Bad w2 docs “resigning “ all the time

[aneftp]

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I know it’s good for my locums business. More chaos with w2 turnover. Means more staffing shortage.

But as long as hospitals don’t crack down on bad docs. They just let them resign so they keep reporting they are never fired. So legally they can say the truth they weren’t fired. Being a bad doctor is subject to interpretation. Usually a combination of bad clinical skills plus bad attitudes. Having both is what eventually leads the employer to telling you or forcing you to resign.

Places are so desperate for w2 docs (and w2 crnas). They will keep hiring them and the cycle of life gives these new hires anywhere between 3 months -9 months is the average I know of before the employers just had had enough. And kicks them out.

But they are always offered the opportunity to resign first. Hardly ever fired.

The crazy thing is some of these employers just pay the docs or crnas out their 90-120 days notice period. Plus let them keep their 50-100k sign on.

It may be better than my locums gigs to get forced to resign. Get 120k for 3 months plus keep the 100k sign on bonus.

 

[CubsDynasty]

In this market though it seems to not matter whether you’re a bad doc or CRNA. I know of several who have reputations around the city, they’ve been fired or resigned from every gig they’ve had, but they’re happily signed on because of the staffing shortage. Of course people will say “I’d rather not have anyone at all than some of these people”, but that’s not how administration sees it. You need to keep operational. I’m no longer shocked when I learn that people we’ve let go and told other places not to hire them, just go ahead and hire them anyway. They think it’ll be different, if not at least you have a bandaid for a few months. I’m talking about docs who are incompetent and killing patients, malicious CRNAs fraudulently billing practices, it doesn’t matter. It’s like we all just work at the VA nowadays.

 

[Maverikk]

Some hospitals I’ve seen turning the tide, a few but it’s a good indicator. My friend who I worked locums with at a place worked at a decent PP gig when things were good, worked hard. Lost a lot of contracts, now they only have their mothership hospital. The group leadership apparently was on the verge of giving up the contract, told them to go talk to other hospitals on the west coast who put out rfps. Now they’re 300/hr W2, 350 after 50 hours, all hours including call from home included. He said their president was getting ulcers from all the stress of losing contracts, constant juggling of billing and just laid down the hammer. Their group was smaller so had less group politics dynamics of people figuring out how to skim with non clinical work, he said his group breathed a big sigh of relief and people actually like their work now. Not many PP groups with a cadre of people who’ve figured out how to skim well will lay down the hammer to benefit all

Also what’s the difference between resigning vs firing?

 

[Gern Blansten]

Are you saying they resign (extend their contract) or that they resign (quit)?
Rhetorical question.

 

[aneftp]

Are you saying they resign (extend their contract) or that they resign (quit)?
Rhetorical question.

These are force resignations due to poor performance/behavior. Or else the alternative would be to get fired. But hospitals/practice give them the chance to resign on their own

So they can go to another place.

 

[Gern Blansten]

Just pointing out that resign and re-sign are essentially the same words but with opposite meanings. Contronyms.
Other examples include buckle or dust.
Dust can mean to pick up dust, but in baking it can mean to sprinkle a fine powder.
Buckle can mean to fasten together or it can mean to collapse under pressure.

 

[amyl]

I have seen this with a few clinically terrible or ethically questionable crnas - just shuffle them elsewhere or resign or go prn and only use them when necessary. Quality matters little - operational ORs seems to matter more. The original principles of medicine seem to have fallen to the pursuit of $.

 

[TheLoneWolf]

At our worst point in terms of staffing, we had to let go of 2-4 anesthesiologists within the first week.

Hanging out in break room and not working, patients waking up midcase, wrong side blocks, refusing to see patients and directing staff to bring them straight to the OR for induction and their first face to face chat.

Weird thing was each was publicly named and shamed prior to firing.

The only 2 crnas we let go, 1 was ultra hush hush and removed from the OR during a case start. Other was a locum CRNA shouting at the anesthesiologist and refusing to preoxygenate the aware and quite sick patient with sats in the 70s. Quietly told to not come back but everyone outside of the situation was kept in the dark. It had to literally take other OR nurses and admin involvement to have these people removed, the anesthesia department just shrugged it off.

I don't like that dichotomy. Our physicians are open to replacement but not incompetent, or dangerous CRNAs.

 

[ryanjmy]

These are force resignations due to poor performance/behavior. Or else the alternative would be to get fired. But hospitals/practice give them the chance to resign on their own

So they can go to another place.

Nobody wants to go through an ugly divorce. You fire someone they sue then it’s a he said she said situation. Nobody has time or money for that.

 

[dannyboy1]

Nobody wants to go through an ugly divorce. You fire someone they sue then it’s a he said she said situation. Nobody has time or money for that.

This. A quick resignation is in the best interest of both the clinician AND the practice. That’s why it happens. However, every licensing/credentialing questionnaire always asks “have you resigned to avoid termination”? I assume that all involved parties lie on that question. After all, it’s almost impossible to catch…

 

[NicholasPavona]

Just pointing out that resign and re-sign are essentially the same words but with opposite meanings. Contronyms.
Other examples include buckle or dust.
Dust can mean to pick up dust, but in baking it can mean to sprinkle a fine powder.
Buckle can mean to fasten together or it can mean to collapse under pressure.

Contronyms. Interesting. Learn something new everyday...

 

[Iso4ane]

How can I be a bad locums guy so I can get a sign on bonus and 3-4months of ‘paid’ leave?

 

[aneftp]

How can I be a bad locums guy so I can get a sign on bonus and 3-4months of ‘paid’ leave?

You gotta be w2. W2 have more rights than pure locums docs.

 

[Coffee PRN]

How can I be a bad locums guy so I can get a sign on bonus and 3-4months of ‘paid’ leave?

Sleep around with the nurses

 

[Gern Blansten]

Contronyms. Interesting. Learn something new everyday...

More examples:
to sanction

Definition 1: to permit or grant approval.

Example 1: In some countries, the government sanctions the ownership of guns by private citizens.

Definition 2: to condemn or penalize.

Example 2: In some states, the government imposes sanctions on the ownership of guns by private citizens.

to screen

Definition 1: to protect or conceal.

Example 1: Because he did not have a hat or umbrella, he used a newspaper to screen his face from the sun.

Definition 2: to show or broadcast (a movie or TV show).

Example 2: The local movie theater will screen the new horror movie tonight.

 

[NicholasPavona]

More examples:
to sanction

Definition 1: to permit or grant approval.

Example 1: In some countries, the government sanctions the ownership of guns by private citizens.

Definition 2: to condemn or penalize.

Example 2: In some states, the government imposes sanctions on the ownership of guns by private citizens.

to screen

Definition 1: to protect or conceal.

Example 1: Because he did not have a hat or umbrella, he used a newspaper to screen his face from the sun.

Definition 2: to show or broadcast (a movie or TV show).

Example 2: The local movie theater will screen the new horror movie tonight.

Thanks!

 

[Status Sciaticus]

isnt it a pain in the butt though to have to declare the reisgnation?
Every credentialing application I have done has questions about voluntary resignations, which would just invite further scrutiny.

 

[sloh]

Just pointing out that resign and re-sign are essentially the same words but with opposite meanings. Contronyms.
Other examples include buckle or dust.
Dust can mean to pick up dust, but in baking it can mean to sprinkle a fine powder.
Buckle can mean to fasten together or it can mean to collapse under pressure.

Also “peruse.” “Peruse” has been in use since the 1500s. “Peruse” originally meant "to read thoroughly," but by extension it also came to mean “to read” and then “to glance over, skim.” For this reason, if you use “peruse,” take care to make clear your intended meaning by the context.

 

[AKMD_1984]

All this work history etc talk is interesting. Yes it’s important but if you are experienced, it’s less of a concern.

I also find locums companies to be very intrusive.

In any case it’s best to keep a low profile.

If there is a dispute, I do not see any issues with outlining exactly what happened. Credentialing committees understand that the longer you’re in practice, the higher the chance of conflict and “things not working out”. Throw in greedy AMCs and you’re asking for lack of loyalty and frequent turnover.

These days, for ER and anesthesia - I think 2 years employment is ok. I don’t think that’s “too short” at all.

A lot of AMCs do not give raises or keep up with market rate pay and inflation. Many refuse to include inflation adjusted pay raises on initial contracts.

So in that case, you resign. You say termination without cause. That’s it.

I met my accountant last month and he was telling me that he hasn’t updated his resume in 14 years. He hasn’t needed to. He has a waitlist of 5 months (he really is that good and does book keeping etc and links your accounts/ cc/ etc). He goes my work and reputation plus word of mouth referrals is plenty. He was telling me when you’re working for yourself, there is no oversight and micro mgt but obviously more responsibility. As an employee there is overall less responsibility (no one can truly blame an employee for failures of a company - they blame leadership), but there is more day to day oversight.

This is why, locums or no locums, it’s best to work for yourself.