Dismiss Notice
Hey Texans—join us for a DFW meetup! Click here to learn more.

USACS share scam.

Discussion in 'Emergency Medicine' started by RustedFox, Nov 9, 2017.

  1. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
    10+ Year Member

    Joined:
    Aug 21, 2007
    Messages:
    3,546
    Likes Received:
    2,463
    Status:
    Attending Physician
    - Can anyone elaborate as to why precisely the USACS "shareholder" idea is a giant scam. I can remember it being said on here not long ago. I have zero experience or knowledge of the offer/structure; so I'd like to hear from someone who knows just why it's a worthless deal.

    Thanks in advance.
     
  2. Note: SDN Members do not see this ad.

  3. fahimaz7

    10+ Year Member

    Joined:
    Jul 18, 2004
    Messages:
    3,276
    Likes Received:
    208
    Status:
    Attending Physician
    5 years to be vested?
     
  4. TooMuchResearch

    TooMuchResearch i'm goin' to Kathmandu...
    Lifetime Donor Classifieds Approved 7+ Year Member

    Joined:
    Oct 20, 2008
    Messages:
    4,751
    Likes Received:
    1,134
    Status:
    Resident [Any Field]
    Because they could just pay you more without handcuffing you to the company? (I remember the thread but not the details). In general, phantom stock programs are there to simulate ownership while really just maintaining control by management.

    Sent from my Moto G (5) Plus using SDN mobile
     
    slurpy15, Old_Mil and Redrox like this.
  5. Not Pudding

    Joined:
    Dec 24, 2016
    Messages:
    13
    Likes Received:
    10
    Status:
    Attending Physician
    Here you go.

    US Acute Care Solutions
     
  6. GeneralVeers

    GeneralVeers Globus Hystericus
    Physician 10+ Year Member

    Joined:
    Mar 19, 2005
    Messages:
    4,846
    Likes Received:
    1,928
    Status:
    Attending Physician
    You summed it up. It's all about keeping you an indentured servant to the company as long as possible. The truth is that the 100K, really only ads up to 20K per year (or $30K including annual bonus) when I was there. My current job I get $30k more PER MONTH than what I got working for USACS without having to be a slave.
     
  7. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
    Physician 7+ Year Member

    Joined:
    Feb 23, 2010
    Messages:
    960
    Likes Received:
    1,337
    Status:
    Attending Physician
    Quick math. Assuming you work 40h/wk, that means you're consistently getting $187.5/hr more than USACS was offering? Even more if you work fewer hours. That's impressive.
     
  8. Alvarez13

    Alvarez13 PGEEE2 mediates FEEEVER
    10+ Year Member

    Joined:
    May 29, 2007
    Messages:
    1,189
    Likes Received:
    92
    Status:
    Attending Physician
    I've seen jobs in NV approaching 350/hr and can totally see USACS paying their docs 170/hr after billing for 400+/hr. Own by doctors my a$$.
     
    slurpy15 likes this.
  9. GeneralVeers

    GeneralVeers Globus Hystericus
    Physician 10+ Year Member

    Joined:
    Mar 19, 2005
    Messages:
    4,846
    Likes Received:
    1,928
    Status:
    Attending Physician
    When I worked for them in Nevada, the average hourly some months was ~$130/hour. At the time they were paying their firefighters $175/hour. I hear that it is up to $200/hour now, which is worth about $240/hour if you include the benefits. Still a lot less than what you can make working at other places.
     
    slurpy15 and mkhuc like this.
  10. southerndoc

    southerndoc life is good
    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Jun 6, 2002
    Messages:
    11,686
    Likes Received:
    588
    Status:
    Attending Physician
    I'm sorry, did you say a firefighter was making $175/hour?!?!?!?!? :wow:
     
    miacomet likes this.
  11. GeneralVeers

    GeneralVeers Globus Hystericus
    Physician 10+ Year Member

    Joined:
    Mar 19, 2005
    Messages:
    4,846
    Likes Received:
    1,928
    Status:
    Attending Physician
    correct, however that was with benefits. Unfortunately the downsides are you can't make your own schedule, and are still locked into the 120 hours/month. As I said, I think they have raised to $200/hour, but still doesn't have the flexibility of of locums.
     
    miacomet likes this.
  12. Alvarez13

    Alvarez13 PGEEE2 mediates FEEEVER
    10+ Year Member

    Joined:
    May 29, 2007
    Messages:
    1,189
    Likes Received:
    92
    Status:
    Attending Physician
    As of 6 months ago, they were in the process of changing firefighter pay. It was 180/hr for first 120 hrs and then 280/hr for hrs over that. Working 140 per month and a slew of benefits got you up to 260/hr.

    Last I heard, I think they were at 200/hr and they upped it to 140 hrs at that rate then switched to 300/hr.

    Might as well do locums on your own and get full ctrl of your schedule and pocket all the travel benefits. That and the feeling of not destroying the specialty of emergency medicine.
     
  13. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
    Physician 7+ Year Member

    Joined:
    Feb 23, 2010
    Messages:
    960
    Likes Received:
    1,337
    Status:
    Attending Physician
    Even with the bump in pay over 140 hrs, I don't understand who the hell would take it. Your average hourly rate is still crap. My read of this isn't: "if you work 130 hours, you get 180/hr, and if you work 150 hours, you get 280/hr", it's "if you work 130 hours, you get 180/hr and if you work 160 hours, you get 140 hours at 180/hr and 20 hrs at 280/hr." Congratulations, you're working 45 hours a week in EM at a ****ty site that noone else wants to work at and you're getting paid $192.50/hr on average. Screw that.

    Even if they give you the new terms with 200/hr and 300/hr, it averages out to $212.50/hr for 160 a month....

    So the deal is: get paid poorly and in exchange you get to work too many hours, fly to an unstaffable hospital, sleep in a hotel and help damage the profession of emergency medicine? I'm good thanks.
     
    slurpy15, sally23, Old_Mil and 7 others like this.
  14. southerndoc

    southerndoc life is good
    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Jun 6, 2002
    Messages:
    11,686
    Likes Received:
    588
    Status:
    Attending Physician
    120 hours/month, locums, are you sure you aren't talking about an emergency physician instead of a firefighter?!? I find it hard to believe that a firefighter would make $175-200/hr and work 120 hours/month.
     
    LostinLift likes this.
  15. WildcatS11

    7+ Year Member

    Joined:
    Jul 17, 2009
    Messages:
    87
    Likes Received:
    68
    Status:
    Resident [Any Field]
    I think its a metaphor.
     
    Redrox and WilcoWorld like this.
  16. Aquaman29

    10+ Year Member

    Joined:
    Apr 13, 2008
    Messages:
    20
    Likes Received:
    0
    Status:
    Pre-Medical
    Can someone PM me, how exactly is the CEO of USACS making out so well? I understand that the shares, are not real entitlements to cash flow. Does a private company owned by the CEO own USACS? How does the details of the scam work?
     
  17. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 24, 2002
    Messages:
    19,271
    Likes Received:
    3,682
    I think it's EmCare that calls their in house locums "firefighters". I, personally, find that insulting to real firefighters.
     
  18. alpinism

    alpinism Give Em' the Jet Fuel
    5+ Year Member

    Joined:
    Nov 6, 2011
    Messages:
    2,999
    Likes Received:
    2,618
    They prey on new grads.

    USACS recruits heavily from programs in the midwest.

    Lots of "free" dinners, concerts, and sporting events for residents and their families.
     
    Old_Mil and Retart13 like this.
  19. alpinism

    alpinism Give Em' the Jet Fuel
    5+ Year Member

    Joined:
    Nov 6, 2011
    Messages:
    2,999
    Likes Received:
    2,618
    USACS has their own "firefighter" program


    Meet Dr. Deepika Singh, a USACS Traveling “Firefighter” and a Mom
    March 16, 2017

    It’s the most counter-intuitive thing you could possibly expect to hear from a physician whose job is to travel, but it’s true: Dr. Deepika Singh spends more time with her family, and more quality time, than when she worked locally at only one site.

    Now an Assistant Medical Director with US Acute Care Solutions (USACS), Singh has made permanent an arrangement she initially thought would be temporary. “I decided to become a Firefighter for a year and after that our plan was to move back to a local place and I’d keep being a local doc,” she said.

    Singh is part of a group of traveling emergency physicians known as Firefighters. Rather than rely on locums when there are unmet staffing needs, these physicians bring with them USACS training, culture and trademark camaraderie wherever they go.

    The surprising thing is that since taking the job, Singh says she spends more time overall, and importantly more quality time with her two young kids, a 4-year-old girl and 6-year-old boy.

    Singh came to work for USACS directly out of residency at one of its sites in Connecticut. After three years, her husband got a one-year position in Rochester, NY, and they decided to move. Rather than look for a job locally, Singh said she loved the USACS culture so much that she decided her best option was to take a temporary position on the Firefighter team.

    She decided to travel despite being pregnant at the time. Not only was she about to give birth to her daughter, she also had a one-and-a-half-year-old at home. “I ended up just loving the whole vibe of the group. They clearly cared about me as a person; not just as a physician. I wanted to stay with them even if that meant traveling,” she said.

    Amazingly, within a few months of the change, Singh found her lifestyle had dramatically changed for the better. When she was a local doc, her schedule was more unpredictable, and usually consisted of shifts interspersed throughout the week. The problem is that she would often return home exhausted after long overnight shifts. Either her kids wouldn’t be home, or if they were, she would be catching up on sleep.

    In stark contrast, now Singh works 4 or 5 days in a row somewhere away from home, and then returns for sometimes nearly three weeks of total freedom. “I can sleep like a normal person, eat dinner at a normal time with my family. Your circadian rhythm can just be normal,” Singh said. “When I come home the quality time is really quality.”

    Whereas in her previous position it was rare, if not impossible, to get three days in a row off, now she has weeks at a time with no shifts: “Instead of trying to cram in everything a parent does before going back to work, I can sleep in, work out and spend time with the kids. It’s like I’m a stay-at-home-mom for those days.”

    At USACS, the current requirements for being a Firefighter are pretty straightforward, and Singh said they weren’t a problem for her:

    • A minimum of 108 hours a month (same as for local docs)
    • Work two weekends a month (or 2.5 weekends on a 5-weekend month)
    • Work either Thanksgiving or Christmas (including the Eve’s)
    • If you fly somewhere, work a minimum of four days in a row
    “Outside of those requirements you have total control over your shifts. The flexibility is amazing,” she said.

    Firefighters are usually assigned to the same place for a few months, or even longer, so they aren’t bouncing around to a different hospital every time they work. In that way, when Singh walks into an emergency department, she knows most of the people. She’s not constantly learning new systems or dealing with foreign environments. “The culture is already there in the ED, and within the hospital.”

    Singh has now been a Firefighter for four years, and she and her family are thinking about making Rochester – what was supposed to have been a one-year pit stop – their permanent home, and Firefighting her permanent job.
     
  20. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 24, 2002
    Messages:
    19,271
    Likes Received:
    3,682
    Yeah, "firefighter" is bull****. "In house locums" would be much more apropos.
     
  21. southerndoc

    southerndoc life is good
    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Jun 6, 2002
    Messages:
    11,686
    Likes Received:
    588
    Status:
    Attending Physician
    Ah, for some reason I thought the Las Vegas Fire Department was paying their firefighters $175/hr, which I thought was totally BS. I didn't realize that the docs were called "firefighters."
     
  22. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 24, 2002
    Messages:
    19,271
    Likes Received:
    3,682
    Yeah, I'll say it a third time - BS, man, BS!!

    I don't recall - were you FF/PM, or "just" EMT-P?
     
  23. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
    Physician Partner Organization 10+ Year Member

    Joined:
    Nov 18, 2002
    Messages:
    5,145
    Likes Received:
    2,221
    Status:
    Attending Physician
    You all are right. "Firefighter" probably isn't the right term. "Scab" would be better. I mean, let's honestly look at what these guys (and gals) are doing most of the time- they're facilitating USACS taking contracts away from democratic groups, ensuring that the next generation of emergency physicians doesn't even have the option to own their job in many areas of the country.
     
  24. southerndoc

    southerndoc life is good
    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Jun 6, 2002
    Messages:
    11,686
    Likes Received:
    588
    Status:
    Attending Physician
    Glitter medic. :) NREMT-P (now NRP I guess). Still maintain my paramedic license and national registration.
     
    Apollyon likes this.
  25. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 24, 2002
    Messages:
    19,271
    Likes Received:
    3,682
    I'm not (and never have been) NREMT. Recerted NY in 2014, then 2017, after expiring in 2005.
     
  26. Aquaman29

    10+ Year Member

    Joined:
    Apr 13, 2008
    Messages:
    20
    Likes Received:
    0
    Status:
    Pre-Medical
    So do all the execs just make a ton and keep the salary and bonus pay low, or is their some deeper opaque ownership structure that no one knows about?
     
  27. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
    Physician Partner Organization 10+ Year Member

    Joined:
    Nov 18, 2002
    Messages:
    5,145
    Likes Received:
    2,221
    Status:
    Attending Physician
    I'm sure there's a little of that, but the vast majority of the fee skimmed off the backs of the docs is going to the owners- i.e private equity or the public shareholders depending on the company.
     
  28. GeneralVeers

    GeneralVeers Globus Hystericus
    Physician 10+ Year Member

    Joined:
    Mar 19, 2005
    Messages:
    4,846
    Likes Received:
    1,928
    Status:
    Attending Physician
    No need for PM. The way the company works is that the CEO (and some of the board members) own the "Holdings" company which owns the billing, coding and HR sub-companies for which USACS grants exclusive contracts. Often they pay the doctors at a loss from other sites, but the sub-companies always get paid regardless of whether or not a site is making a profit. They aren't making money directly off of physician services, but they get paid a ton through the management fee, and profit from the sub-companies they own.

    For example, If I work at a losing site and collect $50/patient, the Holdings company gets their $30 piece of the pie first, before the docs are paid out. That leaves $20 for the docs. Obviously that isn't enough to pay the docs, so it indirectly comes out of another site which is making a profit. They do this by moving the money around. The "management fee" is typically a percentage, so it allows them to move money from a highly profitable site to pay docs at losing site. All the while they still keep collecting their $30/pt at EVERY site.
     
  29. WilcoWorld

    WilcoWorld Senior Member
    10+ Year Member

    Joined:
    Nov 2, 2004
    Messages:
    2,877
    Likes Received:
    1,483
    But "Firefighter" invokes a desire to rush in and help where it's needed.And this facilitates USACS' manipulation of docs.
     
    #28 WilcoWorld, Nov 12, 2017
    Last edited: Nov 12, 2017
    LostinLift and Apollyon like this.
  30. GTP

    GTP
    7+ Year Member

    Joined:
    Jul 24, 2010
    Messages:
    694
    Likes Received:
    55
    Status:
    Medical Student, Resident [Any Field]
    What sorts of locums companies let you do this?
     
    slurpy15 likes this.
  31. GeneralVeers

    GeneralVeers Globus Hystericus
    Physician 10+ Year Member

    Joined:
    Mar 19, 2005
    Messages:
    4,846
    Likes Received:
    1,928
    Status:
    Attending Physician
    Any time you are working locums you are helping to destroy emergency medicine. As for shedule and travel most companies will give you free reign.
     
  32. namethatsmell

    7+ Year Member

    Joined:
    Sep 16, 2010
    Messages:
    586
    Likes Received:
    369
    Don’t you work locums?


    Sent from my iPhone using SDN mobile
     
    Strider_91 likes this.
  33. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Joined:
    Nov 24, 2002
    Messages:
    19,271
    Likes Received:
    3,682
    Yeah, that's what I thought, too.
     
    Strider_91 likes this.
  34. GeneralVeers

    GeneralVeers Globus Hystericus
    Physician 10+ Year Member

    Joined:
    Mar 19, 2005
    Messages:
    4,846
    Likes Received:
    1,928
    Status:
    Attending Physician
    I never said I wasn't complicit in the destruction of our specialty.....
     
  35. TimesNewRoman

    5+ Year Member

    Joined:
    May 14, 2013
    Messages:
    2,087
    Likes Received:
    1,630
    Status:
    Fellow [Any Field]
    Really? Some rural ERs just can’t staff fully. Seems like working occasionally there as an EP helps the field, not hurts it.
     
    slurpy15 likes this.
  36. Brahnold Bloodaxe

    Brahnold Bloodaxe Membership Revoked
    Removed

    Joined:
    Mar 29, 2016
    Messages:
    620
    Likes Received:
    905
    Status:
    Medical Student
    This is why General Veers is one of my favorite posters on SDN, because he has this wearied, jaundiced outlook on these modern times while at the same time minting cash doing locums in the Golden Age of EM and sipping mojitos at exotic locales. That is honorable! That is noble! Whereas being a jaundiced, poor cynic is simply depressing and for losers. lol

    That is all I aspire to in life, to cast my yellowed eye upon a world going rapidly to dogsheit but secure in the knowledge that I was able to make some hay while the sun still shone. Sadly, as a lowly M2 I may have to satisfy myself with a future of being a most cashless of cynics the way things in medicine are going. Will I, too, get my time under the sun? Cue the violins. +pity+
     
    #35 Brahnold Bloodaxe, Nov 13, 2017
    Last edited: Nov 13, 2017
    Strider_91 likes this.
  37. TooMuchResearch

    TooMuchResearch i'm goin' to Kathmandu...
    Lifetime Donor Classifieds Approved 7+ Year Member

    Joined:
    Oct 20, 2008
    Messages:
    4,751
    Likes Received:
    1,134
    Status:
    Resident [Any Field]
    Exactly.

    Sent from my Moto G (5) Plus using SDN mobile
     
  38. TooMuchResearch

    TooMuchResearch i'm goin' to Kathmandu...
    Lifetime Donor Classifieds Approved 7+ Year Member

    Joined:
    Oct 20, 2008
    Messages:
    4,751
    Likes Received:
    1,134
    Status:
    Resident [Any Field]
    I disagree. I know plenty of places using locums and trying to hire up to stop using them. I'm getting credentials at a few sites now. They would rather have someone from (or close to) the community than deal with locums. None of these places are CMG run.

    Sent from my Moto G (5) Plus using SDN mobile
     
  39. EctopicFetus

    EctopicFetus Keeping it funky enough
    10+ Year Member

    Joined:
    May 3, 2004
    Messages:
    10,456
    Likes Received:
    356
    Status:
    Attending Physician
    What part of the country? Texas?
     
  40. TysonCook

    TysonCook Senior Member
    Physician Faculty 10+ Year Member

    Joined:
    Aug 19, 2002
    Messages:
    645
    Likes Received:
    7
    Status:
    Attending Physician
    From what I understand, they are working on a "market" to buy/sell these shares? Anyone w/ USACS have any insight?
     
  41. Restart13

    Classifieds Approved 7+ Year Member

    Joined:
    May 10, 2011
    Messages:
    132
    Likes Received:
    30
    Status:
    Resident [Any Field]
    I forgot where I heard it whether it was on here or another doc was telling me, but supposedly pt satisfaction scores are better where there are SDG's and local doctors practicing rather than corporate employees. That person correlated it to better physician motivation and patient ownership rather than working for a huge corporate company. Hospital CEOs were said to be taking notice too.
     
    slurpy15 and wholeheartedly like this.
  42. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
    Physician Partner Organization 10+ Year Member

    Joined:
    Nov 18, 2002
    Messages:
    5,145
    Likes Received:
    2,221
    Status:
    Attending Physician
    We can only hope they notice it in time.
     
  43. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
    Physician Partner Organization 10+ Year Member

    Joined:
    Nov 18, 2002
    Messages:
    5,145
    Likes Received:
    2,221
    Status:
    Attending Physician
    I agree. Locums is different than a CMG. In fact, in a lot of ways locums (and physician-owned FSEDs) are giving emergency physicians their specialty back.
     
  44. Old_Mil

    Old_Mil Senior Member
    10+ Year Member

    Joined:
    Nov 19, 2004
    Messages:
    2,018
    Likes Received:
    481
    Status:
    Attending Physician
    I am out of medicine now but am pulling $167 an hour Without benefits (14 percent employer contribution for my 401k health, disability) doing a job that doesn't require a college degree.

    I wouldn't touch a 2/pph EM job for less than 300 an hour.
     
    miacomet and EctopicFetus like this.
  45. Old_Mil

    Old_Mil Senior Member
    10+ Year Member

    Joined:
    Nov 19, 2004
    Messages:
    2,018
    Likes Received:
    481
    Status:
    Attending Physician
    You will... But not if you get involved in a hospital based speciality. A rising tide floats all boats. The converse is also true. The tide in medicine in the US is absolutely receding.
     
  46. enalli

    2+ Year Member

    Joined:
    May 15, 2016
    Messages:
    110
    Likes Received:
    93
    What are you doing now?
     
  47. bravotwozero

    bravotwozero Chronically ambitious
    10+ Year Member

    Joined:
    Sep 19, 2004
    Messages:
    1,218
    Likes Received:
    496
    Status:
    Attending Physician
    He’s a lumberjack in British Columbia.


    Sent from my iPhone using Tapatalk
     
    Siggy and Dr.McNinja like this.
  48. Siggy

    10+ Year Member

    Joined:
    Oct 27, 2004
    Messages:
    3,524
    Likes Received:
    1,384
    Status:
    Fellow [Any Field]
     
    bravotwozero likes this.
  49. Old_Mil

    Old_Mil Senior Member
    10+ Year Member

    Joined:
    Nov 19, 2004
    Messages:
    2,018
    Likes Received:
    481
    Status:
    Attending Physician
    I sell shower caps to hotels (OK, not really) . I only share this to try and shed light on just how badly CMGs and management teams are screwing physicians.
     
    slurpy15 likes this.
  50. iish

    7+ Year Member

    Joined:
    Apr 8, 2009
    Messages:
    166
    Likes Received:
    49
    Status:
    Resident [Any Field]
    All physician "ownership" schemes are all scams at large staffing groups. Most of these groups are owned by investors. No actual ownership is being give to the docs. You are just given a little extra money and told that you are a "partner". In reality you're not a partner or an owner. You have no real corporate voting power that typically comes with ownership. Just a little extra cash.

    Most investors and large staffing companies know that doctors are not savvy enough to really understand any of this, but will flock at a few extra bucks.
     
    slurpy15, sally23, gro2001 and 4 others like this.
  51. EctopicFetus

    EctopicFetus Keeping it funky enough
    10+ Year Member

    Joined:
    May 3, 2004
    Messages:
    10,456
    Likes Received:
    356
    Status:
    Attending Physician
    It’s like the BS they float about it being “physician owned”.

    Um what does that mean? USACS says this.. But about 30% of the company is owned by a PE company Carson Welsh I think.

    Team Health is owned by private equity as well and EmCare well their stock got destroyed and are looking at getting bought up.

    Using what I think is their criteria, Apple, Tesla, Smith & Wesson, Bank of America are all physician owned.

    So was Enron.. how did that turn out.
     
    Crusader59, gro2001, Old_Mil and 2 others like this.

Share This Page