Recent content by goodoldalky

How reasonable or asinine this is depends somewhat on your situation. Are you a hospital employee? Asinine. Are you part of a PE-backed contract management group who is contracted out to provide service X at hospital? Asinine. Are you an independent physician who has selected that hospital as a...

Sounds like the patient received some naloxone in the ED initially. However, many opiates' effect lasts longer than the naloxone, which can cause the respiratory depression to return after 60-90 mins. Sounds like that may be what happened here. I tend to avoid using it unless necessary to avoid...

At the end of the day, all these back and forth pissing matches are misguided. All anybody in any speciality really wants to do is their job. To have the resources to do it well and be paid fairly. Most people in most specialties (especially emergency medicine) no longer feel this way, which...

This got bogged down in the weeds. The punchline is people are annoyed at CMG behavior, and this 1099 nonsense is another example. Their habit of using 1099 is simply to save them money. It’s really not because it’s better for the doctors and they do it out of the goodness of their hearts. No...

Your employer is classifying you as 1099 but treating you like it’s a W2. Lots of groups do this, especially in the CMG realm, since it saves them money. It’s not totally by the book as others have alluded to, but they will likely replace you (if they can) if you don’t play by their rules. If...

IES is not subcontracted by or affiliated with Envision. The group has no PE ownership, but is run similarly to a CMG in many ways; there are a few physician owners in the group. IES is divided into sub-groups which are generally regional (I am sure there are differences among them) and in each...

This is not about the reevaluation, it’s about getting on the same page with the disposition.

This is just the **** that sometimes happens that infuriates you, try and forget it. Sounds like transient global amnesia and a good reason to admit, even though the MR is often negative in such cases. My principles to try and avoid getting in such messes: 1. Never call a consultant without...

These banks do well even in such a circumstance as this. As mentioned previously, they get a very strong premium. Sometimes double the prime rate. The key is that these deals are not obtained in isolation - for each Envision KKR brings, a group of investment banks (Goldman, Citi, UBS, Credit...

Love this, but the reality of it is that PE doesn't "lose" in the end. It's a leveraged debt buyout. KKR buys Envision with $1B of their own money from a healthcare fund. They get the other $9B as debt taken out on the Envision business itself, collateralized by it's assets. KKR is not at risk...

Employer: Physician owned partnership (limited number of partners, of which I am not) ER setting: Academic/Community hybrid Region: TX Salary: $330,000/yr (half clinical - 7 shifts per month, 8s/9s, half admin/teaching) W2 or 1099 or k1: W2 Patients per hour: 1.6-1.8 for non-teaching shifts...

My advice is the following. Get together with your group. None of you sign the contract as-is. All of you begin working on part-time/PRN credentialing elsewhere. Split the cost of a good contract lawyer. After review, you all submit the contract back to your employer with your recommended...

This discussion has more to do with the flow of money than the clinical jobs these people have. ACEP has had its hands in the pockets of all CMGs for a long time now, and positions that would be harmful to CMGs are crushed behind closed doors under the power of the almighty CMG dollar. That’s...

Really the only one I’d disagree with after 10+ years is point one. You’ll definitely have the opportunity to save lives. What you won’t get 99.999% of the time is any recognition, accolades, or follow up on that great save. Your young HOCM cardiac arrest that you worked and got back and...

Sucks. Been there. I cried in a stairwell one time after a 2 month old pedi code of mine didn't make it. I had a 2 month old at the time.