What’s happening in Memphis

[Pharmado]

I’ve noticed a huge surge in locums postings for Memphis. One states they need 15 FTEs. Does anyone know what is going on and/or have information on both what group(s) lost their place and which of the PE monstrosities is taking over?

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[Howard888]

I’ve been seeing multiple Memphis postings for few years now. TN known for having less than ideal commercial rates and it’s full on amcs. Cigna just went oon with Napa there.

Guessing the locums is some other staffing company who took over a contract when the previous group or amc asked for too big a stipend.

Hospitals will eventually just employ everyone -but they’re slow on the uptick

 

[amyl]

A friend just left Memphis - he said it was a total **** show - hospital payor mix degrading - for which the hospital was getting government money but not was not passing it on. Incomes dropping wont work in this market so everyone jumped ship… worsening the situation. Now those remaining are overworked and very underpaid… now even the ones that were “stuck” for whatever reason are leaving.
Sounds like another example of the hospital not “getting it,” thinking the problem is short term, and turning to locums.
Sounded like a very care team heavy job.

 

[ASA6]

Sounds like a group or staffing company left. Somnia is taking over in a few weeks apparently. I do hear it's chaos.

 

[Shimmy8]

Total chaos. Locums over 400/hr all the locals bailing.

 

[amyl]

Just gossip but I did hear they called USAP awhile back and we did not decide to bail the group out or otherwise get involved. Memphis seemed like a good possible add as we just did Nashville and I think that’s working… but we weren’t interested once we had a look. I think Memphis is a tough place in a regular market…

 

[Howard888]

All gets down to rates and no surprises act. USAP no longer has any leverage to get an increase in commercial rates with size. In fact, good chance if USAP came in and took Memphis, commercial payers would retaliate by going out of network with USAP and forcing them to arbitration which, even if USAP won, is quite expensive. This would not only hurt their new venture in Memphis but their current one in Nashville. Again, Cigna just went out of network with Napa in TN.

Add in that Memphis payer mix not as good as Nashville and likely stipend dependent -not worth it at all for USAP.

Only expansion USAP will do is into markets that have very high rates or great payer mixes. Again, because they can’t get higher rates any more through negotiation. Costs of staffing still increasing. It’s just not worth the financial risk. Most of those good markets have already been poached by AMCs though. Few still left but most gone.

Only other play USAP might do is converting md only groups over to direction or supervision which was the rumor of the plan for Montana. They can still make money doing that without increasing rates but even then the margins or small.

This is why hospital employment is the future. Hospitals can negotiate higher payment still with payers. Anesthesia groups, private or otherwise, can’t because of no surprises act.

 

[gator2886]

Memphis is a total dumpster fire. Every single hospital is understaffed. All of the hospitals have had shortages of CRNAs and Anesthesiologists for years. It has gotten way worse since COVID. There was not a residency program for about 20 years and it is difficult to recruit. Payor mix is terrible so all the hospital Anesthesia groups are stipend dependent (and are still understaffed.) The reason you are seeing so much attention now is a large system called Methodist is losing its Anesthesia group, and it is not coming back. Recruiters are advertising "Germantown", TN but that is just a suburb, you are still in Memphis Metro. Add to the staffing issues, the CRIME is crazy. Motor Vehicle theft soaring...It is just a sad, sad thing to see. Having said that, if you do not mind some misery, the pay is pretty good. GA is getting $400/hr and Cardiac (I hear) is $500.

 

[caligas]

I did some locums there. Weird experience. Put on my blue suede shoes and I boarded the plane.
Touched down in the land of the Delta Blues
In the middle of the pouring rain.

 

[jjm285]

I did some locums there. Weird experience. Put on my blue suede shoes and I boarded the plane.
Touched down in the land of the Delta Blues
In the middle of the pouring rain.

Did you have a first class ticket at least?

 

[michaelrack]

Not anesthesia, but do live in Memphis. My wife and I have had 2 cars stolen in the last several years

 

[centdoc]

What kind of rates do you think are available, and do you think do solo cases is possible, given the "emergency" need they have?

 

[NoCap1981]

Memphis is a total dumpster fire. Every single hospital is understaffed. All of the hospitals have had shortages of CRNAs and Anesthesiologists for years. It has gotten way worse since COVID. There was not a residency program for about 20 years and it is difficult to recruit. Payor mix is terrible so all the hospital Anesthesia groups are stipend dependent (and are still understaffed.) The reason you are seeing so much attention now is a large system called Methodist is losing its Anesthesia group, and it is not coming back. Recruiters are advertising "Germantown", TN but that is just a suburb, you are still in Memphis Metro. Add to the staffing issues, the CRIME is crazy. Motor Vehicle theft soaring...It is just a sad, sad thing to see. Having said that, if you do not mind some misery, the pay is pretty good. GA is getting $400/hr and Cardiac (I hear) is $500.

Memphis is a dumpster fire indeed and so is the anesthesia world in Memphis. The already dismal payor mix worsened after the pandemic. Local anesthesia groups attempted to negotiate new subsidies with hospital administrators to no avail. The hospital administrators of course played hardball. As a result, there is an exodus of permanent anesthesiologists out the city and an influx of locums providers. Locums providers are the only way some hospitals are staying afloat. This is why you are seeing the rates of $350-$400/hr. In addition, there is big shuffle of providers from hospital to hospital in the area. Many CRNAs have left their permanent posts to take advantage of prn or locums rates at multiple hospitals around the city.

It has always been difficult to recruit to Memphis over the years because of a multitude of facts: crime, location, perceived negative image, etc. People moving to Memphis usually have some tangible connection (typically family) to the city. In the setting of a nationwide shortage of anesthesia providers, the stage is set for a significant healthcare crisis in Memphis. As mentioned above, the crime rates have skyrocketed in the last 2-3 years without any imminent solutions. The recruitment to Memphis just got a lot harder.

I truly hope the hospital administrators in Memphis can get their act together to bring stability to the Memphis anesthesia market. The patients in the city deserve better.

 

[coffeebythelake]

400 an hour isn't enough. Maybe 500+.

I'm getting 400 locally, large metropolitan area, with low ratio ACT with some solo days, plus I get to put my kids to bed at night.

 

[PpfSuxTube]

500 ph is good going. I like this

 

[Howard888]

Yeah 375-400 standard now. For Memphis…would have to be close to 500

 

[Pharmado]

Does anyone have recent experience doing locums in Memphis and know what the rates are?

 

[NoCap1981]

Does anyone have recent experience doing locums in Memphis and know what the rates are?

I know of rates of 350 for sure. I have heard of 400. I'm sure there is room for negotiation. Per usual, you could likely negotiate better rates going directly to the hospital instead of going through a company.

 

[Gator7]

Everyone has slightly different rates 400-500/hr. More for cardiac/transplant.

Getting pretty saturated though. Plenty of local docs have already jumped on the opportunity plus there’s a ton of travelers.

 

[coffeebythelake]

Everyone has slightly different rates 400-500/hr. More for cardiac/transplant.

Getting pretty saturated though. Plenty of local docs have already jumped on the opportunity plus there’s a ton of travelers.

Travellers, especially those flying in are going to get cut first.

 

[mmag]

I hear that one of the hospital systems will be going to go 10 or 14:1 staffing ratio to virtually eliminate need for physicians but still stay compliant.

 

[Dr. Rude]

Travellers, especially those flying in are going to get cut first.

Actually I think the incentive would be to cut the locals first. It is bad long term policy to cultivate a pool of very high priced local mercenaries. Our systems agreed several months ago to minimize local personnel for high priced locum work. It has been very successful for the RN pool. Not so much for the anesthesia pool. But the intent is there. What a lot of local CRNAs have done is go about 0.8 FTE, get their health insurance through the system and then float a bit. Usually locally. Maybe drive about an hour to the next town.

 

[Dr. Rude]

I hear that one of the hospital systems will be going to go 10 or 14:1 staffing ratio to virtually eliminate need for physicians but still stay compliant.

Good luck.
Utilization, productivity, efficiency, length of stay, complications, unplanned admits, including ICU, malpractice, etc. will all take a hit that will dwarf anesthesia payroll savings. They may be too dumb to figure it out for a year or the person(s) calling the shots may just not care.

 

[Pharmado]

Actually I think the incentive would be to cut the locals first. It is bad long term policy to cultivate a pool of very high priced local mercenaries. Our systems agreed several months ago to minimize local personnel for high priced locum work. It has been very successful for the RN pool. Not so much for the anesthesia pool. But the intent is there. What a lot of local CRNAs have done is go about 0.8 FTE, get their health insurance through the system and then float a bit. Usually locally. Maybe drive about an hour to the next town.

You've essentially summed up the entire CRNA market in the Twin Cities. Most of them work 0.6 FTE for insurance and do locums work everywhere else. I want to be angry with them since they are breaking the market, but they are just taking advantage of a broken system.

 

[pgg]

I hear that one of the hospital systems will be going to go 10 or 14:1 staffing ratio to virtually eliminate need for physicians but still stay compliant.

Good thing they'll be saving so much money to cover the malpractice hits and longer hospital stays.

 

[coffeebythelake]

Actually I think the incentive would be to cut the locals first. It is bad long term policy to cultivate a pool of very high priced local mercenaries. Our systems agreed several months ago to minimize local personnel for high priced locum work. It has been very successful for the RN pool. Not so much for the anesthesia pool. But the intent is there. What a lot of local CRNAs have done is go about 0.8 FTE, get their health insurance through the system and then float a bit. Usually locally. Maybe drive about an hour to the next town.

U think locums recruiters care about long term policy? It is much more expensive in short term to do this strategy.

 

[Dr. Rude]

U think locums recruiters care about long term policy? It is much more expensive in short term to do this strategy.

I was thinking about what the people who are writing the checks to get the ORs staffed care about. I.e., hospital leadership. I know that they are pulling their hair out over staff costs.

 

[nimbus]

I hear that one of the hospital systems will be going to go 10 or 14:1 staffing ratio to virtually eliminate need for physicians but still stay compliant.

Compliant with what?

 

[coffeebythelake]

I was thinking about what the people who are writing the checks to get the ORs staffed care about. I.e., hospital leadership. I know that they are pulling their hair out over staff costs.

Imo they just want the ORs running. And a local person will offer more consistent coverage and less likely to call off due to flight delays/cancellations and etc..

 

[ASA6]

U think locums recruiters care about long term policy? It is much more expensive in short term to do this strategy.

I'm told something like this happened in the PNW, and also elsewhere at USAP sites. The hospital/group tells the recruiters you can't present anyone within 60 miles. They don't want local candidates working as locums, because then no one will apply for full time work. Why join the group when you can work there as locums making double and setting your own schedule?

 

[coffeebythelake]

I'm told something like this happened in the PNW, and also elsewhere at USAP sites. The hospital/group tells the recruiters you can't present anyone within 60 miles. They don't want local candidates working as locums, because then no one will apply for full time work. Why join the group when you can work there as locums making double and setting your own schedule?

I'll buy a place further away and list it as my home base

 

[Biochemist21]

Does anyone have recent experience doing locums in Memphis and know what the rates are?

My locums recruiter is asks me if I'm interested in this place weekly. So far I've held him off as I'm currently getting >$400/hr closer to home.

According to my recruiter they are looking specifically for, "as many people as possible who can work 12s (hours), but they might be negotiable and allow you to work 10s." Apparently overtime is "unlimited," so people are routinely making >$25k/wk. I'm ACTA so he insists I can make even more to do liver transplants there, and I told him that there's no way I'm going to do solo liver transplants with surgeons I don't know. Once I explained to him how bad liver transplant cases usually are he's like, "oh, I understand," and hasn't asked me again.

My hesitancy has just been thinking that if they're offering these crazy rates, it must really be a disaster and potential liability I'd prefer to avoid.

I'd really like to hear from anyone who has worked there, either as locums or former permanent staff. Did the prior group implode?

 

[coffeebythelake]

I'm told something like this happened in the PNW, and also elsewhere at USAP sites. The hospital/group tells the recruiters you can't present anyone within 60 miles. They don't want local candidates working as locums, because then no one will apply for full time work. Why join the group when you can work there as locums making double and setting your own schedule?

Well kinda late in the game to cut local people since they are now held captive to the locums company for 2 years. Hnless they get bought out

 

[nimbus]

I'm told something like this happened in the PNW, and also elsewhere at USAP sites. The hospital/group tells the recruiters you can't present anyone within 60 miles. They don't want local candidates working as locums, because then no one will apply for full time work. Why join the group when you can work there as locums making double and setting your own schedule?

This is why we pay our locums slightly less than our own partners. They can pick and choose when they work and don’t have to take call but it comes at a price. And people (just a handful) still work locums for us. Usually fellows looking for extra work or spouses of trainees at the academic hospital. These people plan to move on when they no longer need to live here. Rarely we get someone who moved here to retire but don’t want to stop working completely.

 

[Pharmado]

This is why we pay our locums slightly less than our own partners. They can pick and choose when they work and don’t have to take call but it comes at a price. And people (just a handful) still work locums for us. Usually fellows looking for extra work or spouses of trainees at the academic hospital. These people plan to move on when they no longer need to live here. Rarely we get someone who moved here to retire but don’t want to stop working completely.

You can do this with a stable group and a stable market. In a place like Memphis I’d imagine you have to overpay or you won’t be able to staff the ORs.

 

[aneftp]

400 an hour isn't enough. Maybe 500+.

I'm getting 400 locally, large metropolitan area, with low ratio ACT with some solo days, plus I get to put my kids to bed at night.

I only consider la nyc Chicago Dallas Houston dc sf Atlanta Philly Boston Miami “large metro area”

Basically the top 10. If u are getting $500/hr in those real large metro area. Congrats.

 

[coffeebythelake]

I only consider la nyc Chicago Dallas Houston dc sf Atlanta Philly Boston Miami “large metro area”

Basically the top 10. If u are getting $500/hr in those real large metro area. Congrats.

I'm at 400/hr and I am in one of those cities you listed

 

[mmag]

Compliant with what?

TN is not an opt out state. Hospital bylaws might still require an anesthesiologist/rescuologist somewhere.

 

[narcotics999]

I'm at 400/hr and I am in one of those cities you listed

General or subspecialty? Solo or supervision?

 

[coffeebythelake]

General or subspecialty? Solo or supervision?

General. Mix of both. Ratios when supervising are usually 1:2.

 

[GassYous]

I only consider la nyc Chicago Dallas Houston dc sf Atlanta Philly Boston Miami “large metro area”

Basically the top 10. If u are getting $500/hr in those real large metro area. Congrats.

That's 11 places though

 

[CubsDynasty]

I only consider la nyc Chicago Dallas Houston dc sf Atlanta Philly Boston Miami “large metro area”

Basically the top 10. If u are getting $500/hr in those real large metro area. Congrats.

what about Phoenix #5, San Antonio #7, San Diego #8 and Austin #10?

 

[nimbus]

That's 11 places though

“Basically”

 

[aneftp]

what about Phoenix #5, San Antonio #7, San Diego #8 and Austin #10?

What world do u live in. Phoenix is no where near 5 in metro area. Neither is San Antonio or San Diego or Austin.

 

[CubsDynasty]

What world do u live in. Phoenix is no where near 5 in metro area. Neither is San Antonio or San Diego or Austin.

the one that googles top 10 cities by population

 

[aneftp]

the one that googles top 10 cities by population

Population of U.S. metropolitan areas 2022 | Statista

In 2022, the metropolitan area of New York-Newark-Jersey City had the biggest population in the United States.

www.statista.com

Metropolitan statistical area - Wikipedia

en.m.wikipedia.org

Top 50 Metro Areas in the U.S. Have 31 NFL Teams

This infographic features the metro areas represented by all 32 NFL teams.

www.census.gov

I’d be interested what data point u have phoenix number 5? Or San Antonio or San Diego?

 

[CubsDynasty]

Back under the bridge troll. Google “top us cities in population”. I gave you instructions.

 

[nimbus]

Back under the bridge troll. Google “top us cities in population”. I gave you instructions.

To be fair, the list does shift a bit if you search “top 10 metropolitan statistical areas.” I live in San Diego but LA is on another level for food, culture, subcultures, and entertainment. We go there often.

 

[aneftp]

Back under the bridge troll. Google “top us cities in population”. I gave you instructions.

There is no trolling. u want to google what u want

I’m more concern with metro area. You are more concern with the physical city limits. If you want to play those area. Cities in Alaska are larger than all the “top us cities in population “ by area. Even Memphis would be consider a large city. And Jacksonville city itself would be considered the largest Florida city. And any common person knows Miami metro area is so much larger than Jax city when including metro area.

I have no bias. You seem to be bias towards the southwest and west area. I’ve lived and worked in plenty of places including LA, Memphis Wyoming northeast Midwest. South.

I have not work in the southwest or northwest

 

[gator2886]

Methodist delays surgeries after breakup with anesthesia provider

UPDATE: Ray Wilson, President of the Medical Anesthesia Group, released an additional statement saying, “I have been a part of Medical Anesthesia Group for 37 years of its 52-year history. Our first priority is and has always been patient care. Our outstanding service, leadership, reputation...

news.yahoo.com