How to discourage a doctor

SunBakedTrash

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Sad to read. No one is on your side, especially when you are junior pathologist just starting out. While this article describes the hospital suits, you'll be exploited no less in academics, by big reference labs or by many older pathologists and predatory groups. It's a jungle out here and winter is coming.
 
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Alteran

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Only the oblivious wouldn't know that's exactly what administration's sentiments are. My hospital tried to do a lot of these things but it backfired on them spectacularly.

After my hospital got bought out, the new administration came in with exactly with that play book. They "renegotiated" all the hospital based specialties, including pathology. After the ER, IM, and Critical care/pulmonary docs told them to take a hike, their contracts weren't renewed and they brought in another bunch of corporate physicians to handle the work. The transition was anything but smooth and after a few mismanaged patients, most of the referring surgeons/specialists pulled their stuff out. They tried to renegotiate with radiology, except all the radiology equipment is leased to the hospital by the radiology group. Radiology played hardball and told them to prepare to spend millions out of pocket for their own CT, MRI, and radiology software suites. Needless to say, they were left alone. The GI docs all went and built their own endoscopy centers and the surgeons migrated the bulk of their work to the surgery centers which they have financial interests in. When they came to us and wanted to claim total financial control on the outreach business we brought to the hospital, we pulled it out and built our own lab which is most of our practice today.

Within a year of the new administration taking over, about half of the business bolted for greener pastures. That particular CEO along with the entire administrative team was s---canned shortly thereafter and the hospital has been playing catch up ever since then.

So the moral of the story is administration wins only if you let them by being really passive or just plain lazy.
 
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path19

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Only the oblivious wouldn't know that's exactly what administration's sentiments are. My hospital tried to do a lot of these things but it backfired on them spectacularly.

After my hospital got bought out, the new administration came in with exactly with that play book. They "renegotiated" all the hospital based specialties, including pathology. After the ER, IM, and Critical care/pulmonary docs told them to take a hike, their contracts weren't renewed and they brought in another bunch of corporate physicians to handle the work. The transition was anything but smooth and after a few mismanaged patients, most of the referring surgeons/specialists pulled their stuff out. They tried to renegotiate with radiology, except all the radiology equipment is leased to the hospital by the radiology group. Radiology played hardball and told them to prepare to spend millions out of pocket for their own CT, MRI, and radiology software suites. Needless to say, they were left alone. The GI docs all went and built their own endoscopy centers and the surgeons migrated the bulk of their work to the surgery centers which they have financial interests in. When they came to us and wanted to claim total financial control on the outreach business we brought to the hospital, we pulled it out and built our own lab which is most of our practice today.

Within a year of the new administration taking over, about half of the business bolted for greener pastures. That particular CEO along with the entire administrative team was s---canned shortly thereafter and the hospital has been playing catch up ever since then.

So the moral of the story is administration wins only if you let them by being really passive or just plain lazy.

Yes...however, we are at a distinct disadvantage due to the job market. It was fortunate that the ER, IM and critical care docs were the ones who were replaced, as I'm guessing most of them were able to find a suitable job without too much trouble to replace the one they just lost. If a whole department/group of pathologists was the first to be let go to make an example for the other docs in the system, the story would not be as rosy. For this reason (fear), many pathologists are willing to give in to administration much more than they would in an ideal situation.
 
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bronx43

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Only the oblivious wouldn't know that's exactly what administration's sentiments are. My hospital tried to do a lot of these things but it backfired on them spectacularly.

After my hospital got bought out, the new administration came in with exactly with that play book. They "renegotiated" all the hospital based specialties, including pathology. After the ER, IM, and Critical care/pulmonary docs told them to take a hike, their contracts weren't renewed and they brought in another bunch of corporate physicians to handle the work. The transition was anything but smooth and after a few mismanaged patients, most of the referring surgeons/specialists pulled their stuff out. They tried to renegotiate with radiology, except all the radiology equipment is leased to the hospital by the radiology group. Radiology played hardball and told them to prepare to spend millions out of pocket for their own CT, MRI, and radiology software suites. Needless to say, they were left alone. The GI docs all went and built their own endoscopy centers and the surgeons migrated the bulk of their work to the surgery centers which they have financial interests in. When they came to us and wanted to claim total financial control on the outreach business we brought to the hospital, we pulled it out and built our own lab which is most of our practice today.

Within a year of the new administration taking over, about half of the business bolted for greener pastures. That particular CEO along with the entire administrative team was s---canned shortly thereafter and the hospital has been playing catch up ever since then.

So the moral of the story is administration wins only if you let them by being really passive or just plain lazy.
Is this in a competitive market?
 

WEBB PINKERTON

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It ain't easy to build your own lab nowadays. And it stinks if you are still working for a hospital the local physicians hate. Once they start their own surgery centers etc, they view the institution as competition. It is hell keeping their business. Lost a lot of bidness over the years due to this crap.
 
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Alteran

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Yes...however, we are at a distinct disadvantage due to the job market. It was fortunate that the ER, IM and critical care docs were the ones who were replaced, as I'm guessing most of them were able to find a suitable job without too much trouble to replace the one they just lost. If a whole department/group of pathologists was the first to be let go to make an example for the other docs in the system, the story would not be as rosy. For this reason (fear), many pathologists are willing to give in to administration much more than they would in an ideal situation.

All hospital based specialties were hit at once by admin in a blitz style effort to pit one group against the other. I know each medical community is different, but all the docs who are out here want a certain level of autonomy within their practice and don't take crap from anyone. It immediately became apparent what admin was trying to do and while no specialty was going to go out of its way to help another, those of us with brains decided to take as much of our business as we could out of the hospital where we could control it better. Other than the ER group who lost it's contract, no one lost their job because they still had their respective group's practice outside the hospital - they just shuffled the work elsewhere. Some business went to some of the other hospitals whose administrations were watching the situation over here with glee, a lot went to the surgical centers, and the easy stuff like endoscopy procedures all went in office.

Our situation was rather unique admittedly because most of our business is outreach, not from this particular hospital itself. When they wanted it all for themselves, we took it out and left them with a big financial hole they haven't recovered from today. Were we solely a hospital based group, we would have been hosed completely.

Is this in a competitive market?

Depends on by what you mean. There are a surprising amount of hospitals and surgical centers for the area. Every clinical specialty has options here, and they know it. From a pathology standpoint, we're the only group in town with significant outreach because we're the only group in town motivated enough to get it. It's easy to stand out when everyone else is rather passive, or lazy.

It ain't easy to build your own lab nowadays. And it stinks if you are still working for a hospital the local physicians hate. Once they start their own surgery centers etc, they view the institution as competition. It is hell keeping their business. Lost a lot of bidness over the years due to this crap.

All the hospitals in my area are hated :laugh:. The medical community here makes its decisions on who to do business with by figuring out which administration will just leave them alone.
 

LADoc00

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Only the oblivious wouldn't know that's exactly what administration's sentiments are. My hospital tried to do a lot of these things but it backfired on them spectacularly.

After my hospital got bought out, the new administration came in with exactly with that play book. They "renegotiated" all the hospital based specialties, including pathology. After the ER, IM, and Critical care/pulmonary docs told them to take a hike, their contracts weren't renewed and they brought in another bunch of corporate physicians to handle the work. The transition was anything but smooth and after a few mismanaged patients, most of the referring surgeons/specialists pulled their stuff out. They tried to renegotiate with radiology, except all the radiology equipment is leased to the hospital by the radiology group. Radiology played hardball and told them to prepare to spend millions out of pocket for their own CT, MRI, and radiology software suites. Needless to say, they were left alone. The GI docs all went and built their own endoscopy centers and the surgeons migrated the bulk of their work to the surgery centers which they have financial interests in. When they came to us and wanted to claim total financial control on the outreach business we brought to the hospital, we pulled it out and built our own lab which is most of our practice today.

Within a year of the new administration taking over, about half of the business bolted for greener pastures. That particular CEO along with the entire administrative team was s---canned shortly thereafter and the hospital has been playing catch up ever since then.

So the moral of the story is administration wins only if you let them by being really passive or just plain lazy.


Common scenario. When I left training no one bothered to tell me how dark and evil the real world of the business of medicine was....aside from one mentor, one lone voice who I incessantly hung on every word for a solid year because in the back of mind I was scared that what he was saying was true.

It is only because of that legendary pathologist I became who am I now am: a pirate king. I lived to see a dozen CEOs fall and I will live to see another dozen fall before I sail away forever.

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