USAP RENO

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sevoflurane said:
True. Except we have no bugs.

Have 50 ish mountain lions living in our area. Bear, deer, rattle snakes... all that mountainy scray stuff. But no bugs.
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You don't know what you are missing:

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Mman said:
I am simply referring to raw material costs which tend not to drastically vary from location to location. I mean maybe lumber was free, but that is a lot of pricey looking materials for relatively little money.

I know nothing about the real estate market in your neck of the woods now or back then. I know a decent amount about construction now and then.
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I’m blown away at the cost too....but the property tax records show it was assessed at $1-1.5 mil.
 
sevoflurane said:
Lol... Nimbus you in cali?
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sevoflurane said:
Here in Reno.

www.zillow.com

4585 Alpes Way, Reno, NV 89511 | Zillow

4585 Alpes Way, Reno NV, is a Single Family home that contains 7038 sq ft and was built in 2012.It contains 5 bedrooms and 5.5 bathrooms.This home last sold for $4,350,000 in April 2021. The Zestimate for this Single Family is $5,478,200, which has increased by $36,377 in the last 30 days.The...
www.zillow.com www.zillow.com
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Gorgeous house!!! Would be fun to see what that would cost to build right now ...
 
sevoflurane said:
I think that those looking to make a move should really at least check out Reno.
It is an fantastic place to live for the right person and I think this area will be what Colorado Springs or Denver is 15-20 years from now.

Lots of jobs here. I think Napa offers 100k-140k sign on bonus and I am guessing USAP is similar. Salaries are going up due to demand for anesthesiologists as well as cost of living. I think the trajectory won’t stop as we have amazon, tesla, apple in town. Also large developers are buying up millions of dollars worth of land /100-200 million last year?
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100k Bonus for how long? What are they paying in general? How much vacation? I would have considered Reno back in the day if my ex hadn't been so against it. Would not have gotten a 1 mil house but a 500K. Wonder what that would sell for now?
 
ZzzPlz said:
Gorgeous house!!! Would be fun to see what that would cost to build right now ...
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I don’t even wanna know. Materials prices are insane right now. Some friends of ours were planning to do a 1 bedroom addition. They got some quotes and it was gonna be 140k just for framing!!
 
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nimbus said:
I’m blown away at the cost too....but the property tax records show it was assessed at $1-1.5 mil.
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most municipalities calculate property tax based on comparable sales, or in other words based on the current market. There can be wide divergences between comparable sales and construction costs to replace something, however. Some things like lumber can have wide swings in costs, other things like light fixtures and what not are far more stable in cost over time. There are only so low construction costs can ever get, even excluding labor.
 
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SaltyDog said:
I don’t even wanna know. Materials prices are insane right now. Some friends of ours were planning to do a 1 bedroom addition. They got some quotes and it was gonna be 140k just for framing!!
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chocomorsel said:
100k Bonus for how long? What are they paying in general? How much vacation? I would have considered Reno back in the day if my ex hadn't been so against it. Would not have gotten a 1 mil house but a 500K. Wonder what that would sell for now?
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Would have been a real good real eatate investment, but you can’t predict these things.

I think it’s 3 years for 100-140k sign on. My buddy signed for 140k. We pay fairly for work actually done... so a wide range of incomes. Efficient and fair scheduling.
Median is around 440k... but we probably need 5 or more fte’s to be whole. Some part timers (lots of them in the group) make 300k+ some full timers that take extra shifts make close to or above 600k.
9 weeks on average with a full call load more if you take extra call less if you take leas call or are part time.
I’ve never taken less than 12 weeks, but we have a system where people sell vacation days or trade for call. Took 16 weeks last year and furloughed myself for 5 of those weeks- meaning zero income. Still came in at 460k... but i work hard and am part of several subspecialty teams.
 
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sevoflurane said:
"unfathonable" Really... ??? Lol. You clearly don't know our market now and then.
You could buy a lot for 1+ mil back then.. and I mean a lot.
Remember that Nevada got hit the HARDEST during the housing bubble.

And when I say "explosion" of growth... I mean that 100%. One car garage condo's are going for 700k + in certain areas.
The cat is out of the box and people have realized this untapped location.
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2008 once more?

I get it people with high income wants to live in a no state tax place, but why retirees? CA’s progressive tax rates actually are quite benign to modest income retirees. In addition, no tax on ss.

4million+ house in Reno? You can get a fancy one in Calabasas with that money.

Crazy market.
 
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sethco said:
Probably going to regret responding to this thread...

Don't know how it works in other locations, but here in North TX, it isn't USAP's MO to come in and order changing the staffing model. My particular practice was MD/DO only before and, now 6+ years later, continue to be 100% own cases
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Does WCAS still let USAP physicians invest in their primary funds? They did for the original groups but haven't heard whether it's still an opportunity for those joining more recently. To be clear I'm not talking about investing in USAP as a physician but the WCAS funds that contain their entire portfolio of investments.
 
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Euripides said:
Does WCAS still let USAP physicians invest in their primary funds? They did for the original groups but haven't heard whether it's still an opportunity for those joining more recently. To be clear I'm not talking about investing in USAP as a physician but the WCAS funds that contain their entire portfolio of investments.
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No clue, but what is the benefit of investing in the Welsh Carson funds over just investing with Vanguard, Fidelity, DFA, TDA/Schwab, etc?
 
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sethco said:
No clue, but what is the benefit of investing in the Welsh Carson funds over just investing with Vanguard, Fidelity, DFA, TDA/Schwab, etc?
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They are private equity investments and not investments in companies on the public markets so are dissociated from the vagaries those markets have. They are relatively illiquid though with investment horizons in the 5 - 7 year range typically. Recent example of a WCAS company that sold is Kindred and some recent purchases are here and here. Probably was posted elsewhere but US Acute Care (the EM equivalent of USAP) bought their way out of WCAS recently.

I have friends in USAP (and know many who have left too). Their experience with USAP stock appears to be a mixed bag with the earlier guys doing well and the later guys just ok (based on what they will discuss). I haven't gotten a feel for their WCAS fund investments. Could be due to where they are in the investment horizon.
 
Euripides said:
They are private equity investments and not investments in companies on the public markets so are dissociated from the vagaries those markets have. They are relatively illiquid though with investment horizons in the 5 - 7 year range typically. Recent example of a WCAS company that sold is Kindred and some recent purchases are here and here. Probably was posted elsewhere but US Acute Care (the EM equivalent of USAP) bought their way out of WCAS recently.

I have friends in USAP (and know many who have left too). Their experience with USAP stock appears to be a mixed bag with the earlier guys doing well and the later guys just ok (based on what they will discuss). I haven't gotten a feel for their WCAS fund investments. Could be due to where they are in the investment horizon.
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Good info, thanks. Sounds too high risk for my preference. Still not seeing the benefit of tying up your money for that long unless the return is guaranteed (unlikely) or has a long term (>20 yr) track record of average or better market returns. Even then, I would still hesitate as this is probably heavy in uncompensated risk

My investment in USAP stock itself is at the bare minimum.
 
@Sevo I think you’re in a group with one of my best buds from residency, he raves about the area and practice in general. Everything stated in this thread seems to be everything he’s been saying over the last couple years.

If my world falls apart he’s my first call...
 
It does sound like a great group and a great place to live. My great aunt lives there and she raves about it. I just don't think my wife would be too happy as she's a city girl and I like my group a lot.
 
sevoflurane said:
Would have been a real good real eatate investment, but you can’t predict these things.

I think it’s 3 years for 100-140k sign on. My buddy signed for 140k. We pay fairly for work actually done... so a wide range of incomes. Efficient and fair scheduling.
Median is around 440k... but we probably need 5 or more fte’s to be whole. Some part timers (lots of them in the group) make 300k+ some full timers that take extra shifts make close to or above 600k.
9 weeks on average with a full call load more if you take extra call less if you take leas call or are part time.
I’ve never taken less than 12 weeks, but we have a system where people sell vacation days or trade for call. Took 16 weeks last year and furloughed myself for 5 of those weeks- meaning zero income. Still came in at 460k... but i work hard and am part of several subspecialty teams.
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where is this? Send me the application link lol
 
Sevo is the man and I’m sure the job is good if he says it is good but it is rare for really good jobs to pay >$100k signing bonuses.

Good private groups in my region just don’t do it (unless I am a dinosaur and things have changed).
 
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okayplayer said:
Sevo is the man and I’m sure the job is good if he says it is good but it is rare for really good jobs to pay >$100k signing bonuses.

Good private groups in my region just don’t do it (unless I am a dinosaur and things have changed).
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This year everyone needs help. Hospitals are trying to recoup losses from covid and the best way is in the or. Everyone's hiring. I'm surprised more places aren't offering big signing bonuses tbh
 
Shimmy8 said:
@Sevo I think you’re in a group with one of my best buds from residency, he raves about the area and practice in general. Everything stated in this thread seems to be everything he’s been saying over the last couple years.

If my world falls apart he’s my first call...
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Thanks for the props dude. As I mentioned earlier, it’s the explosive growth that is hard to keep up with. We could have gone ACT model and we discussed it, but the group strongly wanted to stay MD only. Part of the reason we let UHS go.

I was post call today... headed out of town at 6am. By 10:30 I was doing some nice single track in Sedona.

I love Reno, but it is also super accessible to a lot of cool stuff if you want to get out. Seattle, LA, SF, San Jose, San Diego, Portland, Phoenix, and a bunch more are easy 1 hour-ish flights from town.

Makes for easy quick getaways.
 
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28E37E78-361B-4FAC-B4B2-3AC942864C43.jpeg


Hunting hippie vortex gateways
 
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Every group has it’s issues.... we are not perfect, but we do have a board made up of 8 partners that constantly tweak the practice to make things as good as they can be for the members.
 
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circleK said:
How’re the schools in the Reno area?
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I am not the person to ask about that tbh (no kids except for the furry ones).
We do have excellent doggie day cares which includes obedience, pool time and hiking time on the trails. They are usually returned fully exhausted. 😂

We also have the University of Nevada Reno campus and it’s an excellent university/med school. Can teach med studs and AA students if that is your jam.

As for elementary schools/high schools I don’t hear anything bad and I know there are private schools here as well. There is a large percentage of partners that grew up here, left for colllege/med school/residency and returned to practice and raise their families.
 
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I’ll drop a pdf on our practice here and in the job section of sdn once I get back from the trails.
 
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If my current job goes to sh*ts, I am definitely interested. I am already close to that environment in West Texas..
 
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Reno sounds like a nice place to live if youre into outdoor stuff. Ive flown in there for the purpose of skiing before.
 
circleK said:
How’re the schools in the Reno area?
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There’s always private and boarding schools.... joking, but not really.

Depends on how you view education...
niche ranked
51/441 on the Ca side.
2/18 on Nevada side.

We sort of looked around Reno proper a few years ago, felt it wasn’t for us. But you don’t move to Reno for the “big city” feel of Reno either.
 
Nevada has legal weed, casino gambling, and legal brothels. So, above average indoor recreational activities as well as outdoor.
 
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dr doze said:
Nevada has legal weed, casino gambling, and legal brothels. So, above average indoor recreational activities as well as outdoor.
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You're not wrong @dr doze.
I love my State.... we make millions and millions of dollars off of those indoor activities... part of the no state income tax formula. 🥳🥳
 
Trying out a 29’r this week... on the fence over a 27.5... Definately a better goat though.... I’ll post pdf’s on the geoup a little later.... dashing to the pool to hydrate.
 
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Few thoughts before I drop out of this thread:

Reno is not for everyone… if you are looking for an LA type of lifestyle look elsewhere. Different vibe here.

We have Ruth Chris’ steak house, Charlie Palmers, fancy smancy places, etc… but Reno is mostly about being healthy and being outdoors.
The Truckee river runs through town, there are festivals from now until the end of September, biking, kayaking, moto, skiing/snowboarding, camping, burning man, coffee in the morning with 10K mountains staring back at you… easy access to beautiful places for mind and spirit. Resort feel to me compared to some places I've lived.

Not leaving. Pretty much found my place… but it’s not for everyone.

I’ve been through 1099’s PP in the past…then W-2 PP, then mednax and now Napa.
Outside of our short term staffing shortage, I couldn’t be happier.
Dropping a pdf. We are very professional and always with our partners well being in mind.

PM me with questions. Transparency is #1 and a fundamental building block of our group.
 
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AAR
 

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and i dare anyone come up with a better logo for our practice... j/k.... but seriously....
 
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You can't say mednax provided stability and support then one sentence later talk about how it lost money with covid and had to sell your practice. Napa sucks.
 
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GassYous said:
You can't say mednax provided stability and support then one sentence later talk about how it lost money with covid and had to sell your practice. Napa sucks.
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NAPA is horrible, but I am willing to believe they will leave a location alone as long as it is making them enough money. The problem comes when the margins shrink.
 
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