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Dysfunctional office. Is it like this everywhere??

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  • NumberWhizMD
    replied
    That just sounds like a horrible situation. However, I will echo what others have said. If your finances are in a good position for the clinic, there is no reason you should be so severely understaffed. I thought our situation was bad compared to other groups (who have 2 MAs per provider and a scribe), but we still have 1MA per provider and a float. Our finances are in good order, so we can afford it.

    I will agree as well that hiring right now is hard. You do seem to underpay at least for our area. I know that several of the local groups have been offering bonuses and increased pay incentives for new hires, so I think part of it is a lack of qualified staff available.

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  • Random1
    replied
    You probably have no say in any of this. But I would at least ask to review the finances of your office. If the finances are good, and they are just trying to squeeze a nickel, I would prepare to leave or negotiate. If the finances are poor , then you have different issues. I would get a count of wRVUs and compare them to average, at least go into a discussion with good concrete information. My situation is different , but I did not have an MA for several months this past year. I just could not find anyone that I liked, had skills and actually showed up for an interview. It you can hold out until Sept , the situation will likely change.

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  • Zaphod
    replied
    Originally posted by CordMcNally View Post

    That's a pretty broad line that I feel like would be pretty tough to prove. I'm not a lawyer but I would think their legal team worded it that way for a reason.
    Yeah, lol trying to make that line work, it means nothing. It means they can say that it was adequate for all these other drs but for some reason not you, maybe you're the problem.

    Leave a comment:


  • MPMD
    replied
    Originally posted by Dontgetthejab View Post

    my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

    id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it
    i agree that they are in breach of it.

    i think you'd have a very hard time actually proving that if it came down to the wire.

    Leave a comment:


  • AR
    replied
    Originally posted by VagabondMD View Post

    I good start would be to make the claim that there has been a breech. It does not have to be proven or even true, but once the claim is made, it will have to be taken seriously.
    I don't know about that. Really very dependent on where you work.

    Leave a comment:


  • MaxPower
    replied
    There’s definitely a lot of room or gray area when a word like “adequate” is used. What are staffing ratios and workflows like in other offices, either in your same specialty or different specialties? How many other docs are rooming their own patients or taking their own vitals?

    Another tactic would be reducing your scheduled patients to accommodate for the extra work. The downside of that, of course, is that your productivity would suffer. If you’re on salary that isn’t as big of a deal, of course.

    Leave a comment:


  • VagabondMD
    replied
    Originally posted by AR View Post

    Unfortunately that degree of generality is completely useless. What is "adequate"? You say it is not; they say it is. Trying to sue them for breach is gonna be real tough. I'm not a lawyer, but I'm certain if I could craft a reasonable argument for just about anything being adequate. Or at least I could do enough to confuse a bunch of lay people.
    I good start would be to make the claim that there has been a breech. It does not have to be proven or even true, but once the claim is made, it will have to be taken seriously.

    Leave a comment:


  • AR
    replied
    Originally posted by Dontgetthejab View Post

    my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

    id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it
    Unfortunately that degree of generality is completely useless. What is "adequate"? You say it is not; they say it is. Trying to sue them for breach is gonna be real tough. I'm not a lawyer, but I'm certain if I could craft a reasonable argument for just about anything being adequate. Or at least I could do enough to confuse a bunch of lay people.

    Leave a comment:


  • jfoxcpacfp
    replied
    Originally posted by Dontgetthejab View Post

    my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

    id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it
    This would be worth asking for specificity and/or clarification in the final document in the future. I don’t think you did anything wrong - just one of those sections of boilerplate language. I’ve ready many contracts with same and never thought to ask for definition but will in the future, so consider your taking the time to post your story as a contribution to others’ future negotiation activities. When an admin says that “we cannot define that”, the job candidate can say, “here’s why it matters to me...

    Leave a comment:


  • ENT Doc
    replied
    Originally posted by CordMcNally View Post

    I agree but I feel like the phrase 'pandemic' may come up.
    Lol true. But I’d expect these problems can be identified as occurring prior to 2020.

    Leave a comment:


  • CordMcNally
    replied
    Originally posted by ENT Doc View Post

    Hopefully there’s a reasonableness clause. It’s not reasonable to ask a physician to room their own patients, take their own vitals, etc. - especially for an extended period.
    I agree but I feel like the phrase 'pandemic' may come up.

    Leave a comment:


  • ENT Doc
    replied
    Originally posted by CordMcNally View Post

    That's a pretty broad line that I feel like would be pretty tough to prove. I'm not a lawyer but I would think their legal team worded it that way for a reason.
    Hopefully there’s a reasonableness clause. It’s not reasonable to ask a physician to room their own patients, take their own vitals, etc. - especially for an extended period.

    Leave a comment:


  • CordMcNally
    replied
    Originally posted by Dontgetthejab View Post

    my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

    id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it
    That's a pretty broad line that I feel like would be pretty tough to prove. I'm not a lawyer but I would think their legal team worded it that way for a reason.

    Leave a comment:


  • ENT Doc
    replied
    Originally posted by Dontgetthejab View Post

    my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

    id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it
    1. Find another job
    2. Inform your current job in writing that they are in breach of contract. Use objective data and clear examples.
    3. When they don’t correct after #2 use that as your means to get what you are owed under an employer breach.
    4. Leave for #1

    Leave a comment:


  • Tim
    replied
    Originally posted by AR View Post
    I guess the utility of this is specialty dependent. I also think it is hard to have something written that covers all the possibilities. The main one is that (at least in my case) if your practice grows, you're gonna need more staff, and it (at least in my case), doesn't scale linearly as volume increases. However, I don't disagree that it's worth trying for something like this if you can get it.
    In academic and in some private practices there are situations that the "political pecking order" can seriously hamper your production. If you have wRVU incentives, it can be a huge problem. Two MA's, 2 PA's and a scribe with residents and fellows assisting and block time definitely can handle a greater volume than a doc with an MA.

    The response of "normally 5 years we consider adding ...." solves nothing. I suppose the best way is to play the political game, For sure incentive comp metrics are in great detail, not so much the staffing support needed to achieve the targets. I would have no idea how to put something like that in contract language. The comment about not scaling linearly is so important. The staffing level supports a range of production before headcount makes sense.

    Leave a comment:

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