Calling out sick culture!

Started by HoosierdaddyO
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If you're a W2/1099, call out for whatever you want. Let the system cope. I have zero issue with this. This is no longer a profession or a calling - it is a job.

If you're a partner, there's a higher threshold. You can attempt to arrange your own switch, sure. But I'm not doing this as I'm worshipping the porcelein god or dealing with my sick kid or whatever other issue has forced me to call out. I pay a management company to handle this.
 
Bittersteel said:
If you're a W2/1099, call out for whatever you want. Let the system cope. I have zero issue with this. This is no longer a profession or a calling - it is a job.

If you're a partner, there's a higher threshold. You can attempt to arrange your own switch, sure. But I'm not doing this as I'm worshipping the porcelein god or dealing with my sick kid or whatever other issue has forced me to call out. I pay a management company to handle this.
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You're right. It's a job. And part of that job is finding coverage if you can't do your job.
 
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Bittersteel said:
Nope.

Do the nurses do that? Does the CT tech? Does the CEO?

As an employee there's no world in which this is your problem. As a partner, I pay a management company to handle it.
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A partner in an SDG? That may even be worse. You also just listed roles that the hospital can do without in the short term. An ED physician isn't one of them. Whenever I see posts about how we're underpaid, not respected, the specialty is awful, etc. I always come back to these threads and see how little most people value themselves and then those posts start making more sense.
 
Bittersteel said:
Nope.

Do the nurses do that? Does the CT tech? Does the CEO?

As an employee there's no world in which this is your problem. As a partner, I pay a management company to handle it.
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We have an actual paid backup system and a group chat specifically for this reason. It's surprisingly easy and works. We pay ourselves some for the inconvenience of the occasional call day. Probably doesn't work if there are only 4-6 docs covering one small facility.
 
TooMuchResearch said:
We have an actual paid backup system and a group chat specifically for this reason. It's surprisingly easy and works. We pay ourselves some for the inconvenience of the occasional call day. Probably doesn't work if there are only 4-6 docs covering one small facility.
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I support paid backup.

Should be paid the toral shift rate for being on backup, and then double if called in.
 
JacobMcCandles said:
A partner in an SDG? That may even be worse. You also just listed roles that the hospital can do without in the short term. An ED physician isn't one of them. Whenever I see posts about how we're underpaid, not respected, the specialty is awful, etc. I always come back to these threads and see how little most people value themselves and then those posts start making more sense.
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Wrong again.

The mindset you see here from some is a reaction to being shyt on and undervalued by the hospital, not the other way around.
 
Birdstrike said:
Nurse doesn't show up, "Fine, it's her right, PTO."

CEO doesn't show up. "No biggie."

Doc doesn't show up. "OMG END OF THE WRLD THIS CAN NEVER HAPPEN #@)#*%)#@"DFSI!!!"
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Exactly.

Now I’m a rheumatologist, so if I call out it’s slightly different vs the ED - a cancelled day of pts. But still.

I never took a sick day all through residency and fellowship. I showed up coughing my brains out with fevers. I went in with bad stomach bugs, popping Imodium and holding diarrhea to the point of nearly ****ting my pants while dropping a central line in the ICU. (It was a call shift, and I was so volume depleted that I nearly fainted the next morning presenting patients.)

As an attending, there’s no world where I’m going to do things like that anymore. I deal with immunocompromised pts all day long, and I’m not going to get them sick myself. I’m sick? I’m calling in. My spouse dies? I’m sure as hell not going into work, and I would not feel even a nanosecond of guilt.
 
dozitgetchahi said:
Exactly.

Now I’m a rheumatologist, so if I call out it’s slightly different vs the ED - a cancelled day of pts. But still.

I never took a sick day all through residency and fellowship. I showed up coughing my brains out with fevers. I went in with bad stomach bugs, popping Imodium and holding diarrhea to the point of nearly ****ting my pants while dropping a central line in the ICU. (It was a call shift, and I was so volume depleted that I nearly fainted the next morning presenting patients.)

As an attending, there’s no world where I’m going to do things like that anymore. I deal with immunocompromised pts all day long, and I’m not going to get them sick myself. I’m sick? I’m calling in. My spouse dies? I’m sure as hell not going into work, and I would not feel even a nanosecond of guilt.
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Why didnt you arrange someone to cover your shift from your wife's wake? You knew the funeral was tomorrow you had a while 24 hours to coordinate it.
 
Bittersteel said:
Why didnt you arrange someone to cover your shift from your wife's wake? You knew the funeral was tomorrow you had a while 24 hours to coordinate it.
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I think the problem in this thread is that most people hear "sick day" and they think: "Oh, he's got a man-cold. He can gut it out."

Sometimes, you're not physically capable of performing the material and substantial duties of your profession.
I used a lot of "sick-days" in my first year of residency for GI upset, without getting too explicit. Immodium, milkshakes, all that. I "showed up and gutted it out".
Finally, it came to a point. Attending grabbed me and said: "You look pale."
I told my attendings: "There's more than meets the eye here."
Colonoscopy later; ulcerative colitis with a hemoglobin that raised some eyebrows.

Sometimes, you can't "do the job" because you, yourself, are a human.
Listen, people:
I'm all for the nobility of the profession, and the valor of doing the right thing, but you know what?
You're flesh and blood, too.

If you're febrile with shaking rigors, you can't do your job.
If you're pissing your pants with a kidney stone, you can't do your job.
If every time you speak, you cough for :15 seconds and see stars, you can't do you job.

I get it that we're generally fit and sturdy individuals here. ER self-selects for that.
But we get sick, too.
 
dozitgetchahi said:
Exactly.

Now I’m a rheumatologist, so if I call out it’s slightly different vs the ED - a cancelled day of pts. But still.
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In 26 years, I've missed only 1 day of work. That includes residency, 8 years in EM, 1 year fellowship, and the last 14 years in Pain. The only reason I missed is because I had laryngitis so bad I couldn't talk. It was when I was in EM and it was very difficult to get the shift covered. I had to beg two people to each do half the shift. I felt fine, no fever, cough or anything bad. Just couldn't talk to patients. All other days I have been sick, which is many in 26 years, I worked.

Like you, it's easy for me to call out sick now if I want to, unlike the ER. I just send an email or text and they cancel/reschedule my appointments. But I don't. It's because I have a work ethic.
 
It’s almost like there may be a reasonable bell curve from “my gerd is acting up” to “I’m intubated on pressors unexpectedly” and somewhere along that curve, there is a point where it is reasonable and professional to seek coverage, and another point where it is human and fair for your partners/boss to find coverage for you.
 
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HoosierdaddyO said:
I don’t disagree for the most part. I think unless you are truly sick or unable to perform… however, ultimately this sounds like an admin issue and staffing issues then a me issue. And this is coming from someone who maybe has called out 3 times in the last 10 years.

Also, this moral injury component that physicians must be available for their patients, and it’s weak to call out sick… while yes I agree, but also the staffing and the business model shouldn’t rely on me, that should be on the administrators. So I get what you’re saying but at the same time I’m an employee. I don’t run the business.
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There's no sense in applying a private practice mindset to a world where we're all W2 or 1099 employees and others are harvesting much of the fruits of our labor.
 
Birdstrike said:
In 26 years, I've missed only 1 day of work. That includes residency, 8 years in EM, 1 year fellowship, and the last 14 years in Pain. The only reason I missed is because I had laryngitis so bad I couldn't talk. It was when I was in EM and it was very difficult to get the shift covered. I had to beg two people to each do half the shift. I felt fine, no fever, cough or anything bad. Just couldn't talk to patients. All other days I have been sick, which is many in 26 years, I worked.

Like you, it's easy for me to call out sick now if I want to, unlike the ER. I just send an email or text and they cancel/reschedule my appointments. But I don't. It's because I have a work ethic.
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Haha, you're weak! I had laryngitis during residency, and we had a trauma coming in. I told Larry, the nurse who was scribing, that I didn't have a voice and he would have to listen. I ran the trauma, calling out the exam, and, when I was done, I went over to Larry, and he said, "I didn't get any of that". Now, Larry was much of a horse's ass to residents, but I had faith that he would try. Oh well. Scorpions are their nature.
 
Birdstrike said:
In 26 years, I've missed only 1 day of work. That includes residency, 8 years in EM, 1 year fellowship, and the last 14 years in Pain. The only reason I missed is because I had laryngitis so bad I couldn't talk. It was when I was in EM and it was very difficult to get the shift covered. I had to beg two people to each do half the shift. I felt fine, no fever, cough or anything bad. Just couldn't talk to patients. All other days I have been sick, which is many in 26 years, I worked.

Like you, it's easy for me to call out sick now if I want to, unlike the ER. I just send an email or text and they cancel/reschedule my appointments. But I don't. It's because I have a work ethic.
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Oh don’t get me wrong: I still work plenty of days when I’m sick or otherwise don’t feel that great. I have only called out a handful of times in the past few years - mostly because I don’t want to delay patient care, and because I don’t want my schedule overloaded after that point. I intend on working.

But I’m also frankly way past the point of bragging about how few days I’m taking off or whatever. I don’t care. It’s a job, and if I get ill or **** is hitting the fan at home for whatever reason, I’m calling out and I will not feel even a trace of guilt over that. Residency and fellowship were godawful for a number of reasons - one of the biggest being this attitude that everyone should just show up no matter how ill or miserable they’re feeling.

No.

This is just a job after all. And I’m in a PP where as long as you’re covering overhead, basically nobody cares how many days off you take. I have colleagues who seem to really abuse the privilege. So I don’t even remotely give a **** if I take off sick a handful of days in a year.
 
JacobMcCandles said:
I’m still surprised at the number of people who don’t understand how important their job is. I guess it makes sense on why so many work for CMGs because they’re convinced they’re not important. You can’t work from home. If you don’t show up then somebody has to. There’s no other option. This isn’t Applebee’s or even some white collar office job.
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You don’t have to tell me twice. I showed up to work while my dad was in his final days on hospice, and he died while I was working. Because it was the holidays, and it was my shift to work. Getting that phone call mid shift sucked. I am forever grateful for the coworker who dropped everything on his day off and insisted I leave.
 
Birdstrike said:
In 26 years, I've missed only 1 day of work. That includes residency, 8 years in EM, 1 year fellowship, and the last 14 years in Pain. The only reason I missed is because I had laryngitis so bad I couldn't talk. It was when I was in EM and it was very difficult to get the shift covered. I had to beg two people to each do half the shift. I felt fine, no fever, cough or anything bad. Just couldn't talk to patients. All other days I have been sick, which is many in 26 years, I worked.

Like you, it's easy for me to call out sick now if I want to, unlike the ER. I just send an email or text and they cancel/reschedule my appointments. But I don't. It's because I have a work ethic.
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Oh man fellas look at this work ethic haver over here!
 
Pinner Doc said:
You don’t have to tell me twice. I showed up to work while my dad was in his final days on hospice, and he died while I was working. Because it was the holidays, and it was my shift to work. Getting that phone call mid shift sucked. I am forever grateful for the coworker who dropped everything on his day off and insisted I leave.
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I mean that's just....dumb?...toxic?
 
hebel said:
What is this "professional" standard you are referring to? Airline pilots call out sick, CEOs can take sick days, members of Congress can take sick days, Four Star Generals can take sick days, I could go on...the issue isn't that we're professionals, it's that at a systems level we are "essential." COVID showed us what being an "essential" worker actually means to the powers that be. Many are saying it doesn't have to be that way if we put better systems in place, which I agree with in most circumstances.
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You cant compare our jobs to any of the above. Perhaps I view it more akin to a four star general about to lead a major battle. They have redundancy. We dont. It is funny how people get spun up about this. Literally today one of my colleagues had to not work for personal reasons which i of course wont detail here. The answer wasnt “too bad so sad”, the answer was you do you and everyone stepped up around this person and everything was ok. Should you go to work with a temp of 106. Then again, some people on this thread I read as calling out like the nurses do. I had a parent die, a spouse get injured in an MVA etc. I didn’t still go to work, instead my partners said (just like today), you take care of your business and dont worry about work. That being said calling out of a shift has to come with good reason. UGJ use good judgement. Simply put is your reason to call off something others would think is reasonable.

What’s clear to me is the difference we all see in our job. Again, if i worked for a CMG or hospital i might feel the same. However, I am a business owner my business needs me and expects me. I think my groups system is great. Enough pain to call off that you would be reasonable but also if you have a good reason it is stress free.
 
Bittersteel said:
If you're a W2/1099, call out for whatever you want. Let the system cope. I have zero issue with this. This is no longer a profession or a calling - it is a job.

If you're a partner, there's a higher threshold. You can attempt to arrange your own switch, sure. But I'm not doing this as I'm worshipping the porcelein god or dealing with my sick kid or whatever other issue has forced me to call out. I pay a management company to handle this.
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How are you a partner and paying a management company to handle this. Doesn’t seem like a partnership then.. maybe im missing some nuance in this detail.
 
EctopicFetus said:
How are you a partner and paying a management company to handle this. Doesn’t seem like a partnership then.. maybe im missing some nuance in this detail.
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?

The partnership pays a management company that does our scheduling and manages our staffing holes when they come up.
 
EctopicFetus said:
You cant compare our jobs to any of the above. Perhaps I view it more akin to a four star general about to lead a major battle. They have redundancy. We dont. It is funny how people get spun up about this. Literally today one of my colleagues had to not work for personal reasons which i of course wont detail here. The answer wasnt “too bad so sad”, the answer was you do you and everyone stepped up around this person and everything was ok. Should you go to work with a temp of 106. Then again, some people on this thread I read as calling out like the nurses do. I had a parent die, a spouse get injured in an MVA etc. I didn’t still go to work, instead my partners said (just like today), you take care of your business and dont worry about work. That being said calling out of a shift has to come with good reason. UGJ use good judgement. Simply put is your reason to call off something others would think is reasonable.

What’s clear to me is the difference we all see in our job. Again, if i worked for a CMG or hospital i might feel the same. However, I am a business owner my business needs me and expects me. I think my groups system is great. Enough pain to call off that you would be reasonable but also if you have a good reason it is stress free.
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That's why I said above:

Employed - call out like a nurse

Partner - much higher threshold
 
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Birdstrike said:
Lol. Fair enough. Perhaps my “work ethic” wouldn’t be so strong if I got paid time off. I don’t work, I don’t get paid. Incentives matter.
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Yep. my old group had a vacation schedule. It was one of the stupidest things and convinced me of a few things. 1) plenty of EM docs have little to understanding of basic math. 2) Much like USACS idiotic tagline of "ownership" that matters more to EM docs than substance.

For background we were paid hourly, everyone took vacation to help balance our schedule because some of our coverage was more seasonal. If I averaged 20 hours a week my vacation would be time off and I would still get "paid" those 20 hours. We had 2 weeks of vacation a year. I simply said the pot of money we are getting paid is the same and this isnt real paid vacation since we are partners in a group and our income is only based on revenue in. Its not like we work for some corporation and its a benefit.

Maybe it is semantics but its stupid in my opinion. New job, I have never not gotten time off I wanted which includes a few 3 week vacations, I get paid on RVUs. I geenrate them i get paid, I dont i wont get paid. As Bird mentioned.. incentives matter. I dont mind the incentive to work.
 
Bittersteel said:
Our practice management company reaches out to partners / employees and coordinates switches and coverage.
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What’s the name of this practice management entity? Who at this entity is doing the work? It doesn’t seem to vibe with typical SDG setups. Hence my guess of this being vituity ( less likely) or USACS (more likely).

A small SDG would get eaten alive with this expense. The typical cost for PM is very high cause profit. Hence smart groups do it themselves.
 
EctopicFetus said:
What’s the name of this practice management entity? Who at this entity is doing the work? It doesn’t seem to vibe with typical SDG setups. Hence my guess of this being vituity ( less likely) or USACS (more likely).

A small SDG would get eaten alive with this expense. The typical cost for PM is very high cause profit. Hence smart groups do it themselves.
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Lol definitely not vituity or usacs.

Lol "smart groups." We do extremely well. As I alluded to earlier, well enough that we don't have to pay our pre-partners below market rates.
 
JacobMcCandles said:
Because it seems inefficient and unnecessary. Do they facilitate individual trades for this? What guidelines do they have in place if nobody takes the shift? I can’t imagine not engaging my partners directly and instead engaging a third party for something like this.
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I will engage your partners directly for a low low price of a percentage of your earnings! 🙂
 
JacobMcCandles said:
Because it seems inefficient and unnecessary. Do they facilitate individual trades for this? What guidelines do they have in place if nobody takes the shift? I can’t imagine not engaging my partners directly and instead engaging a third party for something like this.
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Seems so vague and lack of detail that it seems false. If you have a PM company name them. it doesnt somehow give away who you are. We use R1 for practice management or we use Praxi for practice management. but the fact it makes no sense to anyone else on this board says plenty. Something is amiss. A group text or email is plenty easy in my group to get help. No need to do the ineffecient piece of spending time to engage a 3rd party so that the 3rd party can do that for me.
 
EctopicFetus said:
Seems so vague and lack of detail that it seems false. If you have a PM company name them. it doesnt somehow give away who you are. We use R1 for practice management or we use Praxi for practice management. but the fact it makes no sense to anyone else on this board says plenty. Something is amiss. A group text or email is plenty easy in my group to get help. No need to do the ineffecient piece of spending time to engage a 3rd party so that the 3rd party can do that for me.
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Ofc we communicate between partners. But our management company helps with more complicated stuff. Our process is highly efficient and we make enough money that this expense is a drop in the bucket. I don't need to name anyone. Dont really care if you believe me or not.
 
EctopicFetus said:
Seems so vague and lack of detail that it seems false. If you have a PM company name them. it doesnt somehow give away who you are. We use R1 for practice management or we use Praxi for practice management. but the fact it makes no sense to anyone else on this board says plenty. Something is amiss. A group text or email is plenty easy in my group to get help. No need to do the ineffecient piece of spending time to engage a 3rd party so that the 3rd party can do that for me.
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“Our management company reaches out to partners/employees to coordinate coverage/switches.”

“Ofc we communicate between partners.”

“We make enough money so we don’t care if we spend money for unnecessary expenses.”

None of his comments make sense or align. No serious group, no matter how successful, would be ok with spending unnecessary money. Something’s amiss but we know that.
 
Bittersteel said:
Ofc we communicate between partners. But our management company helps with more complicated stuff. Our process is highly efficient and we make enough money that this expense is a drop in the bucket. I don't need to name anyone. Dont really care if you believe me or not.
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I don’t think anyone is questioning if it’s real, it’s just strange. My small SDG hired in-house practice management. I can easily imagine outsourcing practice management. That part makes total sense.

What’s strange is letting practice management deal with filling holes/call outs/swaps in the schedule. Where are they finding the coverage? Are they outsourcing that? Are they going internal (and partners are being TOLD they have to fill in? That would be a non-starter in my group).

I think people are just trying to figure out how that works as it wouldn’t be tolerated in many groups.
 
skougess said:
I don’t think anyone is questioning if it’s real, it’s just strange. My small SDG hired in-house practice management. I can easily imagine outsourcing practice management. That part makes total sense.

What’s strange is letting practice management deal with filling holes/call outs/swaps in the schedule. Where are they finding the coverage? Are they outsourcing that? Are they going internal (and partners are being TOLD they have to fill in? That would be a non-starter in my group).

I think people are just trying to figure out how that works as it wouldn’t be tolerated in many groups.
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Im not sure what's so unbelievable here. Maybe in not explainjng it correctly. We use a practice management firm to do all sorts of functions for us. One of the things is helping w scheduling. One of the sub-functions is helping with last minute holes and other scheduling annoyances. We fill it all with our own docs. Sometimes the solutions involve complex 5 way trades.
 
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JacobMcCandles said:
A partner in an SDG? That may even be worse. You also just listed roles that the hospital can do without in the short term. An ED physician isn't one of them. Whenever I see posts about how we're underpaid, not respected, the specialty is awful, etc. I always come back to these threads and see how little most people value themselves and then those posts start making more sense.
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That's irrelevant if we are so damn important the salary would reflect that. Specialists can just not be on call and make far more but a SDG in Oregon that everyone rallied on pays 160 an hour.

Urology friend makes 6k per 24 hour call he is locums and it home call some days he doesnt do anything
 
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Brigade4Radiant said:
That's irrelevant if we are so damn important the salary would reflect that. Specialists can just not be on call and make far more but a SDG in Oregon that everyone rallied on pays 160 an hour.

Urology friend makes 6k per 24 hour call he is locums and it home call some days he doesnt do anything
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You’re comparing different situations. The first with an SDG and the lower hourly rate is the physician buying into a business. It doesn’t matter how it’s structured but it’s rare for someone to get ownership of a business for free no matter the industry. The urologist friend situation is a free market situation. Specialty locums is typically short-lived at a single facility and the hospital feels like they need a urologist so the market is what the hospital and urologist agree on. You could probably find some sleepy locums facilities that are willing to lay handsomely but you’d have to be in house.
 
Bittersteel said:
Ofc we communicate between partners. But our management company helps with more complicated stuff. Our process is highly efficient and we make enough money that this expense is a drop in the bucket. I don't need to name anyone. Dont really care if you believe me or not.
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Understand, those of us in SDGs want to find ways to make it better for ourselves. If you solved some problem there is literally no downside to you to say so. If you do it "in-house" then just say so. I think the question here is your comments dont align, dont make sense with the experience of others on here. Most groups spend 3-7% of their revenue on admin excluding med mal and billing and coding. Every dollar saved is money in the partners pocket. I guess i dont understand what "complicated stuff" your management company could help you with.

My group is very efficient, we earn well, we have thought thru pretty much how we do everything in the last few years. If you have some great way for my group or others to make it better seems like no downside to share. If someone asked me a question about management I would share. I may not say hey we collect $x per patient and our subsidy is $y. I get that.. but Saying we use Praxi for PM or Logix health, Brault, Cosensio, Zotec etc for RCM isnt exactly giving away any important info.
 
Interesting reading ask the opinions in here.

Ethically I think you should be able to call off. Are you thinking you’re best when you’re sick? No

Are you risking getting your chronically ill patients sick? Yes

Logistically I see the issue - do you have a call system which sucks… do you pay a bonus which then comes out of everyone’s pay… etc

To the people who think we owe it to the hospital/our partners… to some extent, sure. I signed a contract to do my shifts and I’m not going to screw my colleagues day off over a stuffy nose. At the same time how is that fair to my wife who is sick at home vomiting herself having to take care of sick kids? Is it more important to protect a co-workers day off than to care for my own family?

How is it fair I did watch my dad arrest and do CPR on him then have to text people in the ambulance to the hospital to find coverage?

To the person who said we are treated unprofessionally because we want sick days… what? The hospital doesn’t care if I’m tough and work sick or not. They just want a warm body in the ED.
 
HLxDrummer said:
Interesting reading ask the opinions in here.

Ethically I think you should be able to call off. Are you thinking you’re best when you’re sick? No

Are you risking getting your chronically ill patients sick? Yes

Logistically I see the issue - do you have a call system which sucks… do you pay a bonus which then comes out of everyone’s pay… etc

To the people who think we owe it to the hospital/our partners… to some extent, sure. I signed a contract to do my shifts and I’m not going to screw my colleagues day off over a stuffy nose. At the same time how is that fair to my wife who is sick at home vomiting herself having to take care of sick kids? Is it more important to protect a co-workers day off than to care for my own family?

How is it fair I did watch my dad arrest and do CPR on him then have to text people in the ambulance to the hospital to find coverage?

To the person who said we are treated unprofessionally because we want sick days… what? The hospital doesn’t care if I’m tough and work sick or not. They just want a warm body in the ED.
Click to expand...

You gotta be some kinda cuhck to think calling out from a hospital employed or CMG job is a sin.
 
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