militarymd

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Now that the "stirring things up thread" has died....I was wondering if you could answer the question I had posed to you in that thread in response to a suggestion you made to me.

Link to question

This was in regards to a non BE physician who functions at a level lower than the rest of the partners.....in a group where we want to divide work, vacation, and income equally.
 

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wow u made a thread out of me?!?! LOL only slightly embarrasing lol..i honestly don't know how to answer that question as I am only a prelim surgery intern still trying to get into ANESTHESIA LOL so i have to defer to ur wisdom on this issue.
 
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militarymd

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medstudent99 said:
wow u made a thread out of me?!?! LOL only slightly embarrasing lol..i honestly don't know how to answer that question as I am only a prelim surgery intern still trying to get into ANESTHESIA LOL so i have to defer to ur wisdom on this issue.
This has nothing to do with anything medically related....just how to address a business.

You had mentioned that we could just let the lower functioning person do easy cases.....but that seems unfair to me....

Would you accept that in your "partners" or "co-workers".....or fellow interns.
 
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in that case i would only hire board certified anesthesiologist
 

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Gern Blansten said:
Just make sure you're not the one that isn't certified.
I agree... As for the original question It doesnt seem fair for someone to get paid the same who doesnt contribute the same amount of work, ie easy cases only. On the other hand I though many groups did not make people partner until they were BC, which would limit their income below that of the partners. Is this how it is in your group military?
 

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Laryngospasm said:
I agree... As for the original question It doesnt seem fair for someone to get paid the same who doesnt contribute the same amount of work, ie easy cases only. On the other hand I though many groups did not make people partner until they were BC, which would limit their income below that of the partners. Is this how it is in your group military?
Groups also face similar issues as their partners age and wish to do simpler, less complex cases. Should they take pay cuts or continue to make as much as their partners. I think this may be a bigger problem in academics, but I am not sure.
 
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militarymd

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Laryngospasm said:
I agree... As for the original question It doesnt seem fair for someone to get paid the same who doesnt contribute the same amount of work, ie easy cases only. On the other hand I though many groups did not make people partner until they were BC, which would limit their income below that of the partners. Is this how it is in your group military?
we pay everyone the same....partner or not....but I think I'm going to have to change it.....

unfortunately....our non-bc folks are urms...so they are "protected"...I guess that's how you can put it.
 

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Gern Blansten said:
Just make sure you're not the one that isn't certified.
i agree. i am not arrogant enough to think that could never happen to me as i understand it 1/3 of ppl taking their anesthesia boards fail. this is probably a bigger problem common to both (this sounds so ridiculous) "urm" and non-urm.
 

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militarymd said:
Now that the "stirring things up thread" has died....I was wondering if you could answer the question I had posed to you in that thread in response to a suggestion you made to me.

Link to question

This was in regards to a non BE physician who functions at a level lower than the rest of the partners.....in a group where we want to divide work, vacation, and income equally.
ah yes. i see. i was wondering what was at the center of your interest in starting a discussion about URMs in medicine. i understand that you are unhappy with a recent hire who has sub-par performance and who failed to become board certified.

in this light, the URM question is completely irrelevent. in your private practice, it appears that you ended up hiring a dud. it would be different if you were to have a problem with an institutional hiring policy. but in the private practice arena, you pretty much operate under a free-market system, and you have only yourself (and your partners) to blame for hiring this dud. in a sense, caveat emptor. you had the right to request any and all relevent documents (evaluations, board scores, references, etc.) and to have as many interviews as you wanted to judge her performance, and to have enough information to make a informed decision.

there are plenty of bad docs out there. it is not affirmative action's fault for allowing this doc into medicine, but your (and your partners) lack of insight for hiring her. if you are stuck with her, it was also your responsibility to have drawn up a contractual agreement to allow for you to release her without legal reprocussions.

if your partners hired her despite your objections, it appears that your main options are to a) suck it up, b) leave, or c) stage a coups. i like "c". ;)
 
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militarymd

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Qtip96 said:
ah yes. i see. i was wondering what was at the center of your interest in starting a discussion about URMs in medicine. i understand that you are unhappy with a recent hire who has sub-par performance and who failed to become board certified.

in this light, the URM question is completely irrelevent. in your private practice, it appears that you ended up hiring a dud. it would be different if you were to have a problem with an institutional hiring policy. but in the private practice arena, you pretty much operate under a free-market system, and you have only yourself (and your partners) to blame for hiring this dud. in a sense, caveat emptor. you had the right to request any and all relevent documents (evaluations, board scores, references, etc.) and to have as many interviews as you wanted to judge her performance, and to have enough information to make a informed decision.

there are plenty of bad docs out there. it is not affirmative action's fault for allowing this doc into medicine, but your (and your partners) lack of insight for hiring her. if you are stuck with her, it was also your responsibility to have drawn up a contractual agreement to allow for you to release her without legal reprocussions.

if your partners hired her despite your objections, it appears that your main options are to a) suck it up, b) leave, or c) stage a coups. i like "c". ;)
Actually, I did not hire this person....I WOULD NEVER HAVE hired this person. This person and others were present prior to my arrival.

Since my arrival, I have slowly become the leader of the group...and hired people who are and will be my partners who are what nimbus called "high performing anti AA whiners" or something like that.

So, now I'm stuck with a low performing non-be URM....who I'm being told by a lawyer that I need to be very careful about letting go....ie they existed prior to me....why all of a sudden that I want to fire someone...."am I discriminating?" against a URM....

I posed a question to see if medstudent had a fair way of keeping this type of person...but I have made up my mind already....I have every intention of firing and not hiring low performers.....URM or not.

In my case, the low performers are URMs.....I probably will have lawsuits on my hands, but it will be worth it to be rid of low performers.
 
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so I did do c)....I had staged to coup.......through hardwork and proper relationships with surgeons with influence and hospital administration, I'm boss, but I'm left with some issues that is not easy to address because of the nature of URMs and their protected status.
 
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in life, there are basically four types of people when it comes to professional performance. they are the same in medicine and they run a continuum. they are

1. hardworking / bright
2. hardworking / dim
3. lazy / bright
4. lazy / dim

i put them in that order specifcally because that's how they should be ranked. also, "bright" and "dim" has less to do with education or intelligence level, and more to do with native ability and ease at understanding concepts (etc). you have to spend the least amount of time managing a #1 and the most with a #4, so naturally everyone wants #1's as colleagues.

the hardest thing to do when it comes to hiring is identifying #3, and they often ultimately cause the most problems. this is because they are often clever enough to make people believe that they are job-worthy during the interview process. then, they quickly figure out how to shirk their responsibilities and piss everyone off once hired. i'd much rather have a #2 at my side than a #3. effort makes up a lot for some lack of ability. as well, there aren't many true #4's in medicine.

as far as the "URM" issue, i hope this isn't specifically about race/ethnicity and AA. as far as firing someone in private practice, all i can say is that most states are "at will" employment and, unless that person has a contract, you don't need much of a reason to get rid of them.
 

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militarymd said:
Actually, I did not hire this person....I WOULD NEVER HAVE hired this person. This person and others were present prior to my arrival.

Since my arrival, I have slowly become the leader of the group...and hired people who are and will be my partners who are what nimbus called "high performing anti AA whiners" or something like that.

So, now I'm stuck with a low performing non-be URM....who I'm being told by a lawyer that I need to be very careful about letting go....ie they existed prior to me....why all of a sudden that I want to fire someone...."am I discriminating?" against a URM....

I posed a question to see if medstudent had a fair way of keeping this type of person...but I have made up my mind already....I have every intention of firing and not hiring low performers.....URM or not.

In my case, the low performers are URMs.....I probably will have lawsuits on my hands, but it will be worth it to be rid of low performers.
Can you define "low performers?" I think I missed out on the initial discussion, but you have a partner/employee that isn't performing to your standards. Is this just because she isn't BC? Does she do fewer cases than the other partners? Does she do everything with less speed? Slower turn over? Make gross errors that could subject the group to malpractice?

I just want to understand the issue at hand. Like the previous poster, I fail, at this point, to see the relevance of her being a URM.

Thanks for explaining...

PMMD
 

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He should hire an URM more like you QTip.
I've heard you described as:
'With speed. i'm agile plus i'm worth your while.
One hundred percent intelligent black child.'
Sounds like an excellent anesthesiologist!
 

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militarymd said:
Actually, I did not hire this person....I WOULD NEVER HAVE hired this person. This person and others were present prior to my arrival.

Since my arrival, I have slowly become the leader of the group...and hired people who are and will be my partners who are what nimbus called "high performing anti AA whiners" or something like that.

So, now I'm stuck with a low performing non-be URM....who I'm being told by a lawyer that I need to be very careful about letting go....ie they existed prior to me....why all of a sudden that I want to fire someone...."am I discriminating?" against a URM....

I posed a question to see if medstudent had a fair way of keeping this type of person...but I have made up my mind already....I have every intention of firing and not hiring low performers.....URM or not.

In my case, the low performers are URMs.....I probably will have lawsuits on my hands, but it will be worth it to be rid of low performers.
Think it would be worthwhile to get a lawyer before you take any action? You know, so they can advise you of the best way to ease said low-performers out and minimize your chance of getting sued.

My instinct would be something like this: go talk to said people and tell them that they are not holding up their end of the practice. Tell them that if they can't get their performance up to the rest of you, that you'll have to take some kind of action. Seems like you'd be giving them a fair chance to get their act together.

But, that all being said, I don't know the inner workings of anesthesiology so I'm fully prepared to be quite wrong.
 
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pmichaelmd said:
Can you define "low performers?" I think I missed out on the initial discussion, but you have a partner/employee that isn't performing to your standards. Is this just because she isn't BC? Does she do fewer cases than the other partners? Does she do everything with less speed? Slower turn over? Make gross errors that could subject the group to malpractice?

I just want to understand the issue at hand. Like the previous poster, I fail, at this point, to see the relevance of her being a URM.

Thanks for explaining...

PMMD
All of the above....and is an URM....my lawyer says that firing someone like that can lead to a discrimination lawsuit based on URM status.
 

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Yo nolagas, 'twas an mighty vivrant pic dude. :cool:

VA Hopeful Dr said:
...My instinct would be something like this: go talk to said people and tell them that they are not holding up their end of the practice. Tell them that if they can't get their performance up to the rest of you, that you'll have to take some kind of action. Seems like you'd be giving them a fair chance to get their act together...
"breathe and stop..."

probably best to first get all the hard data and legal arguments together, and load the gun before the chat. seems like there should be plenty of objective data to question her reliability as a business partner (non BE, etc.). a talk like the above is definitely going to get anybody's litiginous radar up. seems to me that you shouldn't bluff something like this. if she is a partner, is there a way of offering to buy out her share of the practice to end things amicably?
 

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i have nothing else to say beside i think he/she being an "URM"! is irrelevant.
 

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I have been in similar situation, outside of medicine. one important thing mentioned already is objective documentation:
formal performance evaluations must reflect your overall opinion.
create probationary period and allow 3-6 months for employee to improve.
employees who have been on probation should receive evals q3months or less so they dont feel comfortable in lapsing back once they get a improved eval.
have different people do the eval meetings and try and have atleast three people contribute to eval.
create new policy regarding what is considered substandard performance.
hire all peeps to one or two year contracts and keep them on one-two year contracts until partner and change to five or more years.
new hires are automatically placed on probation for first 6 months to year and can be fired without provocation.
just some suggestions which you probaly thought of already, but just in case i thought i would share.
 

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medstudent99 said:
i have nothing else to say beside i think he/she being an "URM"! is irrelevant.

Are you reading the rest of this thread? Hes talking about firing this individual based on poor performance, which can be misconstrued by the legal system to be a racial issue. Does that clear it up for you?
 
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militarymd

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medstudent99 said:
i have nothing else to say beside i think he/she being an "URM"! is irrelevant.
My high priced lawyer doesn't think so. Do you have a law degree and many years of practice?
 
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militarymd

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threepeas said:
I have been in similar situation, outside of medicine. one important thing mentioned already is objective documentation:
formal performance evaluations must reflect your overall opinion.
create probationary period and allow 3-6 months for employee to improve.
employees who have been on probation should receive evals q3months or less so they dont feel comfortable in lapsing back once they get a improved eval.
have different people do the eval meetings and try and have atleast three people contribute to eval.
create new policy regarding what is considered substandard performance.
hire all peeps to one or two year contracts and keep them on one-two year contracts until partner and change to five or more years.
new hires are automatically placed on probation for first 6 months to year and can be fired without provocation.
just some suggestions which you probaly thought of already, but just in case i thought i would share.
I/we didn't fall off the turnip truck yesterday. Many performance criteria in anesthesia is subjective.....additional testing or no additional testing....subjective...

As for things like punctuality....said person just shows on time for the probationary period and when period is over...returns to prior behavior.

Said person knows how to work the system.
 
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militarymd

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Qtip96 said:
Yo VA Hopeful, 'twas an mighty vivrant pic dude. :cool:



"breathe and stop..."

probably best to first get all the hard data and legal arguments together, and load the gun before the chat. seems like there should be plenty of objective data to question her reliability as a business partner (non BE, etc.). a talk like the above is definitely going to get anybody's litiginous radar up. seems to me that you shouldn't bluff something like this. if she is a partner, is there a way of offering to buy out her share of the practice to end things amicably?
Not partner, but has been here much longer than me....has no compunction about raising the minority card.
 

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militarymd said:
\Since my arrival, I have slowly become the leader of the group....
How did this happen?



Anyway, You fire him. get rid of him. IF he is lazy and doesnt dot he work. Fire him. Dont renew his contract. Your lawyer is full of ****. he is not protected. he is not union. Get rid of him. If you keep him and continue bitching its YOUR fault. Because youc an do something about it.. And it has nothing to do with his race and board certification status.

But you also have to understand.. not everyone has the same skills.. someone maybe good at peds. someone else at hearts. someone else in something else.. thats just the way it goes. .. so just understand that people are different. And the fact taht he is an under represented minority means nothing if you are firing him.. Affirmative action only gets them in the door but wont let you skate by if you perform poorly. I think you are just a racist and just have not been around high achieving blacks and you are linking this one guy's bad performance to his race and thats bad.. anyway i hope you do something about it and fire him...
 
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militarymd

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johankriek said:
How did this happen?
Politics.....Probably because I'm not a low performer.



johankriek said:
Anyway, You fire him. get rid of him. IF he is lazy and doesnt dot he work. Fire him. Dont renew his contract. Your lawyer is full of ****. he is not protected. he is not union. Get rid of him. If you keep him and continue bitching its YOUR fault. Because youc an do something about it..
militarymd said:
I posed a question to see if medstudent had a fair way of keeping this type of person...but I have made up my mind already....I have every intention of firing and not hiring low performers.....URM or not.
johankriek said:
But you also have to understand.. not everyone has the same skills.. someone maybe good at peds. someone else at hearts. someone else in something else.. thats just the way it goes. .. so just understand that people are different.
This person is not good at anything....All my new partners can do EVERYTHING better than this person....I understand that people are different...and this one should never have been allowed into medical school...but did....How? You tell me.

johankriek said:
And the fact taht he is an under represented minority means nothing if you are firing him.. Affirmative action only gets them in the door but wont let you skate by if you perform poorly. I think you are just a racist and just have not been around high achieving blacks and you are linking this one guy's bad performance to his race and thats bad.. anyway i hope you do something about it and fire him..
Well, like I said, my mind is made up.....but my high priced lawyer is warning me that there may be consequences.....why? My lawyer has told me why....you don't believe it...that's fine. You can believe what you want.
 

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Laryngospasm said:
Are you reading the rest of this thread? Hes talking about firing this individual based on poor performance, which can be misconstrued by the legal system to be a racial issue. Does that clear it up for you?
all i am saying is the fact that this person is not "white" or "asian" should not factor into this person being terminated. i mean if they are not working out they are not working out. don't u have other non "white/asian" collegues that do a good job. this should be good enough to prove ur are not being prejudice or discriminating. geez...take a chill pill
 

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i'm not posting any comments about "urms/aa" whatever, this is not what i joined medicine for. i'm sure you can come up with something without my input. it looks like u have already made up ur minds. u don't need my responses to do what ur already set out to do.
 
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johankriek said:
I think you are just a racist and just have not been around high achieving blacks and you are linking this one guy's bad performance to his race and thats bad..
Show me my post where I said that this person is a low performer because of his race.

One of the people I'm in the process of recruiting to be my partner is black.....I know of at least one high achieving urm......so stop calling people names.....


I want to see my post where I said what you said I said.
 
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medstudent99 said:
i'm not posting any comments about "urms/aa" whatever, this is not what i joined medicine for. i'm sure you can come up with something without my input. it looks like u have already made up ur minds. u don't need my responses to do what ur already set out to do.
Read the original post....You said let the person stay and do the easy cases....you asked "what's the big deal?"

So I'm asking you how to make it fair.....

You said that this was not possible....and to fire this person...

And I'm going to.....but my high priced lawyer is advising caution because of this person's URM status.....


Then all of a sudden you are all defensive????? What's up about that?

Legal advice...meaning people involved in the court system....ie someone with more experience then me about this stuff is telling me that URM's will use their status (skin color) to keep jobs that they are not entitled to.....

I'm not saying this.....my high priced attorney is....

What's got you so upset?
 

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DreamMachine said:
I may have missed a couple lines.

Military, is this the only URM in your practice? How about replacing him with another that is more qualified and competent? Is that possible? It would be hard to play the race card in that instance. That scenario seems better (on the surface) than facing a big lawsuit or keeping this guy around.
Yes, the only URM...but not the only person that needs to leave....others have been let go already.

I'm not going to recruit based on race status.....I recruit based on qualitifications and personality....ability to fit into group and hospital.......
 

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militarymd said:
I/we didn't fall off the turnip truck yesterday. Many performance criteria in anesthesia is subjective.....additional testing or no additional testing....subjective...

As for things like punctuality....said person just shows on time for the probationary period and when period is over...returns to prior behavior.

Said person knows how to work the system.
All of this is unfortunate...I guess there will always be those who know how to milk the system for all it's worth, URM or not. I think people were jumping on your posts because they are assuming that you are equating low performance with URM status. I think (hope) you were pointing out her ethnicity only in reference to potential legal entanglements. I wonder if your attorney is more worried about her "playing the race card" or "playing the gender card?" I imagine either/both will make getting rid of her difficult, although if you have objective data demonstrating her substandard performance, that speaks volumes.

Good luck!

PMMD
 

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DreamMachine said:
I totally understand.

Have others been let go for the same reasons?
Similar things....but this one is the only one who is not even Board Eligible....you case you don't know what this means...it means you have failed the written boards 6 times.
 

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militarymd said:
Read the original post....You said let the person stay and do the easy cases....you asked "what's the big deal?"

So I'm asking you how to make it fair.....

You said that this was not possible....and to fire this person...

And I'm going to.....but my high priced lawyer is advising caution because of this person's URM status.....


Then all of a sudden you are all defensive????? What's up about that?

Legal advice...meaning people involved in the court system....ie someone with more experience then me about this stuff is telling me that URM's will use their status (skin color) to keep jobs that they are not entitled to.....

I'm not saying this.....my high priced attorney is....

What's got you so upset?

what got me so upset?!?!?! did u see laryngospasm talking down to me like i'm stupid or something? did u not see that...rather than asking me that question why don't larygnospasm why he has so much animosity towards me...man i can read u like a book and i can guess why that is so...don't worry i get this crap all the time. nuthin new :D
 

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militarymd said:
..I understand that people are different...and this one should never have been allowed into medical school...but did....How? You tell me.



\.
DUDE
let this topic die.(john tucker must die). why wont you.. You never responded to my point that I made later on in your previious thread on "stirring things up".

The fact that there is affirmative action in medical school admissions has nothing to do with your current problems. And the fact that you believe that is telling of your personality and your thought processes..

I told you FIre the guy .. Document everything .. ask him to leave.. or leave yourself... Im sorry... life is too short to listen to you bitch and moan abouthow bad affirmative action is.. and how horrible it is for medicine.. especially when i posted the stats that i posted in your other thread that died..
 

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Laryngospasm said:
Are you reading the rest of this thread? Hes talking about firing this individual based on poor performance, which can be misconstrued by the legal system to be a racial issue. Does that clear it up for you?
this is the comment i was refering to...LOL believe this attitude towards "urm's" by well frankly mostly white ppl is nothing new...thanks for clearing that one up for me laryngospasm
 

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militarymd said:
Show me my post where I said that this person is a low performer because of his race.
.
your implying it, by linking affirmative action to this guys performance..
 
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johankriek said:
your implying it, by linking affirmative action to this guys performance..
show me the post....you're reading into it.....why are you reading into things that aren't there?

Usually it is because of what you yourself believe but suppress.
 
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militarymd

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johankriek said:
DUDE
let this topic die.(john tucker must die). why wont you.. You never responded to my point that I made later on in your previious thread on "stirring things up".

The fact that there is affirmative action in medical school admissions has nothing to do with your current problems. And the fact that you believe that is telling of your personality and your thought processes..

I told you FIre the guy .. Document everything .. ask him to leave.. or leave yourself... Im sorry... life is too short to listen to you bitch and moan abouthow bad affirmative action is.. and how horrible it is for medicine.. especially when i posted the stats that i posted in your other thread that died..
militarymd said:
Well, like I said, my mind is made up.....but my high priced lawyer is warning me that there may be consequences.....why? My lawyer has told me why....you don't believe it...that's fine. You can believe what you want.
And I told YOU...I was going to.....and I told YOU....it's my attorney who is telling me that there may be problems...which I'm going to have to endure....why would an experienced attorney who deals in these things think that there may be problems.....why don't YOU tell me?????

Johan.....you don't read too good.
 

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militarymd

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Johan...


show me where on this thread I said anything about AA.....there is none...you brought it up.
 

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I think military is venting a little bit and everybody is entitled to some venting. I think it is sufficient to say that anybody who has failed the written boards SIX TIMES and is no longer BE without returning and repeating a year of residency would be subject to his ire, whether they were black, white, green, or purple.

Enough said.


PMMD
 

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militarymd said:
show me the post.....

go to post 39 and re read..

go to post 39 and re read

you are implying it my friend, and now you are quibbling..

by the way.. are you a chick?
 
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militarymd

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DreamMachine said:
I know the whole race thing, but he is clearly not competent based on this board eligibilty and you have fired non-URM in the past that have been better than him. You gotta fire him and get ready for the lawsuit you will hopefully win based on your past firings and his inability to pass the boards.
The fact that I EVEN have to worry about a lawsuit because of someone's skin color is just PLAIN WRONG....WRONG ....WRONG....WRONG....

It doesn't matter if you win or not.....just that fact that a suit comes means you lose....

court costs, attorney fees beyond what I had to pay already....possible tying up of accounts receivables...etc..etc....dirty tricks that can make a new, growing group incrediblyu unstable because you can't pay the partners.
 

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medstudent99 said:
...i honestly don't know how to answer that question as I am only a prelim surgery intern still trying to get into ANESTHESIA LOL so i have to defer to ur wisdom on this issue.
militarymd said:
This has nothing to do with anything medically related....just how to address a business.

You had mentioned that we could just let the lower functioning person do easy cases.....but that seems unfair to me....

Would you accept that in your "partners" or "co-workers".....or fellow interns/
medstudent99 said:
i have nothing else to say beside i think he/she being an "URM"! is irrelevant.
militarymd said:
My high priced lawyer doesn't think so. Do you have a law degree and many years of practice?
yo mil, this way uncool.

you call on medstudent99 into a discussion, and he humbly states that he does not have the experience to adequately answer your question. you bait him into further discussion appealing to his general sense of right vs wrong. then you b*tchslap him with an argument that he lacks sufficient qualifications to participate.

if course he's not a lawyer. most of us aren't. we're doctors. you'd be a fool to take our legal advice. so why trash an intern in a pissing match?
 
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