breaking shifts

[aggiecrew]

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does an ER doc who has completed a residency have enough negotiating leverage to pick the hours they want to work regardless of what the hospital or ER's standard shift times are?

anyone know anything about this?

thanks

 

[Seaglass]

No.

 

[Sessamoid]

No.

Terse, but accurate.

 

[docB]

No.

Verily.

 

[aggiecrew]

what about if you negotiate a decrease in pay rate?

If you must work a full shift or nothing at all, can you choose how many shifts you work?

 

[Sessamoid]

what about if you negotiate a decrease in pay rate?

If you must work a full shift or nothing at all, can you choose how many shifts you work?

I've never heard of anybody negotiating for a lower pay rate, but I suppose you can always try. The problem comes later when you want more money AND the better schedule. Most democratic groups aren't going to be looking for a lower tier provider unless they are looking to hire PAs. The corporate contract management groups probably don't even have procedures in place for non-standard work contracts. Most groups are pretty flexible about how many shifts you want to work.

Scheduling details vary considerably from place to place. What may be common practice in one area, may not be even an option somewhere else. You need to be more specific in your request as far as what schedule problems you have, where you want to work, how far you are willing to commute, etc.

 

[margaritaboy]

Someone that's further along in their career than me will have to field this and verify or debunk what I am saying:

It seems like I've head of some EPs negotiating with groups to work fewer shifts, or a few undesirable shifts, which is then reflected in their
salary.

 

[Sessamoid]

Someone that's further along in their career than me will have to field this and verify or debunk what I am saying:

It seems like I've head of some EPs negotiating with groups to work fewer shifts, or a few undesirable shifts, which is then reflected in their
salary.

Like I said, it depends completely on the particular case. You can find a few cases of practically anything in the world if you look hard enough. At hospitals that are (for whatever reason) difficult to staff, you may be more able to dictate your hours and pay. Just remember that there's probably a reason that that particular hospital is so hard to get staffing for.

It's not hard to find enough work in emergency medicine at this time. Find a good job that you'll really enjoy and get paid a lot for with reasonable hours is another matter. If you want to work in the more saturated areas, that's especially true.

 

[ERMudPhud]

Someone that's further along in their career than me will have to field this and verify or debunk what I am saying:

It seems like I've head of some EPs negotiating with groups to work fewer shifts, or a few undesirable shifts, which is then reflected in their
salary.

Sure, in my group people work as few as 10 or as many as 15-16 shifts per month based pretty much on what they want as long as they cover their share of undesirable shifts. You get paid pretty much based on how much you work. If everybody wants vacation or everybody is looking for extra money it can get difficult but generally the group is big enough and flexible enough to allow for this. However, nobody has the leverage to work only partial shifts or only the easiest most desirable shifts.

 

[Apollyon]

Sure, in my group people work as few as 10 or as many as 15-16 shifts per month based pretty much on what they want as long as they cover their share of undesirable shifts. You get paid pretty much based on how much you work. If everybody wants vacation or everybody is looking for extra money it can get difficult but generally the group is big enough and flexible enough to allow for this. However, nobody has the leverage to work only partial shifts or only the easiest most desirable shifts.

How big is your group - 10 or less, 11-20, 21-30, or mammoth (i.e. >30)? I believe you only cover one huge hospital, right?

 

[docB]

I guess there's a number of folks out there who don't understand how the ER works enough to know why you can't break up shifts. I'm sure that some also hear how "easy" EM is and how the great lifestyle can't be beat. Anyone that works the pit knows that we give up our pound of flesh for the few perks such as flexible schedule and no call.
You can't break shifts in the ED because you are usually coming in to relieve someone. If you didn't show the earlier guy wouldn't have anyone to signout to. Shifts in most groups are designed to provide needed coverage for the busiest periods. If you were to write your own hours the coverage might not be appropriate.
The flexability that EM provides is great but it's certainly not without limits.

 

[jjs]

I do know of at least one situation where it is possible to "break shifts".

At my medical school, one of the big name ED attendings would only work 4 hour shifts. He did this by finding someone else in the group who was willing to work the other half of his normal 8 hour shift. It probably helped that he was/is one of the bigger names in EM, and easily the biggest name in the department in terms of research productivity and national speaking / recognition.

It may be possible to work a situation like this in a private group if you had someone else who also wanted a similar schedule to you and was willing to split shifts (and salary) in order to attain this goal.

 

[docB]

I do know of at least one situation where it is possible to "break shifts".

At my medical school, one of the big name ED attendings would only work 4 hour shifts. He did this by finding someone else in the group who was willing to work the other half of his normal 8 hour shift. It probably helped that he was/is one of the bigger names in EM, and easily the biggest name in the department in terms of research productivity and national speaking / recognition.

It may be possible to work a situation like this in a private group if you had someone else who also wanted a similar schedule to you and was willing to split shifts (and salary) in order to attain this goal.

People in my group occasionally split shifts for personal reasons but this wouldn't fly as a routine. This is also not the same as what I thought the OP was referring to which would be working say 9-7 when the rest of the group works 7-4.

 

[aggiecrew]

my original post was basically asking if one could set up a standard permanent schedule of say, 10 AM- 3PM M-F by taking whatever large pay cut that was required.

I guess the idea would be that you wouldn't need to be relieving anyone of their shift or wait until your reliever comes in because your schedule wouldn't be part of the rotation schedule.

but I guess in the end, if there really is a need for more personel, they will set up a larger rotation system; and if there isn't a need for more personel, then it wouldn't matter how big of pay cut one is willing to take, they still wouldn't hire you.

but these are just guesses and I'm really just trying to get a better grasp of what the forum readers experience would tell them about the possibility of a schedule such as the one above.

thanks

 

[Sessamoid]

my original post was basically asking if one could set up a standard permanent schedule of say, 10 AM- 3PM M-F by taking whatever large pay cut that was required.

but these are just guesses and I'm really just trying to get a better grasp of what the forum readers experience would tell them about the possibility of a schedule such as the one above.

thanks

Theoretically possible. In practice, I doubt anybody's going to agree to letting somebody get off with doing no nights or evenings. And 10-3 is not going to be a common swing shift in busier hospitals. The busy time is generally more like 11-11.

 

[kinetic]

10 AM to 3 PM?? You want to work five hours a day? I better stop talking now, or Sessamoid will go nuts on my ass.

 

[NinerNiner999]

If you are looking to work 5 hours a day, no nights, without call, I would consider dermatology 😀

 

[frog4brooke]

my original post was basically asking if one could set up a standard permanent schedule of say, 10 AM- 3PM M-F by taking whatever large pay cut that was required.

As a newbie in the field, I do not think this would even be possible. The only time I could imagine such a schedule would be maybe in an academic setting and someone who is headed towards retirement. Or Swing shifts (as Sessamoid mentioned)-but I do not think you could get a schedule that was nothing but swings shifts.

From what I understand may groups have a tiered system and as you practice for longer you are higher up the tiers and may be eligible for more of the "desirable" daytime shifts.

As for a 5hr shift, I do not think that happens often. Sign out time is dangerous to the patients and shorter shifts mean more frequent sign out. A little more is at stake then just a comfy schedule.

Are you ready for a field that requires shift work, at least half of which will be at night? You will work half of the weekends and half all major holidays. While on shifts, you will probably not get to use the bathroom, sit or eat (that often).

Just a thought.
F4B

 

[Sessamoid]

While on shifts, you will probably not get to use the bathroom, sit or eat (that often).

Just a thought.
F4B

Come now, let's not exaggerage. Sometimes I get to go to the bathroom. Sometimes, I even have to sit to do it!

 

[frog4brooke]

Come now, let's not exaggerage. Sometimes I get to go to the bathroom. Sometimes, I even have to sit to do it!

I do not think I have even figured out where the bathroom is yet🙂

 

[ERMudPhud]

How big is your group - 10 or less, 11-20, 21-30, or mammoth (i.e. >30)? I believe you only cover one huge hospital, right?

21-30 Soon to be two big hospitals

 

[ERMudPhud]

10 AM to 3 PM?? You want to work five hours a day? I better stop talking now, or Sessamoid will go nuts on my ass.

Go ahead, Somebody who only wants to work 5 hours a day probably deserves it. We had a resident when I was a chief who tried to do that(actually she wanted 4 hour shifts) when she was pregnant because she didn't want to have to take extra maternity leave and thus extend her residency. It was a complete waste of everyones time. She would barely get started and then she would be ready to sign out.