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  • jdkelso
    replied
    I would recommend leaving on your terms. This practice is mismanaged and the physicians in the practice can't fix it. Physicians sometimes like to fix things and it can be hard to let go. Additionally, it is important to recognize you all did not burn this bridge, the practice management did. The 2 other physicians with more experience with this employer have already calculated the opportunity cost (better to stay or better to go) and they have both left. The Physician is undervalued and this is a fight you will never be able to win. Its is sad; grieve the loss and move on. I would bet your partner will get super excited really quickly. Leaving on your terms will be reviewing the termination without cause provision and planning the termination notice after accepting a new job.

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  • Lithium
    replied
    Originally posted by Gamma Knives View Post
    Unfortunately, it seems that many hospital administrators view physicians as fungible resources. I would prepare to walk away from the contract. Start talking to other groups. Hopefully your partner's employer will see reason but don't count on it.

    I've known many colleagues who have had to move because admin would not budge on contract; they simply plan to recruit other physicians. Administration never seems to have to answer for the fact they end up losing business and spending more to replace physicians that leave when they refuse to meet reasonable requests. These stories are what motivates me to try to reach FI ASAP.
    At my megacorp former employer, we had a new CEO who had a bombastic vision of "disrupting" health care. His stand by was that health care was changing, and that we had to change with it, or we would get lost in the shuffle. He explained how business dinosaurs like Blockbuster didn't change and got eaten alive by the new competition.

    The problem is, health care is not run like most successful FAANG companies. The leadership is too hierarchical and reliant on the Peter Principle for advancement, and the primary goal among administrators is preservation and promotion. It is surprising to me that even for-profit companies like HCA who are beholden to shareholders are not much better in this regard. To the extent the aforementioned CEO says he wanted to "disrupt" the system, there is no evidence it applied to the gordian knot of administration. There have been cuts to benefits throughout the system, but there are more pencil pushers than ever, and I was spending more and more time in meetings and doing non-clinical busywork before I left.

    There must be economic incentives that maintain this crummy inefficient system, but I don't fully understand them. It does make me wonder how much worse working for Wal-Mart Clinic would be. Or what would happen if Bill Gates or Buffett could just take a smaller system over and fix it with scorched earth tactics from the top down. If that is even possible, they would probably never be dumb enough to try.

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  • Hatton
    replied
    Another thought on this situation. Admin seems to miss the concept that OB/GYN patients will notice if the doctor leaves. They will be upset. If another option is available nearby they may leave also. Some will be willing to drive to a nearby town. It is economically crazy to drive the OPs partner away. I wish the OPs partner would add to this thread.

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  • Gamma Knives
    replied
    Unfortunately, it seems that many hospital administrators view physicians as fungible resources. I would prepare to walk away from the contract. Start talking to other groups. Hopefully your partner's employer will see reason but don't count on it.

    I've known many colleagues who have had to move because admin would not budge on contract; they simply plan to recruit other physicians. Administration never seems to have to answer for the fact they end up losing business and spending more to replace physicians that leave when they refuse to meet reasonable requests. These stories are what motivates me to try to reach FI ASAP.

    Leave a comment:


  • Hank
    replied
    Is your partner still under contract? How much longer does the current contract run?

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  • StateOfMyHead
    replied
    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!

    Leave a comment:


  • GastroMastro
    replied
    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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  • JBME
    replied
    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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  • Lithium
    replied
    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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  • Peds
    replied
    That plus I think less pay for more work.

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  • JBME
    replied
    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?

    Leave a comment:


  • Tim
    replied
    “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.

    Leave a comment:


  • Cubicle
    replied
    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.

    Leave a comment:


  • Sundance
    replied
    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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  • GasFIRE
    replied
    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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