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Departing a part-time nightmare


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I really need some advice from my fellow colleagues. I will explain my situation, and the predicament I am facing. I have been a PA for 13 years. I started a new job and brand new specialty 6 months ago. When it sounded too good to be true, it was. I also work in another specialty prn. This was agreed upon when I signed my contract. I am paid an annualized salary for a certain number of hours per week. No benefits, other than a small amount of CME and some paid sick/vaca. It is a solo physician practice, however, I learned that my SP is not "in charge" of his own practice. It is the office manager who has the upper hand. She runs the show, and makes sure everyone knows it. Trying to make a longer story short-I have been giving everything I have into this practice, going above and beyond to be an excellent employee, by increasing productivity, and giving my patients superior care. Initially, the workload was not as much of an issue, because I was building a patient base. I have always had remote access from home, but had to beg to get this. My contract was changed at that time, but it's not clear in the wording. Now, I am booked solid for four months. I am working 10-12 hour days without lunch or a break. I am still not finished and have to work hours from home, but I am not being compensated. I have tried discussing this with my SP, but she doesn't seem to want to deal with any of these issues. It is all being handled by the crazy office manager, who micromanages the heck out of everyone. I started getting 10-12 emails per day, on what I was doing wrong (mostly billing issues), and basically telling me how to practice. She is now making my life miserable. I was sent 128 "tasks" to go back and fix. The tasks were all basically the same reoccurring code that I used (didn't understand initially, but now I do). The code just needs to be removed from the charts. This was the icing on top of the cake. I found this to be so absurd that I laughed. I already dont have time for my administrative tasks that I'm not getting compensated for. AND, my medical assistant is not allowed to help me in many ways. The problem is, I like and respect my SP. My contract says 90 days, but I cannot continue to do this much longer. I have a feeling they will require me to adhere to the 90 days, and pay tail coverage. I am also owed CME money. At this point I don't care, I just want out. I plan to continue my prn job, and that's it. I have to recertify this year as well-after that, I'm done. Tired of getting taken advantage of. Could I argue that 30 days would suffice, otherwise, any time beyond that would only contribute to the detriment of my physical and mental health? I have lost so much time with my family, and have fallen asleep at the computer at 2-3am multiple times. I am the 3rd PA in 2 years. Duh, why didn't I see that!? Please, any friendly advice would be greatly appreciated.

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Guest Paula

First:  Take a look at your contract and determine what your "out" is.  You said it was changed when you got remote access and it sounds like you are not sure what the changes are.  Figure that out.

 

Second:  Stop working from home.  Is your contract set up to work 10-12 hour days without a lunch break?  If you agree to that, you  are stuck.  If it is not then you need to stand up for yourself and demand a lunch break so you can eat and chart. 

 

Third: Is the office manager related to the physician?  If so, how.  You mentioned the physician as a she and as a he, so not clear which one was a typo.  If office manager is related to the physician, get out.  These type of situations seem to be wrought with pitfalls and never turn out well for the PA. 

 

Fourth:  If you can't get out before 90 days plead mental health issues and give them a 30 day notice.  Good luck. 

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Thank you. I like the fourth suggestion! The contract vaguely states that my salary is annualized, and "implies" that the work must be done, no matter how long it takes. There are no hours, times mentioned. The office manager is not related, but I'm convinced she has some type of investment in the practice. The doc is a female, and has about 5 years left before she retires.

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You say you get salary for a certain number of hours.  Have you discussed with them about working beyond your contracted hours? 

 

I had a job with a 90 day notice and when I put in my notice I just asked if we could agree to reduce it to 60 days. You could consider breach of contract on their end by requiring you to work more then contracted hours and then just walk away.  Bottom line is do you think they will take you to court over it?  If the SP is who you have a contract with and she can't even be bothered by your current situation, then it doesn't sound like she would be bothered by suing you. 

 

Agree with above...NEVER work for anyone with a family member in the office.  I worked for a physician with his wife as the "executive director"...what a nightmare. 

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Well I think you answered your own question.

 

These situations in PP where the office manager runs the show are always bad news. Every couple of months here we see a similar thread about it.

 

If it is as stressful as you describe, I would just leave without notice. F**k 'em. What can they do? I doubt they would pursue any sort of legal action when they will have bigger fish to fry finding a new slave provider. Type up a short resignation letter saying how you were basically driven to leave by pressure, volume, and poor management and they may want to rectify some of these things if they hope to keep a provider. Or dont. If you really have a guilty conscience about it I would give no more than 30 days. This is just my opinion, but I've stayed at awful jobs much longer than I should have out of professional guilt, and it didnt end well.

 

I'm of the belief that when an employer runs you into the ground like that you dont owe them anything. You cant leave on "good terms" because this situation is already BAD terms---and I doubt you will be using this place as a reference anyway.  How much notice do you think this office manager would give you if she let you go?

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Herein lies the major issues between corporate hell and private practice hell.

 

Being a physician or even PA never means one knows anything about business. 

 

Office managers can be the scourge of your existence as you have learned. Sometimes having too many corporate suit drones is better than one wicked witch but sometimes not.

 

LEAVE. Maintain professional integrity but get out quickly and concisely, don't look back. 

 

I would give 30 days notice stating you have to move on and that is what you can give them. Sounds like they will screw you on the contract anyway.

 

Look forward to better days.

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I hate to hear about anyone stuck in this type spot but, sadly, it isn't as uncommon an experience as it should be. You could try saying "no..I'm not going to do that" and see what happens. I had a job I hated hated hated and was in a 3 year contract. I kept taking good care of my patients but made such a PIA out of myself to admin we agreed I wasn't a good fit and I left a year early with no problems. Not an ideal ending but it ended up being mutually agreeable.

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Thank you all for responding. It confirms I am making the right decision. I think 30 days is sufficient, and it's going to have to be...the thought of anything longer than that is terrifying. I have no issues with my SP, but in the end, she's allowing her office manager to work this way. I refuse to discuss anything with anyone but my SP. I don't work for the office manager. I already sent her an email summing up all of the issues I have tried discussing with her, but have not heard back. I refuse to do the 128 tasks that were given to me because they are simple, administrative duties that will only add to my work and take away from patient care. I am hoping that my last 30 days won't be even more miserable when I put my foot down and say "anything non-clinical outside of my paid hours can be taken care of by the office staff."

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I would give a different opinion

 

don't give up just yet

and don't give less then 90days notice for simply quitting. that sets you up to be sued..

 

instead

 

sit down and write a detailed letter vocalizing where you have been being taken advantage of and where the "verbal" contract and expectations are at (yup the unwritten stuff)

identify the problems

If the problems are patient safety or license preservation I believe you could make the argument that you will leave in a MUCH shorter time frame then the "simply quit" time frame of 90 days.  Identify that this is due to fear over your own license and that you see no alternative but to resign effective (from 0-30 days) to protect your own license.

 

BUT provide a firm and reasonable solution to the problems and let them be the one to decide rather they want to keep you

 

This way you have "memorialized" what the problems are, have provided them with info, have stated your license is at risk and you are unwilling to do more

 

BY ALL MEANS STOP WORKING EXTRA

 

They can not fire you for being inefficient (well they can) but that is easy to explain - make them do the decisions

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Valid point Ventana. Although, I have already written my SP a letter.I put it in her hands. I laid out the problems, and the solutions are pointless if they are not the office managers ideas. At one point I did speak with the office manager and was told I am not getting paid for any more than x amount of hours per week. If I stop doing the extra work, the patients will suffer. I know things are not going to change, only because I have spoken with the PA's who worked there previously. I don't feel I am just quitting-I feel as if they are more in breach of contract at this point. She has record of when and how long I am logged on the computer. Anyway, thank you for commenting-I also need these types of opinions.

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Tell them that the breach of contract stops, effective immediately, or your contract is void - meaning now nonexistent - and your employment with them stops, effective immediately.  Keep your car keys in your pocket and be prepared to walk right the ---- out the door.  I think they've earned themselves this.  

 

If you want to be the nice one, give them a couple of weeks to reshuffle patients and workload.  That is not your problem.  

 

Maybe the SP will hire you per diem - cash - to help with the transition - with the agreement you walk out the door at 5:00:00 and forget about the place until 9:00:00 the next work day.  And you take a lunch.  Draw up a day-to-day contract - either party walks at will, no notice.  If I was her I would jump at this. 

 

Shame about the SP being basically a decent sort and not a problem - you should email her in a few months to check in and express regret that it didn't work out.  You never know.

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More ideas:

 

Chart as you go. Don't see the next patient until the previous visit is documented and closed.  This will put you behind.  Apologize to the patient that you have no control over your schedule, and give them the office manager's phone numbers, including cell, for complaints.

 

Medical leave. Give notice, and then immediately go out on medical leave.

 

Track your time. If you're getting paid for X hours per week, DO X hours per week.... and then stop.  Probably not in the middle of a patient visit, but don't work any further until the next week: not seeing patients, not charting.

 

YOU ARE NOT THE ONE RESPONSIBLE FOR POOR PATIENT CARE.

 

Get over ever thinking that. If you have any external entity telling you what to do, how long to see a patient, etc. they are responsible for patient care, not you.  There's a difference between working extra in a true emergency and management trying to squeeze any time to take care of emergencies out of your day as "inefficient".

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Lessons to be learned from your experience.  When paid "annual salary", it MUST specify the hours and what you are to accomplish during that time.  I believe it is illegal to not give 30 minute lunch for full time.  NEVER NEVER NEVER take your work home!  Next job run your contract by n attorney or a PA who is savvy in contracts.  Many of us "senior PAs have been there done that as you can see by the responses.  30 days is enough time.  Writ a letter to the SP and keep a copy.  Be polite but let her know the issues.   Finally good luck.  You will be fine.

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hey folks

 

there is a signed contract in place

 

 

you can't just up and leave and expect not to be taken to court......  as well their could be an argument for patient abandonment 

 

you can do a work to rule type thing where you only do enough to fulfill the contract and that is it.....

 

but it would be unwise to simply walk out

 

 

if I heard this from someone I was thinking of hiring I would immediately pass them over.  No gumption, no stick to it, no loyalty (even when not earned) and most of all no honor.....

 

 

 

stick out your contract - you signed your name and gave your word- as mentioned above in my prior post you "might" be able to work around it with alternatives.....

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This solo doc is highly unlikely to actually be 100% aware of the contents of the contract. The office manager might be.

 

If the employer is breaking contract or being unreasonable AND the employee has presented a case for such AND nothing improves -- then the employee should have the ability to say - the contract is not being respected and I cannot continue in this fashion. I will be departing in 30 days UNLESS you would like to review the contract line by line with me and work out a reasonable exit strategy. Either way, not staying.

 

I have never seen a PA sued over contract. Most times it becomes mutual that there is misery and the relationship just needs to end. 

 

A solo doc is highly highly unlikely to commit time, bad press, MONEY and stress to someone who WANTS to leave and needs to leave. 

 

If OP has presented the issues to the SP and received no valid feedback or acknowledgement then due diligence is being followed.

 

I have seen more than one resignation letter that says - "if mutually agreed upon, my final day will be xxxxx".

 

It can work

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I value Vantana's opinion, but in this case I disagree.  No one is going to sue you for quitting a job.  Worst case scenario you will get a crappy referral from them, which to me is something to think hard about.  Virtually every job I apply for requires a crapton of references, so it's no small thing.  Having said that, I would try to stick out the full 90 days and consider it a lesson learned.  If you can't I also understand that.  I walked out on a part time job last year for the first time in my 25 years, and I did not give notice.  The supervising doc that was assigned to me was straight out bat shit crazy.  He would call me for weird stuff at 11:00pm and talk about random stuff forever.  He was also the most paranoid doc I had ever worked with.  I am all for having a healthy fear of lawsuits, but this guy was pathologic in his fear and anxiety.  I won't go into specifics, but one night he called me and threatened to call a pt I had seen and tell her I had overdosed her son on an antibiotic.  It was of course not true, I had slightly titrated an antibiotic dose up to account for the kid not getting the full dose.  The mother had gone into specifics about how the child would always dribble and sometimes spit some out.  The dose I gave was still WELL within the mg's/kg of the kids weight i.e. NOT an OD.  He also threatened to call corporate and tell them I had OD'ed a kid.  It was, for lack of a better description, insane...  I quit the next day, and have never looked back.  Nor did I ever get sued.  And since when did being "honorable" mean taking crazy abuse at a job?  

 

 

Take Rev Ronin's advice.

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After reading all of these, I think it's time to seek legal advice. In regards to not being loyal, no gumption or honor, I am the exact OPPOSITE of this. Hence the reason I have stayed as long as I have already. I have had previous jobs that were also not optimal situations, but I stuck them out and left on good terms.

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It sounds like it is more the OP's sense of responsibility for everything that is holding him in a living hell rather than the contract, the terms of which are a bit muddy.

 

Until you come to grips with taking back the part of the life they didn't contract for, things probably won't improve. I would do that and see what happens.

 

Many of us are, first and foremost, the prisoners of our own misplaced sense of responsibility.

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Thanks for everyone's responses. There is no "right" answer. It's unprofessional to judge ones personal character, especially when you are not the one in the situation, with all of the details. Katera- my office manager is bat shit crazy...and CJ, that's exactly what I plan on doing! Also, as an aside, I don't need any references. I am keeping my prn job, which I love. I will not be job hunting again. I am fortunate to have this as an option.

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Yeah, point of parliamentary procedure, I did mention that there is a clear breach of contract, and to give a chance to remedy it.  

 

Things like honor aside, if you were worried about getting sued, you could always pay an attorney a few hundred bucks to meet with you, hear your story, read the contract and find you a gold-plated out.  That's green law student stuff. 

 

I'm all about karma or honor or professionalism, but when I'm being beat up, I'm gonna raise my hands to you and make you stop the abuse.

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hey folks

 

there is a signed contract in place

 

 

you can't just up and leave and expect not to be taken to court......  as well their could be an argument for patient abandonment 

 

you can do a work to rule type thing where you only do enough to fulfill the contract and that is it.....

 

but it would be unwise to simply walk out

 

 

if I heard this from someone I was thinking of hiring I would immediately pass them over.  No gumption, no stick to it, no loyalty (even when not earned) and most of all no honor.....

 

 

 

stick out your contract - you signed your name and gave your word- as mentioned above in my prior post you "might" be able to work around it with alternatives.....

I could be 100% wrong but I'm not sure patient abandonment applies to a PA leaving a practice. I suspect it would swing on the practice act but technically the patients all belong to the physician as we are dependent practitioners.

Breaking a contract is a calculated risk. The belief that the employer has broken the contract making it void may or may not prevail in court. You never know what a judge or jury may decide. 

They could turn you into the board for some made up things like patient endangerment or unprofessional conduct. Whether it sticks or not, in a way, wouldn't matter. You would end up having to explain it every time you credential or apply for a job for the rest of eternity. It happened to a colleague of mine because the front desk referred to him as "the doctor" and when the patient was unhappy about something he complained to the board that he presented himself as a physician. Now, because we have a PA board under the medical board it was unfounded but he and the staff were required to undergo "training" to remediate the issue and he had to explain it forever.

Better to find a work around rather than walk out. Short term pain for long term gain.

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I don't think he would need to explain it to for credentialing or applying for a job so long as he is resigning and not being terminated.  Other then the general application question "reason for leaving", I have never had to explain details about why I left somewhere.  I left Ohio and moved to Hawaii and worked for an awful physician group.  I toughed it out 6 months and couldn't take it any more.  My contract said 90 days notice.  I requested 60 days and they agreed.  Total 8 months with them.  I don't explain to anyone what a miserable experience it was.  I say I only planned on an extended vacation in Hawaii and that is all the time I wanted to stay there.  Certainly, you need to consider prior employer references down the road, but an employer needs to watch what they say or be sued. 

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I don't think he would need to explain it to for credentialing or applying for a job so long as he is resigning and not being terminated. Other then the general application question "reason for leaving", I have never had to explain details about why I left somewhere. I left Ohio and moved to Hawaii and worked for an awful physician group. I toughed it out 6 months and couldn't take it any more. My contract said 90 days notice. I requested 60 days and they agreed. Total 8 months with them. I don't explain to anyone what a miserable experience it was. I say I only planned on an extended vacation in Hawaii and that is all the time I wanted to stay there. Certainly, you need to consider prior employer references down the road, but an employer needs to watch what they say or be sued.

Almost made me not want to look at 2 bed/2 bath condos in July on Maui but I wouldn't be moving to work. Only to sit back and watch others do so! Sorry that it didn't work out for you. Hmm, maybe USVI need a look/see instead.

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