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mgriffiths

Just stupidity

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One of our competitor hospitals is having some financial trouble and recently laid off a bunch of support staff (mostly administrative) and is on a hiring freeze.  A rheumatology NP I know lost her MA to another position, and with the hiring freeze she knew they wouldn't be hiring another.  As a result, she was tasked with serving as her own MA and as the provider.  The NP wrote administration an email outlining the issue, basically stating that she did not know the MA side of charting and other responsibilities.  The result was the next Monday she was terminated without warning and given $5,000 severance for each year of service (20+ years...so $100k ain't all bad) and continued full benefits for 12 months.  Her appointments were all cancelled, she was given 10 minutes to gather her things and then escorted off the property by security.  Of course this is absolute stupidity as she was booked out completely for over 6 weeks.  So, administration made several bad decisions (including building an unnecessarily expensive $10 million family practice outpatient clinic that sees less than 50 patients per day with minimum 3 full time providers and multiple part time providers cycling through), but decide to fire a provider with experience in an especially hard to recruit specialty who was significantly productive (according to the NP she produced well over 5,000 RVUs in 2018, and administration will have zero repercussions.  Just stupidity and explains why the hospital is in trouble.

Even worse (for the hospital)...the NP was actually planning on retiring in 6 months and had started drafting the email...so they effectively paid her almost a full year's salary allowing her to retire 6 months earlier than planned...plus, since her termination this week she already has multiple job offers and she is planning on working part time for us, and will bring her entire patient panel with her because we have already announced her hire and her patients are calling to schedule.  Even further, because she was fired without notice the hospital forfeited its right to enforce its non-compete...which she gladly explained when they called to inform her she was in violation.

In all...I love how it played out for the idiots at the other hospital, but honestly its scary.  I have a 90 day notice period, where I am required to give 90 days but my employer is also required to give me 90 days notice.  My employer can either choose to have me continue to work for 90 days or just pay me for those 90 days...and I keep my full benefits.  But, I know that is a rare perk, and honestly one of the reasons I accepted this job even though it doesn't have an employer match.

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44 minutes ago, mgriffiths said:

One of our competitor hospitals is having some financial trouble and recently laid off a bunch of support staff (mostly administrative) and is on a hiring freeze.  A rheumatology NP I know lost her MA to another position, and with the hiring freeze she knew they wouldn't be hiring another.  As a result, she was tasked with serving as her own MA and as the provider.  The NP wrote administration an email outlining the issue, basically stating that she did not know the MA side of charting and other responsibilities.  The result was the next Monday she was terminated without warning and given $5,000 severance for each year of service (20+ years...so $100k ain't all bad) and continued full benefits for 12 months.  Her appointments were all cancelled, she was given 10 minutes to gather her things and then escorted off the property by security.  Of course this is absolute stupidity as she was booked out completely for over 6 weeks.  So, administration made several bad decisions (including building an unnecessarily expensive $10 million family practice outpatient clinic that sees less than 50 patients per day with minimum 3 full time providers and multiple part time providers cycling through), but decide to fire a provider with experience in an especially hard to recruit specialty who was significantly productive (according to the NP she produced well over 5,000 RVUs in 2018, and administration will have zero repercussions.  Just stupidity and explains why the hospital is in trouble.

Even worse (for the hospital)...the NP was actually planning on retiring in 6 months and had started drafting the email...so they effectively paid her almost a full year's salary allowing her to retire 6 months earlier than planned...plus, since her termination this week she already has multiple job offers and she is planning on working part time for us, and will bring her entire patient panel with her because we have already announced her hire and her patients are calling to schedule.  Even further, because she was fired without notice the hospital forfeited its right to enforce its non-compete...which she gladly explained when they called to inform her she was in violation.

In all...I love how it played out for the idiots at the other hospital, but honestly its scary.  I have a 90 day notice period, where I am required to give 90 days but my employer is also required to give me 90 days notice.  My employer can either choose to have me continue to work for 90 days or just pay me for those 90 days...and I keep my full benefits.  But, I know that is a rare perk, and honestly one of the reasons I accepted this job even though it doesn't have an employer match.

If that’s the whole story, it’s pretty awesome the way it worked out for the worker for once. Warms the heart.

There might be more to it, but lack of providing an MA cost them more than $100,000 right off the bat, and who knows how much it cost in the disruption aftermath. 

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Similar issue happened to a friend of mine in Endocrinology. 

The corporate eggheads "downsized" and economized and took his MA.

He was supposed to room, vital, refill, answer phones AND see patients in a hugely underserved specialty.

He asked for help and they basically said Pound Sand.

He quit and went to work for a competitor.

Thankfully, the crap corporate overlord sold this clinic system to something a bit less evil and he got his job back with an MA and is able to adequately serve a panel of complex people.

Corporate and Medicine do not belong in the same sentence ever...... sad state of affairs

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Boy, I would have like to have been that NP and gotten the 100,000 payout.  Sweet.  Corporate Medicine is sour. 

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private practice is the answer (with all it's own negatives) but atleast you get to decide your own fate

 

I was recently told "we are taking a different direction" at my cushy state job.  Seems that they (my boss was an idiot attorney) didn't like having a medical provider that they could boss around and tell how to practice medicine.  Initially it hurt, but now I realize i am way better off. 

 

I am hoping for a seismic shift away from corporation employment by the doc's back to private practice cause corp influence in medicine is horrible 

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On ‎10‎/‎10‎/‎2019 at 6:31 AM, ventana said:

private practice is the answer (with all it's own negatives) but atleast you get to decide your own fate

 

I was recently told "we are taking a different direction" at my cushy state job.  Seems that they (my boss was an idiot attorney) didn't like having a medical provider that they could boss around and tell how to practice medicine.  Initially it hurt, but now I realize i am way better off. 

 

I am hoping for a seismic shift away from corporation employment by the doc's back to private practice cause corp influence in medicine is horrible 

Not going to happen.  There are entire swaths of new doc's graduating who have NEVER known anything but working for the corporate man.  I asked my supervising doc (a young guy)  if he was interested in starting his own place?  He had a look of horror and just said, there is no way I could ever do something like that.  So many young docs graduate and go straight to work for a corporation owned practice.  It's the new norm.

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23 minutes ago, Cideous said:

Not going to happen.  There are entire swaths of new doc's graduating who have NEVER known anything but working for the corporate man.  I asked my supervising doc (a young guy)  if he was interested in starting his own place?  He had a look of horror and just said, there is no way I could ever do something like that.  So many young docs graduate and go straight to work for a corporation owned practice.  It's the new norm.

Yep. At this point, more than 50% of physicians work as employees. The physicians I did rotations with were all employees, including one who sold their practice to a corporate entity and then joined them. They said they never looked back, and now only had one job to worry about.
 

As it stands, the physicians are treated well enough that they aren’t going to leave in large numbers. Most of them realize they would be leaving one headache to to take on several new ones. In the example the OP cited, its important to note that it was an APP was the one facing pushback, and no physicians were tasked with picking up the slack and rooming their own patients. 

The only seismic shifts will be more physician employees. At some point, I see a future where physicians who want to strike out in their own to show up in their own forums asking everyone for advice on how to do it, because it’s rare. I’ve even seen several NP forums where physicians come on asking for advice on hiring NPs. 
 

New physicians come out of school looking for jobs that pay decent and allow work/life balance rather than cramming their free time with running a business. Smartest thing any corporation can do is to get the docs conditioned to be happy with a wage over $250k and student loan repayment. 
 

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6 hours ago, Cideous said:

Not going to happen.  There are entire swaths of new doc's graduating who have NEVER known anything but working for the corporate man.  I asked my supervising doc (a young guy)  if he was interested in starting his own place?  He had a look of horror and just said, there is no way I could ever do something like that.  So many young docs graduate and go straight to work for a corporation owned practice.  It's the new norm.

Agreed 100% most physicians I know, more like 75%, have sold practice to a corporation or went straight into the corporate out of residency. As you said Lightspeed, family med are making $250 with GREAT benefits and Loan repayments. I have a friend who is a specialist. She previously had own practice, short lived, now working for a hospital system. Disclosed that with bonuses, etc, made near $700,000 last year  without stress or office concerns(works hard, but also takes plenty time to enjoy life and family). Sad part, and she admits, that her APP, working at least as many hours , is making  approx.$130,000, no raise since change, no bonus structure . He is  afraid to negotiate in fear of loosing job:.

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20 minutes ago, Hope2PA said:

Agreed 100% most physicians I know, more like 75%, have sold practice to a corporation or went straight into the corporate out of residency. As you said Lightspeed, family med are making $250 with GREAT benefits and Loan repayments. I have a friend who is a specialist. She previously had own practice, short lived, now working for a hospital system. Disclosed that with bonuses, etc, made near $700,000 last year  without stress or office concerns(works hard, but also takes plenty time to enjoy life and family). Sad part, and she admits, that her APP, working at least as many hours , is making  approx.$130,000, no raise since change, no bonus structure . He is  afraid to negotiate in fear of loosing job:.

The next step is to rein in the specialists wages, but that’s down the line once nobody knows how to run their own practice. They won’t be poverty stricken, but you’ll be seeing wages of $400,000 for folks that used to make $800,000-$1,000,000 on their own. Free time will be be lure for those folks. $400,000 for 30-32 hour weeks, supervising the work of several APPs and being the figurehead on the marquee, mailers, and website. All they will have to do is show up and leave. Surgical specialties will probably have some kind of incentives, and will be the last folks to transition. All anyone has to do is look to some of the other countries to see how this goes. I have a Scandinavian friend who is a physician, and they do quite well by their county’s standard, but nothing that we would appreciate. 

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All of this is why I have set a goal to be financially independent in 10 years.  At my last job, my employer changed from being great to literally committing billing/insurance fraud and withholding my bonus income in a matter of months.  I probably should have sued, but unfortunately it became evident they were doing a good job of covering their steps, and with everything behind the HIPPA wall I would have a hard time proving the income withholding.  My current employer is good-to-great, but not awesome.

Bottom line, I want to be in a position where if I need to walk away I can.  I have no plans to retire in 10 years...I'd be 40, but if I need to I can.  It will be a hard road, and I have created some of those hardships with the price of my home and some other choices, but I am ok with that.  Sometimes this concept gets brought up with my coworkers and when I state my goal they look at me like I have two heads...or maybe three.  But, in this time of uncertainty, to me its important to work to gain control while I feel that my job is secure.  Maybe I'm overreacting, and I hope so...but if there is a seismic change for the worse I want to be prepared.  If there is no seismic change, then I just to coast until I feel like I'm done.

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