Job nightmare. Advise please

[clausewitz2]

So there's probably a big difference between intellectual aptitude required to get a Ph.D. in physics versus a Ph.D. in biology. I'm not going to dismiss medical training, but it's true that most of our training focuses on memorization with not much emphasis on critical thinking. That might explain why doctors make such disappointing politicians.

I agree that pay is arbitrary, and whoever makes more money is probably going to find a way to convince themselves that that's how it should be. However, the stuff that we do is different -- we're on call overnight, we could make a mistake that might result in someone dying, we train for a really, really long time in a manner that's different and potentially more miserable (maybe depending on who you ask) than getting a Ph.D.. My husband's a software developer, and he spends most of his work life thinking about things and solving problems without a lot of other administrative/interpersonal stuff. I find myself feeling jealous of that and sometimes thinking I'd take less money to have a job with more intellectual freedom.

Yeah, it is certainly a very different set of challenges, and I can totally see why in some ways being a tenured professor at an R1 university is totally a better gig. Thing is, for a significant majority of new PhDs, this is not their ultimate fate. Tenure these days is winning the lottery. Sweet if it happens to you, but not a great thing to pin your hopes on.

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[scootad.]

" Had I been you, day 1 of increased work load would result in an email to administration billing them for the extra work as detailed in my original contract. This would be a courtesy to inform them that I am exercising the increased pay clauses of the contract. Any attempts to not pay this would result in a letter from my attorney and promptly stopping all future work for violation of the contract."

While the sentiments in the above are valid, in an ideal world, it's hard to fault the new hire for not immediately fighting the employers. Many (especially those in their first job) are vulnerable and don't want to burn any bridges. What if their next employer calls their previous one for a reference, and they end up bashing you? The new hire is in a vulnerable spot. The best thing to do is, yes, voice a complaint, but actively seek new jobs, and give notice as per your contract once you get one. Then leave. But I'm not sure threatening a lawsuit is the way to go.

 

[birchswing]

I know you were trying to make a point but I'm fairly sure you swung a bit too far the other way.

Between this post and as usual birschwings "facts" there is a ton of misinformation about the economics of education.

Putting a word in quotation marks is not a cogent argument.

 

[Ceke2002]

union rep lol

So you missed the part about me not being from the US, and going to a Union rep is what I would do if I was in the same situation considering I live in another country? That's cool, I probably should have endeavoured to have made that a little clearer. I just think it's rather sad that Medical Professionals in the US are getting short changed with cr@ppy job situations like the OP's, when you guys deserve so much more than that.

 

[splik]

So you missed the part about me not being from the US, and going to a Union rep is what I would do if I was in the same situation considering I live in another country? That's cool, I probably should have endeavoured to have made that a little clearer. I just think it's rather sad that Medical Professionals in the US are getting short changed with cr@ppy job situations like the OP's, when you guys deserve so much more than that.

not that things are perfect in australia but physician unionization is the norm and they get a much better deal in general. I have only heard positive things from doctors who have made the jump to australia. they feel they have a manageable workload and are well compensated.

fyi ceke, although most physicians are no unionized in the US because they traditionally have been rather foolish and conservative and didn't believe in organized labor, it is actually becoming more common. physicians in some county hospitals, state hospitals, and correctional settings are unionized. some residency programs are unionized. I think we are going to see unionization becoming more common amongst physicians in the US as solo practice dies out and physicians become enslaved in large healthcare organizations that try to exploit them.

 

[michaelrack]

So there's probably a big difference between intellectual aptitude required to get a Ph.D. in physics versus a Ph.D. in biology. I'm not going to dismiss medical training, but it's true that most of our training focuses on memorization with not much emphasis on critical thinking. That might explain why doctors make such disappointing politicians.
.

While many physician politicians (Howard Dean, Jim McDermott) have been a disappointment, I have been impressed by Rand Paul and former Senator Tom Coburn.

 

[birchswing]

While many physician politicians (Howard Dean, Jim McDermott) have been a disappointment, I have been impressed by Rand Paul and former Senator Tom Coburn.

I'd add Ben Carson to the first group. Honestly don't remember enough about Howard Dean to comment, and not familiar enough with the others. I do like Rand Paul when I hear him speak (sometimes), but then I look up his position statements and they don't gel with my world view. But I do respect his intelligence and anti-hawkishness.

 

[Doctor Bagel]

While many physician politicians (Howard Dean, Jim McDermott) have been a disappointment, I have been impressed by Rand Paul and former Senator Tom Coburn.

Wow, so disagree, but I guess I'll save political commentary for another space. In fact, those were exactly the people I was thinking about when mentioning disappointing physician politicians.

 

[TexasPhysician]

While the sentiments in the above are valid, in an ideal world, it's hard to fault the new hire for not immediately fighting the employers. Many (especially those in their first job) are vulnerable and don't want to burn any bridges. What if their next employer calls their previous one for a reference, and they end up bashing you? The new hire is in a vulnerable spot. The best thing to do is, yes, voice a complaint, but actively seek new jobs, and give notice as per your contract once you get one. Then leave. But I'm not sure threatening a lawsuit is the way to go.

If you leave every time an employer tries to push more work on you, you will never keep a job. This is why all of my contracts detail my work load and compensation for additional work. This prevents problems like the OP's. I also don't threaten a lawsuit. I start by informing the company that I'm billing for contract stated rates. If they refuse, I have my attorney write a polite letter detailing the contractual obligations. I've never gotten to a refusal of this yet. Hypothetically, I'd probably obtain a new job and then quit the old with 0 days notice.

There is much greater demand than supply, and I don't enjoy being taken advantage of. The key for the OP is learning from this mistake and making sure future contracts provide better work limitations and pay for increased work.

 

[Ceke2002]

not that things are perfect in australia but physician unionization is the norm and they get a much better deal in general. I have only heard positive things from doctors who have made the jump to australia. they feel they have a manageable workload and are well compensated.

fyi ceke, although most physicians are no unionized in the US because they traditionally have been rather foolish and conservative and didn't believe in organized labor, it is actually becoming more common. physicians in some county hospitals, state hospitals, and correctional settings are unionized. some residency programs are unionized. I think we are going to see unionization becoming more common amongst physicians in the US as solo practice dies out and physicians become enslaved in large healthcare organizations that try to exploit them.

Thank you for this insight. I appreciate learning about the different cultural and socio-political aspects between our two countries. I certainly don't advocate for any sort of union system that forces workers to join. I do believe the choice to be in a Union or not in a Union should be entirely up to the individual employee, I just also think the employee should at least have the option to make that decision by having a Union available to them.

 

[heha]

1. A lot of kids that go into PhD programs aren't that smart, lot of them were the kids who didn't get into med school

2. Doctors get paid a lot, as mentioned before, because of the product they offer.

3. I think PhDs, and all educators should get paid more, good teachers should make as much as nurses.

4. You can't really compare European medicine to American medicine, two different systems

I had to get out of lurkdom to reply to this. As an MD PhD, your first point is so patently false I don't even know where to begin to tear it apart from. Getting my PhD was infinitely harder than getting my MD. Grad school was the hardest, most intellectually challenging, time consuming and stressful time of my life. I was constantly surrounded by incredibly intelligent people whose minds were wondrous and awe inspiring. I'd rather relive all of med school again than have to redo the last year of grad school. Please educate yourself before you spew such opinions in a public space.

 

[Yellow mellow]

I completely agree with you. Before med school, I was a graduate student and what I saw were really bright grad students who worked their tail off with little to no limelight. There was such a contrast between medical and graduate students. Grad students had far less ego than med students. This may not be the case everywhere but this was my experience.

 

[Yellow mellow]

I completely agree with you. Before med school, I was a graduate student and what I saw were really bright grad students who worked their tail off with little to no limelight. There was such a contrast between medical and graduate students. Grad students had far less ego than med students. This may not be the case everywhere but this was my experience.

 

[Yellow mellow]

Oops, meant to reply to heha...

 

[Yellow mellow]

" Many (especially those in their first job) are vulnerable and don't want to burn any bridges. What if their next employer calls their previous one for a reference, and they end up bashing you? The new hire is in a vulnerable spot. The best thing to do is, yes, voice a complaint, but actively seek new jobs, and give notice as per your contract once you get one. Then leave. But I'm not sure threatening a lawsuit is the way to go.

This is me right now. Union tells me to resign before contract ends , says it looks worst if I just let contract ends naturally without an offer for renewal. They also said that my supervisor is not allowed to speak positively or negatively of me, just that I do/did work there. And after talking extensively to nurses and other psychiatrist on the unit, union says that I had gotten rave reviews about my work, problem is new employers are already asking for supervisors name and number and I certainly don't trust him to abide by the rule and I'll never know. So what am I to do, hope that potential new employer will speak with my references which does include my current colleagues and former program director, and not stop at this current boss.

 

[michaelrack]

This is me right now. Union tells me to resign before contract ends , says it looks worst if I just let contract ends naturally without an offer for renewal. They also said that my supervisor is not allowed to speak positively or negatively of me, just that I do/did work there. And after talking extensively to nurses and other psychiatrist on the unit, union says that I had gotten rave reviews about my work, problem is new employers are already asking for supervisors name and number and I certainly don't trust him to abide by the rule and I'll never know. So what am I to do, hope that potential new employer will speak with my references which does include my current colleagues and former program director, and not stop at this current boss.

Why don't you list a different supervisor- the medical director rather than your "boss"

 

[Yellow mellow]

Why don't you list a different supervisor- the medical director rather than your "boss"

I've been told medical director is just as bad and there is protection among the leaders. No way around it really.

 

[Shikima]

Just list them and go with the flow at this point. No point in worrying about it, you'll land a new position soon enough.

 

[kitsens]

Just list them and go with the flow at this point. No point in worrying about it, you'll land a new position soon enough.

Agree with Shikima, besides if these "supervisors" are shrewd albeit incompetent they probably don't want to create unnecessary problems for themselves

 

[Shikima]

And with the general shortage across the country, you'll be fine...

 

[Yellow mellow]

Just list them and go with the flow at this point. No point in worrying about it, you'll land a new position soon enough.

Yeah, namaste.
I wonder if anybody can tell me if this is a decent offer:
PP, W-2, 40 min/pt. for 12pt/day, 225G, no overhead , malpractice and health insurance included, insurance base office.

Because I have a huge student loan debt, I wanted to stick with govt. jobs with the hope of PSLF being around but I don't know if it's worth it. Btw, govt. jobs pay 10G or more but patient load is probably higher.

 

[heyjack70]

Find a VA or state hospital.

 

[splik]

hes escaping from the VA

 

[birchswing]

hes escaping from the VA

Sounds like an inverse of Shutter Island.

 

[Shikima]

Yeah, namaste.
I wonder if anybody can tell me if this is a decent offer:
PP, W-2, 40 min/pt. for 12pt/day, 225G, no overhead , malpractice and health insurance included, insurance base office.

Because I have a huge student loan debt, I wanted to stick with govt. jobs with the hope of PSLF being around but I don't know if it's worth it. Btw, govt. jobs pay 10G or more but patient load is probably higher.

Not a bad gig, 40 hrs per week more or less? You could sign on for a year and see how it goes. Don't like it, move to other pastures.....

 

[Yellow mellow]

hes escaping from the VA

At least this one !

Sounds like an inverse of Shutter Island.

Maybe worst

But thanks everyone for your input.

 

[WingedOx]

hes escaping from the VA

God, this thread really spills home how vastly different each VA is. Helps to be at one with a massive MHSL I guess.

Edit: not sure if splik is responding to Mellow or the OP...

 

[WingedOx]

to mellow - op clearly isn't working at the VA.

yeah, I figured that out eventually... but didn't seem worth it to have another one of those awkward posts with only "." once I figured what I was responding to.

Though for those of us newly in the VA system, it's been a fun month dealing with OPM and E-QIP.

 

[Shikima]

Anecdotally, it appears that the VA system, as a whole, is quite malignant and burdensome. Though there are dept's and systems which are run more smoothly, it appears that could be the exception rather than the rule unfortunately.

 

[Merovinge]

As a PhD finishing up med school, I couldn't disagree more. Plenty of smart people become physicians, but I have to tell you, medicine isn't even like a quarter of the intellectual challenge of harder sciences. Medicine requires quite a lot of work and good pattern recognition, but not anything like as much thought.

I have never felt more like a mouth-breathing dimwit than when dealing with mathematicians or physicists. Really brutally intelligent people are not going into crunchy sciences because they weren't smart enough to get into med school.

Yes, you can coast through a PhD if you really want to, but you must know that if you don't produce, you are done. You are toast. You will not have a career beyond adjuncting for 4,000 dollars a class if you are lucky.

These are really different kinds of "smart" though. My best friend completed his PhD in mathematics at Harvard, suffice it to say he is the smartest guy I know using a traditional definition. Medicine requires more of a floor of well above average intelligence mixed with social skills and toughness to get through and excel. He'd be the first to tell you that working 80+ hour/weeks in a hospital seeing patients and operating all day (like my surgery and particularly neurosurg friends do) for several years to life would be impossible for him, just as I bet most of the neurosurgeons I know couldnt get in nor finish a PhD in math at Harvard. These arguments are perfect examples of apple to oranges.

The salary difference? Lets definitely economics and him working on things that will change the world in 2100 and us making the difference between suffering/death or health in the present moment.

 

[clausewitz2]

I will admit I was mainly reacting to the assertion earlier that people going into PhD programs were doing it because they couldn't swing a med school admission, which is patently false. Totally agreed that they are judged by different metrics and have different demands.

Salaries, especially in healthcare, are derived proximally from a set of facts about distribution of economic resources, political influence, and regulatory capture, and are thus a poor choice for making comparisons of worthwhileness or Mills-ian utility.

 

[keifernny2]

w/r/t the OP's concerns about job references....IMHO the current market is so strong that likely he could get another job without having great references (just as long as there are no negative references or legal actions taken against him).

In my mind this is the benefit of having multiple income streams. If things go sour at one job you're not quite as beholden to it and can jump ship quickly.

 

[Doctor Bagel]

Anecdotally, it appears that the VA system, as a whole, is quite malignant and burdensome. Though there are dept's and systems which are run more smoothly, it appears that could be the exception rather than the rule unfortunately.

Really? I guess I've only had exposure to one VA, but I think of VA jobs as on the cushier/friendlier side. There are a lot of bureaucratic burdens that I can see wearing people down, though. The VA I worked at had a ton of turnover with primary care docs, and I'm sure there was a reason for that.

 

[keifernny2]

The VA I work at has been failing to hire replacement therapists for those that leave, which is making an already challenging situation somewhat of a nightmare (at least for the psychiatrist that is left holding the bag). Luckily, with the federal govt, you can always quit.

 

[Shikima]

The majority of VAs, as cushy as they sound, have a high turn over rate for a reason. And there is a reaason they cannot hire people.

 

[whopper]

Here's my problem with the VA. I never worked in one but as a former forensic psychiatrist in Cincinnati I had to go into one once a week and had friends that worked there.

As with any state job, the longer you stay the more the benefits. OK fine. The problem here is a lot of people become disillusioned with the job and then enmesh with it due to the benefits and otherwise would've left. These are people that start not liking the job, and a new job might given them a fresh outlook, but staying with the state, well that dislike turns into hate. It turns into an attending that no longer really loves their job anymore.

The patient population is difficult.

As with all state jobs, you're kind of on an island. In several jobs you network quite well such as in private practice. In the VA everything is in the building. There's nothing else unless you have side gigs. The difference here is that networking opens opportunities that keep you mentally fresh and happy.

Bad employees tend to stay. Good employees tend to go. I've seen the type of attending stay in a state job that isn't that good. They get caught with the benefits and really didn't have a passion to begin with or lost it. The good ones, realizing it'll kill their soul leave. (Not true of all but true of some).

Due to unions and state rules, it's hard to fire bad employees. While I worked at a non-VA state hospital, all of the bad attendings, nurses, and social workers were all dumped to one unit. Why? Cause the guy running the hospital (a friend of mine) told me he tried to get these people fired and couldn't. He likened them to frat in Animal House and he was the dean.

Here's an example of how bad that unit was. I covered for one of the attendings who was on vacation. A guy on that unit had dementia. No MOCA, no Folstein or other test was done. I had to do it. No dementia work up was done. I had to do it. The guy was on the unit for about 6 months before I saw him. So I see him, do all the work-up, do a MOCA, and when all the lab results are in I tell the social worker we need to get the guy to a nursing home. (All of this happened in 48 hours). Every time I tell someone to do something I just keep getting poo-pooed. Then my coverage ended cause the attending's vacation ended.

By the time I left Cincinnati about 3 years later guess what? That guy was still there, not having 1 referral to a nursing home.

 

[clausewitz2]

Bad employees tend to stay. Good employees tend to go. I've seen the type of attending stay in a state job that isn't that good. They get caught with the benefits and really didn't have a passion to begin with or lost it.

There is a VA psychiatrist here who is famous for two things. The first is screaming at patients during interviews. Not raising his voice, not being confrontational/directive, not being a bit heated, no joke screaming.

The second is urging every single medical student that rotates with him not to go into psychiatry, and engaging in long rants about why no one should enter the field and that it is all pointless and useless.

I am guessing he goes nowhere until he hits Minimum Retirement Age.

 

[whopper]

I am guessing he goes nowhere until he hits Minimum Retirement Age.

This is exactly the type of crap I'm talking about. Once you've invested enough years you're kind of trapped. I say "kind of" cause you could always walk away but many will not even for a job that'll make them happier cause they'll lose the government benefits.

So then they start hating their job among a lot of other things like not try to fix up the place.

I forgot to mention this for those who do not know. The way the benefits schedule work, for every few years you work there, they add something else. E.g. free healthcare for life, a pension that's part of your salary, then a few years later a pension that's a larger part, etc.

So each step of the way it becomes harder and harder to leave.

That's why some attendings leave there pretty soon, like after just a year or two after they realize they might not be loving their job.

 

[smalltownpsych]

This is exactly the type of crap I'm talking about. Once you've invested enough years you're kind of trapped. I say "kind of" cause you could always walk away but many will not even for a job that'll make them happier cause they'll lose the government benefits.

So then they start hating their job among a lot of other things like not try to fix up the place.

I forgot to mention this for those who do not know. The way the benefits schedule work, for every few years you work there, they add something else. E.g. free healthcare for life, a pension that's part of your salary, then a few years later a pension that's a larger part, etc.

So each step of the way it becomes harder and harder to leave.

That's why some attendings leave there pretty soon, like after just a year or two after they realize they might not be loving their job.

 

[manly_man246]

^That goes double for the patients on our VA's geri unit. It's just a depressing place to work overall. I can understand the financial appeal but unless I'm really hurting for money after residency I can't see myself wanting to work in such a soul-sucking, bureaucratic, and inefficient place. And the medicine wards are even worse.

 

[smalltownpsych]

^That goes double for the patients on our VA's geri unit. It's just a depressing place to work overall. I can understand the financial appeal but unless I'm really hurting for money after residency I can't see myself wanting to work in such a soul-sucking, bureaucratic, and inefficient place. And the medicine wards are even worse.

I can't wait for the single-payer system so that we all get to work for the government!

 

[keifernny2]

The other issue with leaving high pt demand jobs (VA or CMHC) that I've seen is that even if you try to cut your hours to, say, half time, in order to pursue other interests, administration doesn't necessarily cut your patient panel. In the end you're covering the same number of patients in half as much time and getting paid half as much . This can make the situation worse. Best to just make a clean break.


Sent from my iPad using Tapatalk

 

[ferning]

Like working at in a private corporate hospital is much better?

Sounds kind of nice to have that protection from being unjustly fired. Better than department meetings that not so subtly say if we dont create psych pts to consult on we could be on the streets. Or tacking on other corporate compliance BS that isnt time reimbursed

 

[smalltownpsych]

Like working at in a private corporate hospital is much better?

Sounds kind of nice to have that protection from being unjustly fired. Better than department meetings that not so subtly say if we dont create psych pts to consult on we could be on the streets. Or tacking on other corporate compliance BS that isnt time reimbursed

I so love department meetings with the admin people. Half the time they tell us our department is bleeding money, the other half the time, they tell us to bring in more business. I still can't figure out why they want us to bring in more business if it doesn't pay. I am beginning to accept that they will never be happy and that it comes out of the fact that even though they are technically in charge, people respect and like the medical providers more than them.

 

[heyjack70]

I so love department meetings with the admin people. Half the time they tell us our department is bleeding money, the other half the time, they tell us to bring in more business. I still can't figure out why they want us to bring in more business if it doesn't pay. I am beginning to accept that they will never be happy and that it comes out of the fact that even though they are technically in charge, people respect and like the medical providers more than them.

Maybe it's time to bring back more procedures to help the bottom line. Who's first up for a lobotomy?

 

[Shikima]

ECT?