Write your own ideal contract

[Trisomy13]

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I am so sold on peds. It's a done deal after today. We did two cases today : a cute little 3kg neonate, 1 day old, myelomeningocele repair/closure, then a 150 kg 77 yr old dude covered in hair, hospital grime, and toe fungus for a SDH evacuation.

Guess which case only needed one person to flip the patient from supine to prone, then transfer to the clean bed?

Guess which one looked (and smelled) like a bloated wookie?

sign me up.

 

[EtherMD]

😱 Ether, man. You gotta keep up with times. Ped is an official ACGME accredited subspecialty since 2 or 3 years ago.

Younglings, see how experienced people don't always know what they talk about.

I stand corrected. I believe Cardiac is now or will be next year as well.
But, this "minor" correction does not invalidate the logic of my argument or the truth about the market place. It just shows you are a smart @@@ and enjoy finding every minor error in my statements. But, the difference between experience and arrogance is that the former knows when to admit error while the latter is a know it all.

 

[urgewrx]

I believe Cardiac is now or will be next year as well.


It just shows you are a smart @@@ and enjoy finding every minor error in my statements. But, the difference between experience and arrogance is that the former knows when to admit error while the latter is a know it all.

Yes, cardiac is accredited starting this July. And, Yes. I'm a smart @SS who enjoys f-ing with you.

🙂

 

[EtherMD]

Those of you who see a fellowship as a "guarantee" to big money need to understand it is one factor (major) during the hiring process. I think it is a big factor in helping you get an interview but then you most close the deal. That is, do you fit well with the Group? Is your personality suited to the job? Are you for real and not just a person who did 12 months to hide years of weak skills and poor personal interactions?

Some Groups consider "experience" to be a plus as well. I view a person with several years of on the job training as more qualified than a new graduate (usually). But, a first tier fellowship trained individual who is also good at everything, interacts well with others, respectful and works hard is the type of person everyone wants to hire. I recommend you develop the skills and personality to become that person.👍

 

[Khalid]

Ive never been paid with a w-2.


For the past four years i have been in southern california. I first took a job strictly fee for service. I am still there. Eat what you kill. somedays i do four good cases.. others i do 2 bad ones. some days i dont get any consults. I do work at 2 other hospitals where i take call for a set amount for a 24 hour stint. maybe 4 times a month. post call i go to the fee for service place if im scheduled or to see if i can pick up some cases. the schedule at my principal hospital comes out a week before so i know whats going on. Sometimes the cases get cancelled or I get done at like noon which is no good. at that point I also have priveleges at another specialty hospital and i go over there to see if i could help with some add ons. My practice is not ideal because i end up going from one place to the other sometimes more than once. moreover, my salary fluctuates from month to month. but i dont have any partners, that i have to worry about. I have someone doing my billing, 5 percent, i have my own malpractice which is reasonable matures at 14k,(best in nation really i think), and i pay my own health and disability insurance. I take about 7-10 weeks vacation per year. I make about average nothing crazy. Once in a blue moon i will do a week there week here locuming in phoenix

I much prefer getting paid as an independent contractor over a w2 because the writeoffs are much better and more extensive and i get to put more money into a retirement account. the downside is you have to pay your benefits.

Possibly the most depressing work environment/ post I have read on here. John, you really can do better than this...

 

[johankriek]

Possibly the most depressing work environment/ post I have read on here. John, you really can do better than this...

umm thats my practice man.. why is it so depressing?

 

[Khalid]

umm thats my practice man.. why is it so depressing?

Man, thats a tough road you're on. I got tired just reading it! I read your posts and you're a good guy, but that schedule is gonna wear you out.

I understand your aversion to groups, but believe me, there are some good people out there with very fair group practice arrangements. Keep your eyes open and give some of these groups a chance--even if it means a partnership track. One step back to take three steps forward...

Keep your chin up!

 

[cubs3canes]

Every job is dfferent. Every fellowship provides different opportunities.

My dream job
Good residency, CCM at a top place with a couple of publications
Academic Critical Care / anesthesia job
2 weeks anes (no call)
1 week CCM beeper call
1 week off/clinical research
Salary 200,000. Full insurance + tail. 15K signing/ moving bonus. Add 25K per year, no partnership. Can moonlight at 200 per hour on week off.
Teaching residents and CRNAs.

I just wanted to add to this forum so we all do not look like greedy bastards.
Is this possible? Does this exist?
What kind of academic jobs are out there?

 

[EtherMD]

Every job is dfferent. Every fellowship provides different opportunities.

My dream job
Good residency, CCM at a top place with a couple of publications
Academic Critical Care / anesthesia job
2 weeks anes (no call)
1 week CCM beeper call
1 week off/clinical research
Salary 200,000. Full insurance + tail. 15K signing/ moving bonus. Add 25K per year, no partnership. Can moonlight at 200 per hour on week off.
Teaching residents and CRNAs.

I just wanted to add to this forum so we all do not look like greedy bastards.
Is this possible? Does this exist?
What kind of academic jobs are out there?

Job definitely exists if you don't mind 1 main O.R. call a month. No problem with the income level at Academics but your first year may be lower.
I like the fact you added "and CRNA's" to your teaching list. It is nice to know CRNA's with a DNAP can count on you.🙄

 

[invitro]

My ideal job (of course I haven't even started 🙄

100% peds at a children's hospital. No/minimal crna supervision. Call q6-7 days with post call day off always. 4-5 weeks vakay.

Breaks=15min in AM, 20 min lunch, 15 min PM.

300k. Near a beach.

That's it.

Hopefully when I graduate, and in the place I want to be (texas), I will find this job.

 

[mille125]

My ideal job (of course I haven't even started 🙄

100% peds at a children's hospital. No/minimal crna supervision. Call q6-7 days with post call day off always. 4-5 weeks vakay.

Breaks=15min in AM, 20 min lunch, 15 min PM.

300k. Near a beach.

That's it.

Hopefully when I graduate, and in the place I want to be (texas), I will find this job.

sorry to burst your bubble, but this is not gonna happen..........

 

[nimbus]

sorry to burst your bubble, but this is not gonna happen..........

Why do you say this? His description is very realistic except the part about getting breaks. At our children's hosp we have essentially that practice except with more vacation and $$. This is in low pay California. i'm sure the invitro could do MUCH better in Texas.

 

[mille125]

Why do you say this? His description is very realistic except the part about getting breaks. At our children's hosp we have essentially that practice except with more vacation and $$. This is in low pay California. i'm sure the invitro could do MUCH better in Texas.

nimbus.........i will preface by saying that I live in Texas...OKAY

1) Near the beach: restricts you to houston, corpus, the Valley, Galveston, Beaumont...best childrens hospital in this group is Texas Childrens

2) 300K to start is about 20 percent higher than the going rate for peds in Texas.

3) Breaks are not likely to be built into a contract.

4) Call expectations are reasonable.......q5 is more common in some places.

5) No to minimal CRNA supervision is also tough given today's political and financial environment.

 

[deleted50478]

My ideal job (of course I haven't even started 🙄

100% peds at a children's hospital. No/minimal crna supervision. Call q6-7 days with post call day off always. 4-5 weeks vakay.

Breaks=15min in AM, 20 min lunch, 15 min PM.

300k. Near a beach.

That's it.

Hopefully when I graduate, and in the place I want to be (texas), I will find this job.

Here are selected lines from a job from gaswork.com that's almost exactly what you want. Vacation starts lower but works up apparently. Breaks aren't mentioned of course and call isn't quoted, but otherwise, it's your ideal job.

-Will anesthesiologist be doing Pediatric Anesthesia? Always
-What percentage of the time will anesthesiologist be personally providing anesthesia care (doing own cases) compared to Medically Directing a CRNA or AA? 100% doing own cases
-Number of Full-time anesthesiologists 10
-Number of Full-time CRNAs 0
-How often will anesthesiologist be on call? Call frequency varies
-Weeks Paid Educational Leave 10 Days
-Weeks Paid Vacation 3 Weeks Initially
-Estimated Minimum Annual Income $320,001 - $330,000
-Estimated Maximum Annual Income Greater than $400,000
-Group City Corpus Christi
-Group State Texas

 

[mille125]

Here are selected lines from a job from gaswork.com that's almost exactly what you want. Vacation starts lower but works up apparently. Breaks aren't mentioned of course and call isn't quoted, but otherwise, it's your ideal job.

-Will anesthesiologist be doing Pediatric Anesthesia? Always
-What percentage of the time will anesthesiologist be personally providing anesthesia care (doing own cases) compared to Medically Directing a CRNA or AA? 100% doing own cases
-Number of Full-time anesthesiologists 10
-Number of Full-time CRNAs 0
-How often will anesthesiologist be on call? Call frequency varies
-Weeks Paid Educational Leave 10 Days
-Weeks Paid Vacation 3 Weeks Initially
-Estimated Minimum Annual Income $320,001 - $330,000
-Estimated Maximum Annual Income Greater than $400,000
-Group City Corpus Christi
-Group State Texas

sounds pretty good...i bet that the call is q3-q5.....there is always a catch...

 

[nimbus]

nimbus.........i will preface by saying that I live in Texas...OKAY


1) Near the beach: restricts you to houston, corpus, the Valley, Galveston, Beaumont...best childrens hospital in this group is Texas Childrens

Sorry about the assumption. You clearly understand the local Texas marketplace better than I do.

2) 300K to start is about 20 percent higher than the going rate for peds in Texas.

We don't have a "starting" salary here. Many of our new hires earn more than old timers simply because they are more gung-ho and willing to work more.

3) Breaks are not likely to be built into a contract.

If Invitro wants to practice MD-only anesthesia, it is unrealistic to expect breaks which are in the realm of ACTs and academics. At least once a week I take my "lunch" sometime between 3-6pm. Carry a few power bars in your bag.

4) Call expectations are reasonable.......q5 is more common in some places.

q 10-14 at our place.

5) No to minimal CRNA supervision is also tough given today's political and financial environment.

Most children's Hospitals are still MD-only in Ca. Perhaps Invitro should look here.

 

[invitro]

Thanx for the reply.

I guess I will have to get used to the powerbars....I hate them though!

On wards I pack chicken and nuts. It's takes me about 5 minutes to gobble that down....I can pack it in a bag.

I know I can do that in residency....hopefully I will be able to eat q4hrs (for 5min though) in PP too.

I know, a really stupid concern, but I hate becoming hypoglycemic.

On the bright side, at least the peds jobs are out there!

BTW I'll do my residency in TX, that's why I want to stay there. But, if I have to, I can move.

I thought TX, GA, alabama, etc were better for doctors than Cali.....I guess mille125 must have had some bad experiences....weird.

 

[mille125]

Thanx for the reply.

I guess I will have to get used to the powerbars....I hate them though!

On wards I pack chicken and nuts. It's takes me about 5 minutes to gobble that down....I can pack it in a bag.

I know I can do that in residency....hopefully I will be able to eat q4hrs (for 5min though) in PP too.

I know, a really stupid concern, but I hate becoming hypoglycemic.

On the bright side, at least the peds jobs are out there!

BTW I'll do my residency in TX, that's why I want to stay there. But, if I have to, I can move.

I thought TX, GA, alabama, etc were better for doctors than Cali.....I guess mille125 must have had some bad experiences....weird.

in general texas is a great place to practice.....tort reform plus no state and local income taxes equals a good practice environment....my previous statements referred to contracts in general...if there is a contract that is paying 30-40% above the mean usually there is a tradeoff with call/location/vacation/etc. There are a few diamonds out there. If you find one you should address it right away.

 

[achieman]

being Chief resident counts nearly as much as a fellowship? I'm assuming the thought process involves the Chief as someone who is well liked by peers as well as attendings, and able to coordinate/multi-task, has management skills, etc.

 

[dan0909]

im hoping to make around... 100k/year.

so, can i work about 20 hours a week as an anesthesiologist and accomplish this lofty goal? will anyone hire me to work 20 hours a week and make 100-150 grand/yr?

 

[me454555]

im hoping to make around... 100k/year.

so, can i work about 20 hours a week as an anesthesiologist and accomplish this lofty goal? will anyone hire me to work 20 hours a week and make 100-150 grand/yr?

At a hospital where I did some of my 3rd year rotations there was one anesthesiologist who worked only a 2 or 3 24hr shifts/month. Not sure how much she was paid but she like the free time.

 

[toughlife]

-CT/CCM certified
-Academic/Private practice
-Two weeks in the ICU two weeks in OR or combination thereof.
-4-6 weeks off a year (1 of these for political activities)
-One week for GME activities
-Would not mind supervising CRNAs but will refuse to teach anyone except residents or AAs.
-Starting in 230-250s plus full benefits.

 

[EtherMD]

-CT/CCM certified
-Academic/Private practice
-Two weeks in the ICU two weeks in OR or combination thereof.
-4-6 weeks off a year (1 of these for political activities)
-One week for GME activities
-Would not mind supervising CRNAs but will refuse to teach anyone except residents or AAs.
-Starting in 230-250s plus full benefits.

Your qualifications dictate a MUCH higher salary in private practice. You should expect high 200's with those qualifications and a two year partnership track. For academics, you got the salary correct (low 200's for first year then around $230-$250)

If you supervise CRNA's then some teaching is amust because you are responsible for the case. Thus, you must "teach" those CRNA's knowledge/skills that are deficient.