emergency medicine physician

hospitalist

medical director

nurse practitioner

nocturnist

US-Acute-Care-Solutions

When I interviewed with this company, they made it sound like it’s going to be a great place to work. I was very excited and hopeful. It took them about six months to get me credentialed. I was very upfront with them about my scheduling needs, and they seemed very supportive and made it seem like my request would be very easily accommodated. Once my schedule came out, I realize they had scheduled me according to the hours that they needed me versus the hours that were agreed-upon prior to hire. Within a couple hours of my first shift, I was regretting leaving my previous employer to come join this company. They lead APP, who came off so personable during the interview, was very standoffish and barely spoke to me on my first day. I was just thrown in there, no EMR training, no orientation, NOTHING! Most of the rest of the APPs at the site (not all) were very arrogant, “clicky”, and gossipy. By the end of the first week, there were rumors going around that I was thinking about leaving. It literally took them about four months before they got my schedule right. 

Physician support was at a bare minimum. There was only one physician that actually was nice enough to come forward, be personable and tell me that I could come to him if I had any questions. The rest of the physicians would act as if any question was a bother and would make me feel stupid for asking. The culture was pure trash. 

They were constantly changing the schedule and hours. The hours I was told at the time of my interview didn’t even exist by the time I actually started working! The joke there was “If you’re not happy with something, just give it about 3 to 4 months and it will change”. There was no consistency with the schedule. There was a shortage of APPs at all times. Everyone felt they were spread so thin. I also remember staying past my shift multiple times to help and when asked for reimbursement I was denied by the chairman. 

Then Covid happened. At this point I was with the company for about 6 months. I was pressured repeatedly to agree to reduced hours. They reassured me that this would be a temporary situation. Well, two hours before my shift I get a call form HR stating that they had decided to let me go due to budget cuts. They made this as a permanent decision. It was a horrible and gut wrenching feeling as I had left my previous employer whom I was with for three years to join this company, solely because they had guaranteed more accommodating hours that fit my family’s needs. The joke is about 2 weeks after they had laid off all these people, I see ads online with them looking to hire APPs again. Clearly they are very haphazard, don’t think decisions through, disorganized and basically don’t know what the heck they are doing. 

Bottom line, I would not recommend working for this company unless you want to be jerked around, feel under appreciated, and basically cater solely to their needs. 

I’ve been with the company 7 yrs now.  I would not recommend the company to anyone.  This is a company that has lost sight of its core values and lost its way.  I’ve seen it transform from a small medical group to a giant national CMG.  Over that time, they have systematically chipped away at their core benefits, compensation and worked tirelessly to trim coverage and squeeze providers.  They stopped valuing their only asset which is their providers.  There is no planning for career longevity because the company continually asks more and more of the providers.  They burn folks out in a few years.  Their entire business strategy is to get into highly competitive cities where it is always easy to recruit new grads with attractive locations.  They just churn through physicians because their pay is so low, they clinical schedule is terrible and the demands are many. The company is now all about EBITA but it used to be about taking care of patients and taking care of the providers.  The ownership aspect seems attractive at first glance but you aren’t really an owner.  You are a minor stock holder. They gift you shares after 5 yrs but really just take the money out of your salary 3-5x over by paying you less your whole career. I’ve been asked to vote on one item in my 6 yrs as an “owner”.  The question was wether I wanted to cut my holiday by 50% or 100%.  Most of the providers end up having shares in the company but the ownership is just a trap.  The company is 98% physician owned but only 40% owned by the docs doing the work at the bedside.  There are still a small number of people at the top taking home 60% of the profits and stock distributions and making all the decisions.  The physicians are treated like cost centers that need to be trimmed year after year.  I would argue that it is the worst emergency medicine CMG to work for.  

Recently worked in the provider enrollment department the team was very unorganized with very little support. The workload was very OVERWHELMING, everyday is always spent trying to catch up on enrollments that previous representatives were responsible for as well as being assigned side projects to help other team members since every one is behind on work items.  The department seems to take on more responsibilities than the actual amount of enrollment representatives that are on the team so you have to learn to juggle between your own daily tasks while trying to help each other with no proper training. The team in a whole is so over worked with a very large work load that makes it very impossible to ever get current. Enrollments are being sat on for periods of a time without being worked causing a lot of delays in completing applications which cause even more problems later down the road and you’re expected to answer for those. It’s like constantly having to put out fires. You receive very little help, no actual training is provided, you are held responsible for any mistakes and errors even if they were completed by a previous team member due to the department tending to switch around work priorities from team member to team member, so if the site falls under your name anything that has happened prior to you taking it on your held accountable for. MICROMANAGING IS AT A ALL TIME HIGH within this role, but if your every needing help expect to not get a response until hours after you’ve asked for assistance. Management has very poor communication except when your being required to answer for errors or any missed items, but if your struggling they won’t provide any help the responsibility will be thrown onto another team member and hopefully they can provide you with the assistance you need. Your left fending without clear instructions. 

Review:
Working at US Acute Care Solutions has its pros and cons, and a lot depends on your specific site and local leadership. The company offers strong benefits compared to many other emergency medicine groups, including a solid 401(k) contribution. However they do not offer PTO. There are also opportunities for flexibility in scheduling and working across different locations.

That said, the day-to-day experience can vary widely. Some sites feel well-supported with good teamwork, while others struggle with staffing and fluctuating schedules. Workload can be heavy at times, and work-life balance is challenging, which is typical in emergency medicine but can feel more pronounced depending on the site.

Leadership support also seems inconsistent—some supervisors are very supportive, while others may contribute to a more corporate or impersonal environment. Pay is generally ok but not always competitive with other options ER staffing groups or even Urgent Care. 

Overall, USACS is not a bad place to work, but your experience will largely depend on the specific hospital and team you join. It’s important to talk to current staff at your site before accepting a position, this is crucial. 

Pros:
Strong benefits 
Good education for NP and PA's with job flexibility though site dependent
Some supportive teams and leadership

Cons:
Staffing can be inconsistent
Workload can be heavy
Experience varies significantly by site
Scheduling can be a nightmare with switching between days and nights; Especially dependent of your scheduler
No PTO
Pay is not competitive in my opinion 

What is the best part of working at the company?
Very supportive immediate leadership. They were very accommodating to me as a first time working mom. Also, they value company morale so anytime an admin saw an opportunity to do/plan something to show employees they’re valued and appreciated, it was always welcomed and approved.

What is the most stressful part about working at the company?
Because of the support I received from the two medical directors I supported, I  didn’t find the job stressful until some of us were laid off via Zoom. It went against everything I thought the company stood for. I was so disappointed and overwhelmed by that experience. That aside, as an admin there isn’t really great training. You’re thrown to the wolves in a sense and I didn’t enjoy that. I often felt lost or like I wasn’t doing enough even though I was trying, and I know from several other admin I wasn’t the only one who felt that way. I received a lot of support and reassurance from everyone I worked with/for so that helped, but I think better, more specific training could go a long way.

What is the work environment and culture like at the company?
In the beginning I felt it was genuinely family oriented. At the end, I think the culture is and will be whatever company leadership thinks will help maintain its employees, which, to be fair, is their job. Just disappointing for those of us who truly bought into it, especially me, since I am a devout skeptic lol.

What is a typical day like for you at the company?
Varies day to day depending on the needs of the medical directors you support.

Unfortunately I began working at USACS just as COVID was reaching a fever pitch in March 2020. Even starting the job was a struggle, as HR “lost” my paperwork multiple times, punching back my start date twice. Although I was told full time staff would be protected and would not face lay offs, we were subject to immediate salary and shift cuts and thrust into treating covid patients without much direction and virtually no PPE. 

Although we remained dedicated to our patients and company, the relationship was not reciprocal and ultimately I was laid off despite earlier promises. The worst part is that they did it over the phone on my only off day on an 8 day block, despite what and the lead PA/medical director working side by side in person in the department. 

They have also laid off an employee who had worked at Holy Cross for over 15 years and within 4 years of retirement. This company is completely devoid of morals and unable to adequately support staff. Virtually everyone working for USACS has been miserable in my experience. Even with layoffs they are unable to guarantee adequate hours and multiple APPs have left on their own volition. Save yourself the aggravation and inevitable unemployment and work ANYWHERE else!

None, acs is not a team approach like they would like you to believe. Each trainer would have a different way of doing things.  It was very confusing, because in san antinio they have five different hospitals.  The changed my primary hospital after I was hired on which resulted in me driving more.  It wasn't the hospital I really wanted to work full time.    They physician where only worried about how many patient's they could see because of rvu's  so, they would sign up for all the patients and then the company would say you weren't seeing enough.  When they where so busy the physician could see all the patient's in a timely manner, they would ask for your help.  Just complain to the supervisor.  It was a crazy system.   
During covid they didn't supply enough ppe for patient or staff.  The acs staff would act like it was just fake.   They restrict the way you can practice medicine by having protocol for every problem.  Cookbook medicine.  The trouble is they work in the real world.  Don't plan on getting the schedule you ask for unless you plan 6 months out.

There is very little direction at this company. There are no defined standards and information is kept highly compartmentalized. The reason for this behavior is to create a form a job security. 

Management and physicians are extremely self entitled and you are constantly reminded that you are here to serve them. Corners are cut and business processes are improvised. You are told to take self action and make judgement calls but when you do you are told that was not what you were intended to do. 

Very clique-y, there is a definite old boys club and they have their own girls club as well. Unless you worship those members you will be culled. They are not interested in actually improving processes or streamlining workflows, only making it appear that way to the physicians groups they absorb. 

There are some good people here, however. They are far and few between and most of them have been beaten into submission by this point. Overall it’s a very frustrating and sad place to work.

Run away if you're a hospitalist looking for short-term work. It's definitely not worth the stress. Not sure how well they've been functioning in the EM sector, but based on a lot of the reviews on here---sounds like it's not going that great. The same problems that have been mentioned multiple times on here is the truth---no appreciation for the providers, even though it's touted as "physician-owned," very obsessed with metrics to the detriment of every single employee, and everyone is over-worked and stretched thin, and then micromanaged on top of that. Their lack of understanding of hospitalist work is even worse, and the leadership consists of ER docs who have no clue what is even happening, and are completely out of touch with reality. Compensation was also very low, and they would not match market standards in the current economy, but wanted to squeeze as much work out of you as possible. I usually don't leave reviews, but I really needed to warn hospitalists about this company. Stay away, it's not worth it. 

I’ve worked for both democratic and corporate run ED groups. After working with USAC’s it’s clear to me why corporate managed groups should not be allowed in health care. We were staffed poorly and patients would wait for hours before being seen. The vast majority of patients would be upset when you walked in the room due to the wait times. Given the limited staffing, we were only compensated to work for 8-10 hr shifts, however would consistently leave 3-4 hours after, due to the inability to sign out. There were often 5-10+ patients roomed and waiting to be seen when the oncoming physician arrived, making it unfeasible for them to take over your 10+ patients. This, in addition to a multitude of other factors lead to burnout. Luckily, I’m back with a democratic group and a lot more satisfied.  

Top Job Titles	Average Salary
Emergency medicine physician 272 salaries reported	$214 per hour
Hospitalist 64 salaries reported	$146 per hour
Medical director 37 salaries reported	$176 per hour
Nurse practitioner 13 salaries reported	$80.65 per hour
Nocturnist 15 salaries reported	$146 per hour

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