Valley Presbyterian Anesthesiology job (Los Angeles)

[Peterluger]

Can anyone comment on this particular job? Valley Presbyterian in Los angeles? Especially if just doing it for a year. Envision is behind it.

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[Peterluger]

Oh and also, what does “$30 ASA unit mean”?

 

[sevoflurane]

Oh and also, what does “$30 ASA unit mean”?

😵

 

[sevoflurane]

It’s 1099. Adjust you compensation accordingly.
30/unit is not good.
LA is expensive.

 

[sevoflurane]

I suppose there is a reason for doing it for a year. Anything is tolerable for a year.

 

[Peterluger]

It’s 1099. Adjust you compensation accordingly.
30/unit is not good.
LA is expensive.

What is the usual range? Is this bad for LA based on what you know about that market?

Compensation Range: $450k-$520k

• Compensation is a combination of productivity with $30 ASA unit plus call stipends

 

[aneftp]

Average anesthesiologist does 10-15k units a year. $30 a unit means $300-450k 1099 income.

LA fee for service billing sucks especially smaller practice. Be lucky to get $60/unit from private insurance (in Florida it’s easily $100-120/unit). Plus medi-cal ($12? A unit) and Medicare ($17/unit?)

so average $30/unit probably averages medi cal and Medicare plus private.

not great. U gonna to have to work like a dog 20k i it’s working post call to obtain 20k units with 4 week off to get $450-500k at average $30 a unit. Working 60-65 hours.

that’s my take.

 

[Peterluger]

Average anesthesiologist does 10-15k units a year. $30 a unit means $300-450k 1099 income.

LA fee for service billing sucks especially smaller practice. Be lucky to get $60/unit from private insurance (in Florida it’s easily $100-120/unit). Plus medi-cal ($12? A unit) and Medicare ($17/unit?)

so average $30/unit probably averages medi cal and Medicare plus private.

not great. U gonna to have to work like a dog 20k i it’s working post call to obtain 20k units with 4 week off to get $450-500k at average $30 a unit. Working 60-65 hours.

that’s my take.

Hmm so its basically a ripoff even for LA? Seems like the full time w2 positions would be better in LA

 

[sevoflurane]

LA isn’t all that good period. Some pyramid scheme groups. I phone interviewed a guy there and it’s just a grind dude. He spends an innordinate amount of time driving AND in the hospital for 400k. 4 weeks vaca. He is burnt out as I would be. Then think of taxes, price of living in CA and your “retirement package”.

 

[deleted162650]

Average anesthesiologist does 10-15k units a year. $30 a unit means $300-450k 1099 income.

LA fee for service billing sucks especially smaller practice. Be lucky to get $60/unit from private insurance (in Florida it’s easily $100-120/unit). Plus medi-cal ($12? A unit) and Medicare ($17/unit?)

so average $30/unit probably averages medi cal and Medicare plus private.

not great. U gonna to have to work like a dog 20k i it’s working post call to obtain 20k units with 4 week off to get $450-500k at average $30 a unit. Working 60-65 hours.

that’s my take.

The above is pretty much spot on.

The wild card with this gig is how much those call stipends add up to. For me to seriously consider this gig, the call stipends would have to approach 75K + per year.

That segways into the next caveat with any production/unit based pay scheme: scheduling.

How is the schedule made and who makes it?
Do the new guys get stuck with the podiatry lineup doin' toe amps on sick patients while the old-timers do the joints and spines churning out units - or is it fair?
Is call equally distributed? Is it easy to pick up extra shifts?
Are you gonna have a lot of down time/gaps where you're stuck in the hospital but not generating units?

My first gig had a unit value not much better than $30. On the plus side though was that hours were good and the schedule was super flexible. (notice it's not my current gig though 😉 )

LA isn’t all that good period. Some pyramid scheme groups. I phone interviewed a guy there and it’s just a grind dude. He spends an innordinate amount of time driving AND in the hospital for 400k. 4 weeks vaca. He is burnt out as I would be. Then think of taxes, price of living in CA and your “retirement package”.

LA proper is a f***ing disaster for a great many reasons - the overwhelming majority of which have nothing to do with anesthesia.

The bottom line is that there is no shortage of people who want to live in SoCal. Any good anesthesia gig in the area ain't gonna be advertising 'cuz they don't have to. If you don't already have an inside track to a premier SoCal gig, you're pretty much SOL and gonna be stuck fighting for the AMC scraps like this job.


PS: @Peterluger , how is it that you seem to know so much about foreign policy/international politics but so little about the business of anesthesia?? 😵

 

[aneftp]

The above is pretty much spot on.

The wild card with this gig is how much those call stipends add up to. For me to seriously consider this gig, the call stipends would have to approach 75K + per year.

That segways into the next caveat with any production/unit based pay scheme: scheduling.

How is the schedule made and who makes it?
Do the new guys get stuck with the podiatry lineup doin' toe amps on sick patients while the old-timers do the joints and spines churning out units - or is it fair?
Is call equally distributed? Is it easy to pick up extra shifts?
Are you gonna have a lot of down time/gaps where you're stuck in the hospital but not generating units?

My first gig had a unit value not much better than $30. On the plus side though was that hours were good and the schedule was super flexible. (notice it's not my current gig though 😉 )



LA proper is a f***ing disaster for a great many reasons - the overwhelming majority of which have nothing to do with anesthesia.

The bottom line is that there is no shortage of people who want to live in SoCal. Any good anesthesia gig in the area ain't gonna be advertising 'cuz they don't have to. If you don't already have an inside track to a premier SoCal gig, you're pretty much SOL and gonna be stuck fighting for the AMC scraps like this job.


PS: @Peterluger , how is it that you seem to know so much about foreign policy/international politics but so little about the business of anesthesia?? 😵

I know my numbers are spot on. Cause my brother is anesthesiologist in downtown Los Angeles the past 14 years. Well they use blended unit. But I know exactly How much is better billed and collected. I’ve seen the print out at his house.

but if you move out a little further. My other buddy was pulling 500k (working like a dog) but 12 weeksoff.

2018 income was $800k with 4 weeks off. Worked around 70 hours a week. That’s also LA county. But in the far off burbs. LA county is huge.

There are a couple of nice gigs in LA proper that pay well but the openings are few and far in between.

 

[Peterluger]

I know my numbers are spot on. Cause my brother is anesthesiologist in downtown Los Angeles the past 14 years. Well they use blended unit. But I know exactly How much is better billed and collected. I’ve seen the print out at his house.

but if you move out a little further. My other buddy was pulling 500k (working like a dog) but 12 weeksoff.

2018 income was $800k with 4 weeks off. Worked around 70 hours a week. That’s also LA county. But in the far off burbs. LA county is huge.

There are a couple of nice gigs in LA proper that pay well but the openings are few and far in between.

Where’s this $500k place (I couldnt message you)? Thanks guys

 

[chocomorsel]

It’s 1099. Adjust you compensation accordingly.
30/unit is not good.
LA is expensive.

That’s what I thought as well. However they give daily stipends to everyone and that brings up the pay. I got an email from the recruiter on this one and I told her to shove it but then I saw the stipend. For call it’s about $1500 and others where in the $1000 range is I remember correctly. I would have to look it up.
But you’d have to live in LA. And a nice house is what 2 mil? And the traffic is horrendous. No Thanks.

 

[deleted162650]

Where’s this $500k place?

If you don't already have an inside track to a premier SoCal gig, you're pretty much SOL

 

[deleted162650]

However they give daily stipends to everyone and that brings up the pay.

Until they decide not to anymore.

 

[lakersbaby]

I could not seem to find any solid groups in the LA area besides maybe Kaiser. Thousand oaks I think has a great group with high unit value. Other than that check Orange county or san diego if Southern Cal is the place you need to be. If not get the heck out of california, this state is turning into a dump.

 

[Peterluger]

The above is pretty much spot on.

The wild card with this gig is how much those call stipends add up to. For me to seriously consider this gig, the call stipends would have to approach 75K + per year.

That segways into the next caveat with any production/unit based pay scheme: scheduling.

How is the schedule made and who makes it?
Do the new guys get stuck with the podiatry lineup doin' toe amps on sick patients while the old-timers do the joints and spines churning out units - or is it fair?
Is call equally distributed? Is it easy to pick up extra shifts?
Are you gonna have a lot of down time/gaps where you're stuck in the hospital but not generating units?

My first gig had a unit value not much better than $30. On the plus side though was that hours were good and the schedule was super flexible. (notice it's not my current gig though 😉 )



LA proper is a f***ing disaster for a great many reasons - the overwhelming majority of which have nothing to do with anesthesia.

The bottom line is that there is no shortage of people who want to live in SoCal. Any good anesthesia gig in the area ain't gonna be advertising 'cuz they don't have to. If you don't already have an inside track to a premier SoCal gig, you're pretty much SOL and gonna be stuck fighting for the AMC scraps like this job.


PS: @Peterluger , how is it that you seem to know so much about foreign policy/international politics but so little about the business of anesthesia?? 😵

Man I’m not even gonna pretend I know anything about business of Anesthesia. They don’t teach us any of this in residency.

 

[Tony C anesthesia]

Can anyone comment on this particular job? Valley Presbyterian in Los angeles? Especially if just doing it for a year. Envision is behind it.

PracticeMatch.com: The Opportunity 560304 is no longer available

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They work > 80 hours/week. So you can imagine everyone might be burnt out there.

 

[Peterluger]

They work > 80 hours/week. So you can imagine everyone might be burnt out there.

U serious? Thats crazy man. Not even worth it at that point.

 

[buccsmf1]

They work > 80 hours/week. So you can imagine everyone might be burnt out there.

i see stuff like this and wonder if they really mean 80+ hours per work. i did 80 hours a week during surgery rotations. 80 hours is working monday to friday 6AM to 8PM every single day. And the on Saturday from 6AM to 4PM. Only day off is sunday.

I just cant imagine anyone that would voluntarily tolerate that lifestyle

 

[deleted162650]

On top of that, you have to buy your own malpractice which is pretty expensive.

Not in CA it isn’t.

 

[nimbus]

That’s what I thought as well. However they give daily stipends to everyone and that brings up the pay. I got an email from the recruiter on this one and I told her to shove it but then I saw the stipend. For call it’s about $1500 and others where in the $1000 range is I remember correctly. I would have to look it up.
But you’d have to live in LA. And a nice house is what 2 mil? And the traffic is horrendous. No Thanks.

You’re

The math isn’t favorable. You are earning $30/unit which is low. You shouldn’t look at anything below $35/imo. You’re going to either have to take a lot of call or have the call stipends be generous to hit that $450-520k. On top of that, you have to buy your own malpractice which is pretty expensive.

If Choco is correct, the stipend is extremely generous approaching 200k/yr. And as Salty says, malpractice insurance is cheap.

 

[nimbus]

how Cheap is malpractice? Claim vs occurrence?

When I practiced in a different group 18 years ago I was paying $11k/yr through The Doctors Co for claims made. My current group is self insured and I pay much less for occurrence.

 

[deleted162650]

Everyone I know is with CAP. About 8k per year.

 

[chocomorsel]

If Choco is correct, the stipend is extremely generous approaching 200k/yr. And as Salty says, malpractice insurance is cheap.

Let me post the email if I still have it. It starts at 200 up to 1500 if I recall per day depending on who’s on call or doing what cases.

OOPS, looks like it's a different hospital but still Envision. But here is an idea of one of their other sites:

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.
HOSPITAL DETAILS:

• 8,100 + Cases (includes covering the Surgery Center) 10 ORs + Cath lab + 2 OB + GI

• Anesthesia Residency starting 2020

• Cardiac call is divided up among the cardiac anesthesiologists

• Cases range from high to low acuity; Level II trauma (CERNER EMR)

• All cases (trauma, OB, vascular, neuro, bariatric, regional blocks, gastro and more!) – no heart, lung, and liver transplant (rarely do peds)

• 1099 Independent Contractor Status

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.

COMPENSATION:

$28.00 per ASA unit ($500K+ expected annually)

*Daily Stipend 220.00

$50K sign-on bonus

Call stipends-
Weekdays:
Trauma - 1 $1,700.00
Trauma - 2 $1,200.00
Neuro $1,100.00
OB $1,300.00
Cardio Vascular $1,250.00
3rd $550.00

Weekends and Holidays:
Trauma - 1 $1,900.00
Trauma - 2 $1,400.00
Neuro $1,400.00
OB $1,500.00
Cardio Vascular $1,500.00
Elective Room (Saturday) $850.00

$300 labor epidural & C-section

Labor epidurals that proceed to C-section $500

 

[chocomorsel]

I know my numbers are spot on. Cause my brother is anesthesiologist in downtown Los Angeles the past 14 years. Well they use blended unit. But I know exactly How much is better billed and collected. I’ve seen the print out at his house.

but if you move out a little further. My other buddy was pulling 500k (working like a dog) but 12 weeksoff.

2018 income was $800k with 4 weeks off. Worked around 70 hours a week. That’s also LA county. But in the far off burbs. LA county is huge.

There are a couple of nice gigs in LA proper that pay well but the openings are few and far in between.

They can keep that 800k. Seriously? Working 70 hours a week? And only 4 weeks off?
I don't need 800k that badly.

 

[nimbus]

Let me post the email if I still have it. It starts at 200 up to 1500 if I recall per day depending on who’s on call or doing what cases.

OOPS, looks like it's a different hospital but still Envision. But here is an idea of one of their other sites:

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.
HOSPITAL DETAILS:

• 8,100 + Cases (includes covering the Surgery Center) 10 ORs + Cath lab + 2 OB + GI

• Anesthesia Residency starting 2020

• Cardiac call is divided up among the cardiac anesthesiologists

• Cases range from high to low acuity; Level II trauma (CERNER EMR)

• All cases (trauma, OB, vascular, neuro, bariatric, regional blocks, gastro and more!) – no heart, lung, and liver transplant (rarely do peds)

• 1099 Independent Contractor Status

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.

COMPENSATION:

$28.00 per ASA unit ($500K+ expected annually)

*Daily Stipend 220.00

$50K sign-on bonus

Call stipends-
Weekdays:
Trauma - 1 $1,700.00
Trauma - 2 $1,200.00
Neuro $1,100.00
OB $1,300.00
Cardio Vascular $1,250.00
3rd $550.00

Weekends and Holidays:
Trauma - 1 $1,900.00
Trauma - 2 $1,400.00
Neuro $1,400.00
OB $1,500.00
Cardio Vascular $1,500.00
Elective Room (Saturday) $850.00

$300 labor epidural & C-section

Labor epidurals that proceed to C-section $500

Those are seriously hefty stipends...over 5k/day and 8k on weekends. We need to up our stipend game.

 

[chocomorsel]

Those are seriously hefty stipends...over 5k/day and 8k on weekends. We need to up our stipend game.

Yeah, I know. I calculated 70K+ a year if you work 46 weeks taking 1st call once every 7 days. It's honestly not bad. But as Salty states, how long will it last? That's a lot of dough, and if they are offering it, they are also making some good money off the contract.

 

[chocomorsel]

Yeah, I know. I calculated 70K+ a year if you work 46 weeks taking 1st call once every 7 days. It's honestly not bad. But as Salty states, how long will it last? That's a lot of dough, and if they are offering it, they are also making some good money off the contract.

And that's only 1st call. When you do Neuro Call, that's extra money; is that separate than trauma call? Or is it, a day of doing Neuro that's not a call day.
And there are going to be plenty of days where you are doing 2nd Trauma call, probably the same amount of time you do 1st call. It seems like the stipends add up a lot.

 

[nimbus]

And that's only 1st call. When you do Neuro Call, that's extra money; is that separate than trauma call? Or is it, a day of doing Neuro that's not a call day.
And there are going to be plenty of days where you are doing 2nd Trauma call, probably the same amount of time you do 1st call. It seems like the stipends add up a lot.

It’s about $2mil/yr stipend money split among however many docs they have.

 

[IlDestriero]

Let me post the email if I still have it. It starts at 200 up to 1500 if I recall per day depending on who’s on call or doing what cases.

OOPS, looks like it's a different hospital but still Envision. But here is an idea of one of their other sites:

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.
HOSPITAL DETAILS:

• 8,100 + Cases (includes covering the Surgery Center) 10 ORs + Cath lab + 2 OB + GI

• Anesthesia Residency starting 2020

• Cardiac call is divided up among the cardiac anesthesiologists

• Cases range from high to low acuity; Level II trauma (CERNER EMR)

• All cases (trauma, OB, vascular, neuro, bariatric, regional blocks, gastro and more!) – no heart, lung, and liver transplant (rarely do peds)

• 1099 Independent Contractor Status

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.

COMPENSATION:

$28.00 per ASA unit ($500K+ expected annually)

*Daily Stipend 220.00

$50K sign-on bonus

Call stipends-
Weekdays:
Trauma - 1 $1,700.00
Trauma - 2 $1,200.00
Neuro $1,100.00
OB $1,300.00
Cardio Vascular $1,250.00
3rd $550.00

Weekends and Holidays:
Trauma - 1 $1,900.00
Trauma - 2 $1,400.00
Neuro $1,400.00
OB $1,500.00
Cardio Vascular $1,500.00
Elective Room (Saturday) $850.00

$300 labor epidural & C-section

Labor epidurals that proceed to C-section $500

That’s a lot of call 1/2 the group must be on call every day. F that. I take one call a month and I still give at least 1/2 of them away.

 

[chocomorsel]

That’s a lot of call 1/2 the group must be on call every day. F that. I take one call a month and I still give at least 1/2 of them away.

I don’t really know if any of that other that OB, Cardiac and Trauma are really call.
And besides I was just making up frequency of call at once a week. Who knows how many people are in the group and therefore how many days of call a month?
Whatever the case, the stipendsmakes it much more appealing. If the senior partners aren’t the only ones making the schedule that is.

 

[narcotics999]

Everyone I know is with CAP. About 8k per year.

Crap, I need to switch. I pays more with NorCal. Do you have a group discount?

 

[narcotics999]

Let me post the email if I still have it. It starts at 200 up to 1500 if I recall per day depending on who’s on call or doing what cases.

OOPS, looks like it's a different hospital but still Envision. But here is an idea of one of their other sites:

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.
HOSPITAL DETAILS:

• 8,100 + Cases (includes covering the Surgery Center) 10 ORs + Cath lab + 2 OB + GI

• Anesthesia Residency starting 2020

• Cardiac call is divided up among the cardiac anesthesiologists

• Cases range from high to low acuity; Level II trauma (CERNER EMR)

• All cases (trauma, OB, vascular, neuro, bariatric, regional blocks, gastro and more!) – no heart, lung, and liver transplant (rarely do peds)

• 1099 Independent Contractor Status

Envision Physician Services is seeking Anesthesiologists for Riverside Community Hospital in Riverside, California. This practice is ideal for an individual who enjoys being clinically challenged and is seeking a blend of high and low acuity cases across all surgical subspecialties. There is also significant opportunity to grow the practice and interested individuals will have ample opportunity to shape that growth by taking on leadership duties. Envision will sponsor leadership training for interested and selected individuals and mentoring is encouraged at all levels.

COMPENSATION:

$28.00 per ASA unit ($500K+ expected annually)

*Daily Stipend 220.00

$50K sign-on bonus

Call stipends-
Weekdays:
Trauma - 1 $1,700.00
Trauma - 2 $1,200.00
Neuro $1,100.00
OB $1,300.00
Cardio Vascular $1,250.00
3rd $550.00

Weekends and Holidays:
Trauma - 1 $1,900.00
Trauma - 2 $1,400.00
Neuro $1,400.00
OB $1,500.00
Cardio Vascular $1,500.00
Elective Room (Saturday) $850.00

$300 labor epidural & C-section

Labor epidurals that proceed to C-section $500

The OB is bad. 1200-1500$ stipend is fairly standard with Medicaid-majority hospitals. But 300$ per case? I know a hospital in LA better part with ~600$ per case.

 

[likewhatevs]

Valley Presbyterian has been a mess for a number of years, though I am confident everybody on Student Doctor already knows that, or could figure it out once they realize it's an Envision site. Envision only has terrible sites. Temecula, Glendale, Lakewood, Riverside, Van Nuys. All of them suck. Marina Del Ray is a nice hospital, but give Envision a few years to completely screw up the department.

St. Vincent's--also in downtown LA--just closed its doors, which means that another crop of experienced anesthesiologists have just been be dumped into the market. And, even with that entire department looking for work, Envision has to rely on Gaswork to recruit. That should tell you what you need to know. If the message isn't clear, here it is in two words: Stay away!


I don't know how big the Riverside department is, but through a proprietary blend of synergy and bullshi+, Envision was able to whittle it down from ~35 stable anesthesiologists to six or seven, plus a revolving door of locum hacks. They presently are hiring CRNAs because no employable doctors will touch them. I don't know if the CRNAs take call, but a department would have to be huge to staff five call spots/day (especially if they get the post-call day off); so it sounds very much to me like Envision shot its mouth off during negotiations about what they would offer the hospital, and now those chickens are coming home to roost. (More call positions=>staff dissatisfation=>staff defections=>more onerous call burden=>greater dissatisfaction. Rinse and repeat.) Others seem to think that the call stipends make it a decent gig, but I can't help but look at their unit value of $28 and see anything but a glaring: No, thank you!!

Not to derail the conversation, but rumors circulated a while back that Riverside Community Hospital was trying to add an anesthesiology residency starting in 2020. Anybody know anything more?

 

[abolt18]

Valley Presbyterian has been a mess for a number of years, though I am confident everybody on Student Doctor already knows that, or could figure it out once they realize it's an Envision site. Envision only has terrible sites. Temecula, Glendale, Lakewood, Riverside, Van Nuys. All of them suck. Marina Del Ray is a nice hospital, but give Envision a few years to completely screw up the department.

St. Vincent's--also in downtown LA--just closed its doors, which means that another crop of experienced anesthesiologists have just been be dumped into the market. And, even with that entire department looking for work, Envision has to rely on Gaswork to recruit. That should tell you what you need to know. If the message isn't clear, here it is in two words: Stay away!


I don't know how big the Riverside department is, but through a proprietary blend of synergy and bullshi+, Envision was able to whittle it down from ~35 stable anesthesiologists to six or seven, plus a revolving door of locum hacks. They presently are hiring CRNAs because no employable doctors will touch them. I don't know if the CRNAs take call, but a department would have to be huge to staff five call spots/day (especially if they get the post-call day off); so it sounds very much to me like Envision shot its mouth off during negotiations about what they would offer the hospital, and now those chickens are coming home to roost. (More call positions=>staff dissatisfation=>staff defections=>more onerous call burden=>greater dissatisfaction. Rinse and repeat.) Others seem to think that the call stipends make it a decent gig, but I can't help but look at their unit value of $28 and see anything but a glaring: No, thank you!!

Not to derail the conversation, but rumors circulated a while back that Riverside Community Hospital was trying to add an anesthesiology residency starting in 2020. Anybody know anything more?

I know Riverside used to have a DO residency program but it shut down as a result of the ACGME/AOA merger. Perhaps they're missing the cheap labor?

 

[deleted162650]

through a proprietary blend of synergy and bullshi+

😆

 

[Peterluger]

Anyone know anything about working for Cedars Sinai?

 

[chocomorsel]

@likewhatevs I would not call Temecula terrible. But I am biased. It’s got wine, and sun and no traffic and cheap on the side of the road fruit all around.
How can that be terrible?
Maybe you just mean the hospital?

 

[kidthor]

@likewhatevs I would not call Temecula terrible. But I am biased. It’s got wine, and sun and no traffic and cheap on the side of the road fruit all around.
How can that be terrible?
Maybe you just mean the hospital?

Agreed - Temecula is a pretty nice, albeit rather suburban city. Much better than many other CA suburbs. It'd be a great place to raise kids.

But yeah I can't speak to the hospital either...

 

[likewhatevs]

Temecula is probably a very nice suburban town, and I wouldn't criticize anybody who wants to live in Southern California but be 2+ hours away from the bustle (and costs) of San Diego and LA/OC. And the brand new hospital is sparkling. But the anesthesia department is a wreck, and has been since the defection of 90% of their staff after Envision's takeover. But, truth be told, Temecula is probably better than the other two "hospitals," you'd work for if you sign on with Envision Temecula: Rancho Springs and Inland Valley, both owned by the struggling Southwest Healthcare System. Those two tiny watering holes ought to be where desperate CRNAs ply their trade. Instead, the geniuses at Envision thought they could give each tiny hospital a call team (and an in-house OB call position) and still make ends meet. All that did was increase the call burden to unsatisfactory levels (remember, this is Temecula/Murrieta we are talking about, so people want lifestyle practices), leading to the constant revolving door and locum hacks.

I don't have it on authority, but I understand that the Temecula/Rancho/Inland cluster was the primary reason that Envision's Southern California Director lost his job.

If you pay any attention at all to Gaswork, you will note that Loma Linda has moved farther and farther south as Southwest has been retreating.

But, again, Temecula Valley is a brand new, sparkling hospital and I'm sure if you want nothing more than to punch the clock for corporate overlords, you could do worse.

If I wanted a new hospital and the tiniest hope of attaining a meaningful partnership, I would look at Palomar. Their present chief is an old horse's a$$ who has cultivated a very submissive, weak, limp mentality, but he's years past his "sell by" date, so I imagine his reign of spinelessness will shortly end. If you can hold your nose (and shut your mouth) until he kicks off/retires, you might have a future there. It would have to be better than Envision.

 

[nimbus]

Temecula is probably a very nice suburban town, and I wouldn't criticize anybody who wants to live in Southern California but be 2+ hours away from the bustle (and costs) of San Diego and LA/OC. And the brand new hospital is sparkling. But the anesthesia department is a wreck, and has been since the defection of 90% of their staff after Envision's takeover. But, truth be told, Temecula is probably better than the other two "hospitals," you'd work for if you sign on with Envision Temecula: Rancho Springs and Inland Valley, both owned by the struggling Southwest Healthcare System. Those two tiny watering holes ought to be where desperate CRNAs ply their trade. Instead, the geniuses at Envision thought they could give each tiny hospital a call team (and an in-house OB call position) and still make ends meet. All that did was increase the call burden to unsatisfactory levels (remember, this is Temecula/Murrieta we are talking about, so people want lifestyle practices), leading to the constant revolving door and locum hacks.

I don't have it on authority, but I understand that the Temecula/Rancho/Inland cluster was the primary reason that Envision's Southern California Director lost his job.

If you pay any attention at all to Gaswork, you will note that Loma Linda has moved farther and farther south as Southwest has been retreating.

But, again, Temecula Valley is a brand new, sparkling hospital and I'm sure if you want nothing more than to punch the clock for corporate overlords, you could do worse.

If I wanted a new hospital and the tiniest hope of attaining a meaningful partnership, I would look at Palomar. Their present chief is an old horse's a$$ who has cultivated a very submissive, weak, limp mentality, but he's years past his "sell by" date, so I imagine his reign of spinelessness will shortly end. If you can hold your nose (and shut your mouth) until he kicks off/retires, you might have a future there. It would have to be better than Envision.

Looks like Loma Linda Murrieta is being staffed by Landmark(St Francis). I was told by a reliable person with first hand knowledge that they have a booming structural heart program. It may be the best option in that area.

 

[AdmiralChz]

What constitutes a “locums hack” (or any “hack” for that matter)? Is it the locums doc who can’t keep a gig down due to professionalism or performance issues? A young single person fresh out of training wanting to move around the country? A mid-career doc whose practice imploded and needs a bridge?

I have a feeling most are talking about the first option but not all locums portend a terrible doc, especially in this day and age. It’s not the 80s/90s when people didn’t really move around much.

 

[chocomorsel]

I may be classified as a “locums hack” myself.
Scared of commitment. Or can’t seem to find a place that will give me good benefits so gonna keep hacking away till that happens.
I totally don’t look up California on my job searches. Not interested in them high ass taxes. I like Texas Taxes.

 

[narcotics999]

Looks like Loma Linda Murrieta is being staffed by Landmark(St Francis). I was told by a reliable person with first hand knowledge that they have a booming structural heart program. It may be the best option in that area.

Define booming program? I assume a lot of cases, but what about $$, staffing, and schedule.

I don’t know other sites of landmark, st Francis is a workhorse place.


Sent from my iPhone using Tapatalk

 

[Peterluger]

Define booming program? I assume a lot of cases, but what about $$, staffing, and schedule.

I don’t know other sites of landmark, st Francis is a workhorse place.


Sent from my iPhone using Tapatalk

How much does landmark usually pay?

 

[hypnosMD]

What constitutes a “locums hack” (or any “hack” for that matter)? Is it the locums doc who can’t keep a gig down due to professionalism or performance issues? A young single person fresh out of training wanting to move around the country? A mid-career doc whose practice imploded and needs a bridge?

I have a feeling most are talking about the first option but not all locums portend a terrible doc, especially in this day and age. It’s not the 80s/90s when people didn’t really move around much.

I "know of" a few docs who did this when their practice was overrun by Northstar, staying on their own terms and charging significant locums rates. Eventually, deathstar (in a most punitive fashion) fired each doc, even walking at least one to his car escorted by security just to make a point (a case that is allegedly in litigation as we speak). In each instance, the timing of people being let go seemed strategic in a not-so-nice way.

 

[nimbus]

Define booming program? I assume a lot of cases, but what about $$, staffing, and schedule.

I don’t know other sites of landmark, st Francis is a workhorse place.


Sent from my iPhone using Tapatalk

Yes a lot of cases. No clue about the other stuff.

 

[Peterluger]

Speaking of presbyterian hospitals....Anyone know anything about Hollywood Presbyterian?

 

[deleted126335]

I "know of" a few docs who did this when their practice was overrun by Northstar, staying on their own terms and charging significant locums rates. Eventually, deathstar (in a most punitive fashion) fired each doc, even walking at least one to his car escorted by security just to make a point (a case that is allegedly in litigation as we speak). In each instance, the timing of people being let go seemed strategic in a not-so-nice way.

High Profile public execution(s). Sends a message to the rest of the troops. Of course the rest of the troops' dedication falls off a cliff. The goal becomes "don't hurt anybody, fly under the radar, and collect my paycheck"