Considerations for inpatient work

[Candidate2017]

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I’m considering picking up inpatient per diem work.

How are inpatient continuity issues avoided and addressed contractually? For example, avoiding:
Another doctor's discharges dumped on me.
Going to court that day for another doctor’s involuntary cert.

Any other inpatient matters that could be problematic and should be addressed in the contract?

Patient cap?
New eval cap?
Time of day when I no longer accept new admissions?
Internist availability?
Per diem rate vs RVU vs other?
Requirements to stay on the unit after rounding?
Etc?

 

[Sushirolls]

Good luck.

I typed out a long winded response and just reduced it to this.

Good luck.

 

[smalltownpsych]

Good luck.

I typed out a long winded response and just reduced it to this.

Good luck.

I found this pretty funny because I have, more times than I would care to admit, done the same exact thing.

 

[nexus73]

I’m considering picking up inpatient per diem work.

How are inpatient continuity issues avoided and addressed contractually? For example, avoiding:
Another doctor's discharges dumped on me.
Going to court that day for another doctor’s involuntary cert.

Any other inpatient matters that could be problematic and should be addressed in the contract?

Patient cap?
New eval cap?
Time of day when I no longer accept new admissions?
Internist availability?
Per diem rate vs RVU vs other?
Requirements to stay on the unit after rounding?
Etc?

Hopefully you're not working with a bunch of dicks who dump work on you. If so just quit.
I'd hope the current doctors aren't forced to stay on the unit or do admits after say 3pm, otherwise it's a crap inpatient job I wouldn't take.
I assume the patient cap would just be what the other doctors have, if they have no cap you have no cap, which would factor into the RVU vs per diem decision.
New eval cap? That's an interesting idea but I doubt it's possible. If you have fewer follow ups it means open beds which means more new evals most likely. Which may play into RVU vs per diem as well.

I think RVU vs per diem is just a math problem to work out. Which option will in general pay you more for the typical volume of work on a typical day? And this data should be available to you.

 

[comp1]

This is going to vary so much. You're not going to be able to avoid all of that because sometimes you're going to want vacation yourself too. Inpatient is about having a good team that treats each other fairly. It's very hard to build that into a contract with so many moving pieces every day. This is why I find that salaried jobs with a schedule where you are either on site or available immediately by telehealth are actually a lot better at creating an equitable work environment than anything resembling encounter based.

 

[Merovinge]

Talk to the other doctors on the unit and get the real scope of practice. There's almost nowhere that will spell all this out for you in a contract. You can explicitly contract out how much you get paid per hour or per eval vs f/u or per RVU of course. If you expect significant amount of time in court, I might try to get that reimbursed on a per/hour basis (and good for you for working for a place that does this needed service).