USAP TEXAS RECKONING?

[dchz]

If that’s the case, I agree.
Just for my own information, how do these 250k PP expect to recruit? Do they say partner salary is? How long the track is?

I have no clue how they recruit. I wanted to punch the guy in the face. My guess is there is always someone desperate enough to join a ****ty gig.

Partners salary was nebulous, I'd guestimate around 500?

The track is 3 years and you only make it if they vote you in.

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[aneftp]

Funny you say that, pinnacle merged with GHA to form USAP.

You still don't see the problem or you're ignoring it just to flex. No grad out of residency is being offered near that. So the best package available is still USAP. Metro, the "true private practice" in Dallas, is offering something closer to indentured servitude.

It's not just DFW, is anyone offering that anywhere in the country without a partnership track?

yes. I know the whole merger between Houston Dallas and Orlando. Those are the 3 original usap practices that merge. They got the best deal.

like my other buddy who was one of the very first mednax buyout. Got sweet heart deal.

so original sellers got the deals

 

[DirtDocMD]

I have no clue how they recruit. I wanted to punch the guy in the face. My guess is there is always someone desperate enough to join a ****ty gig.

Partners salary was nebulous, I'd guestimate around 500?

The track is 3 years and you only make it if they vote you in.

There’s an ad on Gaswork, now. Says low is $250k, high is $650k. The “low” is lower than they were 12+ years ago, so not sure what’s up with that. The high is likely the same, or better than most USAP gigs in Dallas.

 

[dchz]

There’s an ad on Gaswork, now. Says low is $250k, high is $650k. The “low” is lower than they were 12+ years ago, so not sure what’s up with that. The high is likely the same, or better than most USAP gigs in Dallas.

You're telling me if you were a new grad, you'd take this job over USAP?

 

[DirtDocMD]

You're telling me if you were a new grad, you'd take this job over USAP?

Supervising vs. doing own cases? “Owning” vs owning a part of the group? What’s the cost to “buy in” USAP “stock” these days? $200k??

I have pretty detailed info on what they “were”. If they really are at $250k the first year, without a significant step in years 2&3, then, yes, that’s pretty insulting. That’s less than what they were starting at YEARS ago. You may have more current info, but nothing you have tells me if it’s “detailed”. I know you’re getting a part of a real group, not some “stock” that has a manipulated price and can be diluted, at will.

Seriously, I’m not trying to be rude. Enlighten me. You can even PM me. No hidden agenda. Just curious.

 

[nimbus]

The idea is that the amount net to "partners" post USAP is still more than the amount collected before USAP.

Theoretically, 100% of $100 is less than 80% of $150. Note: i have no clue whether this actually occurs in real life or the math for the groups is also favorable.

The problem for new grads in Texas: the "true" private practice groups in major cities are predatory AF.

The question is how long can they sustain that $150 unit?

 

[deleted162650]

For the sake of argument, let's say I'm flexible, where would I go to get the top deal??

I‘d start by asking this guy

My good buddy still pulls over 1 million the past 3 years

Seriously though, that’s a loaded question. Are you just talking money? Lifestyle? ACT v MD? I think I’d probably shoot a PM to Mman too.

I’ve heard of great unit values in MT and WY.

It’s been said that you should ask your friends to name 10 places they would never want to live - and start looking there.

 

[IMGASMD]

It’s been said that you should ask your friends to name 10 places they would never want to live - and start looking there.

Interesting.

 

[aneftp]

usap has a better reimbursment rate than other groups in dallas.... if others make more they are doing shady out of network stuff

Yes. My buddy charges $400/out of network in Texas. It’s hit or miss if insurance pays but most of the time they will pay for “settle” for a lot more than $150/unit.

lol. You saying it’s shady? Not any shadier than a bigger Corp like usap demanding $150/unit in network. It’s all about Negotiating power. The little guy can survive out of network by doing their own business tactics.

the game ends if they ban out of network. Cause in network reimbursement will also be lower as well. That’s why the big guys are fighting to keep out of network billing as well as a tactic to jack up in network.

 

[dchz]

Yes. My buddy charges $400/out of network in Texas. It’s hit or miss if insurance pays but most of the time they will pay for “settle” for a lot more than $150/unit.

lol. You saying it’s shady? Not any shadier than a bigger Corp like usap demanding $150/unit in network. It’s all about Negotiating power. The little guy can survive out of network by doing their own business tactics.

the game ends if they ban out of network. Cause in network reimbursement will also be lower as well. That’s why the big guys are fighting to keep out of network billing as well as a tactic to jack up in network.

is he in DFW area?

 

[IMGASMD]

is he in DFW area?

You mean,

is he hiring?
I want to know too....

 

[GandalfTheWhite]

LOL. How’s that coolaid taste. Overhead for those things in my practice is right around 7%.

Not drinking any Kool-Aid since I'm still a resident.
Its not just the cost of overhead, but the hours spend dealing with the administrative aspect of owning a practice. Those are still work hours. Either way, all things considered, I would want an MD/DO-only PP, but as we have learned, theyre not readily available or are extremely predatory from peoples recent experiences.

Traditional fee for service in Dallas is around 800k. Circa 2003-2015. No one skimming off the top. 55 hours of work. Q5/6 calls. Roughly taking 8-9 weeks off. All MD practices

how much is usap paying even its partners? If usap is still paying the “partners” 800k? Or are the “partners” making 600k?

My good buddy still pulls over 1 million the past 3 years (obviously this year is gonna to take a hit with pandemic).

but that the type of money a pure partner should be making in Dallas in all MD practice.

the previous pinnacle practice was notorious with how they low ball docs.

Is this general anes? Is this friend just going to different outpatient centers to deliver anesthesia as a solo provider or is this a group thats paying 1 million per MD?
What does your buddy do if the insurance doesnt settle? saddle the patient with an OON bill?

 

[IMGASMD]

saddle the patient with an OON bill?

Not sure if you will make that cool mil, if you view the insurance company as the good guy, people bill oon as the bad guy. And the patient is the victim.

just saying maybe a more open mind. And maybe you’re right, you don’t want to deal with the administrative stuff.

 

[aneftp]

Not drinking any Kool-Aid since I'm still a resident.
Its not just the cost of overhead, but the hours spend dealing with the administrative aspect of owning a practice. Those are still work hours. Either way, all things considered, I would want an MD/DO-only PP, but as we have learned, theyre not readily available or are extremely predatory from peoples recent experiences.



Is this general anes? Is this friend just going to different outpatient centers to deliver anesthesia as a solo provider or is this a group thats paying 1 million per MD?
What does your buddy do if the insurance doesnt settle? saddle the patient with an OON bill?

U follow ur own surgeon around. They do it in Vegas also. Nothing new.

 

[aneftp]

is he in DFW area?

Dallas proper. Not boonies. Based Next to where cowboys hold training camp. North Dallas suburbs.

 

[aneftp]

You mean,

is he hiring?
I want to know too....

Actually they were gonna to expand. But told new guy they couldn’t take him on in July due to Covid-19.

There are a lot of jobs just Have to establish urself. The easy thing is to work for the big companies though.

 

[IMGASMD]

Actually they were gonna to expand. But told new guy they couldn’t take him on in July due to Covid-19.

There are a lot of jobs just Have to establish urself. The easy thing is to work for the big companies though.

It’s to take that leap of faith that you
CAN make it. Also okay doing just a lot of surgicenter stuff and not having a steady pay check.

Not many hospitals around that I know of, still letting people come in and eat what you kill.....

 

[abolt18]

I would want an MD/DO-only PP, but as we have learned, theyre not readily available or are extremely predatory from peoples recent experiences.

In only a week of reaching out to several physician-only PP groups via cold-calling/via acquaintances, my impression is that this is not true. But I guess if you're geographically limited it may be your truth. I've talked to several groups in different parts of the country with 1-2 year partner tracks with a fair starting salary reasonable work-life balance (work hard, play hard). The ones I know of through acquaintances, they have specifically said that the groups are extremely fair and reasonable without any history of people getting screwed out of partnership. Basically if you show up and work hard and pass your boards (and don't ruffle too many feathers), you're in.

Maybe look in other parts of the country and you'll be surprised.

 

[deleted697127]

In only a week of reaching out to several physician-only PP groups via cold-calling/via acquaintances, my impression is that this is not true. But I guess if you're geographically limited it may be your truth. I've talked to several groups in different parts of the country with 1-2 year partner tracks with a fair starting salary reasonable work-life balance (work hard, play hard). The ones I know of through acquaintances, they have specifically said that the groups are extremely fair and reasonable without any history of people getting screwed out of partnership. Basically if you show up and work hard and pass your boards (and don't ruffle too many feathers), you're in.

Maybe look in other parts of the country and you'll be surprised.

Not a bad time to be in a salaried partnership track if it’s guaranteed during covid...

 

[GandalfTheWhite]

In only a week of reaching out to several physician-only PP groups via cold-calling/via acquaintances, my impression is that this is not true. But I guess if you're geographically limited it may be your truth. I've talked to several groups in different parts of the country with 1-2 year partner tracks with a fair starting salary reasonable work-life balance (work hard, play hard). The ones I know of through acquaintances, they have specifically said that the groups are extremely fair and reasonable without any history of people getting screwed out of partnership. Basically if you show up and work hard and pass your boards (and don't ruffle too many feathers), you're in.

Maybe look in other parts of the country and you'll be surprised.

I guess thats true. I would really prefer Texas, but not tied down to cities, per se.

 

[dchz]

Dallas proper. Not boonies. Based Next to where cowboys hold training camp. North Dallas suburbs.

That's Frisco, which is not Dallas proper, indeed not the boonies. I talked to the group. It's $250 for 2 years 1099 for a new hire. Felt predatory to me...

 

[GandalfTheWhite]

That's Frisco, which is not Dallas proper, indeed not the boonies. I talked to the group. It's $250 for 2 years 1099 for a new hire. Felt predatory to me...

LOL thats pediatrician money.....

 

[aneftp]

That's Frisco, which is not Dallas proper, indeed not the boonies. I talked to the group. It's $250 for 2 years 1099 for a new hire. Felt predatory to me...

Nope. Incorrect. It’s pure fee for service. It’s more like 600k first year. But they decided not to hire due to pandemic. Eat what you kill. You travel with your own surgeons.

 

[GandalfTheWhite]

Nope. Incorrect. It’s pure fee for service. It’s more like 600k first year. But they decided not to hire due to pandemic. Eat what you kill. You travel with your own surgeons.

And youre likely not going to tell us what group this is, correct? Would be interested in 2022.

 

[DirtDocMD]

Sounds (anyway) like what TxAn used to be (maybe still is???). The catch was, you had to “recruit” your own surgeons. They’d start you off with some business, but in order to really make bank, you had to be able to schmooze some productive surgeons and be able to hustle around town. Not a bad gig, but some “salesmanship” (and some luck) involved.

 

[AdmiralChz]

Sounds (anyway) like what TxAn used to be (maybe still is???). The catch was, you had to “recruit” your own surgeons. They’d start you off with some business, but in order to really make bank, you had to be able schmooze some productive surgeons and be able to hustle around town. Not a bad gig, but some “salesmanship” (and some luck) involved.

This sounds like an awful arrangement. I can only imagine how you’d be forced to overlook some shady stuff and push through risky cases. Want a patient to get more pre-op testing? They’ll move on to the next guy. Have a bad outcome or failed block? On to the next!

Perhaps a more modern example - add on non-urgent case to fill the block but no preop COVID testing. Surgeon asks you to fight the battle with the front desk and argue its very important and can’t wait. That’s a dilemma.

You couldn’t pay me to hustle/sell my soul like that.

 

[dchz]

Nope. Incorrect. It’s pure fee for service. It’s more like 600k first year. But they decided not to hire due to pandemic. Eat what you kill. You travel with your own surgeons.

Yeah ok... I'll bite. They give the high paying spine surgeons the newbie?!???? Or do they give the **** cases to newbie and guarantee them a base pay??

I've seen this group on gaswork and I had a connection to the group and checked them out dude.... I'm not just talking out of my butt.

 

[nimbus]

Sounds (anyway) like what TxAn used to be (maybe still is???). The catch was, you had to “recruit” your own surgeons. They’d start you off with some business, but in order to really make bank, you had to be able to schmooze some productive surgeons and be able to hustle around town. Not a bad gig, but some “salesmanship” (and some luck) involved.

Yeah ok... I'll bite. They give the high paying spine surgeons the newbie?!???? Or do they give the **** cases to newbie and guarantee them a base pay??

I've seen this group on gaswork and I had a connection to the group and checked them out dude.... I'm not just talking out of my butt.

Sounds like Honolulu too. My buddy came back after a year because his “friend” would only feed him scraps and kept all the high value spine work for himself.

 

[amyl]

Over a million a year in dallas with work hours and vacation you mention is doing shady stuff with out of network billing... maybe they will continue to get away with it - maybe they wont. I think I interviewed for every position in dallas... not all divisions of usap offer such low starting pay - i wasnt. 240-250 um no thanks. but my division doesn't go through the recruiter or gasworks or anything like that. the business guys cut w usap >>> than other private practice in dallas (or at least was two years ago) - some small groups threw big numbers around and it was all out of network bs. there are no true partnerships in anesthesia anymore like there used to be or at least very very few... and im not sure those guys are any less predatory anyway.... physician run groups back in the day were often very predatory.
as far as geographic flexibility being lucrative I would imagine they are talking about bfe midwest or alaska or ????

 

[Howard888]

These kind of statements are terrible. There are plenty of non predatory PP groups still out there and doing quite well. Many throughout Alabama, South Carolina, North Carolina, Virginia, Ohio, Indiana...and keep going.

Just no more in Texas because Austin and San Antonio couldn’t resist the greed and finally sold to USAP

Over a million a year in dallas with work hours and vacation you mention is doing shady stuff with out of network billing... maybe they will continue to get away with it - maybe they wont. I think I interviewed for every position in dallas... not all divisions of usap offer such low starting pay - i wasnt. 240-250 um no thanks. but my division doesn't go through the recruiter or gasworks or anything like that. the business guys cut w usap >>> than other private practice in dallas (or at least was two years ago) - some small groups threw big numbers around and it was all out of network bs. there are no true partnerships in anesthesia anymore like there used to be or at least very very few... and im not sure those guys are any less predatory anyway.... physician run groups back in the day were often very predatory.
as far as geographic flexibility being lucrative I would imagine they are talking about bfe midwest or alaska or ????

 

[amyl]

I was speaking specifically about the Dallas market and have no knowledge of the markets you list here. Just dallas.