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Contract Negotiations: Suggestions Wanted Re: Part-Time Arrangement

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  • Contract Negotiations: Suggestions Wanted Re: Part-Time Arrangement

    My contract is up 12/31/19 and the administrators have told me that they will offer me a new 3-year contract. They'll have it ready in the next week or two. I don't know if the terms will be better or worse, but I presume it will be roughly similar to my current arrangement.

    However, I would prefer to cut back to 4 days per week. I'd expect a 20% pay cut and a 20% decrease in PDO/CME days.

    If I was an administrator, that would not be an appealing arrangement. I'd still have to pay for the same benefit package (healthcare, malpractice) while receiving only 80% of the usual production. Beyond that, I'd prefer to have employees who were highly motivated to produce as much as possible rather than employees content to earn less and work less.

    So, is it possible to make the arrangement more attractive to the administration without defeating the purpose (i.e., a better life) of a part-time job?

     

    Also, once I propose part-time employment, I can't un-propose it. The administration will know that I'm no longer hungry, that I'm content to produce less.

    Ideas?
    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

  • #2
    First who cares what the perspective of the admin is. Thats their problem and trying to take their vantage point will guarantee you get much less than theyre willing to offer.

    You're probably still very valuable at 4 days, they may even sweeten the deal to incentivize you. That would actually be my first guess.

    Comment


    • #3




      First who cares what the perspective of the admin is. Thats their problem and trying to take their vantage point will guarantee you get much less than theyre willing to offer.

      You’re probably still very valuable at 4 days, they may even sweeten the deal to incentivize you. That would actually be my first guess.
      Click to expand...


      I care if I want the option of employment there.

      They have expanded too fast in cardiology, adding a new guy each of last two years (doubling the FT staff in 12 months). Now no one is as busy as desired. Despite this, they are trying to recruit a new interventional guy (only one full-time interventional currently) with the aim of developing 24-7 interventional service at our rural hospital. If they are successful, then everyone's volume will drop again.

      I'm half surprised they offered me a contract. One of the new guys is also non-invasive, and they want another interventionalist. In their shoes, I think I would let my contract expire (given that they have already hired a new non-invasive guy), distribute the patients to the two new guys, and then hire the interventionalist.
      Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

      Comment


      • #4
        Hungry? What you are offering is 100% dedication for four days. That is much more cost efficient that cruising at 80% for 5 days. Doesn’t meet the definition of a slacker. That is an excellent deal for the administrators.

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        • #5
          When I was trying to cut down to part time (I changed to 0.75 four months ago) I figured that if I made it attractive to the administration, they’d be more likely to let me have it. I showed them studies that physician burnout decreases with shorter hours, explained how I’d still cover my inbox while off so there would be no delay in care, I waited until we added more physicians in our group to aid in seeing patients, etc., but you know what? They really didn’t care at all, until they knew that I was serious about leaving and finding a new job. I’m sure it all came down to losing 10 hours per week of revenue from my labor, but when they realized that they were going to lose 40 hours a week if I quit, they finally gave in. Your happiness is pretty low on the administrators list of importance, unfortunately

          Comment


          • #6
            The value you have to them is the “enemy they know is better than the enemy they don’t”...

            You’re there. You’ve been there. They might even like you a bit.

            Who they just recruited or might recruit doesn’t fit that. Who knows what theyll get and who knows if they’ll stay.

            So I wouldn’t come across as an aw shucks... I hope u guys will keep me type here.

            Chest up. Tell them why you think you bring value. tell them you’re committed to the hospital. Tell them the only way forward is a 4 day work week.

            Volume works itself out. Expand the pie. Do outreach. See the follow ups a little more often. Don’t use your midlevels. Start seeing more stroke or PAD pts that can fall through the cracks at rural hospitals.

            For cardiology, our value is coverage. Explain that you can hold down the fort (clinic) while the interventionalists can focus on their procedures.

            And be honest with them that cardiology is evolving.. many programs are going to 12 - 24 weeks off, shift based type or even inpatient only type work. Going to a 4 Day workweek isn’t unheard of

            In no way would I volunteer to take a 20% pay cut for that.

            Comment


            • #7







              First who cares what the perspective of the admin is. Thats their problem and trying to take their vantage point will guarantee you get much less than theyre willing to offer.

              You’re probably still very valuable at 4 days, they may even sweeten the deal to incentivize you. That would actually be my first guess.
              Click to expand…


              I care if I want the option of employment there.
              Click to expand...


              Well of course, but dont let that be your frame of mind.

              All these things are very tough in reality. I am assuming that despite all these other changes, they know you and appreciate your work. Its incredibly expensive and hard to recruit/retain docs. Some do crazy stuff still, but I reason in your case it wont be knee jerk.

              Im sure theres a reasonable solution especially given the changes you mentioned.

              Comment


              • #8
                What is your BATNA?

                My employer refused to negotiate any aspects of my most recent contract (part-time work, taking call, emergency coverage).  I wrote out line items for how much I thought hiring a replacement would cost them - in terms of signing bonuses, moving expenses, loan repayment, possible referral bonuses, recruitment, EMR training, and other miscellaneous expenses.  I pointed out that I had had no HR complaints or malpractice suits in five years (agree with @SValleyMD above.  My employer had a psychiatrist arrested for viewing child porn in the hospital several years ago).  Basically, I was saving them a truckload of money by being competent and not leaving.  Why shouldn't I expect them to meet me halfway?

                Of course, they told me to pound sand, so I walked.  They haven't interviewed anyone for my position nearly four months later.  Another psychiatrist died shortly before I left, and the culture has gotten so bad I wonder how they're going to effectively recruit.  Meanwhile I'm a week into Funemployment and wondering why I stuck around so long.

                I'm only saying this because I've followed your posts for the last few years and know you've considered plenty of alternatives besides continuing to work in cardiology full time (being a hospitalist, law school IIRC).  Hopefully administration will work with you.  But if they decide to be obstinate, and you don't need the money, it sounds like you have plenty of interests, energy, and intellectual horsepower to land on your feet.
                “Work” is a four letter word for good reason.

                Comment


                • #9


                  you don’t need the money
                  Click to expand...


                  I don't need the money, but I'd prefer a larger safety margin before retirement, and I don't want to stop working at this point (or ever?).

                  I could do other things, but it's very unlikely that I'll do anything that pays this well.
                  Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

                  Comment


                  • #10
                    You will probably just have to propose a pay cut if you are really worried that the administrators won't want to have you on anymore and you really don't need to the money.   My wife has been looking into cutting back her hours as well and I suggested that she propose fewer hours with the same rvu targets so that she could get paid the same.   Her groups is pretty stupid though, she always gets more then the max rvu bonus she is eligible for and therefore has a disincentive to work/do surgeries towards the end of the year. She has already started to take more days off after she got permission from her dept chair, but they haven't adjusted her paycheck yet.  I think that it is doable, just as long as everybody thinks that you are still adding value to the group.  That's the biggest advantage of private practice vs the employee model, in private practice, the senior guy cuts back while still getting paid more and everybody just kind of accepts it.

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                    • #11
                      "However, I would prefer to cut back to 4 days per week. I’d expect a 20% pay cut and a 20% decrease in PDO/CME days."

                      Of course you'd prefer that...80% pay and 100% benefits for 80% work. Good deal for you, bad deal for them.

                      Proposing 80% total comp for 80% work is more likely to get you to yes. Depends on how good your benefits are, but may look something like 76% salary and 100% benis for 80% work.

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                      • #12





                        you don’t need the money 
                        Click to expand…


                        I don’t need the money, but I’d prefer a larger safety margin before retirement, and I don’t want to stop working at this point (or ever?).

                        I could do other things, but it’s very unlikely that I’ll do anything that pays this well.
                        Click to expand...


                        You don't need the money, and you're not sure you even want to ever retire.  How important is it really that you do what pays the most?

                        I really doubt you need them more than they need you.
                        “Work” is a four letter word for good reason.

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                        • #13
                          Why cant it just be wRVU based, just get paid for what you do? Then you just work as much as you see fit. Does tend to incentivize more.

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                          • #14




                            First who cares what the perspective of the admin is. Thats their problem and trying to take their vantage point will guarantee you get much less than theyre willing to offer.
                            Click to expand...


                            I disagree with bolded.  When you are entering a negotiation it is very important to understand where your counterparty is coming from.  If you understand what their perspective is, then it is far more likely that you can come up with an effective negotiation strategy.

                            It sounds like what you mean to say is that he shouldn't empathize or feel the need to compromise based on his understanding of their perspective.  And I would agree with that.  Nevertheless, understanding what is motivating the other party is critical if you want to negotiate as effectively as possible.

                             

                             

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                            • #15


                              he shouldn’t empathize or feel the need to compromise based on his understanding of their perspective.
                              Click to expand...


                              Yes, I should just tell them the way it's going to be; no compromises necessary.
                              Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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