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  • #16
    Not that I expect you to answer but I can’t help but wonder what outfit would pull this stunt from national headquarters. HCA? Lifepoint?

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    • #17
      I don’t have immense experience with this exact scenario, but have seen on several occasions a decree from faraway administration who has no idea what the local circumstances are that is completely out of touch. Is there some type of more local administrator who would be more sympathetic? Such as the person who knows why the other partners left, and how they’ve been unable to fill open positions for a while now, and understands why asking your partner to be “on call” every day of the year is unreasonable? If so I would talk to that person and have your partner express their concerns, and see if they can effect any change or alteration to the contract.

      Most importantly, as others have said, start trying to nail down some specifics on what employment with that other semi-local group would look like and then use that as a starting point for further negotiation. Sounds like your partner holds all the cards, although admin doesn’t want them to realize that, or bargain from that position.

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      • #18
        Dont allow your partner to become the martyr trying to save the hospital himself. The hospital does not love you back. There's a reason his 2 partners left in a short amount of time and they cant hire more people. If the administration had any self awareness you'd think they would be offering your partner a retention bonus, or increased salary, not a higher call burden at reduced salary. Never underestimate the greed of administrators. This may also be a cost cutting measure for his company/hospital and may be the sign of bad times ahead (closures) , so your partner should be looking for another job regardless. Read the contract he signed re: tail insurance and any restrictive covenant (note- not enforceable in some states but companies still put them in the contracts to discourage employees from leaving).

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        • #19
          The problem that I have come across in negotiating is that you cannot assume that the person that you are negotiating is negotiating in a way that acts in their own best interest or rationally. I think that this particularly true with hospital administrators who are usually only there transiently, have no idea what it would mean to lose a physician, don't particularly have to deal with the ramifications of losing a physician, and can only see the praise they will get from their superiors for getting more from the physicians while paying them less. They aren't really acting in the interest of the corporation who in actuality would lose a lot of money if they lose a particular physician and were unable to obtain a replacement promptly. I find that even occurs with senior physicians who churn through junior partners and ultimately end up retiring earlier then they had wanted to because they don't want to do or can't handle the workload themselves (ie they end up making less then they could have long term due to the lack of retention, not to mention the cost of recruiting and starting out a new physician). Anyways, although tempting, I wouldn't just leave out of spite, I would just leave if I really could find a better position somewhere that was in a location where I wanted to be. It is tempting to leave out of spite, but again, my impression with the hospital administrators is that they turn over with some frequency and even when they do not, they don't seem to usually be held directly accountable when the system loses a physician.

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          • #20
            What if your partner doesn't sign? Does the original contract have a defined duration or remains current until a new one is agreed upon? Agree with the many others suggesting getting an offer from the nearby group to strengthen the negotiating position. As an aside, I have seen this movie before. An OBGyn I used to work with was part of a multi-specialty clinic/group. Group wanted to unfavorably change his contract and despite being busy and well-regarded he wasn't able to negotiate a better deal. Many more primary care docs than specialists so it was difficult for him to push back against management which wasn't viewing it his way. He soon left for a single-specialty practice at different hospital in another area of town. It's worked out well for him, I hope however this turns out it works out well for your partner.

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            • #21
              Agree with nephron. Never assume admin will act rationally. They don’t think that way and often don’t have to live with the consequences. They’re emotional. Expect the worse.

              With that said what I’ve found is just don’t sign anything. I’ve been “negotiating” my contract for 3 years now. They’re not going to put a restraining order on you. They’re not going to kick you out. Call their bluff. Don’t write snarky emails back.. just meet explain your concerns and your suggestions and be positive and keep talking about wanting to work it out. Prepare for the worse for sure, but in my experience you can often stall them out.

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              • #22
                I'd negotiate with the other group/system with added compensation due to the further distance.

                I'm really rooting for you guys because I have no shortages of stories of doctors, "physicians", being taken advantage of. I am envious of OP's partner's position.

                "You're giving me $36,500 to be on call for the entire year? I think you are not seeing the letters after my name because that figure for a "healthcare provider". I'll take call all year for 10x that amount, thanks."

                Or another favorite of mine: red ink in the contract changes, & send it back to administration, with a "Sign Here" yellow sticky note at the end for them to sign.
                $1 saved = >$1 earned. ✓

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                • #23
                  “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.”

                  No physician would ever accept a contract with call responsibility 365. PERIOD!
                  Forget the pay, administrator, negotiations, commute or any other words. The terms of that responsibility are completely unacceptable.

                  As is, start looking for another position and go from there. It is not your responsibility to fix the employers problems. Secure your future employment and decide if you wish to counter.

                  I wouldn’t recommend it, but you might consider the last communication to the administrator an announcement to the hospitalist and providers the cell number to reach him for backup call 365 days.
                  After all, no physicians are employed anymore.
                  Not really. Job first, pay second. You don’t have a job you can accept. Find one and see if there is a second. Keep on working and collect pay on the old contract. Non-negotiable 365 call.

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                  • #24
                    I'm ignorant. Is it the contention of folks on this board that the word "physician" or "doctor" has been replaced with the word "provider" as a subtle (or not so subtle) attempt for health admin to diminish doctors and their contributions?

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                    • #25
                      That plus I think less pay for more work.

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                      • #26
                        Originally posted by JBME View Post
                        I'm ignorant. Is it the contention of folks on this board that the word "physician" or "doctor" has been replaced with the word "provider" as a subtle (or not so subtle) attempt for health admin to diminish doctors and their contributions?
                        You can read lots of pieces on KevinMD and such, but some of the issues:
                        - it’s dehumanizing
                        - it’s a word that makes us interchangeable (for admin) with those with inferior qualifications
                        - we should be recognized for our achievements
                        - the logical extension is that we should call patients “consumers” and if we don’t provide them what they want, we haven’t done our job.

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                        • #27
                          thanks for the insight! My curiosity was piqued because my physician wife was on a weekly call this morning and I kept noting the word "provider" was being used. Plus, she was out sick with the flu last week and an administrator chastised her for not successfully (she actually attempted, which frankly is going above and beyond) finding coverage while she was out, saying to her "I spoke with my supervisor to make sure I was right, and yes, it's not our job to find a replacement. Providers are tasked with finding coverage if they are going to be out." This is within academia. Man you all have it rough out there for sure. anyway, carry on with the OP's topic

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                          • #28
                            Originally posted by JBME View Post
                            thanks for the insight! My curiosity was piqued because my physician wife was on a weekly call this morning and I kept noting the word "provider" was being used. Plus, she was out sick with the flu last week and an administrator chastised her for not successfully (she actually attempted, which frankly is going above and beyond) finding coverage while she was out, saying to her "I spoke with my supervisor to make sure I was right, and yes, it's not our job to find a replacement. Providers are tasked with finding coverage if they are going to be out." This is within academia. Man you all have it rough out there for sure. anyway, carry on with the OP's topic
                            That’s annoying.

                            what makes administrators think they can talk to doctors that way when the doctors are generating the revenue to supply the administrators’ salary? I will never understand

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                            • #29
                              Originally posted by nephron View Post
                              Anyways, although tempting, I wouldn't just leave out of spite, I would just leave if I really could find a better position somewhere that was in a location where I wanted to be. It is tempting to leave out of spite, but again, my impression with the hospital administrators is that they turn over with some frequency and even when they do not, they don't seem to usually be held directly accountable when the system loses a physician.
                              Really excellent advice regardless of the situation.

                              I also like @Sundance's strategy to just not sign.

                              Good stuff Gents, thanks!

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                              • #30
                                Is your partner still under contract? How much longer does the current contract run?

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