I was terminated today

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Medman2737

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Let me explain.

I moved down south in 2019 and joined the private physician-owned multi-specialty group in town as their sole pain specialist. This group was sold and acquired by a local hospital system in 2023. I didn't want to be a hospital employee, so I joined the rival private multi-specialty group. Well, they were acquired 10 weeks ago by a national hospital system.

So, 10 weeks ago I became a hospital system employee.

Now . . . I am very hardworking (Minimum 13K RVU/year I've been down here). I do all the things (stim implants/Intracept/SI fusion/PNS, etc.). However, my number one payor are Medicare Advantage plans (~70%)

They fired me "without cause", but did say it was a "business decision". Though I don't the actual reason I was terminated, I think it was because I was "too expensive" with procedures. It was explained to me that spending too much money on managed medicare patients can end up COSTING the hospital system money. I am not sure how or why this is the case, but it sounds like they would rather have me just do facet blocks and epidurals and stay away from more costly procedures like stim batteries and implanted spacers.

Has anyone ever experienced something like this before?

I would truly like to understand the "why" I was terminated more than anything so I don't continue to make the same mistakes.

Any insight appreciated.


PS-If anyone is hiring in FL, please DM me 🙂
 
Medman2737 said:
Let me explain.

I moved down south in 2019 and joined the private physician-owned multi-specialty group in town as their sole pain specialist. This group was sold and acquired by a local hospital system in 2023. I didn't want to be a hospital employee, so I joined the rival private multi-specialty group. Well, they were acquired 10 weeks ago by a national hospital system.

So, 10 weeks ago I became a hospital system employee.

Now . . . I am very hardworking (Minimum 13K RVU/year I've been down here). I do all the things (stim implants/Intracept/SI fusion/PNS, etc.). However, my number one payor are Medicare Advantage plans (~70%)

They fired me "without cause", but did say it was a "business decision". Though I don't the actual reason I was terminated, I think it was because I was "too expensive" with procedures. It was explained to me that spending too much money on managed medicare patients can end up COSTING the hospital system money. I am not sure how or why this is the case, but it sounds like they would rather have me just do facet blocks and epidurals and stay away from more costly procedures like stim batteries and implanted spacers.

Has anyone ever experienced something like this before?

I would truly like to understand the "why" I was terminated more than anything so I don't continue to make the same mistakes.

Any insight appreciated.


PS-If anyone is hiring in FL, please DM me 🙂
Click to expand...

Your story is widespread, and I'm very sorry to hear it. I don't want to trivialize your tragedy, but I hope young physicians reading this will realize that, "They will never love you back..."
 
Medman2737 said:
PS-If anyone is hiring in FL, please DM me 🙂
Click to expand...
Yo GabbaPentin

Thread 'Another job opening…'

I have a job opening presently if anyone is interested. Multi specialty group. Lots of autonomy assuming you aren’t interested in doing illegal or dangerous things. Physician owned. Working 4 days a week. Greater than 90% MGMA income with zero buy in and we can grow as much as you want. The catch is that you have to work with me. DM me if interested
  • Like

@Yo GabbaPentin
 
Agast said:
Yo GabbaPentin

Thread 'Another job opening…'

I have a job opening presently if anyone is interested. Multi specialty group. Lots of autonomy assuming you aren’t interested in doing illegal or dangerous things. Physician owned. Working 4 days a week. Greater than 90% MGMA income with zero buy in and we can grow as much as you want. The catch is that you have to work with me. DM me if interested
  • Like

@Yo GabbaPentin
Click to expand...
Will Medman be a good fit for Yo GabbaPentin? That is the question...
 
Oh wait, this is the hospital that wanted to force you into doing school physicals? How did that turn out?
 
Hello
Don't want to side track this convo but I'm currently a fellow and interested in opening my own PP in a few years. I would love if I could get access to the private forum so I can get some candid advice
 
Drhappyface said:
Hello
Don't want to side track this convo but I'm currently a fellow and interested in opening my own PP in a few years. I would love if I could get access to the private forum so I can get some candid advice
Click to expand...
Please make a request to join the private forum and start your own thread, thanks
 
buddababa said:
can i get access to the private forum?
Click to expand...
It’s a stickied thread at the top

axm397

Thread 'How to Apply for Access to the Physicians Only Pain Forum'

After a number of issues were raised in the forum, the mods had a discussion and agreed on the following new policy for the forum.

Pain rounds physicians only forum will be restricted to pain fellows and physicians practicing pain in the U.S.

Forum members will be required to have been sdn members for more than 60 days and have more than 5 posts with at least one post within the past 3 months.

If they are inactive for more than 3 months, we will de-activate the access. They have the option to re-apply but will have to be re-credentialed. "active" means posting and engaging in...
 
Agast said:
It’s a stickied thread at the top

axm397

Thread 'How to Apply for Access to the Physicians Only Pain Forum'

After a number of issues were raised in the forum, the mods had a discussion and agreed on the following new policy for the forum.

Pain rounds physicians only forum will be restricted to pain fellows and physicians practicing pain in the U.S.

Forum members will be required to have been sdn members for more than 60 days and have more than 5 posts with at least one post within the past 3 months.

If they are inactive for more than 3 months, we will de-activate the access. They have the option to re-apply but will have to be re-credentialed. "active" means posting and engaging in...
Click to expand...
yeah, i did that one time a few years back, nothing came of it.that's why, but i'll do it again
 
buddababa said:
yeah, i did that one time a few years back, nothing came of it.that's why, but i'll do it again
Click to expand...
I have tried to get access to the private forum too, multiple times. Nobody responds. I guess i am doing it wrong. Far less runaround to get a dea license then get into the private forum
 
geauxg8rs said:
I have tried to get access to the private forum too, multiple times. Nobody responds. I guess i am doing it wrong. Far less runaround to get a dea license then get into the private forum
Click to expand...

Knock three times...
 
Medman2737 said:
Let me explain.

I moved down south in 2019 and joined the private physician-owned multi-specialty group in town as their sole pain specialist. This group was sold and acquired by a local hospital system in 2023. I didn't want to be a hospital employee, so I joined the rival private multi-specialty group. Well, they were acquired 10 weeks ago by a national hospital system.

So, 10 weeks ago I became a hospital system employee.

Now . . . I am very hardworking (Minimum 13K RVU/year I've been down here). I do all the things (stim implants/Intracept/SI fusion/PNS, etc.). However, my number one payor are Medicare Advantage plans (~70%)

They fired me "without cause", but did say it was a "business decision". Though I don't the actual reason I was terminated, I think it was because I was "too expensive" with procedures. It was explained to me that spending too much money on managed medicare patients can end up COSTING the hospital system money. I am not sure how or why this is the case, but it sounds like they would rather have me just do facet blocks and epidurals and stay away from more costly procedures like stim batteries and implanted spacers.

Has anyone ever experienced something like this before?

I would truly like to understand the "why" I was terminated more than anything so I don't continue to make the same mistakes.

Any insight appreciated.


PS-If anyone is hiring in FL, please DM me 🙂
Click to expand...
Are you open to considering Texas?
 
drusso said:
Knock three times...
Click to expand...
home video truffle shuffle GIF

You have to do the truffle shuffle
 
OP-

Sorry this has happened to you.

You mentioned something to the effect that “ they would prefer I performed epidural and facet injections, as opposed to advanced procedures requiring implants that may be more expensive”

Did they negotiate with you and give you the opportunity to shift your practice toward less expensive procedures before they terminated?
 
I think it is a strange scenario. They are implying they are in a capitated care model or a Kaiser type model. That doesn’t sound right. You would know if you were in that model. Perhaps, the real problem is they are paying msrp or near it on the devices or the past cases are failing on audit and getting recouped.
 
BobBarker said:
I think it is a strange scenario. They are implying they are in a capitated care model or a Kaiser type model. That doesn’t sound right. You would know if you were in that model. Perhaps, the real problem is they are paying msrp or near it on the devices or the past cases are failing on audit and getting recouped.
Click to expand...
They must be in some ACO type arrangement. The system gets an incentive payment for undertreating, they want someone who will just treat back pain by dispensing cheap pills.
 
BobBarker said:
I think it is a strange scenario. They are implying they are in a capitated care model or a Kaiser type model. That doesn’t sound right. You would know if you were in that model. Perhaps, the real problem is they are paying msrp or near it on the devices or the past cases are failing on audit and getting recouped.
Click to expand...

I think it is strange too. HOPD and Academic settings get all sorts of subsidies and rebates. In my experience they don't chase collections. They care about facility fees. Sometimes, it seems as if they want to actually eat losses (to justify rebates? etc). They don't consistently or aggressively negotiate with device companies to drive costs lower in the HOPD. They simply don't care.

Medman although experienced and well trained (by Steve) was not board certified in pain management. That may also have altered the calculus.
 
Centurion38 said:
I think it is strange too. HOPD and Academic settings get all sorts of subsidies and rebates. In my experience they don't chase collections. They care about facility fees. Sometimes, it seems as if they want to actually eat losses (to justify rebates? etc). They don't consistently or aggressively negotiate with device companies to drive costs lower in the HOPD. They simply don't care.

Medman although experienced and well trained (by Steve) was not board certified in pain management. That may also have altered the calculus.
Click to expand...

The SOS is the problem here. It's literally the root of all evil.
 
Centurion38 said:
I think it is strange too. HOPD and Academic settings get all sorts of subsidies and rebates. In my experience they don't chase collections. They care about facility fees. Sometimes, it seems as if they want to actually eat losses (to justify rebates? etc). They don't consistently or aggressively negotiate with device companies to drive costs lower in the HOPD. They simply don't care.

Medman although experienced and well trained (by Steve) was not board certified in pain management. That may also have altered the calculus.
Click to expand...
I think it was personally directed at me. Not the post, his termination....

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Medman2737 said:
Let me explain.

I moved down south in 2019 and joined the private physician-owned multi-specialty group in town as their sole pain specialist. This group was sold and acquired by a local hospital system in 2023. I didn't want to be a hospital employee, so I joined the rival private multi-specialty group. Well, they were acquired 10 weeks ago by a national hospital system.

So, 10 weeks ago I became a hospital system employee.

Now . . . I am very hardworking (Minimum 13K RVU/year I've been down here). I do all the things (stim implants/Intracept/SI fusion/PNS, etc.). However, my number one payor are Medicare Advantage plans (~70%)

They fired me "without cause", but did say it was a "business decision". Though I don't the actual reason I was terminated, I think it was because I was "too expensive" with procedures. It was explained to me that spending too much money on managed medicare patients can end up COSTING the hospital system money. I am not sure how or why this is the case, but it sounds like they would rather have me just do facet blocks and epidurals and stay away from more costly procedures like stim batteries and implanted spacers.

Has anyone ever experienced something like this before?

I would truly like to understand the "why" I was terminated more than anything so I don't continue to make the same mistakes.

Any insight appreciated.


PS-If anyone is hiring in FL, please DM me 🙂
Click to expand...
Sorry to hear. What does your contract say?

Ok 10
 
VA Hopeful Dr said:
Since it looks like several people have had issues with this, here's how you get access to the private physician forum:

1. Verify as a physician - Forum Members - Request Doctor Verification

2. Post here - https://forums.studentdoctor.net/forums/account-help-desk.1143/

In that post, I will need something proving that you are an active practicing pain management physician or in fellowship for that.
Click to expand...
Still curious. Is there an advantage of being in that forum? Is there much of a difference as compared to this one?
 
1 Up said:
Still curious. Is there an advantage of being in that forum? Is there much of a difference as compared to this one?
Click to expand...
I have only recently joined so I can say it is somewhere between the children’s table at thanksgiving vs the adult table on one end. The other end is the Oscar after party invite vs just going to the ceremony
 
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