Originally Posted by HighandDry
I'm not a fan of being a hospital employee. One of the biggest perks for me is autonomy. Not only financial, but personally. If I want to make more, I work more. If I want to take a vacation, I take it off. There's nobody telling me how hard to work or how to work. Also you know that the hospital is making money off you.
In my practice, the difference in pay from the lowest earner to the highest earner is astronomical. The guy who makes the most, takes a ton of call and goes to 3 separate locations. That's the way it should be. You should be rewarded for hard work.
A friend of mine is chief of Ortho at one of the Kaiser's in Cali. The problem there is that there are surgeons in his group who are barely working, but they all make the same. He says he can't fire them, because they are shareholders and have been there a long time. Over time it really builds up animosity between the physicians.
I left my 'autonomous', fee for service, private practice group for Kaiser...I am a Chief at Kaiser...and while I agree with your point that the more you work (production) in fee for service equals more pay...I had partners that made more and less than me based on how much they wanted to work...and that our system at Kaiser can have the opposite effect...The reality is that with good Chiefs and leadership there is no better system. Shareholders can and do get fired...Pay and bonuses are withheld if you do not meet certain goals...and the 'model' you work in, and that I used to work in, is short-lived with Obamacare and ACOs around the corner...Work-Life balance is one of our mottos in our Permanente medical groups...For the most part 40hr work weeks...with health and malpractice insurance covered 100%, paid vacation, matched 401Ks, and a pension...plus many other benefits...We can practice patient-centered medicine and know that we have job, income, and retirement security...and leaving us plenty of time for our families, hobbies, etc...
I would be happy to discuss in more details the benefits of working at Kaiser with anyone...just PM me...