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Discuss Latest POF Blog Post: A Hundred Grand Lost On an Employment Contract

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  • Discuss Latest POF Blog Post: A Hundred Grand Lost On an Employment Contract

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  • #2
    I would be incredibly frustrated if this happened to me and argue that them getting credentialed at other places to kick them out of network harmful to the business. Unfortunately like they said, you can't predict the pandemic (unless you're Wimbledon https://www.usatoday.com/story/sport...on/5123987002/) but can learn and add these type of clauses to future contracts.

    I'm not familiar with the PPP loans during the pandemic, but would that have helped at least a little?

    Comment


    • #3
      Seems you could argue getting credentialed elsewhere and being kicked out of network in your clinic materially impacts physician employee #2s work in your clinic, thus going against even the broad "okay" in the email.

      Comment


      • #4
        Pandemic or not it was a dirt ball move.

        They probably should have been more up front about it.

        The issue with this kind of stuff is that if follows you. It harms your integrity / reputation and future (and current ) docs who work with this person will be wary.

        It would have been much better to say: "hey listen, I need to talk to you. Our volume is low and I would like/need to make some extra to help pay off my student loans, etc etc. Would you be OK with me doing some locums? How can we work this out so it does not hurt the group?"

        Maybe I am too old school.

        Probably why I have been screwed over by hospital administrators, but if I read it correctly: This person was using personal days off to work some other place without discussion.

        This is pretty dirt ball in my opinion.

        Guess it depends on what they consider those days to be for? Sick days? Vacation?

        If you spend vacation doing locums I don't really have an issue with it, but if it is paid time off for illness / emergencies then I think it gets a little yucky.

        It feels like calling out sick and working some place else.

        Reputation is an interesting thing.

        You do one crappy thing in life and you get labeled. Not worth the extra money. Better to just do the right thing.

        Comment


        • #5
          Eh, seems pretty clear they were the equivalent of unpaid personal vacation days. The employer in the article even says “I previously assumed everyone I hired full-time would want to work full-time. Since I had no paid time off for the physician employee, I figured they would want to work as much as possible to make as much money as possible.” In this instance, the employee didn’t have a full schedule because of the pandemic which affected his income a good bit (overhead being a consistent 40% of collections so a drop to even only 80% of appointments being booked would cause a decrease of ~1/3 in income). I understand the employer being annoyed that the employee took uncompensated time and wasn’t forthcoming about how it was being spent (being with family vs actually doing locums) and the credentialing headaches but the employer was also a bit slick considering he’s charging the employee a 15-20% differential on billed overhead vs actual overhead with “I would take 40% of collections for overhead and another 5% beyond this for my profit. Sounded pretty good to me at the time since my overhead was somewhere around 30% and as low as 25% some months.” In my opinion, it seems that the employer had a pretty sweet deal for himself, the employee realized he was being taken advantage of and there were better deals to be had with locums, and business is business.

          Comment


          • #6
            Old school or not, the contract itself was flawed.
            • Solely based on percentages of collections. The interests of the owner and employee were not aligned.
            So many physicians want independence and flexibility in scheduling and work load. You would expect to have conflicts.
            That is why minimum wage jobs have hourly schedules. Staff needed to produce revenues. Owner did not define the work expected or virtually any control. The employee’s responsibilities and work were not defined, only how paid. All expenses and volume growth are on the owner. Be a hardass and schedule his work under just the revenue split. Screw the family time and other. You have one customer, man your workstation. The employed physician’s job was to generate revenue. Not according to the contract or management.
            Silly to complain about it.

            Comment


            • #7
              This article could have just have easily been written from the POV of the employee and people would be calling the employer a dirtbag. I don’t think either is a dirtbag, they just were looking out for their respective best interests. I think it would have been a better article if the author had acknowledged this, and not tried to make himself sound like a benevolent soul whose “kindness was taken advantage of”. He set up a model that he thought would reap him the most money, but did not think through all the details. It sounds like he didn’t anticipate the whole being kicked out of network thing and I highly doubt the employee anticipated that at all. If he truly wants a team player who will put the success of the practice at the top of the priority list, he should establish a partnership.

              Comment


              • #8
                Originally posted by Anne View Post
                This article could have just have easily been written from the POV of the employee and people would be calling the employer a dirtbag. I don’t think either is a dirtbag, they just were looking out for their respective best interests. I think it would have been a better article if the author had acknowledged this, and not tried to make himself sound like a benevolent soul whose “kindness was taken advantage of”. He set up a model that he thought would reap him the most money, but did not think through all the details. It sounds like he didn’t anticipate the whole being kicked out of network thing and I highly doubt the employee anticipated that at all. If he truly wants a team player who will put the success of the practice at the top of the priority list, he should establish a partnership.
                Makes sense. I probably did not totally understand the details. Article made it sound like the guy lost out because the employee messed him over.......I didn't really read it that carefully.

                Comment


                • #9
                  While I despise 20 page contracts, before you sign an employment contract you should be upfront (on both ends) on expectations, and if you want something dont sign unless its in there. I made sure I had no call, an OT payment and "mutually agreed upon" OT in my contract- so I couldnt milk prolonging a case for a few minutes to get paid OT and my group couldnt make me stay past my out time repeatedly bc they didnt want to call someone else in. Being up front about it saved both sides from misunderstandings, feeling screwed, etc.
                  Tangler if I remember correctly with a past group you had call thrust upon you then a new hire was not willing to take call. Similar feelings of being screwed over

                  Comment


                  • #10
                    Originally posted by billy View Post
                    While I despise 20 page contracts, before you sign an employment contract you should be upfront (on both ends) on expectations, and if you want something dont sign unless its in there. I made sure I had no call, an OT payment and "mutually agreed upon" OT in my contract- so I couldnt milk prolonging a case for a few minutes to get paid OT and my group couldnt make me stay past my out time repeatedly bc they didnt want to call someone else in. Being up front about it saved both sides from misunderstandings, feeling screwed, etc.
                    Tangler if I remember correctly with a past group you had call thrust upon you then a new hire was not willing to take call. Similar feelings of being screwed over
                    This is much bypassed by those involved, often one does not understand the difference between an "offer letter" and the "20 page contract".
                    A terms sheet is short hand for the key points of agreement. The contract gets into the actual agreement of the "assumptions". Make no mistake, both parties always have different assumptions and will always interpret things in a way that favors their point of view. The attorney in this situation, in my personal opinion was not an advocate for the owner. Simply put the "terms sheet" into legal form and completely blew past the assumptions. Defective contract and defective advice.

                    Comment


                    • #11
                      bad contract which is on the owner and lawyer

                      agree the post could just have easily been written from the other side

                      I don’t get the part about locums and getting kicked out of network. In my limited experience true locums docs need to get credentialed at facilities but for billing purposes the charges are allowed to be submitted in the name of the physician who the locums is covering for

                      Comment


                      • #12
                        Or revoke consent because it is interfering with the work in clinic. But yes, shifting all the risk? Then expect them to mitigate the risk in ways you may not appreciate. This seems like it could have been settled with some additional income splitting to free up more in clinic time... Remember actions produce reactions.

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