What’s happening in Memphis

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a guy from MAG joined our group. He was a partner there and now is in our partner track. The partners in Memphis all took a big pay cut to eat the increased cost of their Crnas. A few left or retired when income fell off for the same or more work load which lead to more and more work for less and less money. The group was unable to recruit new docs and went back to the hospital for $ help to make ends meet. Hospital said no.

I heard gossip that usap was approached about this contract but it was a short conversation.

This ex MAG doc constantly says how great our group and hospital is and how much easier it is to work here. lol I’ve never considered my beloved level one trauma level 4 maternity and transplant center - easy. I think his perspective is warped… just a testament to how bad it must have been up in Memphis.
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Should be at least 500 when you’re in the news. Especially if you cover call/weekends. I wonder what peds people are getting, I’ve heard from my peds friend some of the Portland peds locums are negotiating >500
 
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Maverikk said:
Should be at least 500 when you’re in the news. Especially if you cover call/weekends. I wonder what peds people are getting, I’ve heard from my peds friend some of the Portland peds locums are negotiating >500
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Dude. Maybe I should be doing peds locums in Portland. That is nuts.
 
Yeah no kidding. I don’t know how much is rumor but apparently the private groups are starting to reach out to have locums cover cases. I don’t know if Sound or OAG covers them now but apparently it’s been frustrating some higher ups. The person I know negotiating is around the area and is a known entity. I can’t imagine a peds surgeon accepting some unvetted locums but maybe desperate times
 
coffeebythelake said:
Lots of locums companies right now only advertising for 300/hr? Wtf they must think people are idiots to take that pathetic offer
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Never go by posted rates. Always negotiate based on job specifics and leverage.
 
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Memphis in general is a crappy anesthesia area. All the groups are a mess. East Memphis Anesthesia Services fell apart and was/is pretty sketchy as far as how they treat fellow partners. Baptist is owned by Napa and just lost their entire cardiac anesthesia group (apparently to Methodist loll). Baptist is apparently running 8:1 ratios to keep it all going. Methodist has been well documented in this thread. Regional One Health according to docs I know who've interviewed has some in over her head chair who's running the place into the ground through poor leadership. She appears to be running off existing staff is the word on the street and surgeons I know never see her in the OR (I guess reverse of the MAG situation where the partners were trying to keep it afloat). So that place is a mess too.

I'm just happy to have the flexibility to travel for locums work so I don't have to be married to these places.
 
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coffeebythelake said:
There are some places on gaswork advertising locum 175/hr. They must be smoking some strong ****
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I haven’t seen it this low. Have seen $200. You sure that’s not for AAs?
Anyway there is a sucker born every minute. Someone is taking less than $300 because one of my recruiters told me this is rate he pays in FL because of the weather.
 
makemoney2024 said:
I haven’t seen it this low. Have seen $200. You sure that’s not for AAs?
Anyway there is a sucker born every minute. Someone is taking less than $300 because one of my recruiters told me this is rate he pays in FL because of the weather.
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I’d take that to sleep in the hotel room carrying the beeper or play video games in the office.
 
makemoney2024 said:
I haven’t seen it this low. Have seen $200. You sure that’s not for AAs?
Anyway there is a sucker born every minute. Someone is taking less than $300 because one of my recruiters told me this is rate he pays in FL because of the weather.
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It wouldn't surprise me if someone took that (wanting to family in the area etc.), but also I wouldn't say your recruiter is an unbiased source of information either.
 
I think these rates will last as long as AMCs and hospitals don’t realize they are perpetuating the problem they caused. All the employers are thinking we don’t want to offer raises or better $ to full time doctors because we don’t want to “set the market” high. I guess they think there will be a market correction or at least market change. I think they are counting on 1. People get sick of the locums lifestyle and will chose to settle down in an area they like and will accept a lower paying job to be there 2. They will flood the market with crnas and run extended care teams so they can get the same work out of one dr and 8 crnas that they used to need to pay two drs for. Cigna cutting reimbursement 15% for going over four rooms hasn’t changed the market so I doubt other insurance companies will follow suit.
If the companies and hospitals would just set surgeon and admin expectations temporarily low to give the market time to reset itself, stop using locums and save that money to pay full time staff the locums jobs would dry up and force people back into the regular market. But it takes a little bit of long term thinking and some hard conversations — neither of which are happening
 
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makemoney2024 said:
I haven’t seen it this low. Have seen $200. You sure that’s not for AAs?
Anyway there is a sucker born every minute. Someone is taking less than $300 because one of my recruiters told me this is rate he pays in FL because of the weather.
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There are mommy track and retired docs taking $225-250/hr Florida w2! Prn. I am not Lying about this.

And they fill those needs. Because it’s literally 10 min drive for these docs and easy job. These docs work sporadically 4-5 days a month. Just out of boredom (retired doc or close to ) and mommy docs (to keep up their skill).

Crnas are working for $120/hr 1099 as well a few places in Florida on the coast. Because of location. Again. These are confirmed number. Super easy eyeball.

It’s about locations, needs, desirable area.

That’s why most professional locums docs and crnas do not touch most parts of urban areas of Florida.

I can’t even get my crna who’s currently in New York doing locums for $260/hr down to Florida cause $220/hr is too low for her. Plus she says it’s too hot. Duh.
 
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makemoney2024 said:
I haven’t seen it this low. Have seen $200. You sure that’s not for AAs?
Anyway there is a sucker born every minute. Someone is taking less than $300 because one of my recruiters told me this is rate he pays in FL because of the weather.
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One of our AAs is doing some locums and getting $195/hr and night-time/weekend hours are like $210/hr (he does not work the nights/weekends. Not enough pay differential.)
 
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It’s gonna to cost the Memphis hospitals and surgery center millions and I mean millions (30-50 million) in anesthesia staffing cost subsidies before they can get this under control. Likely 2 plus years. What a stupid decision not to pay the previous old group a bigger subsidy. I don’t know how much the difference they needed to pay. But I can assure you it will will cost them 3-5x more than what they would have just written the private group the extra subsidy money.

That’s why buddy loves chaos. Cause it means he’s collecting $$ as locums.

Let's see if X group is getting 10 million in subsidy for larger anesthesia contract. Tells hospital management they need 13 million for this year. Hospital management says no. Group contract ends (this happen at a different hospital system out East Coast)

Hospital management shops around and AMC says it will cost them 15 million and AMC wants 100% of locums cost paid out by hospital directly for the first 12 months and than 50% the next 12 months. Hospital management has no choice but to pay it now.

You see it happen time and time again in this age.

If I were hospital management in Memphis, I would pay everything internally 650K w2 for anesthesia docs based on 42 hours average pay per week including calls with 10 weeks off. Pay crnas 280K w2 with 10 weeks off based on 40 hours.

If docs want to work extra pay them 300/350/hr extra.

It's by far the cheapest quickest solution. You will minimize your locums cost with that salary structure. Most docs in that area will assume they can likely make 750k w2 pretty easy with some overtime (20 hours of overtime each month is around 7-8k extra a month x 12 months). So they can average 45 hours and make 750K.

It's right around where the average locums doc would make assuming locums docs works 40 hours a week for 42 weeks @400/hr. You discentivie locums work for these local area docs. In exchange these docs get a stable salary.

You eliminate the need for long term locums cost.
 
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Somnia went into Memphis though… I haven’t heard good things about them so very doubtful they’ll be able to staff things. They’re offering 650 for Memphis and outskirts like Germantown. No idea if somnia makes you sign non competes
 
amyl said:
Somnia went into Memphis though… I haven’t heard good things about them so very doubtful they’ll be able to staff things. They’re offering 650 for Memphis and outskirts like Germantown. No idea if somnia makes you sign non competes
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650K 40 hours/10 weeks is what I would shoot for. Has to be in the contract. Or else they can run up the hours on you.

Somnia is notorious bottom feeder in terms of anesthesia compensation/high work load. It's been years since I had any dealings with them though. Maybe they have changed.
 
GA is getting $350-$400 per hour day time, no call at hospitals other than Methodist which is managed by Somnia now. This is a forever problem. (or a great thing if you are locums profiting)
HIGH CRIME in Memphis, No Anesthesiology Residency for about 20 years (there is one now with 1-2 kids per year), poor reimbursement, CEO's not willing to pony up all contribute. The hospitals all trying to cut after hours staffing to a minimum....Dumpster fire. Everyone talks about the hospitals, the Anesthesiologists, the CRNAs-sadly its the citizens that ultimately suffer from lack of access to care.
 
gator2886 said:
GA is getting $350-$400 per hour day time, no call at hospitals other than Methodist which is managed by Somnia now. This is a forever problem. (or a great thing if you are locums profiting)
HIGH CRIME in Memphis, No Anesthesiology Residency for about 20 years (there is one now with 1-2 kids per year), poor reimbursement, CEO's not willing to pony up all contribute. The hospitals all trying to cut after hours staffing to a minimum....Dumpster fire. Everyone talks about the hospitals, the Anesthesiologists, the CRNAs-sadly its the citizens that ultimately suffer from lack of access to care.
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I keep hearing high crime in Memphis from so many people. Can I ask, is it any different than say any major city? Every city has its pockets. Or are we comparing the whole city to say South Side Chicago?
 
makemoney2024 said:
I keep hearing high crime in Memphis from so many people. Can I ask, is it any different than say any major city? Every city has its pockets. Or are we comparing the whole city to say South Side Chicago?
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I hear, from many who know it well, that the city is far more murdery than most.
 
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some of those citizens are to blame for the lack of care.... stop stealing cars and shooting people....
 
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makemoney2024 said:
I keep hearing high crime in Memphis from so many people. Can I ask, is it any different than say any major city? Every city has its pockets. Or are we comparing the whole city to say South Side Chicago?
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makemoney2024 said:
I keep hearing high crime in Memphis from so many people. Can I ask, is it any different than say any major city? Every city has its pockets. Or are we comparing the whole city to say South Side Chicago?
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I had a very lucrative 1099 gig in Memphis surburb (germantown) years ago. I left after 6 weeks because I didn’t feel comfortable and I’m a guy.

I was staying in a new gated apartment complex and there were breakins near FedEx word headquarters.

I got paranoid hearing noises. So I left the job. Felt I was being followed in my bmw convertible as I left the apartment each time.

Gi doc I worked with had gotten robbed at the same time in his own house in well to do neighborhood
 
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aneftp said:
I had a very lucrative 1099 gig in Memphis surburb (germantown) years ago. I left after 6 weeks because I didn’t feel comfortable and I’m a guy.

I was staying in a new gated apartment complex and there were breakins near FedEx word headquarters.

I got paranoid hearing noises. So I left the job. Felt I was being followed in my bmw convertible as I left the apartment each time.

Gi doc I worked with had gotten robbed at the same time in his own house in well to do neighborhood
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Alright. You guys are convincing me
 
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Wow… Germantown. Last time I was there was at least 10 years ago… probably more - and thought it was nice.
Sounds like they need some serious police presence to clean the place up
 
makemoney2024 said:
Alright. You guys are convincing me
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Yea it's way worse (saw your earlier comparison question) and I've lived in decently large cities that had standard amounts of crime by urban expectations. You can get shot driving on the freeway here because... Well Memphis.
 
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aneftp said:
I had a very lucrative 1099 gig in Memphis surburb (germantown) years ago. I left after 6 weeks because I didn’t feel comfortable and I’m a guy.

I was staying in a new gated apartment complex and there were breakins near FedEx word headquarters.

I got paranoid hearing noises. So I left the job. Felt I was being followed in my bmw convertible as I left the apartment each time.

Gi doc I worked with had gotten robbed at the same time in his own house in well to do neighborhood
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Whoa :(
 
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gator2886 said:
GA is getting $350-$400 per hour day time, no call at hospitals other than Methodist which is managed by Somnia now. This is a forever problem. (or a great thing if you are locums profiting)
HIGH CRIME in Memphis, No Anesthesiology Residency for about 20 years (there is one now with 1-2 kids per year), poor reimbursement, CEO's not willing to pony up all contribute. The hospitals all trying to cut after hours staffing to a minimum....Dumpster fire. Everyone talks about the hospitals, the Anesthesiologists, the CRNAs-sadly its the citizens that ultimately suffer from lack of access to care.
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Former colleague of mine is a locum at Memphis. Rates are still very good for both generalists and Cardiac fellowship. If you don't mind the risk of a high crime rate this is a very good gig.
 
Update. Memphis and somonia getting rid of a bunch of locums. The more expensive locums went first. But like 20 of them got their notice a couple of days ago.

There are certain magic numbers that will get u w2 docs very quickly in this market and get rid of 1099 locums docs. And save u money. This hospital and somonia figured out those magic numbers. And hired a bunch of docs w2 plus gave the other docs a gurantee 1099
Magic number as well.

My friend was telling me the locums agency market up was crazy. 40-50% markup. So the hospital and the amc acted quickly. Congrats to them for somewhat controlling their locums cost quickly. Everyone is at loss mitigation these days. Do you want to lose 5 million or 8 million? They chose to lose less than 8 million a year. (I’m just making up the actual numbers). But that’s the way hospitals need to think these days.
 
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aneftp said:
Update. Memphis and somonia getting rid of a bunch of locums. The more expensive locums went first. But like 20 of them got their notice a couple of days ago.

There are certain magic numbers that will get u w2 docs very quickly in this market and get rid of 1099 locums docs. And save u money. This hospital and somonia figured out those magic numbers. And hired a bunch of docs w2 plus gave the other docs a gurantee 1099
Magic number as well.

My friend was telling me the locums agency market up was crazy. 40-50% markup. So the hospital and the amc acted quickly. Congrats to them for somewhat controlling their locums cost quickly. Everyone is at loss mitigation these days. Do you want to lose 5 million or 8 million? They chose to lose less than 8 million a year. (I’m just making up the actual numbers). But that’s the way hospitals need to think these days.
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Well that was quick. Do you know the magic number? Did some of the existing doctors sign on with Somnia?
 
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Guillemot said:
Could be good depending on hours, call, etc. Doesn't have all the details.


GasWork.com - Reference #445497

Reference #445497
www.gaswork.com www.gaswork.com
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Yes. That it’s.

That’s just market rate. 650k/9-10 weeks off based on 45 hours worked for w2

Think about it a 1099 locums doc at $375/hr x 45 hr x 42 weeks equals $708k

Get rid of the middle men (the agency markups)

You can get 85% of ur docs lined up with that pay in this current environment.

Those places that try to pay docs 500-range are dead in the water

Places do not want to “set the market” but the market catches up sooner than later but the future comes fast enough.

Does the hospital want lose more each month they can’t shore up the practice?

The other alternative I mention is to pay docs 450-500k w2 for 40 hour work weeks with 20 weeks off. That’s what I’m targeting. It will be my choice to pursue extra work. I’m sure I can generate 150-200k extra on my 10 extra weeks off. But I have that flexibility to choose myself.
 
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Pharmado said:
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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The organization that came in is not a PE firm, it is a large multi-state group of CRNAs and Docs that have been around for 28 years. Good people. Apparently the group that was there for many years ("MAG") needed more and more money from the hospital, the hospital wanted to see where that money was going and both parties could not come to agree on the level of detail that was to be provided. Apparently the new group offered the previous group great deals but few of the docs stayed.
 
Marcus_Ernesto said:
The organization that came in is not a PE firm, it is a large multi-state group of CRNAs and Docs that have been around for 28 years. Good people. Apparently the group that was there for many years ("MAG") needed more and more money from the hospital, the hospital wanted to see where that money was going and both parties could not come to agree on the level of detail that was to be provided. Apparently the new group offered the previous group great deals but few of the docs stayed.
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Somnia was or still is difficult to deal with.

The original 2-3 founders were lazy as F during residency in the mid 1990s. Got help with their New York based daddies to start up the company and get surgery centers. All they talked was doing as little as possible while trying to make as much.

It’s a free world. But that’s their model.

Look. Money talks. They obviously convinced the Hospital and surgery centers to cough up enough money.

The overall work load is manageable for the pay.
That’s all that matters these days. Pay people. Don’t over work them.

I am sure the Hospital is paying much more to Somnia to run the practice than the old group.

It’s like my friends place. 8 million dollar subsidy with private practice. They left.

New amc comes in. Begs for help after 6 months. Demands 21 million dollar subsidy. Hospital management and amc congratulate themselves for getting staffing up. But they just spent 13 million extra!

Same stuff in Memphis
 
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Howard888 said:
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
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Not sure if the hospitals will or won't be successful.
mmag said:
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.
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this is not what I saw when I interviewed. It was 1 MD to 2 or 3 CRNA mostly and some 1 MD to 4 CRNA. I asked some of the MD and CRNA if those ratios were every higher and they said that once or twice over the lat 6 months if was 1 to 5 in one location. Also too,m I wanted to do my own cases, and I saw that there was an option to do that as well since about 20-30% of rooms were covered by docs.
 
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aneftp said:
Somnia was or still is difficult to deal with.

The original 2-3 founders were lazy as F during residency in the mid 1990s. Got help with their New York based daddies to start up the company and get surgery centers. All they talked was doing as little as possible while trying to make as much.

It’s a free world. But that’s their model.

Look. Money talks. They obviously convinced the Hospital and surgery centers to cough up enough money.

The overall work load is manageable for the pay.
That’s all that matters these days. Pay people. Don’t over work them.

I am sure the Hospital is paying much more to Somnia to run the practice than the old group.

It’s like my friends place. 8 million dollar subsidy with private practice. They left.

New amc comes in. Begs for help after 6 months. Demands 21 million dollar subsidy. Hospital management and amc congratulate themselves for getting staffing up. But they just spent 13 million extra!

Same stuff in Memphis
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Not my understanding or what I have seen or heard--first hand.
 
Marcus_Ernesto said:
Not my understanding or what I have seen or heard--first hand.
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Those dudes stole my other buddy (yes I have a lot of contacts throughout the country). Contract out west on 2007. It’s a dirty business. They ran it into the ground

Now I understand the game has changed but they literally did a bait and switch with hospital admin promising lower cost when cost doubled in one year

It’s just usual business dealings. Who believes the lies one business entity tells another

I do have to congratulate the hospital management for doing damage control. It’s Better to lose 20 million now as oppose to 30 million in another year trying to shore up staffing. When they probably could have just paid the original group 15 million lol

That’s just how stupid hospital admin is these days. But at least they recognize the situation quickly.
Lost mitigation
 
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aneftp said:
Those dudes stole my other buddy (yes I have a lot of contacts throughout the country). Contract out west on 2007. It’s a dirty business. They ran it into the ground

Now I understand the game has changed but they literally did a bait and switch with hospital admin promising lower cost when cost doubled in one year

It’s just usual business dealings. Who believes the lies one business entity tells another

I do have to congratulate the hospital management for doing damage control. It’s Better to lose 20 million now as oppose to 30 million in another year trying to shore up staffing. When they probably could have just paid the original group 15 million lol

That’s just how stupid hospital admin is these days. But at least they recognize the situation quickly.
Lost mitigation
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Agreed. This idea that these multistate PEs are anything more than big box retail anesthesia is misguided.
 
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