Worst Jobs-Biggest Rip Offs

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Howard888

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We tend to mention good jobs-but with inflation, housing, interest rates, debt-what are the biggest rip off/scheme jobs out there?

I know USAP Austin/Central was mentioned as having a very low salary, long partnership, and stock purchase in a city with a crazy high cost of living.

I saw NAPA in Virginia was bad for similar reasons

Who else? Where should people see warning signs? Help folks looking for jobs
 
We have a place nearby which recruits new grads telling them they’ll get, let’s say, $350k starting, and then sells them on it by saying the places down the road start at only $300k. They leave out the part that the other place has full benefits and they take every benefit you use out of your $350k, so you’re actually making less and working harder than the other jobs.

ALWAYS calculate the value of the benefits when comparing jobs. I know that sounds obvious but the majority of residents I work with forget to do that, including myself when I was in that position.
 
I agree with the above post.

I would avoid anything like NAPA or Sound Anesthesia. They are willing to QZ bill CRNAs and stretch you past 1:4. You basically exist to take call and put out fires caused by doctor nurses. Sellout docs and militant overconfident CRNA run groups don't care about younger docs.

Things to look for:
1. Coverage of tail if claims made insurance especially if they terminate you. That can be costly. Go for occurrence based if you can since easier to leave.
2. Hours included in base pay; call or OT pay should be fair whether it's hourly or a fixed amount per day
3. Non compete time and distance. Really it should just be that hospital (or zero miles) since anesthesia docs can't steal patients.
 
ambiturner said:
ALWAYS calculate the value of the benefits when comparing jobs.
Click to expand...

I would venture a guess that the majority of anesthesiologists (or I guess physicians) do not actually know the value of the benefits they receive and that does influence your estimation of your paycheck.

As a random example, our partnership docs total comp is probably about $500K per year. Their paycheck isn't that high, though, so doesn't sound quite as nice. But then when you go out and talk to private practices about their partner earnings, it is always in terms of total compensation. Why? Because I am paying for each of my own benefits. My paycheck isn't as high as my total comp, but it is crystal clear to me what those benefits cost because I see them deducted from my gross.
 
What do you guys think about vacation time? For those in “eat what you kill” kind of groups, if you don’t work, you don’t get paid. Will you vacation time as part of the “benefit?”
 
I talked to an AMC in Orlando… 3 yr track, 325/350/percentage of production. Deal breaker for me was 13 call weekends per year, weekends are Friday 7am - Monday 7am 🥴 does anyone else do weekends like that? Sounds terrible to me
 
epcotdoc said:
I talked to an AMC in Orlando… 3 yr track, 325/350/percentage of production. Deal breaker for me was 13 call weekends per year, weekends are Friday 7am - Monday 7am [emoji3061] does anyone else do weekends like that? Sounds terrible to me
Click to expand...

I did. But not Q4Week. They will say then you should be free on weekends for rest of the month. [emoji1787]
 
epcotdoc said:
I talked to an AMC in Orlando… 3 yr track, 325/350/percentage of production. Deal breaker for me was 13 call weekends per year, weekends are Friday 7am - Monday 7am 🥴 does anyone else do weekends like that? Sounds terrible to me
Click to expand...

is that in house call for 72 hours? Or is it home call? If in house that is ludicrous. If from home it obviously just depends on how often you are there.
 
IMGASMD said:
What do you guys think about vacation time? For those in “eat what you kill” kind of groups, if you don’t work, you don’t get paid. Will you vacation time as part of the “benefit?”
Click to expand...


No.
 
Ill add USAP Seattle to the list....

They said (on their gasworks) 325-350k during the 2 year partnership track, with an average of 55 hours/week. Calculate that out and theyre paying their associates $130-150/hr....

Surrounding areas locums is hitting 300/hr...
 
I once had a practice in Arkansas offer me a 350k base salary plus $55 per rvu production for anything over 11,000 RVU’s. In the pain world that is a pretty bloody ripoff.
 
Mman said:
is that in house call for 72 hours? Or is it home call? If in house that is ludicrous. If from home it obviously just depends on how often you are there.
Click to expand...
I asked that and they seemed purposefully vague. “We spilt call between in house for OB and home call for OR” but didn’t indicate what the weekends were. I can’t remember what the estimated callback rate was, but they seemed like a busy group.
 
epcotdoc said:
I asked that and they seemed purposefully vague. “We spilt call between in house for OB and home call for OR” but didn’t indicate what the weekends were. I can’t remember what the estimated callback rate was, but they seemed like a busy group.
Click to expand...

Sounds like a red flag if I ever hear one.
 
epcotdoc said:
I talked to an AMC in Orlando… 3 yr track, 325/350/percentage of production. Deal breaker for me was 13 call weekends per year, weekends are Friday 7am - Monday 7am 🥴 does anyone else do weekends like that? Sounds terrible to me
Click to expand...

Mman said:
is that in house call for 72 hours? Or is it home call? If in house that is ludicrous. If from home it obviously just depends on how often you are there.
Click to expand...
I did 12 in-house weekends a year at my old job. Could have taken home call but there was so much OB that it made this impossible. This call arrangement wasn’t necessarily explained to me until I had already started; hence the reason it is my “old job.”
 
PainDrain said:
I did 12 in-house weekends a year at my old job. Could have taken home call but there was so much OB that it made this impossible. This call arrangement wasn’t necessarily explained to me until I had already started; hence the reason it is my “old job.”
Click to expand...

Mine was CRNAs in house, you’re allowed to go home. Response time was 20 mins. I was too far.
I think we were q6weekends. So it’s “somewhat” nice to think about your weekend is free for the rest. Just get it over with was the mindset.
 
Our group has about 10-11 weekends of call a year. We have 3 docs on call at each regional hospital and rotate call position so only one of those positions are you likely to get called during off hours and one of the positions you never get called in. I do not feel it has a large impact on my lifestyle and our compensation formula heavily subsidizes call on weekends and holidays.
 
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Curious what you all would think of this job. Small city doing everything but hearts, call is q6-9 for full overnight call, weekend call is every 5 weeks, late call is q6, pay is 500k, employer match 401K, occurrence malpractice 2/6 million, good commercial health insurance, and a life insurance policy of 1million.
 
epcotdoc said:
I talked to an AMC in Orlando… 3 yr track, 325/350/percentage of production. Deal breaker for me was 13 call weekends per year, weekends are Friday 7am - Monday 7am 🥴 does anyone else do weekends like that? Sounds terrible to me
Click to expand...
Is it in-house? If it's not in-house while being tied to the hospital stinks it's not horrible and it's basically one weekend a month....but maybe i need a touch more pay out of a gig like that
 
abolt18 said:
@anbuitachi ?
Click to expand...
I just say that because these places are still thriving despite the bad press that shows up on here and in public. Im sure some NAPA people are on here. Im sure some Northstar, USAP, and Envision etc et etc people are on here and I would like to hear from the belly of the beast instead of internet rumor. People take different jobs for all sorts of reasons but I feel like we only hear from the disgruntled
 
Twiggidy said:
I just say that because these places are still thriving despite the bad press that shows up on here and in public. Im sure some NAPA people are on here. Im sure some Northstar, USAP, and Envision etc et etc people are on here and I would like to hear from the belly of the beast instead of internet rumor. People take different jobs for all sorts of reasons but I feel like we only hear from the disgruntled
Click to expand...


Seems like quite a few USAP folks are happy with their jobs.
 
nimbus said:
Seems like quite a few USAP folks are happy with their jobs.
Click to expand...

Sure they are.

When they have conversations with their families and colleagues and on an internet discussion board.

Do you think that they are when they lie awake at night in the dark?

Northern Virginia was mentioned earlier in this thread. The Fairfax group was one of the most desirable private practices in the country. The department there has historically been filled with the best residents from the name brand programs that everybody mentions in “top 10”. They recently became NAPA employees.

Very few of the docs left when that happened.

Being 40 years old with kids plugged into middle school and relocating is a hard thing for many folks.
 
There was another thread about this which is where it was identified how bad USAP Austin/central Texas was.

USAP varies drastically from practice to practice. Some better than others. Always better for those original partners who sold, but some USAP groups treat junior folks much better. Austin,Orlando, Seattle frequently mentioned as worse. Dallas, Ok city frequently mentioned as best
 
I got a job offer some years back.
250k base, partner track.
4 years to partner.
Partners make >$600.
3 years into what would have been my partner track, they sold to an AMC, got >$2M paydays and left the non partners with garbage AMC offers.
I think I might have gone postal after taking a big pay cut to get into this sweet PP partnership, losing money selling 2 houses, and getting a -$600k+ Crap sandwich instead of a partner offer.
Interestingly one of the partners asked me the details of my job at the time and said he’d stay if he were me. I wonder if they knew they were considering selling out and that I’d never be able to earn it back? The grass isn’t always greener and they definitely worked a whole lot more than me for the $$. Obviously there were other advantages to PP though.
The other garbage job I never followed up on for in in person interview was Kaiser SoCal. They wanted to bring me in as a per diem guy for some kind of probation like period before they offered me an actual job. They couldn’t even explain how much I’d be making year 1, 2, 10. It was crazy. I asked if many experienced, double boarded applicants from 5 star training programs, with chief/leadership roles, early promotion, no lawsuits/red flags, etc. relocate their families for a per diem job and no guarantee of a real job or an understanding of potential income. That didn’t go over well. Who takes that job? Maybe if I was already living there? WTF?
 
Sometimes I wonder if there is a bit of “peacocking” going on when people talk about their jobs. We see this effect on social media all the time. People show off the good parts of their lives (the vacations, the smiling families, the nice material possessions), but don’t show the crummy parts of their lives (the depression, the alcoholism, the marital strife, the work stress). I often wonder if the same thing happens here. If you landed one of those jobs where you make a million bucks a year and work 35 hours a week, you must be someone to envy.
 
IlDestriero said:
I got a job offer some years back.
250k base, partner track.
4 years to partner.
Partners make >$600.
3 years into what would have been my partner track, they sold to an AMC, got >$2M paydays and left the non partners with garbage AMC offers.
I think I might have gone postal after taking a big pay cut to get into this sweet PP partnership, losing money selling 2 houses, and getting a -$600k+ Crap sandwich instead of a partner offer.
Interestingly one of the partners asked me the details of my job at the time and said he’d stay if he were me. I wonder if they knew they were considering selling out and that I’d never be able to earn it back? The grass isn’t always greener and they definitely worked a whole lot more than me for the $$. Obviously there were other advantages to PP though.
The other garbage job I never followed up on for in in person interview was Kaiser SoCal. They wanted to bring me in as a per diem guy for some kind of probation like period before they offered me an actual job. They couldn’t even explain how much I’d be making year 1, 2, 10. It was crazy. I asked if many experienced, double boarded applicants from 5 star training programs, with chief/leadership roles, early promotion, no lawsuits/red flags, etc. relocate their families for a per diem job and no guarantee of a real job or an understanding of potential income. That didn’t go over well. Who takes that job? Maybe if I was already living there? WTF?
Click to expand...

If you are desperate enough. Talk to some folks who were looking for jobs in the the mid 90s.
 
GravelRider said:
If you landed one of those jobs where you make a million bucks a year and work 35 hours a week, you must be someone to envy.
Click to expand...

those all involve taking a partnership track position which gets treated like a 4 letter word around here. But literally all the best jobs require it.
 
I've mentioned this before, but Rush in Chicago is a terrible job. It's a private group with a contract with the hospital. Higher ups take home all the dough and you have no way of knowing what your pay will be or when it goes up. They reward each other for being in "positions" or "committees". No partner track, no RVU incentives. Just some nebulous payout from the chair as he seems fit. Three of my classmates interviewed there and we all turned it down. But it's Chicago so there are suckers abound.
 
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Ronin786 said:
I've mentioned this before, but Rush in Chicago is a terrible job. It's a private group with a contract with the hospital. Higher ups take home all the dough and you have no way of knowing what your pay will be or when it goes up. They reward each other for being in "positions" or "committees". No partner track, no RVU incentives. Just some nebulous payout from the chair as he seems fit. Three of my classmates interviewed there and we all turned it down. But it's Chicago so their are suckers abound.
Click to expand...

there are a lot of programs in chicago desperately looking for staff
and there is the chicago suburbs with plenty of hospitals as well that pay really well..
agree that Rush is a crap place to work
 
GravelRider said:
Sometimes I wonder if there is a bit of “peacocking” going on when people talk about their jobs. We see this effect on social media all the time. People show off the good parts of their lives (the vacations, the smiling families, the nice material possessions), but don’t show the crummy parts of their lives (the depression, the alcoholism, the marital strife, the work stress). I often wonder if the same thing happens here. If you landed one of those jobs where you make a million bucks a year and work 35 hours a week, you must be someone to envy.
Click to expand...
Exactly
 
Mman said:
those all involve taking a partnership track position which gets treated like a 4 letter word around here. But literally all the best jobs require it.
Click to expand...
And that's the thing. Outside of most AMCs, just about every other job has some sort of "track" where you're getting the short end in some way shape or form. I think there are multiple definitions of "bad job" and most of us would like or tolerate someone else's "bad" when being viewed from our side of the fence.
 
Ronin786 said:
I've mentioned this before, but Rush in Chicago is a terrible job. It's a private group with a contract with the hospital. Higher ups take home all the dough and you have no way of knowing what your pay will be or when it goes up. They reward each other for being in "positions" or "committees". No partner track, no RVU incentives. Just some nebulous payout from the chair as he seems fit. Three of my classmates interviewed there and we all turned it down. But it's Chicago so their are suckers abound.
Click to expand...
But it does make you wonder, why doesn't everyone just walk out because as said, Rush isn't the only game in a big place like Chicago. As said elsewhere, we as anesthesiologist do seem to be bad negotiators and seem to not understand supply demand economics.
 
Twiggidy said:
But it does make you wonder, why doesn't everyone just walk out because as said, Rush isn't the only game in a big place like Chicago. As said elsewhere, we as anesthesiologist do seem to be bad negotiators and seem to not understand supply demand economics.
Click to expand...

I think there are a few dynamics at play there. The first is that change is hard. In medicine, its not always as simple as picking up and changing jobs. You need state licenses and hospital credentials. That’s all after going through the process of actually finding a new job. Then you get to the new job and have to learn new systems and insert yourself into the local politics. Sometimes it’s easier to stick with the “devil that you know.”

I think the other side of it is that we are trained not to complain. The squeaky wheels in residency were always looked down upon. Doctors are actually perfect employees in that regard. We are trained to work hard in less than ideal conditions and taught that complaining about it marks you as weak. That sentiment sticks with us.
 
Dr. Rude said:
Sure they are.

When they have conversations with their families and colleagues and on an internet discussion board.

Do you think that they are when they lie awake at night in the dark?

Northern Virginia was mentioned earlier in this thread. The Fairfax group was one of the most desirable private practices in the country. The department there has historically been filled with the best residents from the name brand programs that everybody mentions in “top 10”. They recently became NAPA employees.

Very few of the docs left when that happened.

Being 40 years old with kids plugged into middle school and relocating is a hard thing for many folks.
Click to expand...
Well wait till they are done with middle school then leave. Why do you all put so much weight in your kids keeping you from moving? You know what kids are? Resilient. They survive.
How do military kids do it?
 
GravelRider said:
Sometimes it’s easier to stick with the “devil that you know.”
Click to expand...
Trust me .....100% understand this part (and the rest of your post for that matter). I just think for all the internet complaining our field tends to do (on this forum and otherwise) sometimes we need to just crap or get off the pot. Moreover, as someone on another thread said, we need to learn our value. Sure, on paper, almost all of use are easily replaced, but if you at least think the quality of your skill is excellent or even above average, "bet on yourself" every once in a while.

I'll get off my soapbox
 
GravelRider said:
Doctors are actually perfect employees in that regard. We are trained to work hard in less than ideal conditions and taught that complaining about it marks you as weak. That sentiment sticks with us.
Click to expand...
Exactly. Some of the stuff that nurses and ancillary staff complain about seems like the smallest #$%^ to me sometimes. I just don't say it.
 
chocomorsel said:
Well wait till they are done with middle school then leave. Why do you all put so much weight in your kids keeping you from moving? You know what kids are? Resilient. They survive.
How do military kids do it?
Click to expand...
I’m guessing you don’t have kids. It’s not as easy as it sounds.
 
Don't have kids (so the grown folks are free to tell me to shut up at any point) but as a kid who got dragged all over the place every couple years for my dad's job, it sucked a lot. Lots of tears and temper tantrums along the way.

Eventually, I grew up and realized how fortunate I was to have had the experiences I did at such a young age. Strongly shaped my worldview and has made me much more adaptable and able to relate to others as an adult. Moving around a lot also brought our family a lot closer to each other since we had to stick together.

I think chocomorsel and anbuitachi both have a point. Moving as a kid is definitely not easy, but I think most kids are resilient enough to handle it (at least, we all were in my family). Wouldn't trade my childhood for the world.
 
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epcotdoc said:
I talked to an AMC in Orlando… 3 yr track, 325/350/percentage of production. Deal breaker for me was 13 call weekends per year, weekends are Friday 7am - Monday 7am 🥴 does anyone else do weekends like that? Sounds terrible to me
Click to expand...
This is terrible and embarrassing given that they are hiring AAs for 190k base (without call, 4 10's a week) with a 100k signing bonus (over 5 years). Most AAs clear 250+ taking normal call.
 
Mman said:
those all involve taking a partnership track position which gets treated like a 4 letter word around here. But literally all the best jobs require it.
Click to expand...
True. In the past, the risk/benefit ratio of working a few years towards a partnership were much more favorable. The risk of it not working out has never been higher.
 
Dr. Rude said:
True. In the past, the risk/benefit ratio of working a few years towards a partnership were much more favorable. The risk of it not working out has never been higher.
Click to expand...

i disagree, the overwhelming majority of sell outs to AMC are a thing of the past. That was the most likely risk for it to go bad.
 
Mman said:
i disagree, the overwhelming majority of sell outs to AMC are a thing of the past. That was the most likely risk for it to go bad.
Click to expand...
Maybe. But the perception of risk of fresh/recent grads is very high. Perhaps they are mistaken.
There still is the risk of being assimilated by the hospital, exploitive senior partners, the partnership that you are working towards being a "sub-partnership" that is not revealed until you put your time in, etc.
 
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