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USAP - Partner track worth it?

Discussion in 'Anesthesiology' started by spike7585, Oct 6, 2018.

  1. pgg

    pgg Laugh at me, will they?
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    The proper use of millions (with an s) is when the figure is nonspecific: "tens of millions"

    When the figure is specific, no s: "ten million"
     
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  3. Consigliere

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    And show me where you learned English so I can advocate for a refund on your behalf.
     
    #152 Consigliere, Nov 8, 2018 at 3:58 PM
    Last edited: Nov 8, 2018 at 4:03 PM
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  4. gasier

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    LOL. All your proper English and prep schools and you still have a less paying job than I do, an immigrant from third world country. Ha ha. God bless America! I took that job from you and you can’t do anything about it! Keep attacking my poor English you whiny little <edited by mod>. In the meantime, watch your school debt piling up with interest added annually while I watch my networth growing. And go support Trump, so another immigrant doesn’t take a job from you. USAP is definitely not for you.
     
    #153 gasier, Nov 8, 2018 at 4:30 PM
    Last edited by a moderator: Nov 8, 2018 at 5:46 PM
  5. sethco

    sethco Senior Member
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    Yes, but all on the track do Cardiac. Didn't we already talk about this in the other thread?
     
  6. mostwanted

    mostwanted Senior Member
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    @sethco, does USAP stock pay dividends? Are most partners actively buying stock after the initial buy in?
     
  7. gasier

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    Looks like you are a rare find on this forum, that is an intelligent person who came for information.
    Yes and yes. At least in my group, most reinvest dividend by buying more shares.
     
  8. GigiBuffon

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    BULL****. People are waiting for an IPO or the vesting date 5 years post-buyout (at which you can cash in on your stock). If any, then a small minority of partners bought more shares with their dividends.
    Recruiters don't have spelling like a third grader. This most likely is a doctor who discovered the internet today, a sad representative of our specialty and a poor example for any group.
     
  9. sethco

    sethco Senior Member
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    Yes, it pays dividends per share. Some partners are actively buying, some are selling through the marketplace that USAP set up
     
  10. nimbus

    nimbus Member
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  11. Howard888

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    I know for a fact you are lying. I know people at several groups or divisions who are not at their previous income. I also know that many employees (CRNAs, Nurses, etc) aren’t as happy as presale. Again you are only telling half truths. Some divisions have but mainly through acquisitions and turning these smaller groups into employees while partners and USAP make money off the top. Even if new grads are making slightly more at start are they making as much as a partner or are they still making less as a buy in. Yep they are making less and buying in. Did you have to pay $125000 for your stock? Nope they gave you stock and cash for the revenue you gave up. They are having to pay to give up revenue.

    Wow...on so many levels....I really hope new grads don’t buy that biased BS. While not everything he says is untrue, USAP stock is a pyramid scheme. Yes the original share price has increased because everytime they acquire a new group they get increased earnings through higher rates and a few cost savings-hence increasing the stock price.

    This model only works if 1.You were part of the buyout and 2. You were one of the first people that were part of the buy out

    Yes the guys from GHA, etc made a lot on the stock, but the guys from Austin, Maryland will make way less.

    It really depends on how many groups who will continue to sell to USAP

    But you know who really really will make less?

    Oh yeah new employees or new grads-because they are getting the stock at that magical value you say you wish you could tell us -and they’re having to pay that price, they don’t get it like all of you did who did the buy out. Oh yeah and they have to give up 30% of their revenue forever-what a great deal. But in 10 years after all the people who were part of the buy out retire no one will remember anymore-all employees smart plan.

    And to say their aren’t groups with physicians who are good at business. There are many, that is a cheap fear tactic to convince selling
     
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  12. Consigliere

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    GUEST_65825bc8-ce17-4835-9bb8-d5092e06d1e6.jpg Bye bye, gasier! Use some of your "wealth" to purchase.....
     
  13. chocomorsel

    chocomorsel Senior Member
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    It’s really sad how some people are so money hungry that they dont care what they do to the profession in the long term. Long as their coffers are filled! Reminds me of third world dictators. It’s all about the “me” mentality.
     
  14. gasdoc77

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    In their defense, many of those that “sold out” were from the not-so-bright years of anesthesia applicants where top tier programs would pay your airfare and lodging for interviews. These are docs who just barely didn’t have to go to chiropractic school with all that business acumen. “Hey, look at me selling out the rest of my career/profession for a 2-3x multiple! I so smart”.
     
    #163 gasdoc77, Nov 9, 2018 at 2:16 PM
    Last edited: Nov 9, 2018 at 2:26 PM
  15. nimbus

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  16. GravelRider

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    Last time I said that, I got booed out of the gym, but that’s exactly how I feel about this specialty. A good portion of the old timers are guys who barely made it through med school and were just plain unimpressive people and ended up stepping in $hit with this specialty. I guess I can’t fault someone for being lucky, but that’s all it is...luck.
     
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  17. dhb

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    There is also the fact that if your contract expires and an AMC steps in you get zero, while if you sell out before at leadt you get something...
     
  18. IMGASMD

    IMGASMD ASA Member

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    Or the fact, most contracts around here, most hospitals do a year to year contract. If I can get a lump sum, and never have to worry if my group is still in next year, I may sell too.

    I just hope some of these CEOs will see that AMCs may not be the best solutions. And PP can keep up with the times and regulations and bring more “values” (I know I hate myself for typing that bs word) for a what we do....
     
  19. dr doze

    dr doze To be able to forget means to sanity
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    Timing is everything. This specialty has suffered huge oscillations in numbers and quality of applicants. Unfortunately supply and demand have a great tradition of oscillating out of synchrony. Don’t fool yourself- the medstudents who finished in the mid 80s- early 90s who entered this specialty were very solid as agroup. From about 94-2000. Not so much. Of course there was plenty of variance and dodos in the first group and plenty of rock stars in the second. Timing and being willing to locate to where the opportunities were and some element of luck and business savvy all matter.
     
  20. GA8314

    GA8314 Regaining my sanity
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    Some of the older anes docs I know are so mediocre on every level measurable I can't even fu.cking believe it.
     
  21. dr doze

    dr doze To be able to forget means to sanity
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    SOME. Just like SOME of your generation. Spare me your sour grapes at being born “too late” and missing a time period that was more satisfying financially and emotionally. Must be terrible for you.
     
  22. GravelRider

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    That’s fine. But I just want the older docs to be honest that it was luck that got them where they are and not some imagined blood, sweat, and tears for their current entitlement. If you are lucky, say you are lucky, don’t try to pretend it’s some hard work that these current millennials will never understand.
     
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  23. samwise gamgee

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    These guys are selling out the future of the specialty. I know they believe that it was theirs to sell, but the new generation increasingly does not have the opportunities for owning their own labor/practices or the incomes that their predecessors had. All of this so non-physician investors can reap profit in what is increasingly an example of pure rent-seeking with little to no value added to patients or the health care system. Their mediocrity lies much less in their stats as graduating medical students and much more in their inability to act in the interests of the profession that gave them so much.

    This is the most shameful period in our profession and the ASA should recognize that this AMC threat easily rivals that of CRNA scope of practice. It is difficult to argue that AMC’s haven’t driven down income for new grads far more than any CRNA
    competition.
     
    #172 samwise gamgee, Nov 11, 2018 at 8:43 AM
    Last edited: Nov 11, 2018 at 9:10 AM
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  24. DirtDocMD

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    The AMA has done NOTHING to stop the takeover of the profession by AMC’s.

    The AMC’s have done more to take this profession from MD’s than the AANA has done. When private docs/groups were running things, at least they could make the choice on MD only or anesthesia care team. Now, with AMC’s running the show, profit is the ONLY motive, thus, they maximize CRNA numbers, and keep just enough MD’s around to serve as “liability barriers”. You’re not there for your skills or knowledge. You are there to serve as a buffer between the CRNA employees and the corporation’s pile of money, when something goes wrong. You’re nothing but a medical license and a malpractice insurance policy.

    The AMA should be ashamed. The last ten years has seen the profession simply given away to corporate medicine.
     
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  25. samwise gamgee

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    Look into the hullabaloo about the article regarding management companies in derm. Leaders in that field moved to have an article removed from their main journal due to its critical assessment of the impact of corporate ownership on the field. The fact is that these corporations get their foothold by offering huge sums to docs with ownership that are willing to put their own financial interest above that of their profession, and one could even argue, patient care. Then these guilty parties even have the gall (in the case of dermatology) to further use their power to quash legitimate dissent/analysis in their professional journals.

    The fact is we have docs with blood on their hands. We need to call them out and hold them responsible to the extent that they have taken their bribes to open the door and let these rent-seeking parasites in. Perhaps there should be a curriculum on professional integrity for all trainees. It could even be a part of the ACGME’s core competencies.
     
  26. gasdoc77

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    Taking a slightly different vantage point, if those that sell are disproportionately represented by weak-link beta types, maybe they feel justified with their “sky is falling” worldview. After all, if it was easy come to them why shouldn’t it be easy go.
     
  27. DirtDocMD

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    Agreed. The ASA and ABA may not be able to set LEGAL standards, but they should certaily be able to set ETHICAL standards for this type of behavior. State medical boards could help, and it would also help to enforce laws already on the books banning “corporate practice of medicine”.

    The last barrier is stopping insurance companies from offering such outrageous rates to corporations, while they’ll barely even negotiate improved pay per point with small groups. It gives the large corporate groups an unfair competitive advantage,even WAY more than you see in the retail world when a Walmart buys more in bulk at a cheaper price from a supplier than the local mom and pop shop....

    Also, has the ASA done SQUAT about the “pass-thru” legislation that incentivizes rural hospitals to hire all CRNA groups over MD’s??? Nope. Didn’t think so....
     
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  28. IMGASMD

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    We also relinquished our control of hospital itself. How many hospitals now are for profit and/or run by MBAs who haven’t had the slightest clue what a doctor (any doctor) actually do.

    From what I remembered a few years ago, ASA practice management conference was filled with PP groups. Now just one AMC after another.

    I would like to find out, what happened in NC with Mednax, and also why Envision decided to go back to private. But somehow I doubt there will be any sort of transparency on either.
     
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  29. dr doze

    dr doze To be able to forget means to sanity
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    Virtually all success is some combination of luck, talent, and hard work. I do agree that in general, the younger generation definitely drew a less good hand than the previous generstion(s). You play the cards that you are dealt. Had the job market not turned circa 2000. I would be in a lot worse position than I am today. But I was willing to move to BFE and did and do work hard. Those last two attributes were necessary and are not “just luck”.
     
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  30. GA8314

    GA8314 Regaining my sanity
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    I said some. And it's not sour grapes. I'm very satisfied with my career thus far.

    But, it's hard to understand the level of entitlement that some baby boomers display. Which wouldn't be so bad in itself if some of those same entitled boomers weren't so extremely mediocre from a professional point of view. .
     
  31. samwise gamgee

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    This conversation was getting somewhat interesting until this generation bashing took over. Let’s judge folks on the content of their character, not their chronology.
     
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  32. nolagas

    nolagas Member
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    Most wealth comes from exploitation of others. Selling access to allow useless suits to rob other docs of their income is one topical example.
     
    #181 nolagas, Nov 11, 2018 at 4:44 PM
    Last edited: Nov 11, 2018 at 4:53 PM
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  33. Psai

    Psai Snitches get zero vicryl
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    How does one obtain this immortal exploitation of others? Asking for a friend.
     
  34. nolagas

    nolagas Member
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    Ha! Edited already. Predictive text?
     
  35. GA8314

    GA8314 Regaining my sanity
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    All I'm sayin is I know a lot of boomers who, based on my assessment of competency, couldn't survive in any other field at the success rate financially that they've been fortunate enough to have essentially inherited by virtue of timing (not just in anesthesia btw). That is all. Don't be offended by that as there are also some boomers who are extremely competent, hard working, and indeed have a work ethic which is rare to find in a younger grad.
     
  36. samwise gamgee

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    Capital, bro. Gotta getcha a ton of capital. That’s why private equity is so big in this game.
     
  37. nimbus

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    I’m not a fan of corporatization but if faced with the same choices, I’d think of my options and the decision would come down to the numbers. I love my current practice so it would take a lot to change things but I do have a number. I’d say most people here, even some of the younger folk, also have a sellout number. I do think it’s dumb to sell out for a number that is not life changing which has happened in some cases.
     
    #186 nimbus, Nov 12, 2018 at 2:12 AM
    Last edited: Nov 12, 2018 at 2:17 AM
  38. dr doze

    dr doze To be able to forget means to sanity
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    Sometimes you have a choice between getting something now and zero down the road. Which is really no choice at all.
     
  39. DirtDocMD

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    There are are plenty of AMC’s that weasel their way in with no buyout at all (Northstar/Premier/Envision/etc). I’m not going to indict the 55-60 year olds who sold out while they still had something to sell. Lots of guys had their contracts snaked out from under them and got ZERO.

    The writing is on the wall. State medical boards, the ASA, the AMA, state legislatures are doing next to NOTHING to prevent the “corporitization” of medicine,

    If you spent 25 years at a hospital and have two choices—a) sell to USAP for $2 million, or b) let some other AMC come in and give you ZERO while also understaffing the place and working you like a dog.

    Which are you gonna choose??
     
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  40. GA8314

    GA8314 Regaining my sanity
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    Indeed. This is the worst case scenario. The predatory AMC's.....
     
  41. nolagas

    nolagas Member
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    Nobody was about to take all the contracts from GHA, Pinnacle, South Denver, JLR, etc. Those guys weren’t taking some money before their inevitable downfall. They got paid to screw over everyone who came after them and that’s what they did. You should indict them because what they did is wrong.

    Some little group offered money to hand over the keys that were going to lose anyway? Sure, go easy on them. No harm done I guess, but not the big groups. The big groups are awful.
     
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  42. samwise gamgee

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    O
    If you realize that you live in a world larger than yourself and have a modicum of integrity, it really is in fact a choice, and the correct choice should be obvious to those who care about the future of the profession.

    The level of pure selfishness we seem to justify in this nation and age is striking.
     
  43. DirtDocMD

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    Pinnacle and GHA were essentially regional versions of the now NATIONAL AMC’s. Those guys screwed over little groups long ago to get where they were. No, I don’t hold them harmless. Pinnacle was paying folks $165k/$185k/$215k for their 3 year “buy-in” back in the mid 2000’s. Those guys were always greedy.

    Once again, though, the ASA was well aware that this was going on, and I sure don’t remember them setting any ethical guidelines on what a new grad ought to get paid or how they should be treated.

    Look around. Cops are making more. Teachers are making more. CRNA’s are making more. Insurance companies are PAYING more per point. Now, take a look at MD anesthesia pay. I see jobs with AMC’s (that were controlled by same or similar AMC’s 10 years ago) on gaswork, and the pay is FLAT from what it was back then. At best, maybe up 4-5%. The pay SHOULD be up 20-30% over 10 years.

    Plenty of $150-$160k CRNA jobs that are now pushing $200k. But doc salaries are FLAT. The AMC’s are pocketing it. Lots of folks should be at $550k plus,

    There’s no “free market” for anesthesia, anymore. The AMC’s have control of the hospital contracts, and you’ll get paid whatever they see fit (about $450k max). No, that’s not bad, but give inflation another 10 years, and CRNA’s making $300k who got a 4-5 year jump on you, and their pick of jobs and the ability to jump around every 6-12 months, and ask yourself, “What has the ASA done for you?”...

    AMC’s and the ASA have relegated us to the status of “anesthesia compliance officer” and “corporate liability buffer”.
     
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  44. Arch Guillotti

    Arch Guillotti Senior Member
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    Ask Blade.
     
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  45. DirtDocMD

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    I’ve only been posting here a few months, but I’ve read posts here for years. Blade seems to be a shrewd operator, and certainly smart enough to read the writing on the wall.

    As for the “morality” of it, that some are mentioning?? Well, we’re simply passengers on the ship. I’m not gonna throw women and kids off lifeboats (or my fellow colleagues) to save myself, but I’ll certainly grab a chair or grand piano to float on, especially when our “Coast Guard” (ASA), refuses to help, and simply holds up a mile out, watching the wreck through binoculars.
     
  46. chocomorsel

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    I interviewed with Pinnacle in 2014. This was in Denton, north Texas. They had a three year partner track and they offered me $220k base.
    I said, I love my hometown of Dallas, but y'all are on some BS

    But each group in USAP is different. Some offer high salaries and an associate can make over $450 in Dallas if you work hard and take extra call. But you gotta work like a donkey till partnership which apparently gets you a nice chunk of change.

    I had a friend from residency who did the GHA mommy track position. She said her pay was $230, which I guess isn't bad for mommy track.
    I wonder what the partners were making.

    I am over this whole partnership track BS. If you are lucky enough to find a good partner track which is mostly through contacts, then go for it. And hope they don't screw you before you make partner. I am perfectly content to work for a hospital these days.
     
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  47. dr doze

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  48. B-Bone

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    For all those placing blame on the ASA, what sort of authority do they have to do anything about this? I am asking honestly, because I don't really see any. What exactly would you have them do?
     
  49. DirtDocMD

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    Exactly HOW MANY members have had their membership rescinded or been sanctioned for such behavior?? How many lawsuits has the ASA “sponsored” or offered to help with, in order to prevent such behavior??? Has the ABA pulled anyone’s board certification? Don’t expect them to cure it all, but a helping hand would be nice.
     
    #198 DirtDocMD, Nov 12, 2018 at 1:10 PM
    Last edited: Nov 12, 2018 at 1:18 PM
  50. nimbus

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    Nobody would care if their ASA membership is revoked and the ABA is rightly apolitical.
     
  51. dr doze

    dr doze To be able to forget means to sanity
    Lifetime Donor Classifieds Approved 10+ Year Member

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