Contracted Grp vs Hospital employee

rayman · Apr 10, 2006

In general, hospital employee retirement plans are like a Hoover vacuum cleaner compared to group retirement, benefits, and 401K, 403B, and matching contributions.
Small details like this mean BIG money.

That is a major point and one that should be looked at very carefully. Of two of the largest private hospitals in my town, I have friends that are relatively new crna's at both, one is a hospital owned anesthesia group and the other is separate. The financial packages are ENTIRELY different. At the hospital owned group, your benefits are the same as Joe the cafeteria worker. The one with the separate group...way more impressive, and as rn29306 noted they can add up to big bucks. Of course the case load at the hospital owned group is larger, more diverse and more stable than the other.

MmacFN · Apr 10, 2006

hmmm

important points.

I want to make sure that I protect my future but on the otherhand i want to be in a group or hospital getting the best experience i can as a green professional. I think, initially, i would be willing to give up the extras for good experience. Then later i could hook up with a grp

Does that makes sense?

jwk · Apr 11, 2006

In general, hospital employee retirement plans are like a Hoover vacuum cleaner compared to group retirement, benefits, and 401K, 403B, and matching contributions.
Small details like this mean BIG money.

Absolutely correct. You have to look at the big picture, the WHOLE picture. Benefits can make a huge difference in an overall package. Groups are much more likely to have significantly better benefits than a hospital.

Pension plans are an excellent example. Hospitals have to offer the SAME PLAN to the housekeepers as they do to the professional staff. It's not unusual to find plans with small or non-existent direct contributions and low matches for 401k's. Contrast that to several private groups in my area where it is easily possible to hit the IRS maximum for both group and individual contributions ($41k in 2005). The same for health and disability insurance, often paid for and of higher quality with a group vs. a hospital. Ditto vacation or PTO time. Hospitals sometimes end up offering more cash to make up for lousy benefits. You have to compare EVERYTHING.

Only you can determine what's important and what's not. You're right to look at the TYPE of practice and what they do as well as the compensatoin package. Wanna do hearts and transplants? Sorry, my hospital isn't for you. Lots of OB, spines, and complex cutting-edge laparoscopy? We might be your place.

There are several threads on this topic worth checking out, a couple with horror stories about the downsides. Just remember the big downside to most of these plans, whether signing bonus or tuition reimbursement - most come with a contractual obligation for a specific term of employment. If you don't like the place, you've got a problem, and the employer WILL want their money back if you leave early or are a no-show when you graduate.

MmacFN · Apr 11, 2006

jwk

good points.

While thats a long way off for me, I still have to consider it somewhat before accepting a potential offer from the school. I could shackle myself to that particular system for 2 yrs.

tough decision.

rayman · Apr 11, 2006

I have had several people ask me if I was going to be "sponsored" during school. Years ago during the previous nursing shortage I decided not to sign any contracts while in school so I would be able to make a more educated decsion at the end of school. I am taking the same stance with na school. Sure I'll have loans out the butt, however, I know I can't make an educated decision on this now. I have shadowed crna's, but do I really know what it is like day in and day out 40, 60, 80 hours a week...no. Do I know what kinds of cases I like and don't like to do now...no. Do I know any of the nuances of the biz...no. So for me, I am going to wait until I have an idea of what I am talking and have an idea of what I need to look for. My 0.02.

MmacFN · Apr 11, 2006

hey ray

i feel the same way. I have only 2 CRNA friends (AZ isnt very CRNA friendly) and shadowed about 5 others. Im sure ive seen less than 10% of what CRNAs in other places do/can do. That part is a little frustrating but also exciting.

If worse comes to worse and i took the schools offer, i could always get a loan at the end and pay them back that way. Who knows. The advice here has been excellent though and alot to think about.

jenniek · Apr 11, 2006

hey ray
i feel the same way. I have only 2 CRNA friends (AZ isnt very CRNA friendly) and shadowed about 5 others. Im sure ive seen less than 10% of what CRNAs in other places do/can do. That part is a little frustrating but also exciting.
If worse comes to worse and i took the schools offer, i could always get a loan at the end and pay them back that way. Who knows. The advice here has been excellent though and alot to think about.

I've heard AZ isn't CRNA friendly...and it was a location my husband and I would consider relocating to.

As far as signing on with a group/hospital, I would only do it if I knew 110% that I was going to work there when finished with school and there was no chance of looking elsewhere. If you do decide to do it, hire a lawyer to comb through it to ensure that the salary is based on the current starting salary when you are planned to start employment after graduation and all the other contract stuff that is easily glazed over.....

Jennie

MmacFN · Apr 11, 2006

Hey jen

Dont come here. It will change, i have talked to may MDAs who feel that within 5 yrs it will be a crna landscape, which they welcome. Currently it is extremely oppressive here for midlevels of any kind.

A few CRNAs ive met from the east coast who came here for a change were pretty upset that their whole job was diprivan in the GI room and they wernt allowed in the OR. Sad and a waste of an excellent resource, but its changing.

jenniek · Apr 11, 2006

Hey jen
Dont come here. It will change, i have talked to may MDAs who feel that within 5 yrs it will be a crna landscape, which they welcome. Currently it is extremely oppressive here for midlevels of any kind.
A few CRNAs ive met from the east coast who came here for a change were pretty upset that their whole job was diprivan in the GI room and they wernt allowed in the OR. Sad and a waste of an excellent resource, but its changing.

That's good to hear. We are planning to relocate after I graduate in December 2007, so will move Arizona down on the list of places to watch. Hopefully my husband will have a choice of jobs and I will find a place that is anesthesia friendly. It's hard to know what's going to happen between now and then.

MmacFN · Apr 11, 2006

Well let me tell you what hospitals use them most.

1) Maricopa Medical Center in PHX

2) Mayo Hospital in Scottsdale

various other facilities use CRNAs but in a manner that would probably bore you (like pushing diprivan in out pt GI). I have heard there is a CRNA group in Tuscon and one in Flagstaff as well. How they are doing, im not sure but i hear the Tuscon grp makes a killing and has a good practice (all rural stuff and primary anesthesia delivery).

Hope that helps in your search!

That's good to hear. We are planning to relocate after I graduate in December 2007, so will move Arizona down on the list of places to watch. Hopefully my husband will have a choice of jobs and I will find a place that is anesthesia friendly. It's hard to know what's going to happen between now and then.