Ever Leave a Job Right after Starting?

[cameljocke]

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Ever take a job and then leave within a month of starting for another job? everyone seems to say to do what's best for you, but tips/anecdotes would be helpful.

Thanks

 

[EM4life]

Ever take a job and then leave within a month of starting for another job? everyone seems to say to do what's best for you, but tips/anecdotes would be helpful.

Thanks

In the setting of EM practice, this is probably a very bad idea. EM is a small community, wherever you go, people will ask for references and why you left your old job, this will be a fairly significant red flag unless you had very good reason to do so.

 

[msgsk]

A lot of it depends on your reason for leaving - do you have a good reason (family illness, or...family illness?)
Did you have a conflict with someone recently? Odds are high your new job will call up the director and find out details about why you left.

 

[Arcan57]

It happens, it sucks for the ED and probably for the doc as well (unless they are credentialed at other hospitals in same area). Unless it's an oversaturated market, it's pretty difficult to blackball docs for anything other than ridiculous disregard for patient safety.

 

[dotcb]

This is a red flag. I would avoid doing this if you can avoid it.

 

[emergentmd]

It happens, it sucks for the ED and probably for the doc as well (unless they are credentialed at other hospitals in same area). Unless it's an oversaturated market, it's pretty difficult to blackball docs for anything other than ridiculous disregard for patient safety.

I agree. Unless you are in a hypercompetative market, it won't matter much. You will be able to find a job reasonably easily. Just be truthful on why you left, and unless its a big red flag, no one will care.

 

[Birdstrike]

Ever take a job and then leave within a month of starting for another job? everyone seems to say to do what's best for you, but tips/anecdotes would be helpful.

Thanks

What's the reason? It's all in the reason. Family health crisis? The employers lied to you? The ED is dangerously understaffed? The doctors lounge doesn't have your favorite pop tarts and 5-hour-energy drinks?

The reason is everything.

 

[Groove]

Yea, care to elaborate? It's odd for an EM doc to just flake out after 1-2 weeks on the job without a very good reason. That being said, it's really difficult to burn bridges in today's market.

 

[Vandalia]

What's the reason? It's all in the reason. Family health crisis? The employers lied to you? The ED is dangerously understaffed? The doctors lounge doesn't have your favorite pop tarts and 5-hour-energy drinks?

The reason is everything.

Absolutely. I also think there is a generational aspect. For people my age and older, it was drilled into you in medical school and residency that the absolute worst thing a physician could do or be was to be a quitter, not a team player, or appear lazy. As explained to me during a ward rotation, actively killing a patient at the bed-side would always be viewed as better than even resurrecting a patient from home or the call room. Unless you were in the ICU or morgue, or a member of your immediate family was being buried that morning, you showed up for work. In the same way, the concept of a physician not fulfilling his contract was inconceivable. For people from this generation, the idea of leaving after a couple of months will always induce a negative Pavlovian-type response. (The positive aspect was this type of loyalty was generally considered a two-way street.)

Now, that has changed. One can debate if the change has been for the better or not.

With that said, it depends on the circumstances. If it is due to an illness or similar issue in the immediate family, it should not be a problem. If there is a serious ethical/legal issue, just go ahead and leave. If it is a matter of personal comfort or money, the type of practice you are leaving will play a role. If it is a 60-person group where physicians are coming and going all the time, there will probably not be any repercussions. On the other hand, if you are bailing on a 3 person group and leaving them for an extended time as a 2 person group, they will probably be upset and potential hiring physicians "of a certain age" will not take kindly to it.

It also depends on how your current group treated you. If they took a gamble on you (lesser record than they normally hire), or paid for you to move, or gave an above-average salary, then leaving for comfort will be viewed very poorly. On the other hand, if they gave you nothing exceptional when they hired you - you were a typical hire and got the standard deal - your expected loyalty to them is also lessened.

To summarize, leaving after a couple of months is never good. It might be the only responsible action, it might be the lesser of all possible evils, or it might be considered selfish. Then again, if hospitals and groups are doing what is best for them, the old attitude of physician loyalty (see above) really doesn't apply either.

 

[Cerberus]

Recent grads = absolute flakes. If this is the current trend in medicine then we will soon find ourselves not deserving to call ourselves professionals. Of course if med students keep viewing this as a "lifestyle specialty" I don't expect anything more than flaky, lazy, residents becoming flaky, lazy, Attendings

 

[Angry Birds]

The hospital invests months recruiting you and going through the credentialing process, and it will take them several months to replace you. Just keep that in mind.

 

[Arcan57]

Recent grads = absolute flakes. If this is the current trend in medicine then we will soon find ourselves not deserving to call ourselves professionals. Of course if med students keep viewing this as a "lifestyle specialty" I don't expect anything more than flaky, lazy, residents becoming flaky, lazy, Attendings

Disagree on the absolute flakes comment. We hired 9 new grads last year and the vast majority "get it" in terms of the schedule needing to be covered and showing up to work with your game face on. The comment in the specialty hate thread about e-road did send a chill down my spine and I do share Cerberus's concern what a large influx of fresh attendings that don't like the job and don't have an internal moral code that prevents some of the more egregious abuses EPs can get away with will have on our specialty.

 

[RuralEDDoc]

I'm now one year out from residency. Almost left my current job 2-3 months in. I thought everything was wrong with this job (too many patients, poor supervision of PAs, no hospital back-up, etc). Now I can't imagine leaving this job. The high acuity means I make a huge difference in the lives of my patients, we've improved ED coverage and PA supervision, and our lack of specialty backup exists everywhere but the biggest cities. Having worked part-time at other community hospitals and seeing what my former co-residents go through in their community sites, I see that the "real-world" is very, very different from a well-resourced academic hospital in a big city. The practice of emergency medicine is gritty. It's a hard job.
I'm sharing my experience not in a effort to convince you to stay at your job; it could be truly horrible, I don't know. Or your reason for wanting to leave may be personal and have nothing to do with the working conditions. Just thought you may benefit from hearing other's experiences.

 

[VA Hopeful Dr]

Recent grads = absolute flakes. If this is the current trend in medicine then we will soon find ourselves not deserving to call ourselves professionals. Of course if med students keep viewing this as a "lifestyle specialty" I don't expect anything more than flaky, lazy, residents becoming flaky, lazy, Attendings

Dude, aren't YOU a recent grad?

There was a study recently that showed something like on average new physicians had 3 different jobs in their first 5 years out, or something like that. I think its worth asking if this trend is a result of us being flaky or a systemic problem.

I just left a job after 1 year that I would have left after 3 weeks if I could have afforded to. I was the 5th new hire in 14 months for a 3 person urgent care practice, and I'm now the 6th person to leave in the last 15 months - essentially in 15 months they've had complete staff turnover twice. Is this me being flaky or is it the job sucking?

 

[Vandalia]

Is this me being flaky or is it the job sucking?

Probably the later. However, if you are the 6th person to take the job, you are not going to get much sympathy when you figure out it is a bad job and you want out.

It is like girls/women and wanting to change the "bad boy." It isn't going to happen. If you think the last 20 hires were just bad fits and you can make the job work out, well, you sort of deserve the situation you get into.

 

[VA Hopeful Dr]

Probably the later. However, if you are the 6th person to take the job, you are not going to get much sympathy when you figure out it is a bad job and you want out.

It is like girls/women and wanting to change the "bad boy." It isn't going to happen. If you think the last 20 hires were just bad fits and you can make the job work out, well, you sort of deserve the situation you get into.

Long story, but I was only supposed to be there for 2 months before getting a better job. Lesson learned: get everything in writing.

 

[Cerberus]

Dude, aren't YOU a recent grad?

There was a study recently that showed something like on average new physicians had 3 different jobs in their first 5 years out, or something like that. I think its worth asking if this trend is a result of us being flaky or a systemic problem.

I just left a job after 1 year that I would have left after 3 weeks if I could have afforded to. I was the 5th new hire in 14 months for a 3 person urgent care practice, and I'm now the 6th person to leave in the last 15 months - essentially in 15 months they've had complete staff turnover twice. Is this me being flaky or is it the job sucking?

Yes, I'm 3 years out. That doesn't mean I can't diss on some of the recent grads as we've had several flake out at my current job and leave without giving much notice, call in sick without even attempting to find backup, or come in late perpetually. I'm a little frustrated because it has caused a disruption in my life as I now have a ton of overtime.

And clearly the picture you paint is of a dysfunctional organization that I would leave too. I'm not saying people shouldn't leave there jobs, I'm just saying, I think the professional thing would be give at least 3 mos notification before doing so

 

[VA Hopeful Dr]

Yes, I'm 3 years out. That doesn't mean I can't diss on some of the recent grads as we've had several flake out at my current job and leave without giving much notice, call in sick without even attempting to find backup, or come in late perpetually. I'm a little frustrated because it has caused a disruption in my life as I now have a ton of overtime.

And clearly the picture you paint is of a dysfunctional organization that I would leave too. I'm not saying people shouldn't leave there jobs, I'm just saying, I think the professional thing would be give at least 3 mos notification before doing so

That's all very fair and I can't argue too much, especially since you're paying the price for it. The only point I would suggest is that if you are truly miserable in a job, staying another 3 months is a bad idea. Patient care will suffer and your health and non-work relationships will as well. Plus, and this is a fairly minor point (possibly born of my personal bitterness) but it sends a nice message to the administration about how bad things are.

 

[UnderwaterDoc]

Flakes are everywhere, recent grads or not. We had a "veteran" doc quit just like that without notice after a particularly busy/difficult shift. This doc still had 10 shifts scheduled for the month that were left uncovered and had the be picked up by us, the "flaky newbies".

 

[Promethean]

Probably the later. However, if you are the 6th person to take the job, you are not going to get much sympathy when you figure out it is a bad job and you want out.

It is like girls/women and wanting to change the "bad boy." It isn't going to happen. If you think the last 20 hires were just bad fits and you can make the job work out, well, you sort of deserve the situation you get into.

So, it is never the fault of the institution, always the individual?

If you are the 1st to leave, you are a flake. The third, well maybe there is a pattern, or maybe it is just all these flaky new grads. The 6th? Should have known better than to take a job that bounced so many others. At what point is it reasonable to consider that health care employers are sometimes (often!) exploitative and manipulative?

I was the 10th nurse to leave my first job in the 18 months I worked there, not counting people fired for cause or injured on the job. That represented about an 80% turnover rate. They actively encouraged us to lie to potential hires about how great it was to work there, so that they could get licensed bodies to work the shifts. Some nurses went along with it, because we really needed the help. The administration knew that they were burning people out, so rather than address any of our concerns about patient and staff safety, they pushed new hires to accept signing bonuses that had to be paid back if they left within 2 years.

Sure, now, I know the signs of a hell job, and I wouldn't stumble back into one so easily. But when you are a new grad and you haven't been on the employee side of health care in any meaningful way before, it is easy to make a terrible mistake. Recruiters and even future co-workers have strong incentives to entice you to join them. They aren't going to tell you about the 20 hires that were bad fits, not until after you are already in too deep to get away.

 

[Promethean]

That's all very fair and I can't argue too much, especially since you're paying the price for it. The only point I would suggest is that if you are truly miserable in a job, staying another 3 months is a bad idea. Patient care will suffer and your health and non-work relationships will as well. Plus, and this is a fairly minor point (possibly born of my personal bitterness) but it sends a nice message to the administration about how bad things are.

If they are willing to hear the message.

That was what finally lead me to leave my first gig. They kept us there with guilt, playing on our loyalty to one another and to the patients. I was working 2-3 days of overtime each week, and so was everyone else, and even so, we were understaffed. They reminded us that if anyone quit, it would just increase the burden on everyone else that much more, and since we were all already at the breaking point... well, who wanted to be responsible for that?

It took a lot for me to realize that administration was responsible for that, not the individual staff who were giving their all. By continuing to work in those absurd conditions, I was giving my tacit support to them. I was allowing them to continue to pretend that it was even possible to function safely with so many high acuity patients per nurse, and when the disaster happened, I realized that administration was going to let the individual take the fall. "If they didn't feel it was safe to accept that assignment, they were responsible as professionals to refuse it."

I decided that joining the exodus was the best way to force change on the unit. Maybe in my exit interview, they would finally listen to my concerns. They didn't. A few weeks after I left, a confused patient died in a terrible way because her nurse was too overburdened to keep a constant watch on her. As predicted, the hospital tried to hang that nurse out to dry, while I shuddered in horror, knowing that it could just as easily have been me, or anyone else on that unit.

As others have said, the reason for leaving matters. But if you do have a good reason, don't stay in a situation that is toxic for you just because someone will judge you for it. Someone is going to judge you no matter what. If you can't please everyone, you have to do what is best for you and for your family.

 

[Vandalia]

One can argue that the new graduate is in the best position to avoid bad jobs. EM is not that big. Granted, it might be different if you are training in MA and are looking for a job in AZ, but most people tend to settle around where they trained. There are at least a few EM faculty in almost every training program who know exactly what the situation is at the EDs surrounding them. And if they don't have the information at the top of their mind, they can usually quickly find out.

The problem is that a lot of new - and not so new - physicians, make a decision solely on the base of salary/location, and refuse to accept any information that might contradict that decision.

If you do "due diligence" you can find out about most bad jobs. As someone coming right out of residency, you probably have more access to relevant information than many older physicians, if you chose to use it. Now, there are bad jobs that pop out of nowhere - new group leadership, new hospital leadership, just took on a bad contract, a bad personality/philosophy fit, etc., etc. But most don't fit that category - they have been bad jobs for the last decade.

Just to be fair, I did a little experiment. I picked a hospital at random near my parents. In under 10 minutes, I was able to find every EM physician they have had in the last 10 years, everyone who left and where they are now working, and identified two cases where it is likely I know "someone who knows someone." I was also able to find every worker's compensation claim made by any ED employee over the last 10 years. These claims and how they are handled can tell you a lot about the hospital environment.

Look, I/we moan about patients who don't use one iota of common sense, in fact, we have entire threads on that. You are supposed to have a doctorate, and that means you are supposed to be able to do research. If you are smart enough to practice EM, you should be smart enough to see through most hiring scams.

Make any choice you want, just take responsibility for the choices you make.

 

[cameljocke]

What's the reason? It's all in the reason. Family health crisis? The employers lied to you? The ED is dangerously understaffed? The doctors lounge doesn't have your favorite pop tarts and 5-hour-energy drinks?

The reason is everything.

Sorry for late reply and appreciate responses.

Essentially, the current job is fine, but i'd leave because an opening at a more desirable job (that wasn't open when I initially began my search months ago) has become available. It is preferable to me as far as location, group-type, and reliability over time. Basically, it is everything I could have wanted and unfortunately has only become available shortly after starting another job.

I'm dreading leaving but feeling it's something I'll just have to do.

 

[Birdstrike]

Sorry for late reply and appreciate responses.

Essentially, the current job is fine, but i'd leave because an opening at a more desirable job (that wasn't open when I initially began my search months ago) has become available. It is preferable to me as far as location, group-type, and reliability over time. Basically, it is everything I could have wanted and unfortunately has only become available shortly after starting another job.

I'm dreading leaving but feeling it's something I'll just have to do.

I would suggest being upfront with your director. Tell him exactly the above. See if you can't work out an early exit in some sort of compromise that does not screw either of you. These things happen. Everything is negotiable. Reasonable adults should be able to work out a mutual compromise. That's what I would do, for what it's worth. In the end, he may be happy you came to him out of honesty and good faith without give him the breach of contract screw job, which you probably easily could without much real fear of meaningful litigation (probably would cost them more to sue you than they'd recover in a suit). I suspect you'll be able to work something out if you (and he) act in good faith.

Do what you think is best.

 

[docdragon]

... But most don't fit that category - they have been bad jobs for the last decade.

Just to be fair, I did a little experiment. I picked a hospital at random near my parents. In under 10 minutes, I was able to find every EM physician they have had in the last 10 years, everyone who left and where they are now working, and identified two cases where it is likely I know "someone who knows someone." I was also able to find every worker's compensation claim made by any ED employee over the last 10 years. These claims and how they are handled can tell you a lot about the hospital environment.

This is really impressive. I did research all over the country looking for my first job, and it was often hard to figure out which ED group actually covered a specific ED. And I've found people online who my parents had lost touch with 15+ years ago, people who don't/didn't have an "online presence". The worker's compensation claim check is a brilliant idea - thanks for that!

Community medicine is sufficiently different from academic medicine/training that academics don't entirely prepare you for the subtle lies. I've had our recruiter tell me that people almost never leave, or none in the last ten years, when I now work with and know per diems who used to be full-time and left. But they weren't partners so they don't count. And they aren't quite gone. But they left all the same.

 

[Apollyon]

..when I now work with and know per diems who used to be full-time and left. But they weren't partners so they don't count. And they aren't quite gone. But they left all the same.

Forgive me, but what does this mean? Do they actually still work shifts? If so, then they haven't left. If they are still on the rolls (which doesn't make sense, if they are agency per diems, but does if they are just local guys), but just don't work anymore, then that's another. However, "And they aren't quite gone. But they left all the same." is cryptic.

 

[docdragon]

Forgive me, but what does this mean? Do they actually still work shifts? If so, then they haven't left. If they are still on the rolls (which doesn't make sense, if they are agency per diems, but does if they are just local guys), but just don't work anymore, then that's another. However, "And they aren't quite gone. But they left all the same." is cryptic.

They were full-time, partnership track. They left for other jobs because of practice issues but kept per diem options. They're not full time, not partners, and left those jobs and tracks. If they pick up 1-2 shifts a month to help out, that's still not the same as staying full-time or even consistent part-time.

On paper it's a semantic difference that can be used quite disingenuously.

 

[Mighty Mouse]

I say get out. life is too short. the ED never closes. the show always goes on. be up front, honest, professional, and an adult about it....but screw it....get out. there's absolutely zero reason to be in a job you don't want to be in. there's no loyalty in this business. move on, your shop will be fine in the long run.