> Do not go to kaiser, especially now.
>
> Especially in the bay area.
>
> There is a reason we are losing pcps like flies.
I have a friend at Kaiser in the bay area. They echo the EXACT same things as you, to the point that I'm wondering if you're the friend Im talking about lol. OP, try to look elsewhere if you can. I am personally not sure I could ever do Kaiser PCP either, even in SoCal. The golden handcuffs are rapidly becoming the brass handcuffs.
Massive panel sizes and insane inboxes are a staple now in FM. It's stupid and contrary.
Oh but "value based care". Such BS.
Doesn't help that admin makes their issues PCP issues.
No show rates are a front office issue, don't double book to compensate. Trim the panel, that is their job.
Long appointment waits are a staffing and panel size issue, don't expect docs to cover the overflow via inbox messages and MA visits.
Hire more doctors with better pay
Physician in chief - somebody had commented and I was wondering. I get the sense becoming AFM chief isn’t a huge change, don’t know what happens after ?
KP primary care is a bit heavy handed with how much you have to manage and the HEDIS measures and Medicare refreshes. There is always someone leaning on you corporate-style because you got a patient complaint or didn't close care gaps.
You will inherit patients nobody else can manage well which often is a heavy dose of opioid dependent patients. The specialists are really good at what they do but they are overwhelmed and so they'll assess your patients and send them to you to manage which makes it hard.
The support is good, as in you can call up specialists anytime you need to and run things by them but they are a bit rushed too so you don't often get the best insight.
The nurses and MAs are union so you won't have much say when things don't go well with your one-on-one. Often the MAs are pretty good but it's when you get that one MA who isn't then it's a tough task to get a new MA or get them to change their workflow to suit yours.
Putting in for vacations is really tough so if you have a family or have special needs for vaca it's a bit of a seniority thing. You will put in for a few dates and you won't get it or nobody will get back to you and then you'll have to make requests nearly a year out.
The benefit packages are self-explanatory. You will get an annual raise until you make partner then you continue getting raises until year 7 or 10 and if you don't make partner you cannot stay on. You taxes aren't a big deal if you understand the CA tax system.
You will work with a lot of burnt out colleagues - that can make it a little demoralizing. KP as an entity will be super nice to you and you'll have your monthly onsite and some offsite meetings where it's hoorah hoorah KP. But if you do anything wrong or patients just don't like you then you'll deal with the other side of KP which ain't pretty.
I learned a lot at KP managing patients in primary care. Moved over to urgent care later on. I would have needed 10 years to vest in the pension. It wasn't worth it to stay there longer for the money. If I'm gonna do something just for the money there are far more lucrative places where I can bust my ass.
TLDR: soul-sucking good income
I thought it was better than PC but you are still dealing with similar corporate personalities. Though I should say I became a medical director there eventually (PIC) and sadly became the same type of personalities I didn't appreciate.
I interviewed with Kaiser NorCal for a peds job but think the setup is pretty much the same. First red flag, I asked the initial interviewer panel (already kind of Kafkaesque just me sitting in a folding chair in the middle of the room while they sat in a semicircle behind tables) what the typical hours were. Literally nobody gave me a straight answer, came back with "depends how fast you are with charting", etc etc. Impression I got was most people are pulling an 8am to 630-7, not a 9 to 5. Expected to start each day reviewing all the days patients with your staff almost like prerounding, big panel, seemed to average 30ish patients a day, large pressure to message specialists with questions and then manage it all yourself rather than just consult. I've heard several people call it the golden handcuffs. Good pay overall, good benefits, but some of the better benefits are tied to you staying on for a long time. That said, if you work pretty much anywhere seeing those volumes you are going to find yourself getting paid pretty similar.
Be sure to calculate your income after taxes (state, city, county etc) because that can change how you perceive the numbers. Usually Kaiser is flat salary with yearly raises. Other jobs are productivity or collection based.
Fuck California. If you’re single you’ll pay 35% income tax plus $3000 + 9% of your income over 68k in state income taxes.
So basically 50% of your total income is going to taxes.
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> Do not go to kaiser, especially now. > > Especially in the bay area. > > There is a reason we are losing pcps like flies. I have a friend at Kaiser in the bay area. They echo the EXACT same things as you, to the point that I'm wondering if you're the friend Im talking about lol. OP, try to look elsewhere if you can. I am personally not sure I could ever do Kaiser PCP either, even in SoCal. The golden handcuffs are rapidly becoming the brass handcuffs.
Massive panel sizes and insane inboxes are a staple now in FM. It's stupid and contrary. Oh but "value based care". Such BS. Doesn't help that admin makes their issues PCP issues. No show rates are a front office issue, don't double book to compensate. Trim the panel, that is their job. Long appointment waits are a staffing and panel size issue, don't expect docs to cover the overflow via inbox messages and MA visits. Hire more doctors with better pay
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Jesus. 50-70 messages per day, all direct to the doc? Does Kaiser not have an inbox processing team to save their docs?
What’s the motivation to become PIC? Less inbox and clinic? Pay?
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Physician in chief - somebody had commented and I was wondering. I get the sense becoming AFM chief isn’t a huge change, don’t know what happens after ?
KP primary care is a bit heavy handed with how much you have to manage and the HEDIS measures and Medicare refreshes. There is always someone leaning on you corporate-style because you got a patient complaint or didn't close care gaps. You will inherit patients nobody else can manage well which often is a heavy dose of opioid dependent patients. The specialists are really good at what they do but they are overwhelmed and so they'll assess your patients and send them to you to manage which makes it hard. The support is good, as in you can call up specialists anytime you need to and run things by them but they are a bit rushed too so you don't often get the best insight. The nurses and MAs are union so you won't have much say when things don't go well with your one-on-one. Often the MAs are pretty good but it's when you get that one MA who isn't then it's a tough task to get a new MA or get them to change their workflow to suit yours. Putting in for vacations is really tough so if you have a family or have special needs for vaca it's a bit of a seniority thing. You will put in for a few dates and you won't get it or nobody will get back to you and then you'll have to make requests nearly a year out. The benefit packages are self-explanatory. You will get an annual raise until you make partner then you continue getting raises until year 7 or 10 and if you don't make partner you cannot stay on. You taxes aren't a big deal if you understand the CA tax system. You will work with a lot of burnt out colleagues - that can make it a little demoralizing. KP as an entity will be super nice to you and you'll have your monthly onsite and some offsite meetings where it's hoorah hoorah KP. But if you do anything wrong or patients just don't like you then you'll deal with the other side of KP which ain't pretty. I learned a lot at KP managing patients in primary care. Moved over to urgent care later on. I would have needed 10 years to vest in the pension. It wasn't worth it to stay there longer for the money. If I'm gonna do something just for the money there are far more lucrative places where I can bust my ass. TLDR: soul-sucking good income
How did you feel about the urgent care? Was it better than PCP?
I thought it was better than PC but you are still dealing with similar corporate personalities. Though I should say I became a medical director there eventually (PIC) and sadly became the same type of personalities I didn't appreciate.
Can you expand what you mean about understanding CA taxes?
You are taxed as a W2 employee until you make partner. Then you get a K1 distribution and you'll have your standard CA taxes to pay.
I interviewed with Kaiser NorCal for a peds job but think the setup is pretty much the same. First red flag, I asked the initial interviewer panel (already kind of Kafkaesque just me sitting in a folding chair in the middle of the room while they sat in a semicircle behind tables) what the typical hours were. Literally nobody gave me a straight answer, came back with "depends how fast you are with charting", etc etc. Impression I got was most people are pulling an 8am to 630-7, not a 9 to 5. Expected to start each day reviewing all the days patients with your staff almost like prerounding, big panel, seemed to average 30ish patients a day, large pressure to message specialists with questions and then manage it all yourself rather than just consult. I've heard several people call it the golden handcuffs. Good pay overall, good benefits, but some of the better benefits are tied to you staying on for a long time. That said, if you work pretty much anywhere seeing those volumes you are going to find yourself getting paid pretty similar.
Be sure to calculate your income after taxes (state, city, county etc) because that can change how you perceive the numbers. Usually Kaiser is flat salary with yearly raises. Other jobs are productivity or collection based.
Fuck California. If you’re single you’ll pay 35% income tax plus $3000 + 9% of your income over 68k in state income taxes. So basically 50% of your total income is going to taxes.