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Neurohospitalist Part III: The Saga Continues [Administrator shell game?]

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  • #31


    They only have 2 options now, fold or call.
    Click to expand...


    Or counter. That is not necessarily a bad thing.

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    • #32
      I hope you get what you deserve. Understand that longterm employment is not one contract and done. If you continue to work there, make an effort to smooth any ruffled feathers which there will be after any such negotiation.

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      • #33
        How do the in-laws feel about this high stakes poker match?

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        • #34




          I hope you get what you deserve. Understand that longterm employment is not one contract and done. If you continue to work there, make an effort to smooth any ruffled feathers which there will be after any such negotiation.
          Click to expand...


          There really shouldnt be any ruffled feathers for a reasonable negotiation without someone acting like a tool or being emotionally immature (a much higher probability). This is just a game for most admin types, its not something they worry about. Doctors tend to take it personally, and make it so.

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          • #35


            How do the in-laws feel about this high stakes poker match?
            Click to expand...


            They are astounded by the hubris/entitlement that I have to challenge my employer for a significant raise. I assured them I have backup plan and they were ok with that. They have a very different impression of employer-employee relationship as immigrants and culturally.


            Doctors tend to take it personally, and make it so.
            Click to expand...


            I view it from a game theory perspective (zero sum game). Their is a fixed amount that I can make. My goal is to maximize my guaranteed money and minimize my requirements to make productivity bonuses. His goal is to minimize my guaranteed money and try to make the most money off my labor for the hospital system whilst keeping me employed and happy.


            make an effort to smooth any ruffled feathers
            Click to expand...


            I am not getting any sense right now any tension has developed. With the exception of a surprise email, I have been cordial and professional. I just have to keep the game on the best playing surface (i.e. not in-person) or else I will crumble.

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            • #36





              How do the in-laws feel about this high stakes poker match? 
              Click to expand…


              They are astounded by the hubris/entitlement that I have to challenge my employer for a significant raise. I assured them I have backup plan and they were ok with that. They have a very different impression of employer-employee relationship as immigrants and culturally.


              Doctors tend to take it personally, and make it so. 
              Click to expand…


              I view it from a game theory perspective (zero sum game). Their is a fixed amount that I can make. My goal is to maximize my guaranteed money and minimize my requirements to make productivity bonuses. His goal is to minimize my guaranteed money and try to make the most money off my labor for the hospital system whilst keeping me employed and happy.


              make an effort to smooth any ruffled feathers 
              Click to expand…


              I am not getting any sense right now any tension has developed. With the exception of a surprise email, I have been cordial and professional. I just have to keep the game on the best playing surface (i.e. not in-person) or else I will crumble.
              Click to expand...


              Why do you think there is a fixed amount you can make?

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              • #37
                “I just have to keep the game on the best playing surface (i.e. not in-person) or else I will crumble.”

                Then why meet with them? Do you really think an email is an “equalizer”? A big serve works on clay or hard courts. They simply returned your serve. That meeting is NOT simply a chance to show good sportsmanship and say yes. Dropshots, Cross court and straight down the line for winners are drilled every day. Administrators fight email battles daily too. They are professional emailers. That is their game. You hit a great shot. So what? Did the response include any words like “YES” or “Okay” or a draft that includes even one of your demands? Is it possible as a professional courtesy the purpose is simply to tell you gently and leave you a gracious out?
                “We don’t want you to leave but our offer still stands. We will send you a draft by the end of the week. Looking forward your enthusiasm that keeps everyone that works with you so upbeat. Thanks for stopping by.”

                No such thing as an ultimatum until you turn in your resignation. That can be handled in person or however you wish. The ball is still in play. You can always say No, just keep in mind, the Administrator lose physicians every day or week. That’s why they have recruiters.

                Good luck with your meeting.

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                • #38


                  Why do you think there is a fixed amount you can make?
                  Click to expand...


                  My current contract puts a cap on maximum compensation. They are not negotiable on this and quote Stark Law.

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                  • #39




                    Then why meet with them? Do you really think an email is an “equalizer”? A big serve works on clay or hard courts. They simply returned your serve. That meeting is NOT simply a chance to show good sportsmanship and say yes.
                    Click to expand...


                    True. I just feel it is in poor form to dodge them completely. I will listen to Eminem's "Lose Yourself" before I go in for the meeting to make sure I stick to my gameplan.

                    Comment


                    • #40
                      What quote?
                      “The Stark Law exception for “bona fide employment relationships” requires that each of the following three conditions be met: (1) the employment is for identifiable services; (2) the amount of remuneration provided under the employment relationship is consistent with fair market value and is not determined in a manner that takes into account (directly or indirectly) the volume or value of referrals by the referring physician; and (3) the remuneration is provided pursuant to an agreement which would be commercially reasonable even if no referrals were made to the employer.”

                      There is no reason for a cap. It may trigger an audit of your volumes. Check, work done, pay the man.

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                      • #41





                        Why do you think there is a fixed amount you can make? 
                        Click to expand…


                        My current contract puts a cap on maximum compensation. They are not negotiable on this and quote Stark Law.
                        Click to expand...


                        there is room for interpretation here.

                        One of the main points in most of these discussions is just because they say it is a fact, doesn’t make it a fact.  However, physicians are ill equipped to fact check these things.  It may be a fact that they are unwilling to negotiate, but that’s their decision, not a legal limit.  If you are ‘only’ making 400k, you are not going to be exposed in FMV audit.

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                        • #42
                          Good news. We have secured a deal verbally.

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                          • #43
                            Reading this thread just makes it very clear how valuable fielding a competing offer is.  The egos and toxic maneuvering just goes away when you say "I've got this offer but I would prefer to stay, can you help?" It then becomes a function of numbers.  These administrators want to keep their budgets down but they're really just spending other people's money.  If you give them something they can take to their boss, they can usually work with you.  When their one job is to "manage" the staff, you can never let them look like a patsy our make it appear that they've been out negotiated.

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                            • #44


                              When their one job is to “manage” the staff, you can never let them look like a patsy our make it appear that they’ve been out negotiated.
                              Click to expand...


                              I certainly think that it was a fair agreement for both sides.

                               

                              I truly appreciate everyone's guidance. Effectively I got 10% in base clinical pay, payment for directorship, modest decrease in productivity bonus threshold and a moderate retention bonus. Never would have been able to maneuver without all your help. I am very grateful.

                              Comment


                              • #45





                                When their one job is to “manage” the staff, you can never let them look like a patsy our make it appear that they’ve been out negotiated. 
                                Click to expand…


                                I certainly think that it was a fair agreement for both sides.

                                 

                                I truly appreciate everyone’s guidance. Effectively I got 10% in base clinical pay, payment for directorship, modest decrease in productivity bonus threshold and a moderate retention bonus. Never would have been able to maneuver without all your help. I am very grateful.
                                Click to expand...


                                I'm glad it had a satisfactory ending for you. It's a good lesson for everyone that there is always wiggle room despite what administration would like people to believe.

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