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This post is for my partner who is at the 30 month point in his first attending job as an obgyn. Things have gone great so far. This is a large multi-clinic group of various specialties, so management is not on site. There were originally two other providers in the group, but they both left in the last six months, so now it's just him. The practice is very busy. They have been trying to recruit new providers, but it isn't going well, so it will be just him for quite some time it appears, and there is a drastic obgyn shortage in our area.
Management just presented my partner with a new contract that is actually worse than his old contract, and would like him to sign it. The base pay is the same (mediocre, but acceptable), the stipend pay for call shifts is the same (makes up for the mediocre base pay), and they've added a new "backup call" pay feature for when the hospitalist takes his call, but if the hospitalist is swamped and can't do it, my partner would be the backup and would need to come in.
The pay for that is really a joke, something like $100 per "backup call shift" but that still means you can't leave town, you have to be available just in case, etc. So it's effectively CALL in our minds. If he does get called in during the backup call period, he gets paid per delivery, which is fine. If he were to take "backup call" instead of real call every single day for a year (he's the only doctor so we think he would have to), that would only bump his base by $36,500, plus whatever he would make in deliveries which remains to be seen, but that would mean 0 vacations or drinking, etc..
They have also reduced his ability to earn additional PTO, which used to be earned based on how much call you take, but now simply doesn't exist anymore. They have also indicated that they want to switch to the hospitalist doing most deliveries, meaning less or even zero regular call shifts for him - however his call pay at 1:3 really adds up to something like 25% of his overall compensation. To lose ALL of that would be a dealbreaker.
He's had a soft offer with a new group at another hospital nearby, but hasn't really gotten to the details on it, and would prefer to stay where he is simply because it's closer to where we live.
He sent an email to his immediate supervisor and said 1) You're effectively reducing my compensation by taking away earned PTO and not replacing it with anything 2) if you take away my call and give it to the hospitalist, but expect me to be on backup for the hospitalist, you're effectively keeping me on call (can't leave town, can't drink, etc.) but paying me way less. They responded with "this is the contract" and claim they are trying to standardize the contracts at all their locations.
This location is a harder location to staff, so we think they need to take that into account. If he leaves they literally would have no doctor, none on the horizon, and they are already way overstaffed with MA's, scribes, etc., as they haven't let any go that worked for the two providers that already left. His performance numbers are among the best in their system, he always sees more patients than scheduled, etc., so we are really at a loss for what their thought process is in asking for this, especially since he's all they have.
Neither of us can think of how to move forward, since there is no way he's signing this new contract as it sits, and I can't imagine they're going to fire him if he doesn't since it would effectively close down this clinic. Should he just negotiate with this other group to see what their offer would look like? How do we negotiate this existing situation when we really feel like he's got them over a barrel, but they don't seem willing to negotiate so far? It's kind of crazy to us that they are wanting this, but I think it's one of the problems you have when management isn't local and is spread over too many locations.
Management just presented my partner with a new contract that is actually worse than his old contract, and would like him to sign it. The base pay is the same (mediocre, but acceptable), the stipend pay for call shifts is the same (makes up for the mediocre base pay), and they've added a new "backup call" pay feature for when the hospitalist takes his call, but if the hospitalist is swamped and can't do it, my partner would be the backup and would need to come in.
The pay for that is really a joke, something like $100 per "backup call shift" but that still means you can't leave town, you have to be available just in case, etc. So it's effectively CALL in our minds. If he does get called in during the backup call period, he gets paid per delivery, which is fine. If he were to take "backup call" instead of real call every single day for a year (he's the only doctor so we think he would have to), that would only bump his base by $36,500, plus whatever he would make in deliveries which remains to be seen, but that would mean 0 vacations or drinking, etc..
They have also reduced his ability to earn additional PTO, which used to be earned based on how much call you take, but now simply doesn't exist anymore. They have also indicated that they want to switch to the hospitalist doing most deliveries, meaning less or even zero regular call shifts for him - however his call pay at 1:3 really adds up to something like 25% of his overall compensation. To lose ALL of that would be a dealbreaker.
He's had a soft offer with a new group at another hospital nearby, but hasn't really gotten to the details on it, and would prefer to stay where he is simply because it's closer to where we live.
He sent an email to his immediate supervisor and said 1) You're effectively reducing my compensation by taking away earned PTO and not replacing it with anything 2) if you take away my call and give it to the hospitalist, but expect me to be on backup for the hospitalist, you're effectively keeping me on call (can't leave town, can't drink, etc.) but paying me way less. They responded with "this is the contract" and claim they are trying to standardize the contracts at all their locations.
This location is a harder location to staff, so we think they need to take that into account. If he leaves they literally would have no doctor, none on the horizon, and they are already way overstaffed with MA's, scribes, etc., as they haven't let any go that worked for the two providers that already left. His performance numbers are among the best in their system, he always sees more patients than scheduled, etc., so we are really at a loss for what their thought process is in asking for this, especially since he's all they have.
Neither of us can think of how to move forward, since there is no way he's signing this new contract as it sits, and I can't imagine they're going to fire him if he doesn't since it would effectively close down this clinic. Should he just negotiate with this other group to see what their offer would look like? How do we negotiate this existing situation when we really feel like he's got them over a barrel, but they don't seem willing to negotiate so far? It's kind of crazy to us that they are wanting this, but I think it's one of the problems you have when management isn't local and is spread over too many locations.
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