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This forced stock purchase is so ****ed up. So much lost potential income if one put it into index funds from compounding or being able to put it toward student loans.
Remember the deal was the potential stock being worth 3-5x the purchase value.
This was 2015 with new partnership track people. The original partners strike price was $1
The newer partners strike price was between $2-3 a share (whatever the negotiated internal price)
at least until 2021 maybe 2022. Usap partnership was still the best deal in town. Just the market conditions have changed so quickly. And it’s still evolving.
Hospital systems are very slow to give out money to doctors or subsidize practices. And usap is slowly having to beg hospitals for subsidies almost every where even in previously lucrative practices.
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Oh I don’t blame PE. Someone’s gotta skim and be the Man. Just shifted from PP to AMCs. It can be very profitable to be the skimmer.
Senior partners had been doing it for decades. The biggest scammers never truly intended to offer partnership to many folks. Those people just as bad as private equity.
Guys making 1 million plus during 2000-2013. Than selling out to Sheridan for 7.3 million most senior partner than hooking up a deal with the hospital to give them another 2.5 million a year while working 45 hrs a week and most weekends off
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Yup, the unscrupulous folks from the 90s came from before med schools started vetting med students for things like morals and ethics. Thankfully we’re well past eating our young for the most part. USAP almost the last vestige of miserable seniors fleecing junior partners
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What USAP market is this? If I had to guess I’d say MD
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deleted1130227
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Can anyone confirm that people commonly made these numbers?
Arch Guillotti
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I wouldn’t doubt the buyout numbers. Once PE has their hooks in I find it hard to believe a deal got struck with the hospital.
Huge difference. For a private partnership you give up the 20% for 2-4 years or whatever the track is…. With USAP you give up the 20-40% for the entirety of your career…decades if you stay. This is multi million dollar difference.
What are you taking about. Also that’s on her for signing up for 5 years. 4 would be the most I would have done ever. Now…1-2 for a great rare job
You actually don’t give up anything. The partners who sold out in 2014 were making the same or more after the 2014 buyout. So they were making 700-750k pre buyout. Got their 2 plus million and fake stock.
Between 2015-2019. They were still
Making 750-850k after the buyout
5 year partnership track was common in many big cities 20-25 years ago. Not just her. Mutiple people. This was up north
But 5 years partnership track also common down in Florida 20-25 years ago as well.
We are different ages. So you have to understand anesthesia has different eras.
The people just coming out now the last couple of years completely different market than different 1994-2000 era
2000-2010 era
2011-2020 era
Different market forces.
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Ya… you really need to put things into a 25-30 year period. Right now, it’s insane like circa 2000.
Usap in Maryland took over my friends practice after they abandon it
Let’s just say millions bled in locums money. Hospital ceo fired.
As my locums homies say. Choas is good for business. He likes to roll in and make hospitals pay for their poor decisions.
I keep harkening back on the stupidity of some of these hospitals.
For the most part. Hospitals executives have jo clue how to run the most profitable portion of their hospitals business the ORs.
Let’s just say millions bled in locums money. Hospital ceo fired.
As my locums homies say. Choas is good for business. He likes to roll in and make hospitals pay for their poor decisions.
I keep harkening back on the stupidity of some of these hospitals.
For the most part. Hospitals executives have jo clue how to run the most profitable portion of their hospitals business the ORs.
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deleted1130227
It's less that they have no clue. It's more that they have no/little skin in the game. If they save a chunk of money by squeezing anesthesia and other groups they are heroes. If they push a bad hand and are called and lose... they rarely suffer. They may lose their position, but they usually get a fat severance and land on their feet elsewhere.
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Curious with your fund of knowledge on this stuff, if you could say anything to a hospital c level person ina few sentences just for fun, what advice would you give them about how to maximize OR profitability? These people tend to have the attention span of a gnat, so this exchange, if it were to happen, would require cutting right to the bone.
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you didnt ask me and Im not as knowledgable as aneftp but you have to offer a good wage for the kind of work you have including extra pay for after hours and weekend work... and control surgeon expectations. Its the after hours stuff thats expensive. CRNAs have no interest and thats where burn out occurs. These days people dont want to live in the hospital and want a life outside of medicine so you have to give them one.... either shorter days, less weekends, or more vacation. Put the surgeons on salary to disincentivize them gaming the system and the inevitable fight about a 5pm case after theyve finished in the office or operating elsewhere.
But mainly they need to realize that this market isnt temporary... the crna schools and residencies arent turning them out fast enough. stop paying locums, you are creating the problem you complain about. its great for my handful of locums friends... but i know most of them would quit doing locums if they got a good enough regular deal.
But mainly they need to realize that this market isnt temporary... the crna schools and residencies arent turning them out fast enough. stop paying locums, you are creating the problem you complain about. its great for my handful of locums friends... but i know most of them would quit doing locums if they got a good enough regular deal.
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St joes?
It’s the non-competition agreements. Hospitals/health systems would boot Envision/NAPA/USAP out in a heart beat except the clinicians are tied up. The only competitive advantage those practices have now is they own the clinicians. And I’m already in the business of advising hospitals for what it is worth but until the non-compete issue is resolved not much is going to happen when these companies effectively have regional monopolies.
Hospitals can boot any 3rd party anesthesia company out and ignore non compete and claim for the better good of the community.
The tricky thing is hospitals try to get too cute making their own fake 3rd party company that’s really a shell company for the hospital instead of straight w2 employees with same benefits for everyone (see buffalo residents strike case) where residents have different benefits than regular buffalo faculty.
In 2015 my group was negotiating a buy out. We ended up not doing it. We had multiple offers from national AMCs. As usual I think your numbers are exaggerated, this is what was offered:
1.3M per partner (~12 of us)
350k salary with 8 weeks vacation thereafter
Mandatory 3 years of service after buy out.
Pre-buyout was 500k+ with 8 weeks vacation.
A few years later the hospital took over after refusing a stipend and we all got nothing..
My numbers are never exaggerated. Those who know me well know I don’t lie on numbers.
If you want to double check numbers they are right there for public viewing with most contested divorce records! I’m serious. Just a little sniffing. If the divorce settlement was settled confidentiality (if it’s contested divorce) you can see the numbers in the final divorce decree!
Take $10 to find out. Lol
Arch Guillotti
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sounds kinda creepy
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Consulting is lucrative to help AMCs or hospitals. I know of a few MDs who left their group a few years prior, then the group loses the contract. The MD familiar with the OR/staff/surgeons come back, and consult to get things going with new group. One woman earned $250k in 2 weeks helping transition from PP group to new AMC. What is interesting is that the $$$$ outlay that wasn’t there for the old PP group is now available for the new AMC. But good to be the consultant!
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deleted1130227
He is correct about the info being on court dockets. Also salaries for non profits are often available online through form 990 and sometimes public access.
True dat.... that is the unabridged version... reality is a little bit more sinister......as doctors decided not to participate in hospital leadership and were pushed out first by nurses (nooooo???? realllyyy???? I thought nurses LOVE to nurse patients..... right) then by people who ran bus depos before running hospitals here is the result..... Deliver Quality patient centric care first and foremost, everything else falls into place....
