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Bohuntr

Would you quit without notice?

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I signed a contract in January for a salary of 85K that would convert to production of 30% upon completion of my credentialing, however the SP stated that because she realized "it will take 12-18 months to build a practice, I will keep your salary level even until production is greater than salary."  

 

To me that sounded reasonable, she knew nobody would be able to take a huge hit on pay and would give me a reasonable transition from salary to full production.  At 80 patients a week it would be > 110K per year, which is reasonable for a family practice PA.

 

The Friday before Memorial Day weekend she called me into her office 5 minutes before she left for the day and said that due to ICD-10 pending, she would not be able to maintain my salary and would immediately be moving me to production starting the next Monday.  She gave me a handout that said for only 1700.00 of my own money I could place an advertisement in a local high school football program, and that she had already talked to a friend of hers who managed an urgent care and that he could bring me in one day a week, but one day only.  I still had to be with her four full days a week in case a patient wanted to make an appointment. It has been slow building a practice, so I am seeing anywhere from zero (0) to 15 (fifteen) patients a day.  After a quick calculation I realized this would be a 75% reduction in pay!  I gave two weeks notice the next Friday and she flipped out and told me that I could should be willing to get a part time job evenings and weekends in an urgent care or ER so I could stay and "build my practice."

 

Now I may be wrong here, but it's not my practice to build, neither is it my opportunity cost to lose money by sitting there waiting for patients to schedule appointments when I can be getting paid hourly elsewhere.  We are hidden in an office park, so there is no opportunity for walk-in patients.  Its all word of mouth to increase patient volume.  To make matters worse, she knew I just got married two months ago and my wife and I just purchased a house.  And she feels that this is the time to cut my pay by 75%....  she said that my wife who is also a PA should be able to afford to "share the financial burden" while I build my practice.

 

Needless to say, for the next two weeks she gave me the first and last patient of the day, nothing more.  I just got my final paycheck for my last three weeks, and less a mid-month draw that I had to beg for of 2K, I got a net pay of $8.60 after taxes!  She must be so proud, I made less than my MA!  When I saw where this was heading, during my next to last day my MA walked in and said that my first patient was ready (my only patient that day) and I asked her if she wanted to see the patient.  I said why not, you're making more than I am, and if you get what you pay for, she should be the better provider.  My SP flipped out and I laughed my a$$ off before I walked in to see the patient.

 

To make matters worse, I found out that I'm the 3rd PA she has done this with in the past two years.  Both the others were told that their pay would not be cut less than their salary when the made the switch from salary to production as well.  Apparently, taking a supervising physician at their word is worth jack sh*T!

 

Am I bitter here?  She did not violate the contract, it was in writing, I was stupid enough to take her at her word, so that's a lick on me, but when I got my final check, which didn't even cover my monthly expenses, I flipped.  If I had to do this over again, I would have just quit without notice when she told me she was switching me to production and then offered to "let me work at another practice part time to make up the difference" and that "it will only be for 6 months to a year while I build my practice in her office."

 

For those of you signing contracts, take a lesson.  Your SP may be a gross liar, if it's not in writing, it ain't gonna happen...  don't trust them at all.  There is nothing I can do to "undo" this situation.  I have been taking overtime since July and will work 200 hours this month and next month to make up for the month of June, but can then slow back to normal.  I'm grateful that I had current privileges at an urgent care and could start almost immediately at 10-20 per hour more than my salary rate at my previous job depending on working a weekday vs a weekend day.  It just galls me that she will do this gain to another provider, she obviously doesn't learn if I'm the 3rd one she did this with...  how can I get the word around not to work for this woman without slander?  She is actually a "nice" SP to work for, polite, treats you professionally, always there if you had a question, etc..., but she is the worlds worst business person and can't see more than 90 days ahead with her business plan.  Everything is short term.  I even told one doctor I met last week who I worked for at my last job and the first words out of his mout were "has she quit paying you yet?"  Obviously some people know her method of operation...

 

Should I just walk away and forget about it, or figure out how to subtly warn other providers?

 

I know this was a long one here, but I was shocked about me for being stupid enough to trust her and her for doing this to PA's over and over...  am I wrong and should I only be mad at myself, or is it ok to be pissed at her as well?

 

Bohuntr, MBA, MSPAS, PA-C

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If you have a contract for $85K, then you may be able to sue her for that.

On the other hand, make sure you understand things from her perspective.  Is she a forward-thinking SP with a good business plan that will build a good business?  Sounds like the practice is in a poor location now, but what is the growth pattern?  Is this going to be a booming FP in 10 years?  Can you re-negotiate your contract with her to work part time elsewhere now, with the guarantee of increased reimbursement later when the practice is doing better?  If she can't pay you your contracted $85K a year now, she may be willing to do such re-negotiation.  

As to your actual question - if I signed for $85K a year minimum, and wasn't getting paid $85K a year, I would walk immediately. I do locums work and establish a pay scale before each contract.  If I were to get a check for less than I billed, I would not go back to that hospital until it was fixed.  

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pack up your stuff

walk away

 

you already have another job so you don't need her reference.

 

explain to her in a nice professional polite letter that according to the "VERBAL" contract you had with her that you were surprised and had no choice but to quit as she violated this contract, and it is illogical to think that someone can take a 75% pay cut.

 

In this case I would also likely consult an attorney, if for no other reason that to protect yourself (and to have them send a letter to her simply stating you have retained counsel and considering your options.  If you have ANYTHING in writing - ie emails, faxes, or notes from converstaions, that she would do 12-18 months of salary or that productivity would not decrease your pay, you likely have a case.  You don't have to pursue it, just the threat might be enough to get her to not do it to someone again.....

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just because you have an MD or PA does not mean you can run a business effectively. I have seen plenty of clinicians make poor mgmt decisoons which influence income generation. This is another reason why the private practice model is failing amidst social media, fancy urgent care centers, specialty clinics.

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These practices are often very small businesses that get buffeted by the winds of the economy. Your SP's heart may -- or may not -- have been in the right place. You made a decision which, from your perspective, was the best thing to do at this point. Sounds reasonable to me.

 

I would, on the other hand, let go of your ill will towards your former boss. There is no point in it.

 

It's second down and 14 yards to go: just run your next play and forget the results of the last one.

 

Good luck!

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It wasn't "your" practice to build. What a joke. Lessons learned: always have a contract in writing, and never trust anyone's business projections.

 

Personally I wouldn't accept pay for production unless it was a bonus plan. Reason why is that 1) it's unreliable, and 2) an employer would only offer you that if it was in their best interest; i.e----you cost them less that way.

 

Don't feel one ounce of guilt for quitting. And NEVER work for free, unless you choose to volunteer. You are a professional, and professionals get paid.

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at my primary job we get base salry + production. I hate that method. production bonuses come out of group profits, so if the group takes a loss or buys new equipment, bonuses suck. I just assume my bonus will be zero, then I am pleasantly surpised when it is huge and not overly dismayed when it is not. working equally hard I have had bonuses range from $240 dollars to $19,000. for 240 bucks, the wife and I went to a nice dinner. for 19k , we bought a new car for cash. some of mu colleagues budget for "expected bonuses". big mistake. I would take hourly rate over production or salary any day of the week. determine what I am worth and pay me that whether I see 1 pt/hr or 6. all my rural per diem jobs do just that. last night working a 13 hr overnight shift at a rural site I saw 4 patients. other times I see 14. same pay. totally ok by me.

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Hire a lawyer BEFORE you sign a contract. It only cost me $250 to have an employment attorney take a contract and shred it to bits to protect me. I had never seen that much red ink. The attorney told me not to sign it it until ALL areas had been addressed and he saw a new copy. Saved my butt!

Corporate medicine sucks - see my other post -- but working for a solo doc with a bad business plan can tank your career.

If she has gone through PAs like toilet paper- then word of mouth should warn others without being slanderous.

ALWAYS ask who has worked for the doc or clinic before and ask to interview w that person or contact them.

SILENCE or canned responses of little substance speak volumes.

My previous job is still advertising TWO YEARS later because no one will go work for them knowing how many of us they screwed.

HIRE AN ATTORNEY to review all contracts. Worth the money twice over and more.

25 yr PA

been there, done that

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Yes, next time lawyer.  Good advice. 

My biggest regret is that I stayed the full two weeks, even after the first few days I realized that she wouldn't give me any patients, or only those too early or late for her to bother with; she was just keeping me there to keep me from making money elsewhere.

 

I should have just walked out after 2-3 days and never looked back

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What an icky physician.  Obviously she has a reputation with others who know her MO.  Glad you are out and gone from there. 

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