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  • #16
    I would probably take a month off and then get a new job which would not be difficult.  Might be fun to be stay-at home parent for a bit.

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    • #17




      This post is inspired by The Happy Philosopher’s latest blog, which was effing outstanding.

      While it sounds impossible (it really is not–docs lose their jobs for a myriad of reasons everyday), what would your immediate reaction be? What does the next day, week, month have in store for you? Just assume arrive at work and either the hospital or practice is burned to the ground or is closed, you get your walking papers, and it is a clean cut– no loose ends, tails, expenses, or residual income. Just bye bye.

      I’ll post my thoughts later.
      Click to expand...


      This happened to me about six years ago. I didn't know what Financial Independence was, but I certainly didn't have it. I was five years into my career and the hospital was facing bankruptcy.

      I got the call on a Saturday morning that I would be working another five weeks and then done. I had been planning to visit some breweries with a coworker, but instead, a family member took our very young boys and my wife joined me for beers and contemplation.

      Once the shock wore off, I lined up a couple locums gigs and started looking into full-time positions. We probably jumped into one too soon, as we ended up only staying there a couple years, but a great job in a great location for us came along eventually.

      If it happened today, I'd take at least a few month's sabbatical, then maybe test the waters with some locums work. I might also just take it as a sign that it's time to move on and be done.

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      • #18
        I would take a sabbatical - likely a year or two and see how things go.  If I wanted to get back in the game, I would try to work part time or do some locum work.  I would focus more on ancillary income streams and investing but I think we would be fine.

         

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        • #19
          I think that more doctors do lose their jobs than I originally believed, all because of how medical systems work. Broken healthcare plans. Poorly run medical practices. Litigation burning through a practice's cash flow. You name it. It's there. I've also seen one too many senior owners of medical practices who don't necessarily fire their new associates, but just continue to make the workplace unfavorable to them.

          I guess this happens all the time in industry. I never thought that medicine would be similar until I saw the real world...

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          • #20




            I think that more doctors do lose their jobs than I originally believed, all because of how medical systems work. Broken healthcare plans. Poorly run medical practices. Litigation burning through a practice’s cash flow. You name it. It’s there. I’ve also seen one too many senior owners of medical practices who don’t necessarily fire their new associates, but just continue to make the workplace unfavorable to them.

            I guess this happens all the time in industry. I never thought that medicine would be similar until I saw the real world…
            Click to expand...


            So true. When I was the head of my group, over a period of seven years, I had to move out five different partners, for various reasons (sexual harassment was the cause for two). Four (of the five) had no idea it was coming, and one of those four has not worked since being let go three years ago. The others all eventually landed elsewhere in the local market in situations that were less optimal (including less compensation) than what they had with us, but certainly sufficient to make a living. All four were out of work for between three and six months.

            Most people, including most docs, think that being a doc is a virtual guarantee of consistent employment with a high salary, but nothing could be further from the truth.

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            • #21


              I’ve also seen one too many senior owners of medical practices who don’t necessarily fire their new associates, but just continue to make the workplace unfavorable to them.
              Click to expand...


              Yes. Plenty of private practices offer a low starting salary to young docs, with the promise of a big pay raise at partnership. How do they make so much as partners? In some cases, it's high production and high turnover of young docs. I had this happen to a friend of mine. Two years of doing everything asked at a starting salary subsidizing the partners' salaries, then his contract was not renewed when it was time to join the partners.

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              • #22
                Definitely more common than people realize.

                The other thing that people don't realize is with hospital integration age discrimination becomes a huge issue.

                I've seen some eye openers with 55+ year old plus docs with a wealth of experience not be a able to get a job with a hospital -

                I've had multiple admin guys openly admit that..

                Super unfortunate IMO but I warned some older docs in my group to tread lightly (trying to warn them of what I've seen elsewhere). Many have no clue, but in today's age they're the first to be run out on bogus allegations (or accumulation of complaints that come with doing this job) and can find themselves in tough spots trying to find new gigs.

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                • #23




                  Definitely more common than people realize.

                  The other thing that people don’t realize is with hospital integration age discrimination becomes a huge issue.

                  I’ve seen some eye openers with 55+ year old plus docs with a wealth of experience not be a able to get a job with a hospital –

                  I’ve had multiple admin guys openly admit that..

                  Super unfortunate IMO but I warned some older docs in my group to tread lightly (trying to warn them of what I’ve seen elsewhere). Many have no clue, but in today’s age they’re the first to be run out on bogus allegations (or accumulation of complaints that come with doing this job) and can find themselves in tough spots trying to find new gigs.
                  Click to expand...


                  One example I've seen is in a Hospitalist situation where due to hospital policies, there is no admission cap (common these days), new integration to an EHR system, and the "older" docs having more difficulty putting in orders and notes. The hospital then throws in a 24 hr note policy, and these docs end up spending a few hours after signing out to close out notes. Over time, they lose out on their bonuses, and find that their salary goes down over time. Not really directly age discrimination, but it's a sad reality.

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                  • #24




                    Definitely more common than people realize.

                    The other thing that people don’t realize is with hospital integration age discrimination becomes a huge issue.

                    I’ve seen some eye openers with 55+ year old plus docs with a wealth of experience not be a able to get a job with a hospital –

                    I’ve had multiple admin guys openly admit that..

                    Super unfortunate IMO but I warned some older docs in my group to tread lightly (trying to warn them of what I’ve seen elsewhere). Many have no clue, but in today’s age they’re the first to be run out on bogus allegations (or accumulation of complaints that come with doing this job) and can find themselves in tough spots trying to find new gigs.
                    Click to expand...


                    All the more reason to achieve FI early!

                    Comment


                    • #25





                      I’ve also seen one too many senior owners of medical practices who don’t necessarily fire their new associates, but just continue to make the workplace unfavorable to them. 
                      Click to expand…


                      Yes. Plenty of private practices offer a low starting salary to young docs, with the promise of a big pay raise at partnership. How do they make so much as partners? In some cases, it’s high production and high turnover of young docs. I had this happen to a friend of mine. Two years of doing everything asked at a starting salary subsidizing the partners’ salaries, then his contract was not renewed when it was time to join the partners.
                      Click to expand...


                      This type of churn and burn behavior and dishonesty happens in radiology all too often.  Combine a popular geographic area, with bad job market and greedy partners and you have the perfect recipe (you don't even need all 3).  Although these days, the job market is better and partnership type jobs are disappearing all together from many markets either because of consolidations or simply private groups not offering them.

                      I think getting fired or not renewed is tough because there is always a lot of explaining to do.  Not to mention it's tough looking for work when you got none.  I would recommend doing a lot of research on the group and talking to those who have left before joining.

                      Comment


                      • #26








                        I’ve also seen one too many senior owners of medical practices who don’t necessarily fire their new associates, but just continue to make the workplace unfavorable to them. 
                        Click to expand…


                        Yes. Plenty of private practices offer a low starting salary to young docs, with the promise of a big pay raise at partnership. How do they make so much as partners? In some cases, it’s high production and high turnover of young docs. I had this happen to a friend of mine. Two years of doing everything asked at a starting salary subsidizing the partners’ salaries, then his contract was not renewed when it was time to join the partners.
                        Click to expand…


                        This type of churn and burn behavior and dishonesty happens in radiology all too often.  Combine a popular geographic area, with bad job market and greedy partners and you have the perfect recipe (you don’t even need all 3).  Although these days, the job market is better and partnership type jobs are disappearing all together from many markets either because of consolidations or simply private groups not offering them.

                        I think getting fired or not renewed is tough because there is always a lot of explaining to do.  Not to mention it’s tough looking for work when you got none.  I would recommend doing a lot of research on the group and talking to those who have left before joining.
                        Click to expand...


                        I saw this happen to my friends urology group. It has gotten to the point between payors, rents, etc...that I think these kind of practices are starting to blow themselves up. My friend saw the writing on the wall and bounced before he kept paying all the older partners salaries. Its such a crazy idea since its collectively destructive overall and a more cooperative mentality would actually lead to more for everyone since there is more than enough, but ugh, what can you do. Not come across many docs outside these forums (aside from some friends) that have a solid big picture outlook on things.

                        Comment


                        • #27
                          Good grief this thread got depressing really fast...but I think there are some really good points made here.

                           

                          1. Try and avoid predatory groups.

                          2. Age discrimination is a very real thing.

                          3. Medicine/your specialty/your job can change over time from fun to horrible (think EMR, patient volume, politics, reimbursement).

                          4. You may change.

                           

                          I've seen subtle changes to radiology over time, but no real big disruptions in my practice. I'm in a great group, but I still managed to burn out. Going into it with good financial skills, healthy savings and no debt really helped me. I can't even wrap my head around how I would have felt if I still had 500k in student loan debts and a 10% savings rate.

                          I think driving hard towards FI early in our careers is a good move. Opens up many more doors later in our careers when burnout and dissatisfaction in general are at their maximum. You have the freedom to raise the middle finger to the system and do what you want (part time, alternative practice model, passion project, charity work).

                          I did it and really didn't feel like I was sacrificing, in spite of my spending being a lot lower than my peers. The good news is we really don't have to be all that frugal to do it. At a physician income all you have to do its be a little better than average and make no major mistakes. I guess that is the main message of WCI

                          PS: @vagabondMD - Thank you for the kind words sir!

                          Comment


                          • #28
                            I didn't really lose it. Just got to the point where I felt I had done my part and said I would be finishing up on April 30 - so I could hit gardening season! Now I just do the fun stuff.  Teach - love working with the kids.

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                            • #29
                              If I lost my job tomorrow, I would go out and find another job. Demand>>supply in my city thankfully.

                              There are definately predatory groups out there. I still vividly remember one large group based in a major metro was very straightforward with me and told me that there was a crop of new grads every year that want to stay around and are willing to take any terrible job to do so. Therefore, the group scheduled the associates to work 100+ hours/week for mediocre pay and 90% of them left before partnership. It was just such a shortsighted view in my mind because the practice would wither away once all the old guard wanted to retire, but I guess they didn't care.

                              Comment


                              • #30
                                Def agree that predatory groups exist. And they exist in academics as well, although are even harder to identify.

                                Can't remember if this was posted elsewhere, but pertinent article:

                                http://www.modernhealthcare.com/article/20170210/NEWS/170219988

                                Residents in the first or second year of the three-year emergency medicine residency program at Summa must now find a new hospital by July 1 to finish their training

                                 

                                 

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