Hospital Loyalty

[da3dl3us]

Hey dudes,

I was talking to a buddy of mine who just matched EM. Somewhere in the conversation, he mentioned that hospitals aren't generally loyal to EM physicians, so it's better to work shifts between two hospitals.

I'm strongly considering this field, but the one thing that bothered me about EM was that you're working under a hospital rather than running a private practice and being you're own boss.

So is the above true (having similar experiences) or am I being overly cynical?

---

Members don't see this ad.

 

[USCDiver]

There are many different types of practice structure in EM. Search the forums for discussions of each. Many EDs are staffed by private groups that contract with the hospital.

 

[docB]

You can work for more than one group in an area. I suppose that would insulate you if one group lost their contract. You would probably not then be eligible for leadership positions, partnership, profit sharing, etc. within the groups.

We have several docs who do this, work for other groups and pick up shifts for us. They are considered part timers and don't hold any offices with in the gorup.

The hospital loyalty thing is more of a problem in some areas than others. Your real safety is that if you're a BCEM doc and you have a contract pulled out from under you you'll be able to get another job. Obviously no so if a group fired you for cause.

 

[Haemr Head]

You are only an owner if you join a group practice that has been awarded the contract by the hospital. However, you need to understand that ownership simply means ownership of the accounts receivable and the right to practice at that site until the contract expires. You do not own equipment or space.

Practice groups can be democratic and in this case are the most desirable. However, some group practices require a probationary period that can last years or expect the new faculty member to work the worst shifts. When looking at jobs like this it is important to speak to the most junior people in the group and find out what the survival rate to partnership is.

Some hospital employee practices use incentives for bonus such as RVUs, have generous practice plans, and even subsidize the income for the emergency physicians. You no longer own the RVUs and you can't sell your share of the practice when you leave, but your income may be as good.

I don't understand the strategy of working equally at two sites regardless of the type of practice. You need a home that hopefully will cover the benefits as well as the salary. You need to participate in hospital committees to ensure that the environment you practice in is optimal. By all means, moonlight as much as you want to see how others live and generate a little more income, but find a home. The income you make as an EM physicians is considerably more than the average internist or family practioner. If you want to prioritize income over specialty then go for radiology or better still investment banking.

 

[roja]

If you want to prioritize income over specialty then go for radiology or better still investment banking.

Haemr makes an excellent point.. finding a home is key. Although EM gives us the liberty to be mobile, do lots of things, its still important for your development and growth (career wise and personally) to have a home base to practice in. I will be looking *eep* soon for a "real" job and while I know that there is no such thing as a 'perfect place', I will be looking for a place that will feel like a home base for me.

docB also makes a great point: there are no gaurantees in life, but being board certified pretty much means you'll have a job. No reason to be paranoid.. (unless the aliens are getting through your tinfoiled lined scrubs!)

 

[kungfufishing]

it isnt so much the aliens as this microchip the government put in my head at birth. But then, you all know that since you are just a website with automated fictitious screen names THEY put together to keep gathering info.

 

[da3dl3us]

Awesome, thanks for the advice folks. I think that EM being such a newer specialty, certain things are in the dark. Sorry for being a paranoid android.

But to clarify, it's not about moonlighting to make more money, but the initial curiosity came from a job security issue. But, again, as mentioned above, board certified = job security.

As a side, does anyone know of the market of board certified EM docs in international settings (i.e. Europe, the Gulf, etc.)?

 

[Haemr Head]

Most of the Europeen countries don't really have board certification in EM. There are a few early programs and national societies in most of the countries. Belgium and Great Britain I believe are the most advanced. Finally, with a US medical degree, you can't practice in Europe without obtaining an equivalnce. This is easier said than done.

 

[docB]

No reason to be paranoid.. (unless the aliens are getting through your tinfoiled lined scrubs!)

Well that's just silly. The aliens don't go through the tin foil. It's their mind control beams that get through. That's why you don't line your scrubs, you make a hat. Sheesh! Didn't they cover any of this in your residency? I don't know what the ACGME requirement for training in Management of Alien Mind Control but you should at least know that.

 

[roja]

Well that's just silly. The aliens don't go through the tin foil. It's their mind control beams that get through. That's why you don't line your scrubs, you make a hat. Sheesh! Didn't they cover any of this in your residency? I don't know what the ACGME requirement for training in Management of Alien Mind Control but you should at least know that.

Jeez. I knew there was something *wrong* with my residency. Here I was telling all the applicants that I couldn't think of much to improve my residency program. Now I have something I can tell them so I don't sound like my program isn't as close to perfect as one can get.



(of course, I try not to tell them that *I* am one of the final five )

 

[Jeff698]

Yo Roja,

What's the picture?

Enquiring minds....

Take care,
Jeff

 

[docB]

It's a needle in a haystack isn't it?

 

[roja]

docB wins a cool refreshing beverage of his choice.


A needle in a haystack. The responses to my picture were, ah, disconcerting and I can't seem all unprofessional here. Since its no big secret where I am.

 

[Jeff698]

A needle in a haystack. The responses to my picture were, ah, disconcerting and I can't seem all unprofessional here. Since its no big secret where I am.

Oops, apparently I need to get my glasses checked. I couldn't quite see the needle until I knew to look for it.

You could always dig out Quinn's old avatar. You'd get some real confusion going there.

Take care,
Jeff