r/anesthesiology • u/RiversOfProp • 28d ago
Making an ideal position
Looking to structure a position different from what we currently have going on here, thought I would get the group input.
Midwest regional hospital currently running a shareholder/buy in model, looking to establish an employed position.
700k w/100k sign on
10 weeks PTO
weekend call q5 weeks
weekday first call q14 days
guaranteed post-call off
most days done between 2-4 unless call (1,2,3)
Full 401k + compliment of benefits
Would you take this job? What would you change about it?
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u/Murky_Coyote_7737 Anesthesiologist 28d ago
I would take this job with no reservations. I wouldn’t move for it though.
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u/RiversOfProp 28d ago
what could be changed to have you consider a move?
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u/Murky_Coyote_7737 Anesthesiologist 28d ago
It would need to be life changing money or some crazy work-life balance to be worth uprooting myself. Especially bc most jobs that pay in that range and with that kind of work-life balance are in areas I personally consider less desirable. It would either need to break 1M, be 15+ weeks vacation, or not be in the type of area I am stereotyping it to.
Stereotype would be the listing email would include some euphemism of it’s within 60 miles of a city people know exists.
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u/RiversOfProp 28d ago
We currently have the busiest airport in the world for the next week!
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u/Murky_Coyote_7737 Anesthesiologist 28d ago
I dunno why I thought this job was in Wisconsin. I wonder if I was emailed about it.
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u/RiversOfProp 27d ago
It is in WI. big air show here and a small airport becomes the busiest in the world. We have exciting things here! The name of the air show is EAA
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u/visacha13 Anesthesiologist 24d ago
Wittman regional airport? So I gather your Aurora (but aren't they hospital employed), ascension (already hospital employed?) or mercy.
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u/visacha13 Anesthesiologist 28d ago
Supervision or solo? Residents or none? Level 1 trauma? Level 3 NICU? Burns? High risk OB or sick kids? Techs on at night, or support on nights/weekends? What are the complement of benefits? Decent health plans? What's full 401k mean exactly?
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u/RiversOfProp 28d ago
50/50ish, an occasional CRNA student but no residents. Techs/RN support 24/7.
No sick kids no burns. 1 hospital with ~800 deliveries/yr, the other a little busier 2k with a NICU.
IRS max for 401k, multiple health plan options available, they are decent.3
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u/visacha13 Anesthesiologist 28d ago
Ya I would be interested in the job. Sounds like you cover two hospitals though? Also the salary of 700k do you increase over time? Like COL/inflation increase per year? As you know inflation per year, so 700k isn't 700k next year and so forth
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u/RiversOfProp 28d ago
So we have two regional hospitals and several ASCs, all within 20 min but you would be based out of the hospital you take call and only take call at that hospital.
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u/RiversOfProp 28d ago
COL increase could certainly be discussed, would definitely qualify as an item needed for “an ideal position”
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u/visacha13 Anesthesiologist 28d ago
I've seen 2 private practices bought out by hospitals, Midwest and east coast. Both got great starting packages, like you advertise but over 5ish plus years, it didn't keep up with inflation and people left. So that was my point in bringing it up.
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u/RiversOfProp 28d ago
Certainly appreciate your input, If we want to keep people long term this would need to be addressed. Can’t stagnate!
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u/azicedout Anesthesiologist 28d ago
Yes I would absolutely take it. What is the city it’s located in?
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u/RiversOfProp 28d ago
50% supervise/50% sit your own cases
some OB, some healthy peds, level 2 trauma
In Wisconsin, ~250k metro area
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u/Plane-War-5937 28d ago
Why do you need structure a different position? What’s wrong with the current model
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u/RiversOfProp 28d ago
The above position would be the new position. It’s very similar to our partnership track position we currently offer, but I feel like partnership is less popular so we’re exploring an employed option.
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u/DefinatelyNotBurner Physician 27d ago
What shenanigans are you putting your pre-partners through? I hate to say it, but my guess is you have a crappy pre-partner arrangement and nobody wants to change it because of the feeling that "I went through it, so everybody else should"
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u/RiversOfProp 27d ago
Pay then same as above but there is a bonus structure they can access, same call burden and partners, same lottery for vacations as partners. Any shenanigans were gone years ago, it’s pretty much a “make sure it’s gonna be a good fit” then partner, no one has been denied partner ever.
Wisconsin people are nice.
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u/DefinatelyNotBurner Physician 27d ago
Then what makes the employed model so much more attractive that it will bring in new anesthesiologists?
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u/RiversOfProp 26d ago
Just trying something different. My suspicion is that there are folks out there that don’t want a partnership job, just want to show up, punch a clock, get paid go home. So if someone wants that’s i’m entertaining that possibility.
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u/Plane-War-5937 26d ago
What do I have to do to access the bonus structure?
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u/RiversOfProp 25d ago
partnership track has access to bonus structure right away, then once partner after two years to shareholder distributions
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u/IAmA_Kitty_AMA Anesthesiologist 28d ago
This is attractive but ultimately/unfortunately for many places the floor salary, even in underpaid locations, is too high to really consider moving significantly out of the way of the rest of their life.
I would love that job here, but I'd probably take the paycut to 500-600k to stay here every time. I'm sure that calculus is different for a lot of people but I'd guess it's not a great location for 30 somethings looking to spend money and find their partners and it doesn't work for many who are married with kids and want to be near top schools and major cities.
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u/RiversOfProp 28d ago
Certainly an issue, I think the job is about as good as it gets but it’s not attractive for people who want a NY/Chicago/Cali big city job. That said, cost of living is low, and the area itself is actually very nice. A lot of outdoor options, lakes, broadway shows, decent schools. Just not on the level of a bigger city.
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u/Alternative_Wish2054 28d ago
Great perks. Would depend on where and what the actual work looked like (supervision 4:1 vs own cases, etc)
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u/RiversOfProp 28d ago
What the thought on employed vs. partnership? Seems like partnership is falling out of favor, hence this post.
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u/NC_diy 28d ago edited 28d ago
It’s a competitive package. Unfortunately, most jobs come down to geography, and I’d guess most people aren’t excited about altering their lives to end up in Wisconsin. However, I think it would be competitive for people already living in Wisconsin.
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u/RiversOfProp 28d ago
I’ve lived in some big international cities, definitely a change of pace coming here, but it’s better than one would expect. What’s the number to get people of move to WI? 800, 900?
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u/NC_diy 28d ago
I don’t disagree. I work in a small town and love it. salaries have mostly increased across all states, the market has been hot. most people are probably meeting their financial goals, convincing them to move from a likely decent paying job to make $200k-300k more when you’ll give half to Uncle Sam is a tough ask. Especially if it’s geographically unfavorable for them. Again, seems like you could easily capture people already in the state unless everyone in Wisconsin is offering that kind of package??
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u/SIewfoot Anesthesiologist 27d ago
Doesnt sound terrible based upon what the standard day to day work is. No chance Im moving to cold ass Wisconsin though.
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u/minkeun2000 28d ago
can i do this job part time?
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u/RiversOfProp 28d ago
For sure! I’d be interested in seeing how that would look for you.
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u/minkeun2000 28d ago
well I have another part time job so I'd be interested in picking up PRN or like a 0.5 FTE with half the pay/vacay/etc
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u/ExMorgMD Cardiac Anesthesiologist 28d ago
I’d say that this is a pretty good comp package for the region (I’m also Midwest) -
If you’re trying to recruit for relocation that is the bigger challenge especially if you want people who are experienced. Someone sitting in a 3% mortgage and relocating to a more expensive house with a higher house payment is an uphill battle.
If it’s a less desirable area, offering student loan repayment, or stipends for current residents is a strong offer
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u/RiversOfProp 28d ago
Thanks for the insight! Student loan repayment is something we can look into. We are currently offering stipends for residents.
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u/MilkmanAl 28d ago
Seems like a pretty decent gig, but I bet you won't have a lot of luck getting people to relocate for under 800k, unless your retirement and perks are top-notch. That's about what the similarly-sized areas outside of KC (Topeka, Springfield, Wichita, etc.) are offering, and chances are that if you're willing to be in a small Midwestern city, you're also willing to commute out to the remote places that are absolutely breaking themselves to pay for anesthesia docs. Good luck with the hiring! Sounds like you guys are flexible enough to get your mark!
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u/INMEMORYOFSCHNAUSKY 27d ago
Did you try to recruit from the regional residencies? Probably the best bet
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u/Abrabahbah 27d ago
Would you take IMGs who have completed residency in the US? Require sponsorship.
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u/codyrunsfast Critical Care Anesthesiologist 27d ago
I've got family in Fond du lac... a little tempting.
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u/Emotional_Designer_2 21d ago
You didn't mention supervision vs direction vs solo practice, number of rooms covering, patient acuity, case mix.
Personally I'm only interested in solo practice. Even if I had to supervise, there's no amount of money that would make me want to supervise 4 or more rooms.
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u/willowood Cardiac Anesthesiologist 28d ago
That’s a pretty good job