[notalawyer] What does your contract say? [/notalawyer]
BUMP
Looking for new perspectives.
I recently told the NH I won't be serving as a facility physician for them at all, because I have no contract with them.
My employer is not happy about this.
I checked with the lawyer who reviewed my contract twice on this issue, who says that there is stuff in my contract about seeing patients in the clinic and seeing them in the hospital. There is nothing about me being on-call for a local nursing home or taking on the liability of my patient's care in the nursing home after-hours.
The response from our admin is that "well any patient who has you as their PCP, you are expected to be their nursing home doctor" (AKA I have to write all their nursing home orders, I have to assume liability for their medical care in the facility, I have to be on-call for them 24/7 for those patient's needs). They say that is just how things have always been done in the community. That's because the elderly physicians here have given away free labor for decades. I feel no obligation to continue this practice.
To clarify, I work under a hybrid model. I do strictly outpatient primary care and some addiction medicine in a hospital-owned clinic for 3 weeks, then do 1 week of inpatient hospitalist work.
They are expecting me to serve as the NH physician on any patient I discharge from the hospital to the NH as well as any patient who sees me in the outpatient setting as their PCP who gets admitted to the nursing home. Meaning they send me 20 pages of orders to sign and call me anytime of day or night about the patient's care.
I have told the NH and admin I am willing to do this, but I will have to have a new contract with the NH and will need to be compensated for both the extra work and liability. They counter that I can just bill my notes as NH notes.
Also, this NH in question does have a facility physician of record that they pay to put down on paper. The physician in question has no clinical responsibilities because she is essentially retired.
***By the way, our outpatient clinic patients do not have the option of contacting their providers after hours. Their options are to wait for normal business hours or call 911/go to the nearest emergency room. Just writing that so no one thinks its standard for outpatients to have access to us 24/7.
