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Let's just keep it real for a minute.

You're a partner in a practice and someone comes to you and says, "Hey we want to buy your practice and oh by the way he's a quick 2 million bump for your bank account. All you need to do is grind it out for 3-5 more years, what do you think?"

Now sure, maybe it's a low ball deal, damn 2 million? maybe 1.5 after the taxes? and if you're smart with that money and not going to Spearmint Rhino you can probably live ok on that and do some BS locums or maybe even part time after the 3-5 years. Sure it's trouble to hear for us young folks stepping into the field, but on the flip side.....
41022-will-smith-I-aint-even-mad-tKbi.jpeg
 
nimbus said:
In some groups, people pay a nominal $xxxxx when they become partner to purchase one share of the corporation. That is the cost basis from which the capital gains are calculated. If it's held for less than a year, I guessed it would be considered short term. But maybe there is a work around.
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there are lots of workarounds
 
Scotty_G said:
Aneftp did the person on year 4/5 partnership track have a clause in his contract or they just got the 750k w/o trouble?
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4/5 years partnership track.

No clause. Fair group. They tell u after 2 years if u are going to make partner. U are free to leave after 2 years if not offered and they pay malpractice tail which is fair.
 
Guys it's economics 101.

Most people get rich SELLING their business.

It's been this way since forever.
 
sevoflurane said:
We've been saying that for years... for this exact reason.
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The people I know that took this job in recent years were wedded to Phoenix and only Phoenix. I don't know much about that market but it doesn't sound like there were too many other options for practice. I think they were just happy to have a job in their location of choice.
 
Do we have any legal recourse if we are offered a "partnership track" that was never there in the first place? Is there justification for a lawsuit against a group that offers a "partnership track" if they knew or had good knowledge that said "track" would be nonexistent? I know partnerships aren't guaranteed, but I would think that when they make the offer that it is in good faith that a partnership would be a possibility. My suspicion is that the group I am with (a predatory group on the east coast) is milking a bunch of new grads while they pad their retirement and work 26 hours a week. We have a bunch of young guys who are employed by them and we are all working 60-65 hour weeks while we relieve the old, fat, lazy, pieces of #$@% at 1pm so they can go sit in their McMansions and get fatter by the second (yes, I am angry and bitter). They are holding on for as long as they can before either selling to an AMC or what seems more likely is a hospital takeover. I have pretty good information that this has been in the works long before I signed my contract. They knew the partnership was not going to be there, but they are using it as bait in a contract to entice new grads in what is already a pretty crummy job market. This seems like it would be illegal to me.
 
This happens in all fields. It happens all the time in Radiology. In fact, happened to me at my first job. Can't imagine there is a legal case to be made with a legitimate chance of winning.
 
If you see the writing on the wall, why are you still there? I wouldn't want to hold out hope for a buy out after I made partner, I'd be looking for a good place to try to spend 20 years. That's not likely at the AMC.
 
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One more thing, one local group that had monster contracts sold out a few years ago for a lot of money. They had to stay for 5 years. They were miserable. Every year it got worse. This year is the last one, and they all want to leave. It will be interesting to see if they offer sweeter deals to keep some of them.
You may get a nice payday, only to sell your soul to 3-4:1 coverage regardless of acuity or extender capability, 6 weeks vaca, deteriorating morale, etc.
You earn it.
 
IlDestriero said:
You may get a nice payday, only to sell your soul to 3-4:1 coverage regardless of acuity or extender capability, 6 weeks vaca, deteriorating morale, etc. You earn it.
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Many of us have sold our souls to this coverage arrangement already. You definitely earn every penny.😱
 
Oh I am actively looking for a long term job, but I am not going to quit until I have something worthwhile. I have loans and bills to pay...

My point is that I was duped when I signed the contract for this "partnership track." I moved from where I did my residency and my wife left her job that she liked for me to take this job. If they knew that a partnership wasn't going to be there and offered it under false pretenses with good knowledge that the group was going to either sell or become hospital employed, I would think that would be illegal. To me the partnership track thing is put in a contract "in good faith" that the group has plans to make you a partner, should they deem you a good fit for the partnership. If they knew that plans were in the works to become hospital employed then that offer in the contract was not made "in good faith."
 
Arch Guillotti said:
Many of us have sold our souls to this coverage arrangement already. You definitely earn every penny.😱
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Except I hope you're making >90th percentile income and taking 10 weeks vacation. The AMC usually offers the same job for <50th percentile income and 6 weeks off. The CEOs Continental GT ain't paying for itself.
 
GravelRider said:
Oh I am actively looking for a long term job, but I am not going to quit until I have something worthwhile. I have loans and bills to pay...

My point is that I was duped when I signed the contract for this "partnership track." I moved from where I did my residency and my wife left her job that she liked for me to take this job. If they knew that a partnership wasn't going to be there and offered it under false pretenses with good knowledge that the group was going to either sell or become hospital employed, I would think that would be illegal. To me the partnership track thing is put in a contract "in good faith" that the group has plans to make you a partner, should they deem you a good fit for the partnership. If they knew that plans were in the works to become hospital employed then that offer in the contract was not made "in good faith."
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I think that in order to have a case, you'd have to have proof that they engaged in these negotiations before you were hired and had a deal in place to sell the group when they offered you a partner track contract. Otherwise it's just speculation and seeing what they might offer in a buy out.
 
IlDestriero said:
One more thing, one local group that had monster contracts sold out a few years ago for a lot of money. They had to stay for 5 years. They were miserable. Every year it got worse. This year is the last one, and they all want to leave. It will be interesting to see if they offer sweeter deals to keep some of them.
You may get a nice payday, only to sell your soul to 3-4:1 coverage regardless of acuity or extender capability, 6 weeks vaca, deteriorating morale, etc.
You earn it.
Click to expand...
.
 
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IlDestriero said:
One more thing, one local group that had monster contracts sold out a few years ago for a lot of money. They had to stay for 5 years. They were miserable. Every year it got worse. This year is the last one, and they all want to leave. It will be interesting to see if they offer sweeter deals to keep some of them.
You may get a nice payday, only to sell your soul to 3-4:1 coverage regardless of acuity or extender capability, 6 weeks vaca, deteriorating morale, etc.
You earn it.
Click to expand...

Welcome to my life. Just change monster contract to good contract and lot of money to decent money. Add some vacation. 1-2 that can will leave, maybe can't go on would be a better description. 2-3 are negotiating part time, either days only or a fraction of an FTE. :hello:. Those that got sucked into the lifestyle or had the bad divorce will have to eat it and keep working hard.

The younger docs are making the same choices we did at that point in our careers, spending their time for more money. The smart ones are driving Camrys and minivans and buying small houses. The others are driving BMWs and nice SUVs and building big houses.
 
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Ezekiel2517 said:
There's no doubt they'll have to offer more money once the 5 yr contract is up. Otherwise they'll have a mass exodus of anesthesiologists to deal with.
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Problem is, between the non-competes and the fact that they gobbled up so much of the market share there's just no place to go. Sure those that are single (or at least kid free) can pack up and move, but it's not so easy when you've got kids in school, or a spouse with a job they like, etc. Many will just have to grin and bear it. Those that voted for the buy-out and aren't close to retirement were being very short-sighted I think.
 
Scotty_G said:
Gravel are you in NJ?
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Yeah...somewhere in the tristate area of suck. I grew up here, went to school here, and trained here (northeast). My family is here and while I would be more than willing to relocate, my wife is very hesitant. These groups in this area know that people want to or need to be around here and so they screw you over. To me it's a sorry indictment of the medical profession where these old greedy losers are preying on the people who could potentially inject some new life into the profession. Instead of physicians creating a united front against hospital administration, government regulators, big business, midlevel encroachment, etc..., we are allowing a bunch of greedy old timers to cannibalize the profession. It happens in every specialty, not just anesthesia...
 
GravelRider said:
Yeah...somewhere in the tristate area of suck. I grew up here, went to school here, and trained here (northeast). My family is here and while I would be more than willing to relocate, my wife is very hesitant. These groups in this area know that people want to or need to be around here and so they screw you over. To me it's a sorry indictment of the medical profession where these old greedy losers are preying on the people who could potentially inject some new life into the profession. Instead of physicians creating a united front against hospital administration, government regulators, big business, midlevel encroachment, etc..., we are allowing a bunch of greedy old timers to cannibalize the profession. It happens in every specialty, not just anesthesia...
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But, if you controlled your own fate then you could give them the finger and start your own practice. In fact, if you were in a specialty like ENT, Ortho, Urology, Plastics, Derm, Gi, Pulmonary, Renal, Cards, etc the opportunity exists TODAY to create your own practice from day 1. Sure, the road is harder but after 3-4 years you are in the driver's seat.
 
BLADEMDA said:
But, if you controlled your own fate then you could give them the finger and start your own practice. In fact, if you were in a specialty like ENT, Ortho, Urology, Plastics, Derm, Gi, Pulmonary, Renal, Cards, etc the opportunity exists TODAY to create your own practice from day 1. Sure, the road is harder but after 3-4 years you are in the driver's seat.
Click to expand...

Sort of... Those specialties all have more opportunities to build their own practice when compared to hospital-based specialties like anesthesiology. However, the majority of them are becoming employed now as well. In heavily populated markets the deck is so stacked against you that it is extraordinarily difficult to build your own practice. Just think of simple things like rent in an office in the Boston, NYC, DC metro areas. I know everyone says move to the middle of nowhere, but the problem is that's not where the patients are, so not every physician can move to the middle of nowhere.
 
GravelRider said:
Sort of... Those specialties all have more opportunities to build their own practice when compared to hospital-based specialties like anesthesiology. However, the majority of them are becoming employed now as well. In heavily populated markets the deck is so stacked against you that it is extraordinarily difficult to build your own practice. Just think of simple things like rent in an office in the Boston, NYC, DC metro areas. I know everyone says move to the middle of nowhere, but the problem is that's not where the patients are, so not every physician can move to the middle of nowhere.
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Move to a nice suburb outside a low tax state and open a practice. There is always room for another outstanding physician in any specialty. Don't believe the hype that you can't find work. For example, if you came to my area as an EP specialist today within 3 years you could expect 7 figure income.

I agree that you should avoid the large cities but any medium sized town in a low tax state is the perfect place to hang a shingle.
 
Ezekiel2517 said:
There's no doubt they'll have to offer more money once the 5 yr contract is up. Otherwise they'll have a mass exodus of anesthesiologists to deal with. Personally there's no way in hell I'd live in Phoenix unless I were making serious cash.
Also, if all they got was 1.9 each, that's pretty pathetic. Not even that much after taxes. I'm sure there are a lot of other reasons they sold but at least the partners in the NJ group that recently sold got 3.4
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It's not pathetic for 1.9 mil if it's an all MD group.

You are living in a fantasy world trying to command 3 mil plus unless you are in an ACT model with unequal and limited amount of shareholders.

One group (if you call it a group) since there were only 3 primary shareholders and 12-15 docs and the rest of them crnas (plus using srna for free labor). The super partner got in excess of 7 mil and the two other partners got around 3 mil each. That's the type of unequal system where you see buyouts in the 3 mil plus range.

Not in an all MD partnership system. And in an ACT model involving more than 15 equal partners you aren't going to get that 3 mil plus range unless you are dealing with 60% plus commercial insurance which is rare these days.
 
aneftp said:
It's not pathetic for 1.9 mil if it's an all MD group.

You are living in a fantasy world trying to command 3 mil plus unless you are in an ACT model with unequal and limited amount of shareholders.

One group (if you call it a group) since there were only 3 primary shareholders and 12-15 docs and the rest of them crnas (plus using srna for free labor). The super partner got in excess of 7 mil and the two other partners got around 3 mil each. That's the type of unequal system where you see buyouts in the 3 mil plus range.

Not in an all MD partnership system. And in an ACT model involving more than 15 equal partners you aren't going to get that 3 mil plus range unless you are dealing with 60% plus commercial insurance which is rare these days.
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.
 
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Ezekiel2517 said:
In NJ deal, 30+ people got the 3.4 mil.

I'm well aware that 1.9 was the best they could get for an all MD group, that's what sad. I'm sure people remember the highly profitable CA group Sheridan bought out a couple years ago. I know what the partners got in that deal too. Partners in the Valley group must've been making well over 500 for quite some time now and now it will be a lot less for at least next 5 yrs. In that context, 1.9 isn't impressive. But I know these deals aren't just about money, a lot of other factors involved
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I don't know the NJ practice. Was it ACT?

Another group in central Florida 25-maybe 30 partners got 2.6 and they have about 50% commercial insurance payer mix. But that ACT model.

But all MD is just a different beast. My friend in Texas all MD currently around 1.4-1.6 mil offer. They are shopping around.

As for the 1.9 mil. Yeah. I am sure they are making $500k plus. And probably taking around 350k after buyout. (That was the type of buyout my other friend from residency got in mid Atlantic from mednax). Essentially it's a prepayment taxed at favorable capital gains rate.

Just simple math says if you are 55 years or older. Take the cash offer (also usually now entails partial stock offer as well). The $150k reduction in salary even for 5 years means you still come out ahead at age 60 with a lot of freedom and financial security (unless u get divorce or simply mismanage the money). It offers a chance for a lot of early retirement. And the ACA is a god send for those in late 50s/early 60s.

As much as people hate the ACA. U can game the system and take advantage of generous subsidies and Obama will essentiall enable u to get health care coverage for super cheap. Something to consider. Let's just say my 58 year old neighbor with pre existing medical conditions including CAD and DM is paying less than $400/month with the ACA with only a $2000 max out of pocket expense. And he's very well off. Retired since age 54 Wall Street bond trader. But the govt thinks he's "poor" cause he's just living off savings and hasn't even tapped his retirement account yet. So to the govt he's making 250% of poverty. Good enough for super cheap health care coverage.
 
Bumping an old thread- how is the locums market temperature check in Phoenix?

Is the future of anesthesiology in this city going to be an employed model for most hospitals? The current model of 4-5 private practice groups covering 1 tertiary medical center seems unsustainable.
 
NicholasPavona said:
This forum has admittedly regressed into a wasteland of stupidity and political conversations though. He is missed.
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Feel free to post an interesting case for discussion.

Not a lot changes in the technical realm of anesthesia. Do you really want to debate spinal vs general for TKAs or elderly hip fx some more?
 
pgg said:
Feel free to post an interesting case for discussion.

Not a lot changes in the technical realm of anesthesia. Do you really want to debate spinal vs general for TKAs or elderly hip fx some more?
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I want to do neither. There are no interesting cases for me anymore. You put the patient to sleep, you wake them up. How interesting can you get?
 
NicholasPavona said:
I want to do neither. There are no interesting cases for me anymore. You put the patient to sleep, you wake them up. How interesting can you get?
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If you don't want to talk about anesthesia and you don't want to talk about other subjects, why are you here?

Go ahead and tell me you're just trolling, and I can remove the burden of forum participation from your weary shoulders.
 
‘K boys - everyone’s on edge bc they’ve seen their accounts decimated. Let’s chill and be friendly - remember we are all on the same side - anesthesiologists need to stick together more and look out for each other.
Here’s a positive side note vacation recommendation - just got back from impressions isla mujeres - an all inclusive actual 5 star adults only resort - food, drinks, service were amazing - romantic quiet relaxing vacation i highly recommend - seems like some of yall could benefit from some R and R.
 
amyl said:
‘K boys - everyone’s on edge bc they’ve seen their accounts decimated. Let’s chill and be friendly - remember we are all on the same side - anesthesiologists need to stick together more and look out for each other.
Here’s a positive side note vacation recommendation - just got back from impressions isla mujeres - an all inclusive actual 5 star adults only resort - food, drinks, service were amazing - romantic quiet relaxing vacation i highly recommend - seems like some of yall could benefit from some R and R.
Click to expand...
Currently on a pedi mission trip in the caribbean.
Different type of fulfillment.
French Polynesia in May.
That’s going to be the real R&R from all this chaos.
Agree though, we’re in it together.
Americans first.
Anesthesiologists a close second.
 
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