Jump to content

Looking for some advice...extra duties suddenly added outside contract.


Recommended Posts

looking for an opinion on a situation. sorry for the long write-up.

I just signed up for a new job in Urgent Care. Everything seemed hunky-dory at first, but now that I've started they made it clear that they expect some extra duties. Firstly, I was just informed that since this multi-specialty clinic has a need for coverage, the UC providers will also be covering some Primary Care patients as time permits. Fine. But they have a complex patient demo and complex relationships with insurance, and the coding is far more complex with all sorts of extra regulatory and compliance and medicare/caid items, and we'll have extra coding/billing training. Fine, whatever. I'm not a medical biller, but ok.

But then....I was just told that since there is also a need, the UC providers will now have to take a FULL WEEK of primary care call every 7 weeks...so for the entirety of that week, I can be woken at 3 a.m., every night, even with work the next day, and I have to be near a computer at all times. Well, umm...my contract did note I might be needed for "reasonable, occasional" duties, but no mention was ever made during the interview or contract that I would be responsible for perpetual on-call coverage of primary care patients as an urgent care employee.

And it's one thing if the salary was extraordinary, but honestly, with my experience, the pay is moderate at best...I took the job (and left a better paying one) for proximity to home and benefits.  I absolutely would not have taken the job if I knew there was a week of primary care call.

I'm thoroughly pissed. Of course I can leave, but i'd rather stay and insist on the original contract terms.

Anybody ever go through something like this, and what did you or would you do?

 

Link to comment
Share on other sites

Legally, the contract probably wouldn't stand up in court.  But depending on the location and how desirable it is (e.g. How easily can they replace you?), you may have very few options (other than to leave of course) except to ask nicely.

I know a physician who has three PAs working for him. But they all quit within two years, but he doesn't care because it's such a desirable location that he always has applicants (especially new grads) who will take the job for really crappy pay (I think less than 80k) and LONG LONG hours full of lots of filling out forms and billing - just overall treated poorly.  It sucks but unfortunately, it's just supply and demand. 

 

There are are a couple practices we are told to avoid in the area because they also do the same to graduating residents in their first job. 

Link to comment
Share on other sites

  • Administrator

Sorry to hear that.  I really don't know what you can do besides put your foot down and quit if it's not rolled back.  Having said that, for next time...

- Go for hourly, NOT SALARY.  If they won't "convert" your position to salary, then you don't want to work for them.  They put nurses on time clocks, so you can go on one too.

- Negotiate call pay up front, even if "this position doesn't require call".  If they won't agree to it, again, run away.

Best wishes...

Link to comment
Share on other sites

It's a contract.  It's a legal agreement between them and you.  Would they waive any contract terms for you?  No.  Set up a meeting with your bosses, bring your contract and say " I'd really love to help you guys out, but this thing you made me sign really limits what I can do.  We can renegotiate, though".

 

Link to comment
Share on other sites

  • Moderator

ugh

 

I would have an honest and professional discussion where you hold your ground and state that you will not take the extra duties with out compensation (if you want them at all)

 

Call is $100+/day (I get either $100 or $300/day) to cover call for facilities

 

I would also point out that there will be liability to the facility if you are being asked to make decisions out of your area of expertise..... they would never ask a surgeon to cover IM call,,,,,,,

 

 

be professional, hold firm (try to organize and have a unified voice if their are others in your situation) 

 

BTW this is likely being pushed by the Doc's that want to be on call LESS as they know it stinks....

 

 

and lastly - polish up that CV 

Link to comment
Share on other sites

Dude----primary care call SUCKS. Well ok, all call sucks, But especially when you are covering for complex demographic and pts that arent yours. I used to have to do 1 week a month...I'd get maybe 5-6 calls a week, but always at the most annoying times, like when I'm trying to enjoy my life OUTSIDE OF WORK. And you have to be sober the whole time. 

Tough spot, they d!cked you for sure. The contract is vague too which they will certainly use as defense. "Call every 7 weeks is reasonable, we feel". 

I would politely talk with admin and tell them this was not disclosed at hire, this is not what you agreed to, and then most likely you will either need to ask for compensation (not worth it IMO), or resign. Because what's good for the goose is good for the gander, and chances are other providers need their jobs and are going to acquiesce.

 

Link to comment
Share on other sites

21 hours ago, quietmedic said:

looking for an opinion on a situation. sorry for the long write-up.

I just signed up for a new job in Urgent Care. Everything seemed hunky-dory at first, but now that I've started they made it clear that they expect some extra duties. Firstly, I was just informed that since this multi-specialty clinic has a need for coverage, the UC providers will also be covering some Primary Care patients as time permits. Fine. But they have a complex patient demo and complex relationships with insurance, and the coding is far more complex with all sorts of extra regulatory and compliance and medicare/caid items, and we'll have extra coding/billing training. Fine, whatever. I'm not a medical biller, but ok.

But then....I was just told that since there is also a need, the UC providers will now have to take a FULL WEEK of primary care call every 7 weeks...so for the entirety of that week, I can be woken at 3 a.m., every night, even with work the next day, and I have to be near a computer at all times. Well, umm...my contract did note I might be needed for "reasonable, occasional" duties, but no mention was ever made during the interview or contract that I would be responsible for perpetual on-call coverage of primary care patients as an urgent care employee.

And it's one thing if the salary was extraordinary, but honestly, with my experience, the pay is moderate at best...I took the job (and left a better paying one) for proximity to home and benefits.  I absolutely would not have taken the job if I knew there was a week of primary care call.

I'm thoroughly pissed. Of course I can leave, but i'd rather stay and insist on the original contract terms.

Anybody ever go through something like this, and what did you or would you do?

 

That is the problem with vague contractual language that includes things like "other duties as required". It can be anything and they are, simply, screwing you.

It is unlikely you would prevail in any contract related issue...it's just a sad truth even if the law is on your side it takes time and money and dogged determination to take on a large organization. 

I had a similar thing happen after I signed on here just over a year ago. 2 months in we took on a "strategic partner" and they basically shoved all our employment agreements in the shredder and changed the number of shifts and hours we are required to work every month. It was really a "take it or leave it" kind of thing and in the last year our best support staff has left as well as 5 of the 19 providers. They don't care. They will flush out the people who aren't happy and hire people who take this as the current normal.

I think you are in a spot where you either have to suck it up or move on. I hate it for you....

Link to comment
Share on other sites

1.  Learning the coding part?  Well, okay...especially if you can benefit by it via RVUs.

2.  "Covering some primary care patients"....well, okay...that's half of what we do in the ED/UC anyway.

3.  Call schedule?  "Sorry boss, you pay me so poorly that I am forced to work a side gig on my evenings and weeknights a an internet blogger/pastry chef/house cleaner/real estate agent (pick your hobby that you are going to turn into a job), I really don't have time for any extra call.  If you want to PAY me (a LOT) for that call then I might be able to make it work, otherwise, no-can-do.

Bottom line is you have to be able and willing to walk away.  I was almost put into a VERY uncomfortable position in my primary gig this week (won't go into details here, just an uncomfortable situation mixing personal & professional in the age of "#MeToo).  I just explained that this wasn't a good idea...and clearly said "I am not doing that" about three times to various folks in management.  Within 2 days management had found a better, much more professional, workaround to their problem.  Had they attempted to force me into this, I would have walked away. 

Tying this thread to the "student loan" thread....this is just one example of why debt is so terrible.  It really DOES make you a slave, forcing people to stay in jobs they hate (or, in my case, would have opened me up to tremendous risk for zero gain) just because ya gotta pay the bills.  

Link to comment
Share on other sites

  • Administrator
11 hours ago, Cideous said:

lol umm no.  Just no way.  I would *NEVER* take call for primary care as an UC provider.  Never ever....

I would. 1 hour of pay for 1 hour on call, at my regular pay rate, with time and a half over 40h, double time over 60h per week, and all charting on the clock. Plus shift differential for evening and night hours, of course.

No need to be unreasonable and say never, just be real clear how much your time is worth to you.

Link to comment
Share on other sites

I am reminded that one of the reason I work in UC now after a career in FP/Primary Care is I hated call with a passion. 

I will never forget getting a wakeup call at about 1:30 AM by the service.I get the message it's about someone's grandmother and the number. I call. The man answering is obviously drunk and there is some kind of party going on in the background. I tell them who I am and that I am returning his call. He actually yells into the room "he sounds like he was asleep!" as if there is someone from our small RHC sitting awake by the phone 24/7. Then he proceeds to tell me about Me-Maw needing some of her meds refilled. I called him a dumb ass and hung up. Then I called the service and told them I didn't care if that family caught fire and I had the last fire hose in the county DO NOT CALL ME. Anything that can't wait until office hours....go to the ER.

I have had people wake me to treat a rash over the phone. To refill their blood pressure meds because they no-showed their last 3 appointments. To refill pain meds hoping the after hours call guy would take the path of least resistance.

Call sucks...period. Taking call for FP patients you know nothing about when you are working in UC is just dumb.(Not you...whoever made this decision.)

Link to comment
Share on other sites

1 hour ago, sas5814 said:

Call sucks...period. Taking call for FP patients you know nothing about when you are working in UC is just dumb.(Not you...whoever made this decision.)

Who's dumb - the person that takes the call or the person that get's someone to take their call so they get an extra week of sleep?

Food for thought...:-D

SK

 

Link to comment
Share on other sites

1 hour ago, CJAdmission said:

This is when you say, "Hey, this is not in job description, let's amend my contract." 

They increase duties, they increase compensation. Piece of cake.

 

When you amend the contract, shoot for the stars- you may not get that bowl of red M&Ms and a Butler, but who knows?

Link to comment
Share on other sites

6 minutes ago, thinkertdm said:

When you amend the contract, shoot for the stars- you may not get that bowl of red M&Ms and a Butler, but who knows?

Honestly, it's not the money...it's the lifestyle. When I go home, work is over. I don't want to worry where my phone is, if it's on, if I have to call to find call coverage because I'm going to a movie and turning my phone off, etc. I don't want to be woken at 3am on a workday, and it's not what I signed up for.

UPDATE:

So I spoke with admin. They confirmed all their UC providers cover call (and apparently none complained), and that it was an unfortunate "miscommunication" but that the ball is in my court. They advised me to "try it and see if it's that bad" and that they don't expect many afterhours call.  Essentially, they made me feel like I was petty and overreacting for their little "oversight" and are telling me to cool down and just try it first, because everyone does it (except every other UC that I know of).

Link to comment
Share on other sites

(except every other UC that I know of)

 

 

Exactly. I have worked in probably a dozen different UCs and none of them had call of any kind much less for an entirely different service line. You are now sliding down the slippery slope. The "everybody does it argument" is what is know as sophistry... loosely defined as trying to make BS sound like common sense. I predict if everyone swallows this more will follow.

There are a couple of ways to handle this. Push back, leave, or do it but everyone that calls say something along the line of "I'm sorry but I don't practice family medicine or know you as a patient. If you have a problem that can't wait until office hours you should go to the ER."

Now Google "hoisted on their own Petard." :-)

 

Link to comment
Share on other sites

36 minutes ago, quietmedic said:

UPDATE:

So I spoke with admin. They confirmed all their UC providers cover call (and apparently none complained), and that it was an unfortunate "miscommunication" but that the ball is in my court. They advised me to "try it and see if it's that bad" and that they don't expect many afterhours call.  Essentially, they made me feel like I was petty and overreacting for their little "oversight" and are telling me to cool down and just try it first, because everyone does it (except every other UC that I know of).

Typical and predictable. What's good for the goose is good for the gander, and I've been stonewalled by this so many times. You really only have leverage if A) everyone else is in solidarity about standing up to this nonsense, B) You are too valuable to be ignored, or C), there is some serious legal/contract issue they are infringing upon.

 

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More