$135,000​

 

[Arch Guillotti]

Not sure about age restrictions but the maximum contribution amount does increase with age. It starts around $60k in your early 30s and goes up to over $300k in your late 60s. This amount is in addition to your 401k contribution.

There is also a lifetime maximum.

 

[NitroS]

Does qualifying time for the pension start as an associate or as a partner?

associate

 

[secretasianman]

These polling results are a testament to how good the job market is right now. 5-10 years ago when things were tight, the numbers would be flipped.

 

[nimbus]

These polling results are a testament to how good the job market is right now. 5-10 years ago when things were tight, the numbers would be flipped.

They were never flipped. Kaiser has become more attractive over the years.

 

[GassYous]

They were never flipped. Kaiser has become more attractive over the years.

Even with the rn bs and slow turnover there's something about steady schedule.

 

[secretasianman]

Yes so more people would choose kaiser in a tighter market when there’s more uncertainty.

 

[nimbus]

Yes so more people would choose kaiser in a tighter market when there’s more uncertainty.

It’s not a hypothetical. They weren’t choosing Kaiser 5-10 yrs ago. More people are choosing Kaiser now.

 

[kidthor]

It’s not a hypothetical. They weren’t choosing Kaiser 5-10 yrs ago. More people are choosing Kaiser now.

It’s true. Although I have my reservations about their model, a good handful of my colleagues jumped from my academic place over to Kaiser. All of them are happier there and it suits them well enough (and they get paid more with better benefits and less stress).

 

[epidural man]

I just worked a gig for a couple of days in SoCal. It wasn't LA - I would say it was the zit on the butt of California (Lancaster, CA).

But it paid $2400/day, and I was done at 1-2 pm both days I worked.

Not bad.

I also do per diem for LA County at the same zit area for $220. I am getting underpaid there. Should I ask for a raise?

 

[GaseousClay]

It’s not a hypothetical. They weren’t choosing Kaiser 5-10 yrs ago. More people are choosing Kaiser now.

More people choose kaiser because the newer grads don’t want to grind. Few of my friends who are faculty are saying most residents have no desire to work a lot. This is a broad generalization but seems to be the trend that the days of people trying to grind out and earn huge amounts of money are at the wayside. Hence why Kaiser applications have been blowing up in recent years.

 

[ucladoc2b]

More people choose kaiser because the newer grads don’t want to grind. Few of my friends who are faculty are saying most residents have no desire to work a lot. This is a broad generalization but seems to be the trend that the days of people trying to grind out and earn huge amounts of money are at the wayside. Hence why Kaiser applications have been blowing up in recent years.

Way to go with the generation bashing. On a per hour basis/effort level, Kaiser is probably significantly higher pay than a lot of the PP. Several PP your are stuck paying your own malpractice, health insurance, and other benefits.

 

[ambiturner]

Way to go with the generation bashing. On a per hour basis/effort level, Kaiser is probably significantly higher pay than a lot of the PP. Several PP your are stuck paying your own malpractice, health insurance, and other benefits.

That seems to be the main advantage of employed practices versus traditional partnership the past few years. You need to make 5-10,000 more per year just to keep your W2 constant and keep up with rising health insurance, increases to profit sharing contributions, higher SS limits…

 

[ucladoc2b]

That seems to be the main advantage of employed practices versus traditional partnership the past few years. You need to make 5-10,000 more per year just to keep your W2 constant and keep up with rising health insurance, increases to profit sharing contributions, higher SS limits…

It’s a big deal. PP does have some flexibility in how it’s run and some tax advantages (although these can be replicated in an employment contract).

Smaller PP have trouble finding these benefits affordable. Not to mention the costs of running a business and dealing with complicated insurance contracting.

 

[abolt18]

Way to go with the generation bashing. On a per hour basis/effort level, Kaiser is probably significantly higher pay than a lot of the PP. Several PP your are stuck paying your own malpractice, health insurance, and other benefits.

Bashing? Laughable. They were just saying that IN GENERAL, new grads seem less focused on money and more focused on a little work-life balance. How is it bashing?

 

[UnoMas]

I am soon to be a new grad and looking to grind. Looking for a place to grind out 70-80 hours a week for a few years to reach Financial Independence then switch to a lifestyle practice or academic. A few of my classmates share the same mentality. I think it’s called Coast FIRE (with or without the RE). The hard part is finding a place without a heavy and long taxation i.e buy-in.

I think every generation thinks the next generation is lazier and less motivated yet we ended up working similar amount of hours unless older people in your groups work more hours than the young ones consistently, which I doubt is the case.