Ivy Clinicians

We love hearing how emergency physicians describe Ivy Clinicians to colleagues. They’re spot on! This is exactly what we set out to do.

Check out Ivy’s centralized emergency medicine job marketplace for yourself here: https://www.ivyclinicians.io/

With Ivy Clinicians, the details you’re searching for have come into focus.

Find all the info you need to secure your next emergency medicine job at ivyclinicians.io.

No, we did not say we wanted an EMT job in Alaska. We said we wanted an emergency physician job in Knoxville!

Emergency Medicine Workforce Newsletter: If Boarding is So Terrible, Why is the House of EM Doing So Little About It?

Also: VACEP's Prudent Layperson win, Michigan Medical Society wants CPOM laws enforced, Medicare doesn't like us, taking health insurance away from Americans leaves them uninsured, & MRI is a magnet.

If Boarding is So Terrible, Why is the House of EM Doing So Little About It? Also: VACEP's Prudent Layperson win, Michigan Medical Society wants CPOM laws enforced, Medicare doesn't like us, taking health insurance away from Americans leaves them uninsured, & MRI is a magnet.

It’s a team effort and one we couldn't do without your support. Share this post with a colleague who could use the tools provided on Ivy Clinicians!

We’re continuously adding onto the tools available to you on Ivy Clinicians with one goal in mind: transparency!

So far we have a simplified job application process, salary survey, and facility/employer reviews.

What should we do next?

ACEP Open Book is a free & seamless way to find info about any emergency medicine employer in the US! Simply search for an employer, location, or facility to get started.

Open Book is seamlessly integrated with Ivy Clinicians so that all the information you need for your emergency medicine job search is in one central location.

Give it a try and let us know what you think: openbook.acep.org

Ivy Clinicians 👉🏼 bridging the gap between the real world and artificial world one salary survey at a time.

Ivy Clinicians is creating emergency medicine job transparency to infinity AND BEYOND! 🚀

After months of brainstorming and collaboration, ACEP Open Book is here!

This partnership with American College of Emergency Physicians - ACEP allows us to share the benefits of Ivy Clinicians with an even larger audience. 👏🏼

To check it out for yourself head to openbook.acep.org!

EM Workforce Newsletter: Investors Shocked by Hospital-based Physician Losses After No Surprises Act.
Also: EM residency applications up, TMB on CPOM, HCA gutting hearts & souls, Abridge abridges documentation time, & pharmacists' wildcat strikes.
---
After years of reading articles about acute care physician companies’ “exorbitant” revenues (see KFF Bill of the Month archives), many investors have been shocked by publicly traded hospital companies’ announcements that in-housed physician practices lost massive amounts of money in Q3 2023.

While Envision declared bankruptcy this year, Envision practices at HCA facilities were internalized by the health system. That ownership change made Envision’s former practices’ financial performance visible to the public.

On its Q3 earnings call, HCA revealed that the former HCA-Envision joint venture, now named Valesco, lost $100 million in the quarter (26.3%). Bill Rutherford, HCA’s Chief Financial Officer, explained: “There's no doubt the issue for us in the quarter was the Valesco operations. We’re not clearing as much revenue as we anticipated.”

In the earnings call Q&A, Justin Lake, a healthcare analyst with Wolfe Research, was so bewildered at the degree of HCA’s physician practice losses that he had difficulty formulating his question. He asked, “I'm going to pile on with this physician stuff. So just, I've never seen a business kind of be off this far from, like, you guys are obviously very, very good at what you do. I know this is a new business, but to be $50 million of revenue on a $250 million baseline, 20%. So I just the like, can you triple click on that for me and just say like, what did you think was going on versus what is? And then the, for – when you gave your headwinds, tailwinds for next year, the only headwind you talked about was that payment, which makes sense. But you've given some numbers around the subsidy costs right, the physician costs that run through other operations. And they do seem like they've been a pretty big drag on margins.”
---
To read the rest of this week's newsletter, head to

Investors Shocked by Hospital-based Physician Losses After No Surprises Act Also: EM residency applications up, TMB on CPOM, HCA gutting hearts & souls, Abridge abridges documentation time, & pharmacists' wildcat strikes.

Wonder no more. All the information you need BEFORE applying for an emergency medicine job is on Ivy Clinicians.

We developed Ivy to help emergency medicine clinicians combat burnout and find jobs they love.

Start your search today!

We think we’ve got a pretty brilliant idea on our hands. Take a look for yourself today at ivyclinicians.io!

Emergency Medicine Workforce Newsletter: Not Every Good Idea Is Legal.
Also: Highly rated EM residency to close, less pay beyond the 4 walls, Doctors Council union, physicians sued for patients seen by PAs & NPs, and PE vs pets.
---
The ACEP23 Closing Session featured a tireless advocate of emergency physician autonomy face-to-face with a fierce opponent of corporate monopolization. Bob McNamara, MD, founder of AAEM - The American Academy of Emergency Medicine, was at the microphone, while Lina Khan, Chair of the Federal Trade Commission, was broadcast on a massive screen. Dr. McNamara asked Chair Khan if the American College of Emergency Physicians - ACEP would violate US antitrust laws by excluding employers from its conference exhibit hall for not abiding by ACEP policies.

McNamara's underlying question was: could ACEP kick out Envision, TeamHealth, Sound, and SCP from its trade show because private equity firms own them? Dr. McNamara received rousing applause from the audience. In response, Khan answered the question she wanted to be asked, not the one that was asked. Since Lina Khan didn’t answer, let’s dig into it.

To read the full newsletter:

Not Every Good Idea Is Legal Also: Highly rated EM residency to close, less pay beyond the 4 walls, Doctors Council union, physicians sued for patients seen by PAs & NPs, and PE vs pets.

Looking for an emergency medicine job in your area OR somewhere new?

Ivy Clinicians has all the details you need to make your job (and potentially move) decision.

Get started today at ivyclinicians.io!

Out with the old, in with the new. Ivy Clinicians is breaking down barriers to high-quality emergency medicine jobs.

Get started here: ivyclinicians.io

“The national uninsured rate reached an all-time low of 7.7 percent in early 2023,” according to the US Department of Health & Human Services.

However, insurance rates vary dramatically by state. States that have chosen not to expand Medicaid since the passage of the Affordable Care Act in 2010 have significantly higher uninsured rates. For example, eighteen percent of people in Texas are uninsured compared to ten percent in neighboring New Mexico.

As a result, emergency medicine practices in non-Medicaid expansion states have much higher average county-level uninsurance rates than their peers. Southwest Medical Associates, which staffs twenty EDs, mostly in Texas, has an average uninsurance rate of 22.1%. On the other end of the spectrum is UPMC - in Pennsylvania, New York, and Maryland - with an average uninsurance rate of 6.4% for their EDs’ counties.

Like the county-level income stats, private equity-backed emergency medicine practices are (in aggregate) located in counties with higher uninsurance rates. Health system-owned EM groups are located in counties with lower uninsurance rates than clinician partnerships or private equity-backed groups.

Want to dive in deeper? Download our full “The State of Emergency Medicine, Sept. 2023” report here: https://emworkforce.substack.com/p/state-of-the-us-emergency-medicine

Curious which emergency medicine practices - and practice types - staff EDs in the wealthiest (or poorest) counties in the US?

The charts are based on Ivy Clinicians’ data, all of which is available to you at ivyclinicians.io.

For our full “The State of Emergency Medicine, Sept. 2023” report, head here: https://emworkforce.substack.com/p/state-of-the-us-emergency-medicine

Curious which emergency medicine practices - and practice types - staff the most freestanding EDs in the US?

The charts are based on Ivy Clinicians’ data, all of which is available to you at ivyclinicians.io.

For our full “The State of Emergency Medicine, Sept. 2023” report, head here: https://emworkforce.substack.com/p/state-of-the-us-emergency-medicine

Want to help us spread the word? Share this meme to your story or send it to your colleague. The emergency medicine world needs to know about Ivy Clinicians!

ivyclinicians.io

Curious which emergency medicine practices - and practice types - staff the most Level 1 trauma centers in the US?

The charts are based on Ivy Clinicians’ data, all of which is available to you at ivyclinicians.io.

Find the full report here: https://emworkforce.substack.com/p/state-of-the-us-emergency-medicine

Emergency Medicine Workforce Newsletter: An FTC Lawsuit & a Congressional Hearing Show USACS’ Vulnerability. Also: APP hoses doctors more, shrinking primary care physicians, the CPOM mirage, EmPATH, & United Healthcare for All.

Lina Khan and the Federal Trade Commission issued a bombshell lawsuit against US Anesthesia Partners (USAP) and its founding private equity owner - Welsh, Carson, Anderson & Stowe (Welsh Carson) - on 9/21/2023. The FTC alleges that USAP and Welsh Carson “engaged in a three-part strategy to consolidate and monopolize the anesthesiology market in Texas. First, they executed a roll-up scheme, systematically buying up nearly every large anesthesia practice in Texas to create a single dominant provider with the power to demand higher prices. Second, USAP and Welsh Carson further drove up anesthesia prices through price-setting agreements with remaining independent practices. Third, USAP sidelined a significant competitor by striking a deal to keep it out of USAP’s territory.”

Welsh, Carson, Anderson & Stowe is the same private equity company that funded the creation of US Acute Care Solutions in 2015 (three years after Welsh Carson created USAP), along with the EM group Emergency Medicine Physicians (EMP). The same WCAS partner - Brian Regan - was in charge of both the USAP and USACS deals. On USACS’ formation, Regan wrote, “EMP really fits all of our criteria for a partner.”

In its 106-page suit, the FTC explains: “Welsh Carson entered the emergency medicine market and engaged in a similar roll-up strategy to the one it deployed with USAP… a similar strategy to consolidate the market.” The suit quotes Brian Regan that Welsh Carson’s strategy is “to build a platform with national scale by consolidating practices with high market share in a few key markets.” USAP’s sizeable market share would give it “[n]egotiating leverage with commercial payors.”

To read the rest of this week's newsletter, head to:

An FTC Lawsuit & A Congressional Hearing Show USACS’ Vulnerability Also: APP hoses doctors more, shrinking primary care physicians, the CPOM mirage, EmPATH, & United Healthcare for All.

Take a look at this breakdown of residency teaching ED’s staffed by employer versus EM residency teaching emergency departments staffed by employer type. What do you think? What changes would you like to see in this area?

Because of the data available to us (and you!) through Ivy Clinicians, we were able to consolidate these findings in The State of Emergency Medicine 2023.

Head to the link in our bio (or highlights) for the full report! More to come.

Don’t get left behind. Check out what Ivy Clinicians has to offer at ivyclinicians.io!

2023 has been a tumultuous year for the business of emergency medicine in the United States, to put it lightly.

With all the changes - including Envision Healthcare and OPYS Physician Services declaring bankruptcy, and American Physician Partners abruptly ceasing operations - Ivy Clinicians has become a central location for the latest information.

Ivy has published The State of Emergency Medicine, Sept 2023 to share its data with the EM community. This report aims to visualize the current state of US emergency medicine practices.

To read the full report, click the link in our bio and saved to highlights! We’ll also be sharing more findings in the coming weeks. So make sure you’re following so you don’t miss it.

No need to endlessly search the web for emergency medicine jobs. With Ivy Clinicians, everything you need is all in one place.

Now, about those hobbies. Which one are you ready to get back to (or start fresh)?

We’ve said it before and we’ll say it again: Ivy Clinicians will save you time in your emergency medicine job search!

As Doshi said, we’re a one-stop-shop! No more searching endlessly without finding the information you need.

It’s all waiting for you on Ivy Clinicians!

ivyclinicians.io

EM Workforce Newsletter: State of the US Emergency Medicine Employer Market, September 2023.

https://open.substack.com/pub/emworkforce/p/state-of-the-us-emergency-medicine

2023 has been a tumultuous year for the business of emergency medicine (EM) in the United States. Two acute care physician organizations - Envision Healthcare and OPYS Physician Services - declared bankruptcy, and American Physician Partners abruptly ceased operations. With the rapid evolution of EM’s employer ecosystem, this report aims to visualize the current state of US emergency medicine practices.

Ivy Clinicians has matched all 5,705 US emergency departments with their emergency medicine practices. Ivy’s data also connects employers with their ownership structure. EM practice structures generally fall into five categories: clinician partnerships, health systems, private equity, public companies, and government (Veterans Health Administration, Military, and Indian Health Service).

We have harnessed Ivy's data to answer the following questions:
- What are the largest emergency medicine practices and practice types?
- Which practices and practice types staff the most EM residency teaching sites, level 1 trauma centers, and freestanding emergency departments?
- How do the practice settings of EM employers compare in terms of county-level per capita income, uninsurance rates, and rurality?

State of the US Emergency Medicine Employer Market, Sept. 2023 Analysis based on Ivy Clinicians data.