Reason 476 to get to FI-- you could get fired

[VagabondMD]

Yes, you could get fired (lower case fired, the one where they tell you not to come back to work tomorrow or ever again). Docs tend not to worry much about this and assume that if they lose a job, there will be a soft landing. It's not always the case.

In my world, we are currently renegotiating our hospital contract, and it has turned very contentious. Our group has serviced the hospital for over 40 years, but the new CEO could not care less. (I hear this from colleagues all around the country.) There are open threats and hostilities. I think we will still have a contract in 90 days, but there is a real possibility that we will be out on the street. It's unimaginable...until it happens to you.

Some of my partners are really sweating over this, and while the timing for job loss is not to my choosing, if it happens, other than having nowhere to go in the morning, until I figure out what to do next, the bills will get paid, my son will start college in the fall, and my dogs will continue to eat premium dog food (not that Purina crap ?).

Better to get FIREd than to be fired (or at least get FI'ed first). It's a topsy-turvy healthcare world, and you never really know what's coming next.

[Dr. Mom]

Is your group negotiating with other hospitals in the area?  The new "for-profit" hospital in our area pushed the ER group, so they left.   They came to our community hospital.  They kept a great contract.  We now have the best ER docs in our area.

[DMFA]

Thank God the dogs won't be woefully relegated to eating that horrible plebian food. That was my biggest worry, too.

[Hatton]

Good to know the the Vagabond's dogs will continue to eat and his children will go to college even if the group implodes.  You have to love financial independence.

[RJ]

This is so true. Employed doctors should never get too comfortable. There are so many reasons one may be fired, contract not renewed, etc. Many moons ago I knew of a situation where surgical tech unanimously reported a surgeon for "inappropriate contact with patient during surgery" as crazy as it sounds. In reality, surgeon was trying to reposition party of te body they were operating on and I guess it appeared too rough for inexperienced tech. Well, after short meeting with CEO surgeon was forced to resign rather than getting fired. No one gives a s**t about our training or expertise. It's all about staff happiness and comfort.

[Zaphod]

RJ wrote:

This is so true. Employed doctors should never get too comfortable. There are so many reasons one may be fired, contract not renewed, etc. Many moons ago I knew of a situation where surgical tech unanimously reported a surgeon for “inappropriate contact with patient during surgery” as crazy as it sounds. In reality, surgeon was trying to reposition party of te body they were operating on and I guess it appeared too rough for inexperienced tech. Well, after short meeting with CEO surgeon was forced to resign rather than getting fired. No one gives a s**t about our training or expertise. It’s all about staff happiness and comfort.

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Someone tried that where I am as well, no OR experience and had never seen anything. Sx repositioned a pts head using the hair, which if you've never seen it Im sure is very shocking but have seen all those that work on head and neck regions do so. Definitely understand how it can come across though. Was reported and a kerfluffle ensued. Luckily we are a small office and the rn was educated.

[PhysicianOnFIRE]

 

Vagabond MD wrote:

I think we will still have a contract in 90 days, but there is a real possibility that we will be out on the street. It’s unimaginable…until it happens to you.

It's sad how common these stories are. I hope it doesn't happen to you, especially after all you've done to design your ideal practice with a part-time gig this fall.

I worked at a hospital that went bankrupt and shut it doors overnight. For better or worse, I was considered expendable (despite being the only anesthesiologist in the county) before the inevitable closure of the hospital.

[Bam]

Long-time reader of the forum, first time poster. I've been in practice not quite ten years and my group has experienced nearly the same situation described by Vagabond twice. If my wife and I hadn't gotten debt free within a few years of starting the turbulence would have been much worse than it was. Unfortunately hospital based service providers are much more vulnerable to this type of event.

[VagabondMD]

@DMFA and @hatton1 , my dogs truly appreciate your concern for the quality of their food and their overall well-being.

@Dr.Mom, that is something that we have not considered. To my knowledge, no other hospital contracts are currently in play.

@PhysicianOnFIRE , I have taken the "que sera, sera" approach. An earlier early retirement plan had me out at the end of 2017, and, some recent good fortune has me feeling a lot like Lee Majors (aka Steve Austin) in that 1970's hit series.   Maybe I just need an excuse to pull the RE trigger.

[VagabondMD]

Bam wrote:

Long-time reader of the forum, first time poster. I’ve been in practice not quite ten years and my group has experienced nearly the same situation described by Vagabond twice. If my wife and I hadn’t gotten debt free within a few years of starting the turbulence would have been much worse than it was. Unfortunately hospital based service providers are much more vulnerable to this type of event.

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Bam, thanks for posting your experience. It's all too common. Docs in the PEAR specialties cannot get too comfortable.

[RJ]

This is a little off topic, but our organization changed leadership last year that seem to have adapted a multi year plan to bring out compensation down (group of 250 physicians). This is all done in the name of "compliance", but all the changes seem to lead to decrease in compensation. This includes ever increased percentage of "at risk" compensation for coding, quality and patient satisfaction scores, demands to increase minimal work hours, higher and higher percentage of accurate coding threashhold, etc etc. I am on compensation committee for the group and our yearly negotiations with them resemble a blood bath. It seems that yearly CEO bonuses are tied to cost cutting.

[VagabondMD]

RJ wrote:

This is a little off topic, but our organization changed leadership last year that seem to have adapted a multi year plan to bring out compensation down (group of 250 physicians). This is all done in the name of “compliance”, but all the changes seem to lead to decrease in compensation. This includes ever increased percentage of “at risk” compensation for coding, quality and patient satisfaction scores, demands to increase minimal work hours, higher and higher percentage of accurate coding threashhold, etc etc. I am on compensation committee for the group and our yearly negotiations with them resemble a blood bath. It seems that yearly CEO bonuses are tied to cost cutting.

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You answered my question in the last sentence. I wanted to know if the administrators were going to "share the pain" of the challenging reimbursement environment. Maybe it's me, but it seems like they never do.  

[CM]

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[VagabondMD]

CM wrote:

 

However, all of the displaced physicians that I know continued their careers with little trouble or delay. That isn’t the case for many in other professions. We may not have job security, but I think it’s fair to write that we have career security.

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Yes, I expected that point to come up in this discussion.

At some point, you may not want to move, uproot your family, retool your skill set, learn another byzantine computer system, work all of the lousy shifts as the low man/woman on the totem pole, remake your professional network, and or suffer other indignities. If you must in order to provide for your family, you will do all of those, and even subject your dogs to crummy dog food (!), but it is far nicer to have the leisure to find the right opportunity or none at all.

[Bam]

CM - All very true. Career security is a very good description, but many other variables come into play in these situations depending on your type of practice that make the loss of a job or contract difficult. Moving kids in school, spouse with a good job, family close by, etc.

Life goes on and we'll all do fine. As it turns out what I've been through has allowed me to work less which has been wonderful for my family life and circling back to Vagabond's initial thoughts being debt free (though not quite FI) made this transition easier.