I think I’m being bullied at my job

[Hem_onc1331]

Hi, when I joined my job - I was supposed to be single hospital based with 3 inpatient and 2 outpatient days. We are in a way RVU based , and the amount I get paid is pretty much in line with what is fair market value in this area. We are a hospital employed group.
However the structure of my job is I think extremely lopsided in terms of call and weekend coverage . For instance weekends are unequally distributed - I got more weekend days than the rest - and when I asked why I was told “seniority” even though there is no sort of compensation for me doing additional days in terms of pto or anything else. Other than that I sometimes am just told to cover 2 hospitals inpatient consults randomly because a lot of people have taken pto? Volumes being 30 pts in 1 hospital and 20 in another - with NPs though It’s 5 days a week so typically I use my days as admin time to catch up on clinic. My question is -
- am I being an dingus if I refuse to cover unsafe patient volumes ?
- would there be any repercussions to me just refusing to cover more than the equal weekend coverage?

I’m just exhausted and I know I need to look for a new job, but just wondering if this is just a normal thing in other jobs too? Where weekend + hospital call coverage is not equitably distributed?

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[MD46]

How many total physicians in your group?

If it is an employed model everyone should be the same and share equal call regardless of seniority.

In private practice its whatever the partners want.

What is your usual clinic volume?

What was initially decided per your contract? Was this discussed previously and you were told something else?

Have you talked to your cheif of division and brought this up?

 

[HemeOncHopeful19]

You're getting screwed

All this should have been in your contract and when you interviewed

From your post history you may work in NYC? That might be a different beast in terms of abusing the younger docs

Did you post about this exact same job 1 year ago with similar issues? Hem-Onc job advice - thinking of quitting my current job Or did you leave that job and land in this dumpsterfire?

 

[dozitgetchahi]

Hi, when I joined my job - I was supposed to be single hospital based with 3 inpatient and 2 outpatient days. We are in a way RVU based , and the amount I get paid is pretty much in line with what is fair market value in this area. We are a hospital employed group.
However the structure of my job is I think extremely lopsided in terms of call and weekend coverage . For instance weekends are unequally distributed - I got more weekend days than the rest - and when I asked why I was told “seniority” even though there is no sort of compensation for me doing additional days in terms of pto or anything else. Other than that I sometimes am just told to cover 2 hospitals inpatient consults randomly because a lot of people have taken pto? Volumes being 30 pts in 1 hospital and 20 in another - with NPs though It’s 5 days a week so typically I use my days as admin time to catch up on clinic. My question is -
- am I being an dingus if I refuse to cover unsafe patient volumes ?
- would there be any repercussions to me just refusing to cover more than the equal weekend coverage?

I’m just exhausted and I know I need to look for a new job, but just wondering if this is just a normal thing in other jobs too? Where weekend + hospital call coverage is not equitably distributed?

When you interview and hammer out your next contract, don’t settle for anything less than equal coverage.

Seniority frankly doesn’t mean **** in a hospital system.

 

[Hem_onc1331]

How many total physicians in your group?

If it is an employed model everyone should be the same and share equal call regardless of seniority.

In private practice its whatever the partners want.

What is your usual clinic volume?

What was initially decided per your contract? Was this discussed previously and you were told something else?

Have you talked to your cheif of division and brought this up?

There are 10 physicians and 5 different hospitals covered -don’t ask how. And yes when I did interview here I was told that covering 2 hospitals is not done on the same day. I did bring it up to my chief and was given very elusive answers. We were formerly a private practice and now hospital employed - just something that happened recently. My clinic volume is 17 pts/day

 

[Hem_onc1331]

You're getting screwed

All this should have been in your contract and when you interviewed

From your post history you may work in NYC? That might be a different beast in terms of abusing the younger docs

Did you post about this exact same job 1 year ago with similar issues? Hem-Onc job advice - thinking of quitting my current job Or did you leave that job and land in this dumpsterfire?

Yes this is the same job. I’m still in the dumpster fire , but just that we went from being a private practice to now hospital employed

 

[Hem_onc1331]

When you interview and hammer out your next contract, don’t settle for anything less than equal coverage.

Seniority frankly doesn’t mean **** in a hospital system.

When you interview and hammer out your next contract, don’t settle for anything less than equal coverage.

Seniority frankly doesn’t mean **** in a hospital syst

So I did ask for equal call and it’s a part of my contract. However it’s a mild inequality- I’m doing more long weekends than others two years in a row

 

[Mehena]

It's possible that older physicians received big payouts by promising extra coverage to hospitals, using the sweat of their younger colleagues.

Predicting which private practices will last long-term is getting harder. Many are hiring new graduates under the guise of expansion, but really to make themselves more attractive for a buyout by private equity firms or hospitals.
Once, I asked the founder of PP oncology group about a potential buyout, but he avoided giving a clear answer. Later, I ended up working for a hospital with better predictability, and not long after, the PP I inquired about was bought by a hospital.

 

[osprey099]

It's possible that older physicians received big payouts by promising extra coverage to hospitals, using the sweat of their younger colleagues.

Predicting which private practices will last long-term is getting harder. Many are hiring new graduates under the guise of expansion, but really to make themselves more attractive for a buyout by private equity firms or hospitals.
Once, I asked the founder of PP oncology group about a potential buyout, but he avoided giving a clear answer. Later, I ended up working for a hospital with better predictability, and not long after, the PP I inquired about was bought by a hospital.

Side question: is it possible for a "retired" private practice partner to still receive a payout when a pp gets bought by private equity or hospital?

This may be a good way to gauge if a pp is close to being sold. If you have a lot of gray hair partners refusing to retire, it may mean they are hanging on and waiting for right time to sell. Conversely, if several partners have retired recently, that may be an indirect way of confirming the stability of the pp because if if the practice were to sell, wouldn't these partners hang on for another year or two to enjoy that payout?

 

[HemeOncHopeful19]

So I did ask for equal call and it’s a part of my contract. However it’s a mild inequality- I’m doing more long weekends than others two years in a row

Ok but in your initial post you said “extremely lopsided in terms of call and weekend coverage”

Which one is it? It’s hard to say without knowing the actual situation you’re in but overall I would guess you’re being taken advantage of.

 

[gutonc]

So I did ask for equal call and it’s a part of my contract. However it’s a mild inequality- I’m doing more long weekends than others two years in a row

In my former group of ~15 docs, 5 offices and 7 hospitals (where I worked for 11 years and was the medical director for 4 years), we worked to even out the weekend/holiday call schedule over a 3 year cycle, since there are always going to be inequities in a group that size over a shorter period of time. It wasn't always perfect, but it was usually pretty good.

I can't say if that is or isn't what's happening to you, just pointing out that it may not be as unfair as it might seem to you right now.

 

[Hem_onc1331]

In my former group of ~15 docs, 5 offices and 7 hospitals (where I worked for 11 years and was the medical director for 4 years), we worked to even out the weekend/holiday call schedule over a 3 year cycle, since there are always going to be inequities in a group that size over a shorter period of time. It wasn't always perfect, but it was usually pretty good.

I can't say if that is or isn't what's happening to you, just pointing out that it may not be as unfair as it might seem to you right now.

In my former group of ~15 docs, 5 offices and 7 hospitals (where I worked for 11 years and was the medical director for 4 years), we worked to even out the weekend/holiday call schedule over a 3 year cycle, since there are always going to be inequities in a group that size over a shorter period of time. It wasn't always perfect, but it was usually pretty good.

I can't say if that is or isn't what's happening to you, just pointing out that it may not be as unfair as it might seem to you right now.

Thank you that’s helpful. Just wondering how was the hospital coverage typically split for the newer attendings across 7 hospitals? Like on a day to day inpatient coverage standpoint.
Also was there transparency on the weekend/holiday call cycle?

 

[gutonc]

Thank you that’s helpful. Just wondering how was the hospital coverage typically split for the newer attendings across 7 hospitals? Like on a day to day inpatient coverage standpoint.

Each office was on/near a hospital campus. Each office was responsible for covering the hospital(s) nearest them. The docs in each office got to decide how they split that up (doc of the day, a week at a time, etc). That said, inpatient coverage at most of them was minimal.

Also was there transparency on the weekend/holiday call cycle?

Everybody can see the call schedule online. The holiday schedule was emailed out at the beginning of the year, weekends were done quarterly and the weekday schedule was done a month at a time. Everybody could see who was on call when.

ETA: If call burden transparency is NOT the case where you are, then they are definitely trying to f*** you.

 

[NotAProgDirector]

Here's the deal. Your job was private practice to start. These are usually sweat equity type positions. You put in lots of sweat early, and then you get equity later on.

Now you're hospital employed. That's not the way it's going to work anymore. There's no partnership, no infusion money, etc. The past partners likely took a huge payout by selling the practice. And now they're still running it as-if it's a private practice because that's all they know, and they want the sweet deal they thought they were entitled to. There's a good chance that they may have engineered higher salaries for more senior docs also.

Somewhere along the line there's going to be a reckoning. And you are unlikely to come out financially on top.

The solution to your problem: get a new spot with a better contract.