How common is it for a locums job to say yes and then the contract never gets offered?

[futuredo32]

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Apparently the above is the question I really need to ask. I will be seeing patients today and I guess I will figure it out and just go with it.

I unexpectedly got a great paying addictions job out of state and I will be terminating with patients at my small private practice as well as the clinic where I prescribe meds. My biller sent letters to my private patients which they have yet to receive. Most of my private patients have been with me since 2016 or a little earlier. When in their appointment is the best time to tell them? This was totally out of the blue. I have been looking for an addictions position and didn't find one locally, my recruiter for my weekend job called Thursday night and suggested I at least interview via phone. I swore I wouldn't leave the state for a job but the money is amazing and more importantly I will get the hours in for the practice pathway for addictions. I phone interviewed Friday and he called me Friday and I decided that although the location sounds dreadful, it is a good career move. I have fired a few patients, but this is new. If I had more tine I would give my patients more time. I have a really good rapport with all of my patients and honestly though I don't love psych, I do like most of my patients and it will be hard for me. I have a clinic to refer them to that can see them within a month which offers medication management as well as therapy for most, the rest will have to call their insurance to find a psychiatrist and or therapist who takes their insurance. Some patients will hear it first from me, some will receive the letter first. In a perfect world they would all hear it from me first. I know they will survive just fine without me but I know some will have a hard time. Any advice appreciated.

 

[AD04]

When in their appointment is the best time to tell them?

Someone I know had to do this and flew back and forth every week to establish closure with his patients. Try to tell them in person instead of letting them be surprised by mail. I would tell patient towards the end of the visit. End the visit 5 or so minutes early and break the news. They may wish you well. They may cry. They may hate you for a bit because you're "abandoning" them. Be sympathetic and allow them a bit of time to grieve if needed.

Do this for about 1 - 2 months or whatever time you allow yourself to transition.

I have been looking for an addictions position and didn't find one locally, my recruiter for my weekend job called Thursday night and suggested I at least interview via phone. I swore I wouldn't leave the state for a job but the money is amazing and more importantly I will get the hours in for the practice pathway for addictions. I phone interviewed Friday and he called me Friday and I decided that although the location sounds dreadful, it is a good career move.

Are you sure you got the job? Is the contract already signed? Do they not need a face-to-face interview? Don't you want to visit the site first?

Make sure you actually have the job before you start telling people you will leave.

 

[futuredo32]

Someone I know had to do this and flew back and forth every week to establish closure with his patients. Try to tell them in person instead of letting them be surprised by mail. I would tell patient towards the end of the visit. End the visit 5 or so minutes early and break the news. They may wish you well. They may cry. They may hate you for a bit because you're "abandoning" them. Be sympathetic and allow them a bit of time to grieve if needed.

Do this for about 1 - 2 months or whatever time you allow yourself to transition.



Are you sure you got the job? Is the contract already signed? Do they not need a face-to-face interview? Don't you want to visit the site first?

Make sure you actually have the job before you start telling people you will leave.

The clinic wants someone ASAP. This all moved VERY fast. My recruiter called me last minute because I have always turned down out of state or even in state but far from home jobs, but he knew I was looking for an addictions position and it pays amazing.

No one wants any more interviews. This was supposedly a competitive position and I interview well. I need addictions experience and couldn't find anything local and the timetable for the practice pathway is ending, anywhere on planet earth will have to suffice. I will have to hope that the contract is presented and signed. I am going through the same locums company I use for my weekend moonlighting and they have an established relationship with this clinic, so I hope it goes forward. It doesn't matter to me if if's awful. I went through hell for the last two years of my residency and if I handled that, I can't imagine worse unless they beat me daily and even if they do, I will smile and do my job and do it well. Part of the package is that I get a letter. I am likable in person usually and can fake being happy well enough to win an academy award. I will work my @ss off to make them happy and get my hours and a good LOR.

I have no choice but to tell my patients and tell the clinic where I work NOW because I have to give them 30 days by law. The letters are in the mail. I don't have time to fly back and forth weekly for closure, I am expected to work full time Mon-Fri. In 6 weeks I am slated to start working in the addictions clinic out of state and they are paying me a ridiculous amount of money . I am taking two weeks off in between to pack and relax, I need to take that time for me. My patients are getting the legal 4 weeks and I get two weeks to not work.

If by chance this falls through, I can almost definitely tell the clinic where I currently work that I am staying and they will keep me. They had no idea I was leaving, neither did I. I will tell them Tuesday of this week. The locums company is flying me home monthly so I can work a weekend a month at the hospital where I work a weekend a month because I want to keep that job so I will still have that as well. And being that I don't want to stay in psych forever, I can likely find a part time outpatient job to cover my micro private practice. I am keeping my current apartment because I love it and will want to keep living here. Potentially as a last resort I could tell my private practice patients I am staying and I bet 95% of them would stay but honestly, I don't make much money there after malpractice, paying my biller and rent because it's just a day a week and it's a long drive and I have been thinking about ending that for awhile.
I kinda think telling them at the end is a lot for them to have to deal with until their next session or last session. I don't want endless lengthy phone calls between appointments or after their final appointment. For those with the right insurance- which is most of them, they are getting a great psychiatrist who may keep some for therapy if they choose to go to that clinic.

 

[PikminOC]

Keep us posted on your new job!

 

[FlowRate]

Sounds like the cart is a bit in front of the horse. I hope everything works out.

 

[futuredo32]

Sounds like the cart is a bit in front of the horse. I hope everything works out.

How common is it for someone to be offered a job and have it yanked? I'm fine with ending my little private practice. I am actually relieved about that in many ways. It needed to happen and every week, I would just think maybe next week or next month. If nothing else, I am glad this gave me a much needed push for that. I am pretty sure I could tell my clinic job that I want to stay and they will totally let me stay. Being that I want two weeks off prior to moving and starting a new job I don't really have any other options but to put the cart before the horse. But I would send my CV to clinics locally. How long does it take before I should receive a contract? I sent my recruiter a very detailed description of EVERYTHING I needed in my contract being that I am a locums employee and we don't get any benefits that a regular employee gets like vacation or sick days or conference days. My own psychiatrist is even getting licensed in that state so I can do telepsychiatry with him for the year because i have been seeing him for analysis for years and want to continue. I was not thrilled to move out of state to say the least, but when my recruiter presented it, I knew it was the "right" career move and I just decided to give it to God and if I got it I would take it (no offense to anyone who doesn't believe) . I guess if I don't get it, then I will just know it wasn't actually meant to be. Psychiatry jobs are plentiful. Worst case scenario, I will find something else. I'm usually super anxious.

 

[SourceOfDenial]

If you don’t have a signed contract, you don’t have another job. I wouldn’t tell patients you’re leaving without that unless you are leaving regardless, which it sounds like you’re not.

 

[Mass Effect]

Sorry if I missed it, but why do you need addictions experience? I thought you were applying FM. Are they requiring addictions experience for another residency?

 

[futuredo32]

Sorry if I missed it, but why do you need addictions experience? I thought you were applying FM. Are they requiring addictions experience for another residency?

My PCP does both. I think it would work well, it does for him and its really not likely I will match into FP.

 

[futuredo32]

If you don’t have a signed contract, you don’t have another job. I wouldn’t tell patients you’re leaving without that unless you are leaving regardless, which it sounds like you’re not.

I have to give them a 30 day notice. Worst case scenario I find a different job. Its possible this job will backtrack and not offer me a contract but I'm going to assume they are so I can terminate with my patients legally.

 

[clausewitz2]

Two questions:

A) why is this job unwilling to give you thirty days after delivery of a contract to start the job, or even 45 days? Why do you absolutely have to quit now?

B) why are you cool with leaving your state for this job but not to pursue FM training, which is what you really want? You could have been done with an FM residency by now if you were willing to apply more broadly.

 

[dl2dp2]

If you don’t have a signed contract, you don’t have another job. I wouldn’t tell patients you’re leaving without that unless you are leaving regardless, which it sounds like you’re not.

Spot on.

Even if you get a signed contract, they can still fire you. Then the question is whether it's worth it for you to litigate for breach.

 

[FlowRate]

How common is it for someone to be offered a job and have it yanked?

I don't have any objective statistics or experience with this specifically w/r/t physicians. I watched it happen to a family member twice in one year--each time by different universities.

 

[SourceOfDenial]

I’m guessing you already have a license to practice in the other state?

 

[futuredo32]

I’m guessing you already have a license to practice in the other state?

No. The plan is that I will get extensive assistance from the locums company to do that. That's the norm

 

[SeniorWrangler]

Good luck, I don’t mean to join the chorus of nay-sayers but it seems to me that all the risk is on your side and none on your potential employers.

To answer the original question, I’d do it about halfway through, to give people time to process. Some will be very upset but many will take it in stride since doctors move constantly these days.

 

[futuredo32]

Got the contract I need to sign plus fill out a ton of paperwork in 48 hours

 

[SourceOfDenial]

What is this mythical state that grants full medical licenses in a 30 day turn around?!? There is a lot of outrageous stuff on this forum but that has gotta be up there.

 

[futuredo32]

Its 45 days. I want 2 weeks off.

 

[futuredo32]

They have reciprocity with Michigan. That speeds it up

 

[Trismegistus4]

What is this mythical state that grants full medical licenses in a 30 day turn around?!? There is a lot of outrageous stuff on this forum but that has gotta be up there.

Going back through my emails, I can tell you I was issued an Indiana license 22 calendar days after submitting my application.

 

[PikminOC]

And monthly flights back too!

 

[birchswing]

You're giving better termination than I've ever received. I've had two.

One was with a psychiatrist where they hadn't called to confirm my appointment. So I called and they said he no longer worked there and that his final day was the day before I was scheduled to see him (the day I was calling). At the time I thought he scheduled me the day after his last day on purpose to avoid the issue. I only found out years later he was supposed to report for incarceration around that same time but ended up fleeing the country instead of reporting to prison. I'm not entirely sure who knew what when, but I didn't know anything about what was going on. Only in looking at court records and the board of medicine site was I able to later piece together what happened. had been in very bad shape the entire time I was seeing him, but his behavior wasn't much weirder than others I've seen. This was at a community services board on top of it where you'd think they'd be on top of continuity of care. No letter or anything.

The other time was when I wrote to my endocrinologist through the web portal. She wrote back that she could not respond to me because I didn't have an upcoming appointment. I replied that I did have an upcoming appointment (I could see it on the portal, and I had been waiting months for the appointment). She responded saying someone should have told me she was leaving the practice and that my appointment date was past her departure. They then canceled my appointment, and that was it. I did get a form letter from her months later saying she was leaving and it was bittersweet, etc., but it was well after what they told me was her last day.

So I applaud you for telling your patients. Realistically I doubt anyone would actually sue if you didn't. I've been through "abandoment" (I didn't actually consider myself abandoned, but I know that's what they call it), and to do anything about it would cost so much money and time compared to just turning to your PCP or finding another doctor yourself.

Anyhow, I've always liked this line when leaving someone, "I'm not pushing you away. I'm pulling me closer to myself." (That's meant to be more humorous than sincere if it wasn't clear.)

 

[futuredo32]

It was really hard. I was surprised that some of my med management patients got so emotional. They were all emotional. It was odd because I had 2 brand new evaluation patients who I scheduled prior to knowing about this other job. My biller has always been an issue and she has yet to send any letters so I will be sending them all. It was difficult. I will call most of them prior to sending a letter. On the other hand I told my recruiter I was working long days Monday through Wednesday and could fill out any paperwork Thursday and I get tons of paperwork saying that it needs to be filled out in 48 hours and one document needs to have a notary public sign it and I seriously cant get it done that fast. So I don't know.

 

[futuredo32]

You're giving better termination than I've ever received. I've had two.

One was with a psychiatrist where they hadn't called to confirm my appointment. So I called and they said he no longer worked there and that his final day was the day before I was scheduled to see him (the day I was calling). At the time I thought he scheduled me the day after his last day on purpose to avoid the issue. I only found out years later he was supposed to report for incarceration around that same time but ended up fleeing the country instead of reporting to prison. I'm not entirely sure who knew what when, but I didn't know anything about what was going on. Only in looking at court records and the board of medicine site was I able to later piece together what happened. had been in very bad shape the entire time I was seeing him, but his behavior wasn't much weirder than others I've seen. This was at a community services board on top of it where you'd think they'd be on top of continuity of care. No letter or anything.

The other time was when I wrote to my endocrinologist through the web portal. She wrote back that she could not respond to me because I didn't have an upcoming appointment. I replied that I did have an upcoming appointment (I could see it on the portal, and I had been waiting months for the appointment). She responded saying someone should have told me she was leaving the practice and that my appointment date was past her departure. They then canceled my appointment, and that was it. I did get a form letter from her months later saying she was leaving and it was bittersweet, etc., but it was well after what they told me was her last day.

So I applaud you for telling your patients. Realistically I doubt anyone would actually sue if you didn't. I've been through "abandoment" (I didn't actually consider myself abandoned, but I know that's what they call it), and to do anything about it would cost so much money and time compared to just turning to your PCP or finding another doctor yourself.

Anyhow, I've always liked this line when leaving someone, "I'm not pushing you away. I'm pulling me closer to myself." (That's meant to be more humorous than sincere if it wasn't clear.)

Most asked why and I told them that it was to get board certified in addictions. I felt that it was appropriate to tell them. I'd want to know if I were the patient. One asked if I could see her once a month at even 5 AM on weekends and I can't justify paying rent and malpractice for one patient. I could actually keep seeing them 3 Saturdays a month but that's kind of a lot for me to work. I will miss them as well. I hope this addictions position is the right choice. I know they will all be fine with another psychiatrist or therapist. I'm so sorry you went through that. I'm quite attracted to most of my physicians and I'd have a difficult time if most just up and left.

 

[Mass Effect]

You're giving better termination than I've ever received. I've had two.

One was with a psychiatrist where they hadn't called to confirm my appointment. So I called and they said he no longer worked there and that his final day was the day before I was scheduled to see him (the day I was calling). At the time I thought he scheduled me the day after his last day on purpose to avoid the issue. I only found out years later he was supposed to report for incarceration around that same time but ended up fleeing the country instead of reporting to prison. I'm not entirely sure who knew what when, but I didn't know anything about what was going on. Only in looking at court records and the board of medicine site was I able to later piece together what happened. had been in very bad shape the entire time I was seeing him, but his behavior wasn't much weirder than others I've seen. This was at a community services board on top of it where you'd think they'd be on top of continuity of care. No letter or anything.

Your psychiatrist fled the country to avoid incarceration? WTH goes on in the world?

 

[PikminOC]

Your psychiatrist fled the country to avoid incarceration? WTH goes on in the world?

Lots of people with money do that, usually to a home country

 

[PikminOC]

ME and I

 

[Mass Effect]

Lots of people with money do that, usually to a home country

I'm familiar with the practice. I just find it disconcerting that so many doctors are among that population.

 

[Sushirolls]

I know of 0 people

 

[PikminOC]

I know of 0 people

But you may have heard of some. Physicians are people too, with foibles

 

[birchswing]

Yeah, he went back to his home country. He kept a public Facebook page so I was able to see what he was up to. He opened up shop in the home country advertising himself as an American-trained psychiatrist (which is true; he did his residency in the US). Was a funny read to see his posts. When working in the US (I only looked for his page after he disappeared), he made jokes about Southern yokels (presumably his patients) choking on chicken bones. He was actually not a bad psychiatrist. He wasn't a great psychiatrist. He had a bad temper. But was not the worst I've seen. I actually had both sympathy for him reading about his problems in the medical board notes (drug and alcohol problems including prescribing to himself in a roundabout way that led to DUIs), but also found it pretty inspiring how he seemed to bounce back in his home country.