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

[thinkertdm]

I completely agree with the quality of life issue- but that's not the real problem.  The real problem is that they agreed to pay you to do x for y.  You both agreed on it, and signed a contract.  If they guy building my garage decides, hey, he doesn't need a two car garage, I'll just put in a one car bay, with crushed stone instead of pavers, would I say, naw man, that's good, here's your money?  

At this point, you have three options- take the one bay garage while the contractor is laughing his ass off; leave without any repercussions- he's the one who broke contract; or renegotiate for a one bay garage.  You have two cars, so that's out.

Dont let him give you a line of bullshit about "everyone".  Everyone ain't you.  This is between you and them.  In fact, you don't even need to ask, you tell them they are in breach of contract.

ps I am not a lawyer.  I just tell dad jokes.

[Cideous]

8 hours ago, BruceBanner said:

 B) You are too valuable to be ignored.......

 

This is where I respectfully disagree.  In the area I work in at least, they will drop you like a rock over something like this, and there will be 10 people standing in line ready to take your UC slot.  We use to be valuable, but those days are coming to an end with the massive influx of providers (NP's and PA's) getting out of school with HUGE student debt and willing to do anything, work for anything, and put up with anything just to get your job.  And if you think corporate admins won't hire a new fresh out of school new grad to take that slot, think again.  3 out of the 3 places I work hire new grads with no experience, give them about two weeks of training and then turn them loose.  Only one place gives any PTO (one week a year).  No CME money and NO CME time off.  The last time they had a slot open up, over 50 providers applied.  You get my drift here?

[CAdamsPAC]

On 3/1/2018 at 4:48 PM, 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?

 

And this is all AFTER the contract was signed? Well IMHO a new amended contract and salary need to be discussed. Bait and switch in a "big no go Ghostrider"! What else did they not tell you and do you think they can be trusted in the future?

 

[CAdamsPAC]

16 hours ago, quietmedic said:

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).

Yeah, I know people who tolerate being cussed and spit at , but don't expect me to tolerate it. Their reply is to demean you and guilt trip you because your peers are sheep. Why wasn't this clearly brought up during the hiring process? Because they planned on dicking you after the fact! It's your play decide how far over the bar they can bend you! 

[ventana]

12 hours ago, Cideous said:

 

This is where I respectfully disagree.  In the area I work in at least, they will drop you like a rock over something like this, and there will be 10 people standing in line ready to take your UC slot.  We use to be valuable, but those days are coming to an end with the massive influx of providers (NP's and PA's) getting out of school with HUGE student debt and willing to do anything, work for anything, and put up with anything just to get your job.  And if you think corporate admins won't hire a new fresh out of school new grad to take that slot, think again.  3 out of the 3 places I work hire new grads with no experience, give them about two weeks of training and then turn them loose.  Only one place gives any PTO (one week a year).  No CME money and NO CME time off.  The last time they had a slot open up, over 50 providers applied.  You get my drift here?

 

till the new grads and new employees do crappy medicine, kill people and get sued.....   then they realize employee turnover is a bad thing....  till then not for me...

 

[BruceBanner]

13 hours ago, Cideous said:

 

This is where I respectfully disagree.  In the area I work in at least, they will drop you like a rock over something like this, and there will be 10 people standing in line ready to take your UC slot.  We use to be valuable, but those days are coming to an end with the massive influx of providers (NP's and PA's) getting out of school with HUGE student debt and willing to do anything, work for anything, and put up with anything just to get your job.  And if you think corporate admins won't hire a new fresh out of school new grad to take that slot, think again.  3 out of the 3 places I work hire new grads with no experience, give them about two weeks of training and then turn them loose.  Only one place gives any PTO (one week a year).  No CME money and NO CME time off.  The last time they had a slot open up, over 50 providers applied.  You get my drift here?

I think we actually agree. I was listing the only scenarios where one would actually have the leverage to stand up to their employer, but I have a hard time imagining a PA (at least in primary settings) who is truly too valuable to be ignored, for all the reasons you listed. So yeah.

A lot of folks here advocate we stand up and make professional demands when we are being trampled on by employers, which I agree with in principle, but I always think why the hell would they acquiesce when there are 10 newbies willing to take our place for less money, and when all of your colleagues will tow the company line to keep their jobs...

[quietmedic]

for those still reading... Now it gets even more fun.

My supervising MD (a family med trained doc, not EM) has been calling me in for daily chart reviews.  Part of it, of course, is to get me up to speed with Family Medicine (which I wasn't hired for and never practiced)... But the majority of it is to train and retrain and reretrain me to write & code the chart right. Every single chart I write is printed out, and then there are comments, editor's marks and circles all over as if I'm being graded in grade school. If I mentioned a relevant FHx history item in my HPI, I am dinged as to why I didn't add it ONLY in the (laboriously annoying to navigate) FHX section, as it should be, because its not a *proper* chart otherwise. (using one of the worst EMRs ever written for this job).

Oh, The providers here are expected to write the chart as billers...organize every action taken under the correct diagnosis code, add all the proper counseling codes, assessment codes, CPT codes that the MA missed, you name it.  For each chart I write, I spend 15 more minutes reorganizing every thought, every order, every blood draw, and every piece of advice I have under the correct icd10 code. Then, I get 15 minutes of critiquing per chart to show me how I did it all wrong. Then another 10 minutes on what I should add in to make this a *proper* 99213 (or whatever). Then I have to fix everything, and send it all back to my Sup to make sure it's right. Then, maybe then, I can lock my chart. Is this really my job?  Do any of you have to do the biller's and coder's job like this on every chart?

And, to top it off, I was just told, every, yes, EVERY UC patient I see, I have to run by my sup primary care MD (who  often disagrees with my "ER" style treatments which apparently don't fly in primary care) who is in the building. Even though I've been doing UC for years now (with very positive reviews before this).

FML...

[sas5814]

Time to move on. Since my last post about my current employer changing all of our contracts unilaterally 30+ % of the APPs have bailed out and not been replaced because "things are slow right now". The fact that AFTER someone is hired it takes 3 months to get them credentialled and onboarded doesn't seem to be a conversant thought.

I had the noon to 8 shift today and when I arrived at 11:45 he had seen 19 patients already.....you know slow season.

My merit raise was due in January. I have asked about it 3 times and haven't heard back.

I started calling system recruiters this morning.