Senior partner woes

[kingsnake]

q-school wrote:

kingsnake wrote:

wcinewbie wrote:

kingsnake wrote:

Classic scenario of elder partner wanting to slow down and who feels entitled. We just had our oldest partner go 75% time, and he expected no penalty for taking 25% less call. F that. Clearly states in the contract call is to be shared equally. Now he has to pay $1000 per call day to whomever picks up his call and for me to pick it up that isn’t enough. Younger folks have picked it up though, luckily.

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What specialty are you?  What are the call responsibilities and how does one decide what the appropriate compensation for call is?

I work in ophthalmology.  Call involves EMTALA responsibilities at the trauma center and inpatient consults which are usually rare.  The hospital pays us for call at what I consider decent for a new attending in addition to what we bill for our specific services.  Right now, there seems to be other docs in our practice who are willing to take that call for us if we want to “give up” that privilege/responsibility.  There are many docs in the community who would prefer not to have that burden.

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GI, employed group, we don’t get paid to take call. We (the GI docs) agreed that he will pay $1000 per call day he doesn’t take to whomever picks up his call.

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pre tax or post tax?

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Pre tax... Not worth it to me personally so I have not taken any of his call. When we were short GI call coverage in the past I have taken additional call days for $2000 per day pre tax.

[CM]

q-school wrote:

Rex wrote:

I disagree with any idea of “supervising” him further.  I didnt catch anything that would imply that to be appropriate.

 

His attitude actually isnt that uncommon for someone in his position.  As i mentioned previously, i wouldnt have recommend agreeing to his previous terms.  At this point, unless he says or does something that causes concerns, such “supervising” is just asking to open new or old wounds and cause problems.  Planning for a transition is appropriate but not more.

 

Taking aside any possible “Axis II” issues what he really did is a poor negotiating tactic.  He asked for the ridiculous.  Some people think you should shoot for the moon but that isnt true.  Whenever you want to push someone to your side, you can ask for a lot but NOT for something the other party will find is ridiculous.  That just turns the person off to further negotiating.  For instance he could have asked for a specific amount per year to manage it.  If he asks for a million dollars then not only does he get a no way, nobody listens to him further.  If he had asked for an amount that was on the higher side but not ridiculous then while he may not get that amount, the negotiations sort of start from that basis.

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so called anchoring style of negotiations.

I am not sure where I fall on this issue.  I agree with you-I get turned off when people start shooting for the moon.  I also think that with partnerships, the options for negotiating are different than when dealing with someone for a one time deal.  I probably would strongly have suggested that since the door was opened, starting jan 1, some of the responsibilities get transferred to ease the eventual transition and to prepare someone to be capable of absorbing the responsibilities.  i personally think as the senior member of the group it sets a poor example to negotiate so aggressively with your own partners, but it’s hard to know the nuances of a group.  in this case, it makes me worry that I’m getting screwed by him somewhere else without knowing.  maybe he was letting you guys know how hard he is fighting on your behalf on many different fronts.   obviously jmo, ymmv.

 

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[q-school]

Rex wrote:

I disagree with any idea of “supervising” him further.  I didnt catch anything that would imply that to be appropriate.

 

His attitude actually isnt that uncommon for someone in his position.  As i mentioned previously, i wouldnt have recommend agreeing to his previous terms.  At this point, unless he says or does something that causes concerns, such “supervising” is just asking to open new or old wounds and cause problems.  Planning for a transition is appropriate but not more.

 

Taking aside any possible “Axis II” issues what he really did is a poor negotiating tactic.  He asked for the ridiculous.  Some people think you should shoot for the moon but that isnt true.  Whenever you want to push someone to your side, you can ask for a lot but NOT for something the other party will find is ridiculous.  That just turns the person off to further negotiating.  For instance he could have asked for a specific amount per year to manage it.  If he asks for a million dollars then not only does he get a no way, nobody listens to him further.  If he had asked for an amount that was on the higher side but not ridiculous then while he may not get that amount, the negotiations sort of start from that basis.

Click to expand...

so called anchoring style of negotiations.

I am not sure where I fall on this issue.  I agree with you-I get turned off when people start shooting for the moon.  I also think that with partnerships, the options for negotiating are different than when dealing with someone for a one time deal.  I probably would strongly have suggested that since the door was opened, starting jan 1, some of the responsibilities get transferred to ease the eventual transition and to prepare someone to be capable of absorbing the responsibilities.  i personally think as the senior member of the group it sets a poor example to negotiate so aggressively with your own partners, but it's hard to know the nuances of a group.  in this case, it makes me worry that I'm getting screwed by him somewhere else without knowing.  maybe he was letting you guys know how hard he is fighting on your behalf on many different fronts.   obviously jmo, ymmv.

 

[CM]

Rex wrote:

I disagree with any idea of “supervising” him further.  I didnt catch anything that would imply that to be appropriate.

 

His attitude actually isnt that uncommon for someone in his position.  As i mentioned previously, i wouldnt have recommend agreeing to his previous terms.  At this point, unless he says or does something that causes concerns, such “supervising” is just asking to open new or old wounds and cause problems.  Planning for a transition is appropriate but not more.

 

Taking aside any possible “Axis II” issues what he really did is a poor negotiating tactic.  He asked for the ridiculous.  Some people think you should shoot for the moon but that isnt true.  Whenever you want to push someone to your side, you can ask for a lot but NOT for something the other party will find is ridiculous.  That just turns the person off to further negotiating.  For instance he could have asked for a specific amount per year to manage it.  If he asks for a million dollars then not only does he get a no way, nobody listens to him further.  If he had asked for an amount that was on the higher side but not ridiculous then while he may not get that amount, the negotiations sort of start from that basis.

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So perhaps he is a poor negotiator rather than an aggressive negotiator. Either way, he made an offer and was rebuffed. He might be a bad guy, but this proposal (by itself) doesn't indicate that. This sort of thing occurs regularly in group practices.

Now if he becomes unhappy and pouts and starts causing trouble for the group, then he is a bad guy.

[q-school]

kingsnake wrote:

wcinewbie wrote:

kingsnake wrote:

Classic scenario of elder partner wanting to slow down and who feels entitled. We just had our oldest partner go 75% time, and he expected no penalty for taking 25% less call. F that. Clearly states in the contract call is to be shared equally. Now he has to pay $1000 per call day to whomever picks up his call and for me to pick it up that isn’t enough. Younger folks have picked it up though, luckily.

Click to expand…

What specialty are you?  What are the call responsibilities and how does one decide what the appropriate compensation for call is?

I work in ophthalmology.  Call involves EMTALA responsibilities at the trauma center and inpatient consults which are usually rare.  The hospital pays us for call at what I consider decent for a new attending in addition to what we bill for our specific services.  Right now, there seems to be other docs in our practice who are willing to take that call for us if we want to “give up” that privilege/responsibility.  There are many docs in the community who would prefer not to have that burden.

Click to expand…

GI, employed group, we don’t get paid to take call. We (the GI docs) agreed that he will pay $1000 per call day he doesn’t take to whomever picks up his call.

Click to expand...

pre tax or post tax?

[kingsnake]

wcinewbie wrote:

kingsnake wrote:

Classic scenario of elder partner wanting to slow down and who feels entitled. We just had our oldest partner go 75% time, and he expected no penalty for taking 25% less call. F that. Clearly states in the contract call is to be shared equally. Now he has to pay $1000 per call day to whomever picks up his call and for me to pick it up that isn’t enough. Younger folks have picked it up though, luckily.

Click to expand…

What specialty are you?  What are the call responsibilities and how does one decide what the appropriate compensation for call is?

I work in ophthalmology.  Call involves EMTALA responsibilities at the trauma center and inpatient consults which are usually rare.  The hospital pays us for call at what I consider decent for a new attending in addition to what we bill for our specific services.  Right now, there seems to be other docs in our practice who are willing to take that call for us if we want to “give up” that privilege/responsibility.  There are many docs in the community who would prefer not to have that burden.

Click to expand...

GI, employed group, we don't get paid to take call. We (the GI docs) agreed that he will pay $1000 per call day he doesn't take to whomever picks up his call.

[Dr. Mom]

Zaphod wrote:

Dr. Mom wrote:

q-school wrote:

maybe he is not a sociopath after all.  ???? 

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So, before we let go of that idea, does your group need to be more closely supervising this individual under the guise of educating yourselves for the eventual transition?  From your prior description of him/her, I would not be so quick to just go back to the old status quo of full trust, but then that would not have been my status quo anyway. (My husband teases me that I write far more positively for you guys here than my baseline cynical personality.) Glad it appears to be working out for your group.  But, please watch closely to protect yourselves.

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Idk, it seems like he correctly surmised the group didnt want to do anything in the management arena and tried to take advantage, but got greedy. It was worth a shot to him since it turns out was willing to do it for free. Just good negotiating and game theory but too greedy.

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Greedy to total acquiescence makes me a little suspicious.  Also fair or not, I sensed a tone in NJDoc's writing that seemed different to me.  Just want to be sure he is playing the same game they are.

[CM]

Zaphod wrote:

Dr. Mom wrote:

q-school wrote:

maybe he is not a sociopath after all.  ???? 

Click to expand…

So, before we let go of that idea, does your group need to be more closely supervising this individual under the guise of educating yourselves for the eventual transition?  From your prior description of him/her, I would not be so quick to just go back to the old status quo of full trust, but then that would not have been my status quo anyway. (My husband teases me that I write far more positively for you guys here than my baseline cynical personality.) Glad it appears to be working out for your group.  But, please watch closely to protect yourselves.

Click to expand…

Idk, it seems like he correctly surmised the group didnt want to do anything in the management arena and tried to take advantage, but got greedy. It was worth a shot to him since it turns out was willing to do it for free. Just good negotiating and game theory but too greedy.

Click to expand...

Agree. If someone is an aggressive negotiator I wouldn't hold that against him.

[Zaphod]

Dr. Mom wrote:

q-school wrote:

maybe he is not a sociopath after all.  ???? 

Click to expand…

So, before we let go of that idea, does your group need to be more closely supervising this individual under the guise of educating yourselves for the eventual transition?  From your prior description of him/her, I would not be so quick to just go back to the old status quo of full trust, but then that would not have been my status quo anyway. (My husband teases me that I write far more positively for you guys here than my baseline cynical personality.) Glad it appears to be working out for your group.  But, please watch closely to protect yourselves.

Click to expand...

Idk, it seems like he correctly surmised the group didnt want to do anything in the management arena and tried to take advantage, but got greedy. It was worth a shot to him since it turns out was willing to do it for free. Just good negotiating and game theory but too greedy.

[Dr. Mom]

q-school wrote:

maybe he is not a sociopath after all.  ????

Click to expand...

So, before we let go of that idea, does your group need to be more closely supervising this individual under the guise of educating yourselves for the eventual transition?  From your prior description of him/her, I would not be so quick to just go back to the old status quo of full trust, but then that would not have been my status quo anyway. (My husband teases me that I write far more positively for you guys here than my baseline cynical personality.) Glad it appears to be working out for your group.  But, please watch closely to protect yourselves.

[q-school]

NJDoc wrote:

q-school wrote:

awesome news!  hopefully you guys can begin to work on a transition plan if he truly intends to retire in a couple years. 

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Thanks – and yes, we all agreed to begin an orderly transition starting in 2 years.

 

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maybe he is not a sociopath after all. 

 

[NJDoc]

q-school wrote:

awesome news!  hopefully you guys can begin to work on a transition plan if he truly intends to retire in a couple years.

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Thanks - and yes, we all agreed to begin an orderly transition starting in 2 years.

 

[q-school]

NJDoc wrote:

Just a follow up – we, the partners, unanimously voted his requests down and offered to take over all administrative duties starting Jan.1.

There was a rapid change in tune,  he withdrew his mandates and wants to stay in charge, and will do so without any guaranteed income.

 

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awesome news!  hopefully you guys can begin to work on a transition plan if he truly intends to retire in a couple years.

[NJDoc]

Just a follow up - we, the partners, unanimously voted his requests down and offered to take over all administrative duties starting Jan.1.

There was a rapid change in tune,  he withdrew his mandates and wants to stay in charge, and will do so without any guaranteed income.

 

[MPMD]

kingsnake wrote:

Classic scenario of elder partner wanting to slow down and who feels entitled. We just had our oldest partner go 75% time, and he expected no penalty for taking 25% less call. F that. Clearly states in the contract call is to be shared equally. Now he has to pay $1000 per call day to whomever picks up his call and for me to pick it up that isn’t enough. Younger folks have picked it up though, luckily.

Click to expand...

It's funny in medicine there is really no basis to feel entitled unless you are still functioning as a rainmaker and most of these docs simply aren't. No one is referring you patients because you work in a group that was founded by old John unless you are still doing good work.

I actually do know of one scenario with a true rainmaker where a group was a mess until one guy came in, that guy fixed things up and also was the most productive doc, now he still controls things and gets paid crazy money to do less work, but no one seriously thinks that the group as it stands would last long or be nearly as profitable if he left. That position is shared by both the group and the contracting hospital, hence $$$. Market forces at work there.

Much more common is older docs expecting significant accommodation for minimal contributions in the past. This is particularly challenging for early career people who are working their asses off and not really quite understanding how this dude who refuses to take call is exactly benefiting them.

It goes without saying that docs who demand this sort of thing would never tolerate being on the receiving end of it.