Got an offer for Eating Recovery Center. Total comp is 300K (260K base plus 40K in easy bonuses), full benefits. Holding a panel of 18-20 patients with residential plus PHP. Only child. Only eating disorders. Patients seen 3x per week residential, plus 1-2x per week PHP. I have a primary therapist and nurse under me that work on patients. Weekend call is phone only. Phone only for the week as well for my patients (I believe it's every week), but I've been assured that you're rarely called. Anyone have any experience on them? They're a huge company with a number of locations. Pediatrician on site, as well.
Anyone have experience working for ERC?
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I don’t have experience with them but that doesn’t sound bad. Assume half PHP and half residential that’s 40-50 patient contacts a week. So 8-10 a day? Pretty laid back. And residential notes are gonna be pretty easy since they’re there for a while.
I’m surprised they’re having you see them 3x a week in an eating d/o residential honestly since 1) there’s not a ton pharmacology wise you’re gonna do for the primary eating d/o (obviously for comorbid conditions but let’s be honest the eating disorder is likely primary if they’re in a residential for eating d/o) and 2) you’re probably not gonna change meds more than once a week anyway (it’s not like a lot of them are likely to be on stimulants….I hope). Unless they’re planning on you doing therapy with them as well?
I’m surprised they’re having you see them 3x a week in an eating d/o residential honestly since 1) there’s not a ton pharmacology wise you’re gonna do for the primary eating d/o (obviously for comorbid conditions but let’s be honest the eating disorder is likely primary if they’re in a residential for eating d/o) and 2) you’re probably not gonna change meds more than once a week anyway (it’s not like a lot of them are likely to be on stimulants….I hope). Unless they’re planning on you doing therapy with them as well?
Well, there are admissions, family meetings, staff meetings. My main concern is constantly dealing with such a high risk population with a very high comorbid personality disorder chance, having to deal with families and patients that want to leave early, etc.
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It does not seem bad except the 3x per week follow up requirement. That is excessive for most residential cases. You are correct that residential treatment comes with a lot of extra work and hassle. If the team manages most of it this could be a good job, if not it could be quite busy.
Also what is the length of stay in residential? Shorter stays mean more intakes, discharges and acuity for the same number of beds.
Also what is the length of stay in residential? Shorter stays mean more intakes, discharges and acuity for the same number of beds.
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well yeah I mean it’s an eating disorder population. Gonna be the more severe end of an eating disorder population in a residential program too. This is one of the more difficult patient populations to work with. So unless you’re interested in/really into treating eating disorders you’re probably not gonna have a good time.
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Those things, and a whole lot more, are par for the course with respect to a child eating disordered population. All day, everyday.
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We refer to ERC often and it seems like a pretty good place to get treatment. Why are you seeing patients 3x per week in residential? If I recall correctly, ERC is mainly based on ACT, CRT, and DBT which is what the therapists are doing with the patients. Otherwise, they're there to normalize their eating patterns through the meals, not by seeing the psychiatrist.
If you're seeing 18-20 patients 3x per week, that's 54-60 times a week you're seeing patients which I'm not even sure include your PHP patients, coming out to 27-30 hours a week @ 30 minutes per patient, which is a really liberal estimate as many patients may need 1 hour or more for admissions, if they have lots of comorbidities, and complicated family structures that you have to navigate. Is that 3x per week including family meetings? If not, then that many patients and the frequency per week sounds unsustainable. I also don't believe that phone calls are that rare. It sounds like a lot of work to me for that level of pay. Cut the number of patients in half and it sounds much more manageable if you want to work in this space.
If you're seeing 18-20 patients 3x per week, that's 54-60 times a week you're seeing patients which I'm not even sure include your PHP patients, coming out to 27-30 hours a week @ 30 minutes per patient, which is a really liberal estimate as many patients may need 1 hour or more for admissions, if they have lots of comorbidities, and complicated family structures that you have to navigate. Is that 3x per week including family meetings? If not, then that many patients and the frequency per week sounds unsustainable. I also don't believe that phone calls are that rare. It sounds like a lot of work to me for that level of pay. Cut the number of patients in half and it sounds much more manageable if you want to work in this space.
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Pros: the people there are pretty dedicated and describe the workload as reasonable
Cons: the pay will never be great and they are known to string MD’s along
Cons: the pay will never be great and they are known to string MD’s along
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String them along how? They have nps prescribing right now.
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I think it's more what type of work you want to do. Taking ED primary for all patients at RTC and PHP LoC is an ultra-specialized practice. If this is something you want to do, it seems like a pretty reasonable place to work. If you do not want to spend your time specializing in ED, I would definitely not take this job straight out of training or while you are early in your career as this will not be a remotely representative sample of CAP. Separately, always being on for phone call can be a bit annoying, would want to make sure there are strong boundaries on the use.
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ERC posted a PT job online. I sent my resume and later had a phone interview with one of the physician directors. I was told that I would hear back. After some time, I reached out again. They hadn’t hired anyone. I was then invited to dinner with the physician director and the current psychiatrist. I learned that the current psychiatrist for this city’s location (not residential) hadn’t been able to take any vacation for over 1 year as they didn’t have a replacement. The psychiatrist was pushing for a PT replacement to take vacations. I said I would be interested in discussing further. The physician director then told me that I should spend a few days shadowing the current psychiatrist before they make a decision.
The current psychiatrist had been told for awhile that they were working on getting someone. Despite trying to get to a point about discussing a contract, I was told to do some free shadowing to get there. Pass
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Thank you labor laws that allow someone to be able to be limited in the pursuit of gainful employment that helps the health of the population and puts food on the table for their family throughout the entire country. If only I, as a human being, could have rights that even resembled a corporation...
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I mean I highly doubt that would actually be enforceable or held up if it came down to it but it’s a pain to fight it if they come after you.
One could also just ask to have the noncompete removed or limited. Nobody is forcing anyone else to sign a contract.
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Would you say the same thing about a contract that allows you to give up your bodily rights (just because Squid Games is so topical, there are plenty of other examples)? Just because nobody is forcing you to sign a contract does not mean that we should allow any such preposterous language to exist. Why does the doctor just trying to work have to fight lawyers/lawsuits, it takes the corporation 5 seconds to greatly restrict your rights.
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lol I mean this is a classic argument about the EULAs that people sign every day there's a new update for their phone or whatever without reading. Ever seen the human centipad southpark? Companies can put whatever crap they want in a contract, it doesn't mean it's reasonable, enforcable or would hold up when it goes to court. You're welcome to go to a company with a contract that says you get all the executives' first born children to play on your fantasy little league baseball team and a pot of gold buried at the end of the contract....doesn't mean it'd hold up.
Similarly, anybody can sue anyone else for pretty much anything in the united states. Or companies try to have you sign liability waivers all the time that excuses them from any accident or misadventure that occurs while you're performing an activity on their watch/premises...but it's actually impossible to sign away liability for gross negligence. Doesn't mean they won't try. Just because you can do something doesn't mean it holds up legally.
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^^This can be problematic.
I'd also make sure there actually is a pediatrician for medical management. I have done inpatient ED and many of the patients discharged are still medically fragile and no where near the mindset to abandon their eating disordered behaviors. The ERC in my area is ok but not affiliated with an inpatient unit which I have heard can make things difficult when your patients inevitably relapse and require a higher level of care.
