New job, moving REALLY slow

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futuredo32

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I am currently working as a locums psychiatrist and they know I am not staying. For quite awhile there was quite the drought in psychiatry jobs. I am not brave enough to do full time private practice at this time. Then, all of a sudden, it was raining jobs in psychiatry. I want to work in the Metro Detroit area of Michigan and was offered a position for a private practice clinic the week prior to Memorial Day, amazing pay (for the area) no call, no requirement to supervise the midlevel or anyone else 5 weeks PTO) as a clinic employee. The clinic is currently comprised of the owner who is a psychiatrist , a mid-level, and about 7 therapists. He had a 2nd clinic in another city and sold it. I am the first psychiatrist he has ever hired. He is planning to retire in a few years. They are moving SO slow. The lawyer he uses is apparently in the hospital and that is the delay for a contract. I have casually suggested to his office manager (she's my contact person) that I send them documents so they can credential me, that they send me forms for insurance panelling and she doesn't address my suggestions. I turned down another job that was absolutely decent, but pays about 170k less per year. I am turning down other jobs. I can probably stay as a locums until my current position finds someone new, currently we are extending slowly, but obviously it's a 30/30. (I don't want to become an employee at my locums job). On one hand, I kinda understand, they haven't hired a psychiatrist EVER at this clinic, so perhaps they don't understand how long credentialing and paneling take, but are they this naive? I don't want to be stuck with no job or months without a job. The practice manager has emailed me a few times since my virtual interview. Once to offer me the position, once to say that they were confused as to how to word PTO in the contract (sick days and vacation) and asked if 5 weeks PTO was acceptable, once to ask what my BC was , once to ask if I had a Suboxone license (I said no but I will get one) and the last to let me know the delay in the contract was due to the psychiatrist's business lawyer was in the hospital and sick and that was the delay in the contract. I have never had an employed position, only locums or contract (and my micro private practice.) Is it normal to have to sign a contract before credentialing and insurance paneling? I know some places move slower than others. I am currently being credentialed for a weekend moonlighting position for a hospital and we started in March, but they are working on credentialing and paneling no contract- I did moonlight there in the past as a locums years ago and they were slow then too. Anything else I can say to get them to move faster? This position I am waiting for is EXACTLY what I am looking for- outpatient adult, 10 am-6 pm, high paying, no call, very close to home, enough PTO. The only thing that would make it better would be if they allowed me to do psychotherapy, but that's not realistic and I have my micro practice for that. I don't understand why they are moving so slowly. I understand that this position isn't a done deal until we have both signed the contract. I would LOVE for this position to work out, but why are they moving so slow? Anything appropriate I can do to speed things up? Should I interpret their slowness as a lack of interest? During my interview, the owner said he would pay me more than I was currently earning and asked how much it was, I am doing locums and making more than a facility employed position, he matched it. His ad for a psychiatrist is still online. I don't know if one pays for an ad for a period of time and it just stays online? For Michigan, Metro Detroit is definitely one of the best places to work and most difficult places to find a position. Thank you for any advice or input.

Members don't see this ad.
 
I can’t vouch for other practices, but I do own one. I have past contracts that I can adapt quickly myself. Changing the terminology to hiring a psychiatrist, counselor, psychologist, etc is fairly easy. I can do it in an hour. Once the potential hire requests changes, I do utilize an attorney to adapt the contract. If my primary contracts attorney is out for a week, I would likely stall. More than a week and I would get my back-up attorney up to speed. Once I find someone that I want, time is money.

Credentialing can vary significantly. I’ve got a venture going now, and I think we can have it down to 1 month.
 
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The delay might be entirely innocent but the inability of the owner to have a contingency plan for his regular business lawyer being out of pocket may suggest the level of administrative flexibility you are going to have to put up with in this practice. how long have they kept you waiting?

they are familiar with credentialing, they are doing it for their other clinical employees.
 
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Why not schedule a quick chat with the psychiatrist to feel things out?
 
Nothing has happened at all to move things forward since his practice manager said he wanted to hire me the week before. His practice manager is the one who contacts me. There were other jobs that are totally decent close to home. I said no to tons. If I reach out soon some may still be open. They all pay SIGNIFICANTLY less than this one, but I would rather take one that pays less than not be able to work closer to home. I am going to email the practice manager today.............
 
Nothing has happened at all to move things forward since his practice manager said he wanted to hire me the week before. His practice manager is the one who contacts me. There were other jobs that are totally decent close to home. I said no to tons. If I reach out soon some may still be open. They all pay SIGNIFICANTLY less than this one, but I would rather take one that pays less than not be able to work closer to home. I am going to email the practice manager today.............
So you have changed your mind about taking this position?
 
Except for one low paying part time and one with a 70/30 split, the rest are gone, so I am really hoping this one comes through. I emailed and called the office manager Friday...................................... not looking good for me.
 
Could use advice. The new job offered a contract. 20 dollars less an hour which is still amazing for outpatient private practice, I pay own malpractice and need a 6 year jail and I can't solicit patients or their families. Does that mean if I work there for a year or 2 I couldn't take patients with me if they asked? I turned down most everything thing else . I'm confused about no solicitation and put off by paying my own malpractice. I get 5 paid weeks off a year. It's kinda an independent contractor job but kinda not.
 
Talk to your contract lawyer about the nuances of the solicitation for patients.

Paying your own liability insurance isn't a deal breaker or that much of an issue, just make sure you have in the contract access to the medical records and your liability company too, in the future should a lawsuit ever appear and that the language is conducivie to them not be a barrier to that process.

Now its at the point where you need to decide for yourself if its worth it or not.

Or go open your own GP practice...
 
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Could use advice. The new job offered a contract. 20 dollars less an hour which is still amazing for outpatient private practice, I pay own malpractice and need a 6 year jail and I can't solicit patients or their families. Does that mean if I work there for a year or 2 I couldn't take patients with me if they asked? I turned down most everything thing else . I'm confused about no solicitation and put off by paying my own malpractice. I get 5 paid weeks off a year. It's kinda an independent contractor job but kinda not.

If you are a contractor, expect to pay your own malpractice. Non-solicitation is common in private practice. That typically means that you can’t recruit patients when you leave. If you leave and they find you, it’s fine.
 
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Could use advice. The new job offered a contract. 20 dollars less an hour which is still amazing for outpatient private practice, I pay own malpractice and need a 6 year jail and I can't solicit patients or their families. Does that mean if I work there for a year or 2 I couldn't take patients with me if they asked? I turned down most everything thing else . I'm confused about no solicitation and put off by paying my own malpractice. I get 5 paid weeks off a year. It's kinda an independent contractor job but kinda not.
How much per hour?
 
Could use advice. The new job offered a contract. 20 dollars less an hour which is still amazing for outpatient private practice, I pay own malpractice and need a 6 year jail and I can't solicit patients or their families. Does that mean if I work there for a year or 2 I couldn't take patients with me if they asked? I turned down most everything thing else . I'm confused about no solicitation and put off by paying my own malpractice. I get 5 paid weeks off a year. It's kinda an independent contractor job but kinda not.

If they're paying you by the hour how does this 5 weeks of PTO work?
 
I am having a lawyer look it over and try to negotiate on my behalf. I assume it's the hourly rate for the time off?
 
"The new job offered a contract. 20 dollars less an hour". This sounds fishy. Why would he go back on the previously agreed amount?
No compete clauses are common in contract, but I have asked them to be reduced to something reasonable like 1 year and the employer has always complied.
 
"The new job offered a contract. 20 dollars less an hour". This sounds fishy. Why would he go back on the previously agreed amount?
No compete clauses are common in contract, but I have asked them to be reduced to something reasonable like 1 year and the employer has always complied.
During the interview he said "I will pay you more than you are making now" I am working as a locums and making 200 an hour. In the email it said he met with his CPA and lawyer and due to COVID they could only offer 180 an hour.. They wanted to take away of PTO and I said no to that and we settled. I am going to have a lawyer look the contract over
 
During the interview he said "I will pay you more than you are making now" I am working as a locums and making 200 an hour. In the email it said he met with his CPA and lawyer and due to COVID they could only offer 180 an hour.. They wanted to take away of PTO and I said no to that and we settled. I am going to have a lawyer look the contract over

Yes and the lawyer should be able to advise you on the whole non solicitation thing. You aren’t soliciting them if they are already your patients. That actually doesn’t tend to hold up so I would definitely have your lawyer look at that language specifically in the context of state law. Most states have an abandonment statute where the patients must be given advance notification that you’re leaving and information on how to follow with you to avoid patient abandonment. People try to include this language all the time so you don’t take your patient panel with you when you leave but it’s actually not legal depending on the state. What you aren’t allowed to do is post flyers all over the office soliciting NEW patients from their office to come see you at your new private practice you’re opening down the street, but the patients are free to see whoever they want.
 
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I am having a lawyer look it over and try to negotiate on my behalf. I assume it's the hourly rate for the time off?

Okay but if you are not showing up to the office how are they calculating the hours? This needs to be made super explicit in the contract, if he is willing to push his luck with the hourly rate then he will probably try to push on other things in the future.
 
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"During the interview he said "I will pay you more than you are making now" I am working as a locums and making 200 an hour. In the email it said he met with his CPA and lawyer and due to COVID they could only offer 180 an hour.. They wanted to take away of PTO and I said no to that and we settled."
Its red flags galore! If I was in this situation, I would just walk away and open my own practice.
 
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"During the interview he said "I will pay you more than you are making now" I am working as a locums and making 200 an hour. In the email it said he met with his CPA and lawyer and due to COVID they could only offer 180 an hour.. They wanted to take away of PTO and I said no to that and we settled."
Its red flags galore! If I was in this situation, I would just walk away and open my own practice.
Love me, love me not. Right? Why are contract negotiations not happening in any kind of meeting or real time? This is NOT that hard. Have they never done this before? They are making it hard and lengthy....and not telling you why. I would move on at this point.
 
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Love me, love me not. Right? Why are contract negotiations not happening in any kind of meeting or real time? This is NOT that hard. Have they never done this before? They are making it hard and lengthy....and not telling you why. I would move on at this point.
I am working 90 minutes away. Meeting in person would be difficult for me and my current locums employer. I have a contract. I am having a lawyer review it.
 
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