5 Day Work Week?

[aneftp]

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Busy hospital system with multiple branches. Consistently poor staffing for eyes but boy howdy they know how to do ortho.

5 hour block for years, consistently need 3+. Not a black hole, show up on time, get cases done efficiently. Funnily they asked if I could bring more volume, but they won’t let me.

They turned “elective” block into 2 weeks prior notice to keep it. Clearly that doesn’t work with services that have urgent/emergent cases. And they won’t staff after hours. I’m not doing my case and being the scrub and circulator as well, if they’ll even open a room.

Why not just buy your own equipment for your own ASC. I’m sure you have the numbers and can at least break even?

Sure it’s a gamble. But it eliminates the headache dealing with the hospital. And as you say. Hospitals lose money on eyes as well Might as well control what you can control (your schedule)

I see the ep docs doing procedures at stand a lone ASC these days and those are even riskier cases. Certainly some ASA 4 ablations at the strip mall ASC next to Panera bread. The MDs don’t want to go back there solo. lol. So the crnas tried to do it solo and chicken out as well. And I ain’t dumb to take that ASC. Especially since they aren’t budging with their $375/hr rate for docs and $225/hr rate for crna.

It’s gonna to cost 10% PER PROCEDURE for anesthesia charges. (knowing full well they are collecting 20-25k per procedure just in facility fees). Hospitals collect even more like 35k. And it’s a jointly owned hospital/ep doc joint venture
6 procedures. 120k-150k in facility fees

12k-15k in anesthesia collections sounds more than fare.

 

[Lab Lover]

Busy hospital system with multiple branches. Consistently poor staffing for eyes but boy howdy they know how to do ortho.

5 hour block for years, consistently need 3+. Not a black hole, show up on time, get cases done efficiently. Funnily they asked if I could bring more volume, but they won’t let me.

They turned “elective” block into 2 weeks prior notice to keep it. Clearly that doesn’t work with services that have urgent/emergent cases. And they won’t staff after hours. I’m not doing my case and being the scrub and circulator as well, if they’ll even open a room.

That is not uncommon these days about true elective cases. Think cataracts. Not retinal detachments. Agree with the comment about urgent/emerent cases. Just curious, what is considered reasonable based on the consensus of opinion for time to OR from time of patient recognition of vision change, time of optho diagnosis, to time to OR? what is considered "reasonable"? Are there specialty society guidelines or position statements on the above?

 

[cittykat]

It’s like rad onc ordering us to do a total body mri at 2am on Monday morning so they can have their scans by 8am. They do what’s best for them. I forced them in at 3am to sit there which they refused to do. No idiot rad onc doc is coming in at 3am Monday morning. So in the end they gave up on the mri. Not about patient care. It’s about self interest.

Never saw this in 30+ years.

 

[aneftp]

Never saw this in 30+ years.

Trauma one center where there are no rules.
I accommodated the first two times. Sunday night about the only time you can shut ur eyes more than 3 hrs straight.

The third time was…this is a trend. And it’s ridiculous to accommodate. I’ve learned to say no more over the years. Or I’m not young and stupid anymore.

 

[cittykat]

Trauma one center where there are no rules.
I accommodated the first two times. Sunday night about the only time you can shut ur eyes more than 3 hrs straight.

The third time was…this is a trend. And it’s ridiculous to accommodate. I’ve learned to say no more over the years. Or I’m not young and stupid anymore.

Been at L1TC for 25+ years. Have yet to see it. They need some guidelines.

 

[aneftp]

They can staff ortho because they do ortho all day every day.


If you want good staffing with people who know what they’re doing at a hospital, you need to consistently book elective cases there. Can’t show up for 3-4 cases/year and expect people to know what they’re doing.

And I’m not talking about anesthesia.

Eyes are much trickier to call their own shots at hospitals

Urology can call their own shots with hospital systems though. Enough septic urology procedures for urologist to hold hospitals hostage even when they barely bring any volume to the hospitals. I’m talking about the urologists who do ASC owner outpatient procedures 95% of the time. And cover hospitals calls once in a blue moon.

That’s why eyes need to do the calculations if it’s at least break even to have their own equipment for retinal detachment.

 

[cittykat]

That is not uncommon these days about true elective cases. Think cataracts. Not retinal detachments. Agree with the comment about urgent/emerent cases. Just curious, what is considered reasonable based on the consensus of opinion for time to OR from time of patient recognition of vision change, time of optho diagnosis, to time to OR? what is considered "reasonable"? Are there specialty society guidelines or position statements on the above?

In my experience, the urgency is very much dependent on who is on call. Some of the retina docs on our call panel have never done a case at the hospital.

 

[Arch Guillotti]

In my experience, the urgency is very much dependent on who is on call. Some of the retina docs on our call panel have never done a case at the hospital.

Most of them send them elsewhere because it is inconvenient after hours and they probably don‘t have the staff they want.

 

[Lab Lover]

In my experience, the urgency is very much dependent on who is on call. Some of the retina docs on our call panel have never done a case at the hospital.

I get it. I was just curious about their specialty society’s guidelines ( if there are any) or the consensus of opinion of optho docs.

 

[aneftp]

I get it. I was just curious about their specialty society’s guidelines ( if there are any) or the consensus of opinion of optho docs.

I’m Obviously not an eye expert. But one of the anesthesia docs married to retina guy. One of the largest groups in my area. Said it’s all about the macula. And it can be less than 24 hrs true emergency or wait a couple of days.

So the answer all depends on the eye situation. It’s almost like urologists and sepsis and stones lol. Sometimes is true emergency we need to get it done tonight. Or it can wait a little longer.

But I’m just trying to reason to do what’s best for the patients. And if you piss off 25 patients in your office to cancel all ur appointments and to get a retina detachment fixed for one guy. Isn’t that worth it? For patient care? The other patients waiting in office aren’t gonna to lose their vision.

We always talk about healthcare here and some sacrificing has to be done. It’s a difficult subject to discuss because it involves revenue streams of offices.

 

[Crabbygas]

I was in a situation recently where I was at some risk of a retinal detachment. Optho says if x, y,z happens that's an emergency, call us. I'm like, is that a call at midnight Saturday sort of emergency or call at 7am the next business day sort of emergency. He says oh you should call right away, But we won't be able to get an OR open on a Sunday so there's that.

 

[aneftp]

It seems to be like the eye docs don’t know the dirty game of just sending the patient through the emergency room of any well known hospital who has know eye docs on staff like academic centers who they know will do the surgery asap.

I’ve seen general surgeons bypass insurance pre approval and send their patients for gallbladder whatever stupid elective procedure that can wait through the emergency room and the patient gets added on at 5pm when they are done at their outpatient centers.

 

[eyeeye_captain]

Most of them send them elsewhere because it is inconvenient after hours and they probably don‘t have the staff they want.

Yeah, the only one I’ve heard of in my region that has good staffing after hours is a Level 1 that requires busy call. If you have the D team and have to circulate, scrub, and operate for your case, it’s a recipe for bad outcomes. No thanks to both.

I get it. I was just curious about their specialty society’s guidelines ( if there are any) or the consensus of opinion of optho docs.

If the macula is off, you’ve got ~1 week to get it fixed with no statistical difference in vision. If it’s on and you can’t get them done in 24-48 hours, you’ve can put a gas bubble in and position them, or potentially do laser or cryotherapy and never see the OR.

It seems to be like the eye docs don’t know the dirty game of just sending the patient through the emergency room of any well known hospital who has know eye docs on staff like academic centers who they know will do the surgery asap.

I’ll let Hopkins (link) and Michigan (link) tell you that, yeah, it’s happening more than ever. Witt the rise of private equity, I’m sure more will be shifted there unless they’re able to squeeze more blood out of the stone (docs). Anecdotally, they’re pushing back. I had someone with a detachment a couple months ago with an extensive medical history who gets all their care at an academic place with a residency, understandably wanted to go where they were well established. The academic doc says nope, you’ve already got somebody and punted.

 

[ambiturner]

Yeah, the only one I’ve heard of in my region that has good staffing after hours is a Level 1 that requires busy call. If you have the D team and have to circulate, scrub, and operate for your case, it’s a recipe for bad outcomes. No thanks to both.

If the macula is off, you’ve got ~1 week to get it fixed with no statistical difference in vision. If it’s on and you can’t get them done in 24-48 hours, you’ve can put a gas bubble in and position them, or potentially do laser or cryotherapy and never see the OR.

I’ll let Hopkins (link) and Michigan (link) tell you that, yeah, it’s happening more than ever. Witt the rise of private equity, I’m sure more will be shifted there unless they’re able to squeeze more blood out of the stone (docs). Anecdotally, they’re pushing back. I had someone with a detachment a couple months ago with an extensive medical history who gets all their care at an academic place with a residency, understandably wanted to go where they were well established. The academic doc says nope, you’ve already got somebody and punted.

These are interesting articles. Percentage-wise, how much more does commercial typically pay than Medicare in ophthalmology? These arguments resemble the discussions that are common in private anesthesia groups - namely that Medicare doesn’t pay anywhere near enough to cover the cost of care. For anesthesia the solution has been subsidies and then employment. I suppose the same could be true for surgery if punting to the academic centers isn’t going to be viable. But as the editorial points out, what’s the point of having so many retina specialists if they’re going to ship out detachments?

 

[aneftp]

So ASC may lose $4000-8000 per emergency case. It seems the way the article is written. Because they get reimbursed less than hospitals. Fair enough

No one likes to lose money. But maybe consider it the cost of doing business and maintaining continuity of care. The ASC writes off those losses anyways. So knock off another 33% off. Still losing money.

But for a surgeon who owns an ASC. Every hour they are away from the ASC literally costs them $1000 an hour due to cases they could be doing at their own ASC.

So the articles don’t factor that into the equation either. You aren’t gonna to make money off emergency surgery. But you are losing very little in overall scheme of things.

Just the way I look at things. And more importantly you have control. And not enough dependent on the hospital.

 

[Mman]

No one likes to lose money. But maybe consider it the cost of doing business and maintaining continuity of care. The ASC writes off those losses anyways. So knock off another 33% off. Still losing money.

 

[eyeeye_captain]

These are interesting articles. Percentage-wise, how much more does commercial typically pay than Medicare in ophthalmology? These arguments resemble the discussions that are common in private anesthesia groups - namely that Medicare doesn’t pay anywhere near enough to cover the cost of care. For anesthesia the solution has been subsidies and then employment. I suppose the same could be true for surgery if punting to the academic centers isn’t going to be viable. But as the editorial points out, what’s the point of having so many retina specialists if they’re going to ship out detachments?

That’s going to vary widely by plan. Detachments tend to be in Medicare and Advantage (shudder) age, and I do a decent amount of Medicaid (double shudder) in the younger ones.

So many because we’re swamped in clinic, where we actually make money. I’ve routinely had over 10k visits a year for I don’t know how long. That generates maybe 300 cases. If we don’t have OR availability, well, *shrug*, what can we do other than limp along like I said. That’s why I pointed things out. I don’t know how it works with the PE groups but we try to find a way to get everything done in house. The editorial is salty, but hey, that’s also what he signed up for in academics.

So aneftp is insinuating you open your ASC after hours? Woo boy, would like to see that fly regularly, especially since we’re talking lifestyle jobs. It’s hard to get a buy in offer already with our fluctuating volume and low reimbursement. Disposables alone will be over $1k for almost every case. If you operate like one of my very good but fiscally blind academic mentors, probably 2, pushing 3.

 

[aneftp]

That’s going to vary widely by plan. Detachments tend to be in Medicare and Advantage (shudder) age, and I do a decent amount of Medicaid (double shudder) in the younger ones.

So many because we’re swamped in clinic, where we actually make money. I’ve routinely had over 10k visits a year for I don’t know how long. That generates maybe 300 cases. If we don’t have OR availability, well, *shrug*, what can we do other than limp along like I said. That’s why I pointed things out. I don’t know how it works with the PE groups but we try to find a way to get everything done in house. The editorial is salty, but hey, that’s also what he signed up for in academics.

So aneftp is insinuating you open your ASC after hours? Woo boy, would like to see that fly regularly, especially since we’re talking lifestyle jobs. It’s hard to get a buy in offer already with our fluctuating volume and low reimbursement. Disposables alone will be over $1k for almost every case. If you operate like one of my very good but fiscally blind academic mentors, probably 2, pushing 3.

What I’m saying is to take a loss and it doesn’t happen often (the emergency cases) but u have control of your own schedule. And not dependent on the hospital staffing.

Companies take losses all the time. Hospitals take losses all the time as we all know. Now as long as it’s not consistent loss. You end up ahead regardless.

But that’s the psychology of business of healthcare these days. Hospitals are taking a huge losses in anesthesia revenue collections. But win overall.

 

[Twiggidy]

Going back to the original ethos of this thread, I strongly believe that a 4 day work week should be considered a normal full time position given that most of the time we're not working normal hours during those 4 days and often have to cover evening call or weekend call. I know you can make your own schedule with locums but with burnout being such a big issue nowadays, 4 days should be baseline and if someone wants to earn more the 5th day can be voluntary. That's just my take.

 

[aneftp]

Going back to the original ethos of this thread, I strongly believe that a 4 day work week should be considered a normal full time position given that most of the time we're not working normal hours during those 4 days and often have to cover evening call or weekend call. I know you can make your own schedule with locums but with burnout being such a big issue nowadays, 4 days should be baseline and if someone wants to earn more the 5th day can be voluntary. That's just my take.

And weekends and nights (if not true night float system) need to be compensated extra

Admin and chiefs try to drink the corporate kool aid saying weekends are part of ur w2 package.

Separate weekends from the pay package. Someone doing a full 72 hr weekend beeper should be compensated either with a full week off or money.

There are many ways to fix a staffing issue.

 

[cittykat]

https://www.amga.org/getmedia/e10c612d-2bb9-43ad-b807-46091b37c90f/amga-consulting-whitepaper-anesthesiology-v3.pdf

 

[aneftp]

https://www.amga.org/getmedia/e10c612d-2bb9-43ad-b807-46091b37c90f/amga-consulting-whitepaper-anesthesiology-v3.pdf

The numbers make very little sense
210 shifts on average (22 weeks off) according to the article

I mean I have been pushing for these 20-26 weeks off and I think it’s great.

 

[JoelJoel84]

The numbers make very little sense
210 shifts on average (22 weeks off) according to the article

I mean I have been pushing for these 20-26 weeks off and I think it’s great.

Yes but I believe they said those example jobs contain shifts are 10 hours each (7a-5p daily?) with q4 call, and likely q3-q4 weekends then, as well? For like $600k?

That job sucks and I don’t know anyone with it that bad.

 

[cittykat]

The numbers make very little sense
210 shifts on average (22 weeks off) according to the article

I mean I have been pushing for these 20-26 weeks off and I think it’s great.

They’re assuming 7-8 weeks off.

2100 hrs (210 shifts) over 44 weeks.

 

[cittykat]

Yes but I believe they said those example jobs contain shifts are 10 hours each (7a-5p daily?) with q4 call, and likely q3-q4 weekends then, as well? For like $600k?

That job sucks and I don’t know anyone with it that bad.

Even worse. $540k

 

[aneftp]

They’re assuming 7-8 weeks off.

2100 hrs (210 shifts) over 44 weeks.

Like I have said numerous times. Blockbuster video style management still sticks to the tradition q4/5 call model

2100 hours requires close to 700k of compensation with 8 weeks off

$310-320/hr w2 average EXCLUDING benefits to combat Locums docs per hourly wage

Why?

While Locums pays more in most parts of the country ($350-425/hr). A fair trade off for GUARANTEED PAY W2 would need the within 10-15% of the hourly pay of Locums docs

 

[Dantrolene FC]

I’ll highlight this as someone on the other side of the drape who is seeing this adversely affect patient care.

I’m pretty laid back, but when you potentially hurt my patients, I go through the roof. I keep privileges at a hospital for my extra sick or certain insurances patients. A few weeks ago I had 3 retinal detachments come in, so urgent surgeries to be done. I was told I could do 1 if I did a 7:00 start, and no, they couldn’t fully open the room or do after hours. Nobody could cover.

I’ve known the anesthesia group for years. We’re friendly and collegial. Our kids are in the same classes.

I was very fortunate to be able shoehorn the other 2 on my partner with lucky circumstances. This kind of attitude, while I don’t begrudge you getting yours, does in reality lead to potential harm to patients.

I’m only 2 years out of training, so take this for what it’s worth. But the government, with all its regulations and decreasing reimbursements, and hospital and private equity greed, has ruined private practice anesthesia (and other specialties).

With a private group, you’re going to cover those cases. If your contract says you’re covering 20 anesthetizing locations per day, then you’re doing that. But nowadays, people don’t want to do private practice. They’re (we’re) employees now.

When we were short staffed at my hospital, the surgeons would complain to me that their room was on hold because of a shortage of anesthesia staffing. If I was private practice, I’d be sweating because that’s my problem for not covering the rooms. But since I’m employees, I just refer the surgeon to the CEO’s office to ask them why they aren’t hiring more anesthesiologists.

An owner of a restaurant works 80 hours per week to keep the doors open. The employee works 40 hours per week because there’s less skin in the game. When you make the physicians employees, the mindset comes with it.

 

[aneftp]

I’m only 2 years out of training, so take this for what it’s worth. But the government, with all its regulations and decreasing reimbursements, and hospital and private equity greed, has ruined private practice anesthesia (and other specialties).

With a private group, you’re going to cover those cases. If your contract says you’re covering 20 anesthetizing locations per day, then you’re doing that. But nowadays, people don’t want to do private practice. They’re (we’re) employees now.

When we were short staffed at my hospital, the surgeons would complain to me that their room was on hold because of a shortage of anesthesia staffing. If I was private practice, I’d be sweating because that’s my problem for not covering the rooms. But since I’m employees, I just refer the surgeon to the CEO’s office to ask them why they aren’t hiring more anesthesiologists.

An owner of a restaurant works 80 hours per week to keep the doors open. The employee works 40 hours per week because there’s less skin in the game. When you make the physicians employees, the mindset comes with it.

Of course. The Wall Street journal just wrote an article how insurance premiums are going up 11% again this upcoming year.

It’s because hospitals are strong willing insurers and forcing higher payments.

All the Obamacare care (of course I have to mention it) did was encourage hospital systems to get bigger and bigger. The smaller ones got purchased by the bigger fish. This is the best way to get the best rates from the insurance company with market share.

If hospitals are getting reimbursement. All these fake 501c really operate as for profit hospitals. Let’s not kid outsells. Our system is over used. Hospitals throw low hanging fruit at their employee surgeons to keep operating. Take aware the financial incentives of rvu or whatever compensation model is involved. I’m sure case load would go down 50% after hours. Yes 50% . Because 50% of cases we do after hours and weekends are purely elective that can wait to the next day or Monday.

 

[aneftp]

Had a talk with my of my friends. She only works 0.6 fte at 325k (540k is full salary at hospital A). But she works 16 plus 24 hrs (so 40 hrs straight). With 2 crnas overnight. So when you factor in the 10 weeks of vacation. She only works a total of 80 hours in one month. Those 80 hours only consume 4 days out of 30-31 days a month. So this allows her to have a second job.

It’s one of the biggest scams lol. Only the idiots working 5 days a week are finally realizing it what a bad deal they have.

And she’s got a second gig (540k) (10 weeks off) outpatient (another scam) working 30 hours a week in reality. It’s a full time gig cause she convinced admin she’s a medical director so needs 4 hr of admin time. So her official schedule is 3x12 plus 4 hrs admin time. No outpatient center operates 12 hrs all day. She refuses to go the main hospital when outpatient finishes at around 4-5pm saying it’s not part of her contract.

All guarantee money plus loan forgiveness since it’s for a 501c. I calculated her pure w2 hourly wage for this w2 gig at around ($428/hr) BEFORE HEALTH BENEFITS AND RETIREMENT.

That girl working the system. I love it.

That’s how you attract w2 employees.

She’s working less than the clowns at either job. Especially the ones at the place she’s taking call.

 

[cchoukal]

Had a talk with my of my friends. She only works 0.6 fte at 325k (540k is full salary at hospital A). But she works 16 plus 24 hrs (so 40 hrs straight). With 2 crnas overnight. So when you factor in the 10 weeks of vacation. She only works a total of 80 hours in one month. Those 80 hours only consume 4 days out of 30-31 days a month. So this allows her to have a second job.

It’s one of the biggest scams lol. Only the idiots working 5 days a week are finally realizing it what a bad deal they have.

And she’s got a second gig (540k) (10 weeks off) outpatient (another scam) working 30 hours a week in reality. It’s a full time gig cause she convinced admin she’s a medical director so needs 4 hr of admin time. So her official schedule is 3x12 plus 4 hrs admin time. No outpatient center operates 12 hrs all day. She refuses to go the main hospital when outpatient finishes at around 4-5pm saying it’s not part of her contract.

All guarantee money plus loan forgiveness since it’s for a 501c. I calculated her pure w2 hourly wage for this w2 gig at around ($428/hr) BEFORE HEALTH BENEFITS AND RETIREMENT.

That girl working the system. I love it.

That’s how you attract w2 employees.

She’s working less than the clowns at either job. Especially the ones at the place she’s taking call.

I would phrase it differently: It's not a scam, it's her hustle and she negotiated for her worth.

 

[RedandBlack7]

Had a talk with my of my friends. She only works 0.6 fte at 325k (540k is full salary at hospital A). But she works 16 plus 24 hrs (so 40 hrs straight). With 2 crnas overnight. So when you factor in the 10 weeks of vacation. She only works a total of 80 hours in one month. Those 80 hours only consume 4 days out of 30-31 days a month. So this allows her to have a second job.

It’s one of the biggest scams lol. Only the idiots working 5 days a week are finally realizing it what a bad deal they have.

And she’s got a second gig (540k) (10 weeks off) outpatient (another scam) working 30 hours a week in reality. It’s a full time gig cause she convinced admin she’s a medical director so needs 4 hr of admin time. So her official schedule is 3x12 plus 4 hrs admin time. No outpatient center operates 12 hrs all day. She refuses to go the main hospital when outpatient finishes at around 4-5pm saying it’s not part of her contract.

All guarantee money plus loan forgiveness since it’s for a 501c. I calculated her pure w2 hourly wage for this w2 gig at around ($428/hr) BEFORE HEALTH BENEFITS AND RETIREMENT.

That girl working the system. I love it.

That’s how you attract w2 employees.

She’s working less than the clowns at either job. Especially the ones at the place she’s taking call.

Agree. I found I can travel and do locums for 7 days straight and make the same as I was making working a full time job for one of the large AMCs. It’s not ideal going away but 40 weeks off is way better than 17 or 13 or 8 for similar money. The quicker docs realize this and stop taking these jobs the quicker perm jobs will get better

 

[Twiggidy]

The locums hustle is certainly lucrative and I applaud those that have figured out the hustle. I would wonder what kind of work relationships people who rely on locums work have developed. Many don’t care and have a mercenary approach to this gig but I will say there is some value (a lot I’d argue) in working at a place where you’ve established collegial relationships with nurses and surgeons.

 

[cittykat]

The locums hustle is certainly lucrative and I applaud those that have figured out the hustle. I would wonder what kind of work relationships people who rely on locums work have developed. Many don’t care and have a mercenary approach to this gig but I will say there is some value (a lot I’d argue) in working at a place where you’ve established collegial relationships with nurses and surgeons.

100%. Hospitalists, intensivists, and consultants too.

 

[aneftp]

The locums hustle is certainly lucrative and I applaud those that have figured out the hustle. I would wonder what kind of work relationships people who rely on locums work have developed. Many don’t care and have a mercenary approach to this gig but I will say there is some value (a lot I’d argue) in working at a place where you’ve established collegial relationships with nurses and surgeons.

It takes the younger ones longer to navigate. I’ve seen a few newbies. Completely loss at times. Some develop pretty bad habits. Just my observation. Sure there is some variability in how to navigate politics of the or and non or sites.

I’m pretty established at my places as locums. So a known entity. That isn’t an issue I have. But I adapt pretty quickly. Nothing replaces experience.

Will see how the newer generation keep adapting. I called some do the new ones entering clowns. They are. But they will learn like all of us. Pick and choose your battles. Especially as locums.

 

[SRYSPAC]

Had a talk with my of my friends. She only works 0.6 fte at 325k (540k is full salary at hospital A). But she works 16 plus 24 hrs (so 40 hrs straight). With 2 crnas overnight. So when you factor in the 10 weeks of vacation. She only works a total of 80 hours in one month. Those 80 hours only consume 4 days out of 30-31 days a month. So this allows her to have a second job.

It’s one of the biggest scams lol. Only the idiots working 5 days a week are finally realizing it what a bad deal they have.

And she’s got a second gig (540k) (10 weeks off) outpatient (another scam) working 30 hours a week in reality. It’s a full time gig cause she convinced admin she’s a medical director so needs 4 hr of admin time. So her official schedule is 3x12 plus 4 hrs admin time. No outpatient center operates 12 hrs all day. She refuses to go the main hospital when outpatient finishes at around 4-5pm saying it’s not part of her contract.

All guarantee money plus loan forgiveness since it’s for a 501c. I calculated her pure w2 hourly wage for this w2 gig at around ($428/hr) BEFORE HEALTH BENEFITS AND RETIREMENT.

That girl working the system. I love it.

That’s how you attract w2 employees.

She’s working less than the clowns at either job. Especially the ones at the place she’s taking call.

Meanwhile, this hospital system in Tampa is trying to enforce a yearly hour requirement, where weekend call-ins (for CV/Peds) and work past 5 PM don't count. You could get called in on pager, work until 10 PM, and now not working a full day the following day (vs the previous waterfall relief) might mean you would owe the hospital system at the end of the year 🤣

 

[aneftp]

Meanwhile, this hospital system in Tampa is trying to enforce a yearly hour requirement, where weekend call-ins (for CV/Peds) and work past 5 PM don't count. You could get called in on pager, work until 10 PM, and now not working a full day the following day (vs the previous waterfall relief) might mean you would owe the hospital system at the end of the year 🤣

It’s Hca.

I posted something like this months ago what Hca was trying to do

like sign up for extra shifts when short staff. But Hca will claw but the extra shift if u dont do enough hours.

Some c suite crunching numbers.

Works well in theory. …in theory

 

[RedandBlack7]

It’s Hca.

I posted something like this months ago what Hca was trying to do

like sign up for extra shifts when short staff. But Hca will claw but the extra shift if u dont do enough hours.

Some c suite crunching numbers.

Works well in theory. …in theory

i think its baycare

 

[aneftp]

i think its baycare

So baycare is following Hca

These c suite just attend the same leadership meetings and do copy cake follow the other idiot.

I don’t mind putting in the work hours

The real problem is the value of beeper hours. They value is closer to $0

No one is working for free

 

[aneftp]

That’s some crazy cray stuff with the 1900 hours requirement

I calculated my hours worked. Officially it’s 1800 hours based on 500k salary and 20 weeks off.

My real work hours are closer to 1100 for the year.

I’d like have to give back 200k of salary lol.

 

[Lab Lover]

So baycare is following Hca

These c suite just attend the same leadership meetings and do copy cake follow the other idiot.

I don’t mind putting in the work hours

The real problem is the value of beeper hours. They value is closer to $0

No one is working for free

Availability is not the same as productivity. You mentioned that you love being paid to sleep. I do too.

 

[Status Sciaticus]

LOL what a bunch of clowns.

 

[aneftp]

Availability is not the same as productivity. You mentioned that you love being paid to sleep. I do too.

I work and I know how to work. That’s the difference. My availability is what costs money

We just got done with World Cup soccer. Obviously these elite players when they play on their regular teams get paid $$$. Some of them sit on the bench for some games. But they still get paid for their availability. And they get paid extremely well.

An administrator gets paid whether he doesn’t produce. Remember that. They can be losing millions and that’s not productive

 

[Twiggidy]

Availability is not the same as productivity. You mentioned that you love being paid to sleep. I do too.

But I argue time is money. Even if I’m beeper attached to a hospital and not necessarily doing a case that’s time I could be doing something else outside the 30 min radius

Maybe we’re saying the same thing

 

[CopaceticOne]

But I argue time is money. Even if I’m beeper attached to a hospital and not necessarily doing a case that’s time I could be doing something else outside the 30 min radius

Maybe we’re saying the same thing

Yep, you are.

 

[Lab Lover]

But I argue time is money. Even if I’m beeper attached to a hospital and not necessarily doing a case that’s time I could be doing something else outside the 30 min radius
Maybe we’re saying the same thing

Not so much. Call intensity is a big deal especially as one ages. The low intensity in house call vs the high intensity in house call vs the home call but 30 minute availability with rare-mild call backs are three separate entities that should be compensated at different rates.

 

[RedandBlack7]

Not so much. Call intensity is a big deal especially as one ages. The low intensity in house call vs the high intensity in house call vs the home call but 30 minute availability with rare-mild call backs are three separate entities that should be compensated at different rates.

Fair but they should all be compensated. A lot of these groups are trying to milk calls out of people essentially for free. Like there’s a night float but you’re the backup call if needed. It’s very rare to be called but 20-30 of those calls a year could be 30-50k extra easily if they were with a modest stipend.

 

[aneftp]

Not so much. Call intensity is a big deal especially as one ages. The low intensity in house call vs the high intensity in house call vs the home call but 30 minute availability with rare-mild call backs are three separate entities that should be compensated at different rates.

You are drinking the same drinks blockbuster video management wants you to drink about low call back intensity

Low intensity is still some intensity.

I’ve seen gigs with 4 docs providing backup and primary calls split between 4 docs 365 days a year.

And that’s with low intensity ob and average Or intensity.

 

[Lab Lover]

You are drinking the same drinks blockbuster video management wants you to drink about low call back intensity

Low intensity is still some intensity.

I’ve seen gigs with 4 docs providing backup and primary calls split between 4 docs 365 days a year.

And that’s with low intensity ob and average Or intensity.

How would you settle the conflict in a multisite private practice:

Doc X: What we are paid for is time away or potentially time away from our families. It is all the same.

Doc Y: Dude, you are spending most nights at your site in the call room while I am lucky if I see the call room in my hospital. I should be paid more per hour

This is not an uncommon scenario.

 

[aneftp]

How would you settle the conflict in a multisite private practice:

Doc X: What we are paid for is time away or potentially time away from our families. It is all the same.

Doc Y: Dude, you are spending most nights at your site in the call room while I am lucky if I see the call room in my hospital. I should be paid more per hour

This is not an uncommon scenario.

You quit the harder job. Everyone is mobile these days. Yes it can be a burden one family’s. But it’s far better to work away and work less and make twice as much away and be home home after making the cash. Because ur presence at home and more time off is actually better and ur spouse will actually appreciate you home for 26 weeks out of a year. Fully at home and not even working.

A few of the professionals locums said it actually saved their marriages to work away from home. Because they were miserable with the daily grind coming home 6pm grumpy. Now they have more time fully attentive to the family at home since their time off is massive. And their overall pay is the same or even more than their daily grind job working 44 weeks a year.

 

[Arch Guillotti]

You quit the harder job. Everyone is mobile these days. Yes it can be a burden one family’s. But it’s far better to work away and work less and make twice as much away and be home home after making the cash. Because ur presence at home and more time off is actually better and ur spouse will actually appreciate you home for 26 weeks out of a year. Fully at home and not even working.

A few of the professionals locums said it actually saved their marriages to work away from home. Because they were miserable with the daily grind coming home 6pm grumpy. Now they have more time fully attentive to the family at home since their time off is massive. And their overall pay is the same or even more than their daily grind job working 44 weeks a year.

Dude. It’s the same “job”.