Kaiser vs. USAP career advice?

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seniormd said:
Avoid USAP at all costs. You will work very hard for that money. They are aggressive and will fire doctors in a second.
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Need more details please. This is very blanket statement that can apply to any group.
 
dchz said:
Need more details please. This is very blanket statement that can apply to any group.
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Their model is big on CRNAs. They want a small hospital crew of MDs supervising crnas working days. They farm the other MDs out to surgery centers alone during the day. MDs working all of the nights and weekends in the hospitals. They want to cut the MD pool down to accommodate the nurses. Some MDs leave after the buyout, which they want. The rest left over are relatively expensive. So any opportunity to get rid of an MD is not overlooked. They can bring in cheaper non partners. Very impersonal and uncaring. At least that’s the case in my state.
 
osoprop28 said:
I believe Kaiser's starting salary is around $390?
And for USAP, it seems like if you take regular amount of calls with their usual work hours, you make around $400k
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Good luck making anywhere near 400K with USAP... that place is big SCAM.
 
osoprop28 said:
I think USAP is anywhere from 45-60 hours? But they said it depends on how much you want to work & earn so it varies.

My base salary is $350k for USAP but can make more with call. They quoted me that some docs make up to $750k since it's eat what you kill, but I'm not sure how much you have to work to make that amount..

And yes that $100k stock buy in is what's concerning me a little bit..
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IF you make $750k at USAP, you will live in the hospital 48/14, and not be able to eat, sleep, or go to the bathroom. Plus it is all W2, so the tax man will then take almost half. Everyone needs to wake up to the scam that is USAP.
 
Urzuz said:
I have never worked with CRNAs as an attending, but from having witnessed firsthand interactions during training, and reading about others' supervision practices on this board, it is clear that working with a CRNA is less anesthesiology and more psychiatry. "How can I keep her happy? Better not be late to break her out for her lunch. Will she get mad at me if I want to induce the patient differently? I don't want to be pedantic and sour our relationship even though I like things done differently. Maybe I'll just let her practice bad medicine because it probably won't lead to any morbidity." Look no further than this board as to how spineless anesthesiologists can be when dealing with their CRNAs, especially if they aren't directly hiring and firing them.

The only way I can see supervising CRNAs leading one becoming a better physician is that you probably get more real life training in crisis management. Apart from that, solo MD is the way to go if you place value on things such as job satisfaction and the actual care you will be providing.
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You got that right. crNa supervision is a fellowship in psychiatry.
 
centdoc said:
You got that right. crNa supervision is a fellowship in psychiatry.
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In which USAP city did you work? Sounds like you got burned. Sorry, but it happens and can be even worse in some PP groups. No one takes advantage of you as well as your own people. Nature of the business.

However, being from TX, the USAP groups in Dallas can make 400k+. Not easily per say as you may work a lot as an associate, but once you become partner, it does become easier. There are a lot of upper middle class people in DFW with good insurance.

Me personally, three years is way too long to join a partner track, but then again, that's me. Works for a lot of people.
 
centdoc said:
Good luck making anywhere near 400K with USAP... that place is big SCAM.
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centdoc said:
IF you make $750k at USAP, you will live in the hospital 48/14, and not be able to eat, sleep, or go to the bathroom. Plus it is all W2, so the tax man will then take almost half. Everyone needs to wake up to the scam that is USAP.
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You seem to be trying to warn the youngings out there. I really applaud the effort.

But like @chocomorsel says, would you give more details on which city you worked for and what the practice was like before it sold?

Thanks much!
 
Whatever u make as a fake Usap partner. You will always give up 20% to welsh Carson Anderson private equity forever.

Ask welsh Carson Anderson “partners” at their office are they giving up 20% to another firm. Nope. Never. That’s a true partner.

honestly the Usap guys in Florida make decent money but work closer to 55-60 hours a week. Many post calls days a few hours. It’s gotten a little better recently. But making 500-550k as a fake partner with those hours and while you can take as much time off as possible. You aren’t earning money. So go ahead as full “fake partner”. Take 10 weeks off. Your income as partner will be closer to 425-450k.

just image the new grads giving up 20 plus 20 plus forced stock. If they took 10 weeks off. They be making 350k working 55-60 hours. You might as well take a job in academics for 325-350k with 45 hour work weeks and equivalent of 7 weeks off with sick leave,annual leave and cme week.
 
FFP said:
I didn't follow most of this discussion, because it smelled of Ponzi. But the real value of a stock like this should be either the amount one can get for selling it (market or liquidation value, both almost zero in this case) or the value of the dividends it throws at its owner in a safely foreseeable timeframe (2-3 years in this case). I would not trust the paper increases in owner equity, so I strongly doubt that USAP stock is a good investment based on EITHER calculation. Suckers, beware!
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Yup, you nailed it. Ponzi Scheme is the right term for forced purchasing of USAP stock in my opinion.
 
aneftp said:
Whatever u make as a fake Usap partner. You will always give up 20% to welsh Carson Anderson private equity forever.

Ask welsh Carson Anderson “partners” at their office are they giving up 20% to another firm. Nope. Never. That’s a true partner.

honestly the Usap guys in Florida make decent money but work closer to 55-60 hours a week. Many post calls days a few hours. It’s gotten a little better recently. But making 500-550k as a fake partner with those hours and while you can take as much time off as possible. You aren’t earning money. So go ahead as full “fake partner”. Take 10 weeks off. Your income as partner will be closer to 425-450k.

just image the new grads giving up 20 plus 20 plus forced stock. If they took 10 weeks off. They be making 350k working 55-60 hours. You might as well take a job in academics for 325-350k with 45 hour work weeks and equivalent of 7 weeks off with sick leave,annual leave and cme week.
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When you refer to 55-60 hours per week, do you count time spent as “back up”? Those invisible hours that actually make the work week look like 80 hours.
 
seniormd said:
When you refer to 55-60 hours per week, do you count time spent as “back up”? Those invisible hours that actually make the work week look like 80 hours.
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THIS is precisely where training fails to prepare residents. Academic physicians don't often practice in an environment where they have a plethora of home call positions and residents aren't aware that ANY obligation to the hospital or AMC should be compensated. If you are a true partner, it is sweat equity ie the joy of being a business owner.

Similarly, AMC's will hand off tasks/responsibilities and reward you with some BS title (maybe even an extra 5G) while laughing all the way to the bank. (Think "medical director"...ooooohhh)
 
gasdoc77 said:
THIS is precisely where training fails to prepare residents. Academic physicians don't often practice in an environment where they have a plethora of home call positions and residents aren't aware that ANY obligation to the hospital or AMC should be compensated. If you are a true partner, it is sweat equity ie the joy of being a business owner.

Similarly, AMC's will hand off tasks/responsibilities and reward you with some BS title (maybe even an extra 5G) while laughing all the way to the bank. (Think "medical director"...ooooohhh)
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When you’re salaried employee and not being compensated for your time, that’s a **** deal.

I don’t see nurses volunteered to take calls. When they’re overtime, they get paid overtime, 1.5X or 2X their base hourly pay.

Just recently saw a posting advertising, post call day guarantee off. Second call, hold beeper for $500. Overtime “bonus” if called in for ~200/hr. I chuckled.


We are trained to take responsibility for the patients, and being exploited as such. AMCs paying and treating you like an employee but wants you to take responsibility like an owner. Take home may not substantially different, but at least I get a say in practice management. I vote not to cover a sh!++y location, if my partners disagree with me, I will go. NOT I am being TOLD to go. It’s really subtle difference, but better for my mental health.
 
IMGASMD said:
When you’re salaried employee and not being compensated for your time, that’s a **** deal.

I don’t see nurses volunteered to take calls. When they’re overtime, they get paid overtime, 1.5X or 2X their base hourly pay.

Just recently saw a posting advertising, post call day guarantee off. Second call, hold beeper for $500. Overtime “bonus” if called in for ~200/hr. I chuckled.


We are trained to take responsibility for the patients, and being exploited as such. AMCs paying and treating you like an employee but wants you to take responsibility like an owner. Take home may not substantially different, but at least I get a say in practice management. I vote not to cover a sh!++y location, if my partners disagree with me, I will go. NOT I am being TOLD to go. It’s really subtle difference, but better for my mental health.
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Back up call is mentally taxing. It paralyzes you. Exploitation is the only way to describe it. Just as you close the garage door, you’re called back. Then after walking out of the locker room, the surgeon cancels the case since the rep can’t get the equipment. Sound familiar? The administrators will do all sorts of clever things to make you feel important to temper your frustration, while they sleep soundly in bed. Simply not worth it. If they need a back up, I want $250 per hour for every hour I’m backing you up. Oh, and somewhere up stream someone mentioned day off after call...folks, you’ve already worked that day, it was from midnight to 8 am. Don’t do this to yourselves.
 
seniormd said:
Back up call is mentally taxing. It paralyzes you. Exploitation is the only way to describe it. Just as you close the garage door, you’re called back. Then after walking out of the locker room, the surgeon cancels the case since the rep can’t get the equipment. Sound familiar? The administrators will do all sorts of clever things to make you feel important to temper your frustration, while they sleep soundly in bed. Simply not worth it. If they need a back up, I want $250 per hour for every hour I’m backing you up. Oh, and somewhere up stream someone mentioned day off after call...folks, you’ve already worked that day, it was from midnight to 8 am. Don’t do this to yourselves.
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Is there anybody here who gets $250/hr for backup call? If so, sign me up!! I’ve spent my entire career doing it for free.
 
Airway said:
Glad you said that! Was very angry at myself
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I actually see no difference between sitting in the hospital and being at home. Only difference is that it’s my food and my shower.
 
I have a Different perspective on USAP and call from home. If USAP is able to negotiate 20 percent higher rates from payers vs the former private group they aren’t hurting you the partner that badly. The stock purchase is the worst part of the deal. if you can stomach the track and stock scheme USAP is t a bad deal for certain people. There are usap partners in Florida and Texas making in excess of $600k per year. Do they work hard? You bet they do.

ive taken a ton of second call in my career. As long as the call backs are rare it doesn’t bother me much. To each his own.
 
The fact is that irregular work hours affect people differently, but the general consensus is that it stinks.
There is a psychiatrist in my family who is 82 years old. He still works because he says it’s easy. He has a small practice and sees 3 patients a day, all before noon then one day from 4-6 pm. He shares an office with other doctors and gets $225 per hour. That’s a great deal. The more aggressive docs in his group see patients all day long but they still have bankers hours.
 
seniormd said:
The fact is that irregular work hours affect people differently, but the general consensus is that it stinks.
There is a psychiatrist in my family who is 82 years old. He still works because he says it’s easy. He has a small practice and sees 3 patients a day, all before noon then one day from 4-6 pm. He shares an office with other doctors and gets $225 per hour. That’s a great deal. The more aggressive docs in his group see patients all day long but they still have bankers hours.
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Anesthesiology isn't Psychiatry or FP. Still, I know anesthesiologists in their late 60's and early 70's still working DAY TIME only hours. They are getting $200 per hour and can work part time or full time. So, that means 2-3 days per week for 8 hours per day is available at many locations for older providers.

That said, a full time career over 3 decades taking busy night call will take a toll on you. I know it has taken a big toll on me and likely shortened my life expectancy by several years.
 
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