Interesting Article on Non-Competes

[sas5814]

I have always felt these clauses were BS and too many are way to restrictive to be fair. It seems the FTC agrees.

 

https://news.yahoo.com/ftc-wants-ban-companies-telling-150006694.html

[iconic]

It will help patients too

[ventana]

I think I am starting to see the icebergs of corp medicine starting to melt ever so slightly.  

[LKPAC]

This isn't only about the medical field.  The other side of the coin is that you take a new employee, train them, give them experience, expose them to your client base - then they take their talents (which you helped them develop) and possibly steal your clients, elsewhere to compete with you.

Generally, I oppose the government mandating these things.  Let the free market work it out.

[sas5814]

1 hour ago, LKPAC said:

Let the free market work it out.

I agree. That would include eliminating non-competes. If someone leaves for another position and clients go too....they weren't really yours. Its not a free market if employers can place arbitrary restrictions on employees. There is probably a place for reasonable non-competes in some places but telling someone that works for a sandwich shop they can't work at another sandwich shop? Some of the ones I have seen in PA contracts are insane. Can't work within 50 miles for 3 years......

Just no

[CAAdmission]

1 hour ago, LKPAC said:

This isn't only about the medical field.  The other side of the coin is that you take a new employee, train them, give them experience, expose them to your client base - then they take their talents (which you helped them develop) and possibly steal your clients, elsewhere to compete with you.

Generally, I oppose the government mandating these things.  Let the free market work it out.

The alternative is to retain these employees by treating them really well. This will be a shocking concept to our corporate overlords. If you look at many hospital executives, they have no loyalty to anything except money. Someone offers more, they will bail. 

The story I hear most commonly is the opposite. Hire someone, provide poor to no training, treat them like a commodity and work them to death. Then act surprised when they walk. Rinse and repeat. 

[SedRate]

On 1/6/2023 at 10:23 AM, CAAdmission said:

The alternative is to retain these employees by treating them really well. This will be a shocking concept to our corporate overlords. If you look at many hospital executives, they have no loyalty to anything except money. Someone offers more, they will bail. 

The story I hear most commonly is the opposite. Hire someone, provide poor to no training, treat them like a commodity and work them to death. Then act surprised when they walk. Rinse and repeat. 

This 100%

[ventana]

I fully support getting rid of non competes. 
while we are at it how about not allowing for profit owners of hospitals??

[rev ronin]

33 minutes ago, ventana said:

I fully support getting rid of non competes. 
while we are at it how about not allowing for profit owners of hospitals??

Although it may be apocryphal, it's been said of the Providence system that "non-profit is a taxation status" rather than a modifier for how they do business.

[ventana]

55 minutes ago, rev ronin said:

Although it may be apocryphal, it's been said of the Providence system that "non-profit is a taxation status" rather than a modifier for how they do business.

At least a not for profit is not trying to answer to investors and pay dividends.  By back stock and all that garbage.  

[ohiovolffemtp]

1 hour ago, rev ronin said:

Although it may be apocryphal, it's been said of the Providence system that "non-profit is a taxation status" rather than a modifier for how they do business.

The only thing I disagree with in this statement is the fact that it only refers to a single hospital system.  The only systems I've not seen act this way are the VA and the IHS, both of whom have other major issues and neither of whom I'd like to see treat anyone I cared about.  My apologies to the many on this board who work for the VA and try to do well, but over the years, across transporting patients to VA hospitals, doing part of my PA training at a VA facility, and caring for VA patients in my civilian ED's, I've been underwhelmed by the quality of care.

[CAdamsPAC]

6 minutes ago, ohiovolffemtp said:

The only thing I disagree with in this statement is the fact that it only refers to a single hospital system.  The only systems I've not seen act this way are the VA and the IHS, both of whom have other major issues and neither of whom I'd like to see treat anyone I cared about.  My apologies to the many on this board who work for the VA and try to do well, but over the years, across transporting patients to VA hospitals, doing part of my PA training at a VA facility, and caring for VA patients in my civilian ED's, I've been underwhelmed by the quality of care.

Agree with the understanding of flaws existing across all healthcare entities that employ humans.

[SedRate]

3 hours ago, ohiovolffemtp said:

The only thing I disagree with in this statement is the fact that it only refers to a single hospital system.  The only systems I've not seen act this way are the VA and the IHS, both of whom have other major issues and neither of whom I'd like to see treat anyone I cared about.  My apologies to the many on this board who work for the VA and try to do well, but over the years, across transporting patients to VA hospitals, doing part of my PA training at a VA facility, and caring for VA patients in my civilian ED's, I've been underwhelmed by the quality of care.

Sadly, I have to agree with some of what I've seen from the VA and IHS. 

[CAdamsPAC]

12 minutes ago, SedRate said:

Sadly, I have to agree with some of what I've seen from the VA and IHS. 

My IHS experience seems that poor care/provider are better than none!

[SedRate]

9 minutes ago, CAdamsPAC said:

My IHS experience seems that poor care/provider are better than none!

True for most things except for some things like Ortho surgery or when poor care means no xrays are performed at all... It's never fun to try to fix complications from things that were mismanaged initially. Granted, I've seen this in the community too, not just VA/IHS. 

[CAdamsPAC]

1 minute ago, SedRate said:

True for most things except for some things like Ortho surgery or when poor care means no xrays are performed at all... It's never fun to try to fix complications from things that were mismanaged initially. Granted, I've seen this in the community too, not just VA/IHS. 

4 to 6 week  for an ORIF was my worst IHS Ortho experience in Alaska, most of the time a months wait for a "routine" clinic appointment if lucky.

[SedRate]

5 minutes ago, CAdamsPAC said:

4 to 6 week  for an ORIF was my worst IHS Ortho experience in Alaska, most of the time a months wait for a "routine" clinic appointment if lucky.

Yeah, that's pretty bad. 

[ventana]

11 hours ago, ohiovolffemtp said:

The only thing I disagree with in this statement is the fact that it only refers to a single hospital system.  The only systems I've not seen act this way are the VA and the IHS, both of whom have other major issues and neither of whom I'd like to see treat anyone I cared about.  My apologies to the many on this board who work for the VA and try to do well, but over the years, across transporting patients to VA hospitals, doing part of my PA training at a VA facility, and caring for VA patients in my civilian ED's, I've been underwhelmed by the quality of care.

And yet the VA leads the way. 
 

I think they most recently beat out every major hospital and health system in quality of care.   Yes they might be inefficient but they deliver higher quality care to their population better than any other healthcare system in this country.  

[rev ronin]

2 hours ago, ventana said:

I think they most recently beat out every major hospital and health system in quality of care.   Yes they might be inefficient but they deliver higher quality care to their population better than any other healthcare system in this country.  

Quality of care as measured how and by whom?

If they're celebrating substitute endpoints like BMI, A1c, and BP, they're the best at making numbers match targets. We've confused that with quality for too long.

[CAdamsPAC]

2 hours ago, rev ronin said:

Quality of care as measured how and by whom?

If they're celebrating substitute endpoints like BMI, A1c, and BP, they're the best at making numbers match targets. We've confused that with quality for too long.

 

2 hours ago, rev ronin said:

Quality of care as measured how and by whom?

If they're celebrating substitute endpoints like BMI, A1c, and BP, they're the best at making numbers match targets. We've confused that with quality for too long.

Self-aggrandizement by a bureaucracy for self-preservation IMHO.

[ohiovolffemtp]

On 1/15/2023 at 8:40 AM, ventana said:

And yet the VA leads the way. 
 

I think they most recently beat out every major hospital and health system in quality of care.   Yes they might be inefficient but they deliver higher quality care to their population better than any other healthcare system in this country.

I'll completely agree that my perspective is skewed because I work in community ED's so I see only the conditions that are worsening, etc.  However, when I see a patient that was told his flaccid paralysis of 1 side would be scheduled for an outpatient CT by the VA and within the next 45 minutes he got a CT and a helicopter and multiple other VA patients that needed immediate specialty care they weren't getting, I'm not impressed.  And transferring a patient to the VA takes hours and completion of paper transfer packets that are then FAX'd so a nurse can review vs a phone call to a civilian transfer center who finds the appropriate hospitalist or specialist to speak with who then makes an immediate decision.

No, the VA practices medicine with no sense of urgency.  IHS may not be the greatest, but in my experience, they do practice with a sense of urgency (often a sense of urgency to punt).

[sas5814]

23 hours ago, ohiovolffemtp said:

No, the VA practices medicine with no sense of urgency.  IHS may not be the greatest, but in my experience, they do practice with a sense of urgency (often a sense of urgency to punt).

Well we have gone a bit off track but that is ok. Sometimes one thing leads to another and its all still relevant conversation. I take no offense to these observations. I'll add my view having now been here for 2 years.

I had actually written a long response about all the reasons why the VA system often seems to be such a mess but decided it wasn't worth the words. It is a highly flawed system. I try to find a couple of people every day and make some real difference in their care. maybe I'm tilting at windmills but there is good being done in the midst of the chaos.

Burnout and survival apathy abound.

[ohiovolffemtp]

Scott,

Thank you for serving those who served.  I think you're an example of a dedicated person trying to get results in the middle of a system that doesn't focus on that.

[SedRate]

10 hours ago, sas5814 said:

It is a highly flawed system. I try to find a couple of people every day and make some real difference in their care. maybe I'm tilting at windmills but there is good being done in the midst of the chaos.

Burnout and survival apathy abound.

I think this is everywhere nowadays, not just the VA and IHS. 

Thanks for doing what you do. 

[ventana]

14 hours ago, sas5814 said:

Well we have gone a bit off track

Burnout and survival apathy abound.

 

this is where it is hard. 
sure burn out in the VA but check out the community place. Shelling out providers fast then they can hire.  People quitting, retiring or being miserable on job.  
you have to see both sides of the fence before passing judgement and the private sector is in melt down mode right now.