Past PIP and effect on licensing and credentialing

[newnew24]

A few months into my first hospitalist job post-residency, an adverse outcome patient case was reviewed.
While the cause of the adverse outcome was multifactorial and it is possible that extra imaging/quicker specialist consultation may not have made a difference, I was queried. Admittedly, there were points I could have improved on, like better documentation to reflect that I was aware of everything going on. Based on this, the hospital ended up
Proposing a voluntary PIP. I honestly was so naive, I had never heard of such. All I knew was that I was taught in residency to be quick to admit fault and appear ‘teachable’. I also didn’t know ( yes, medical training can be so sheltered), that often, PIPs are just ways to continue to document how much you suck and eventually terminate you. All I was focused on, was keeping the job and not having to move again, as well as not having to pay back the sign on bonus which I had already used to pay debt from relocation. I agreed to the PIP.
The situation ended in them continuing to complain about everything I did and blaming me for systemic issues and eventually terminating me without fault, after the PIP term was completed. There was no official feedback on the PIP itself.

I retained a lawyer which in hindsight, it is clear he has minimal experience in defending doctors or navigating employment issues as it pertains to physicians. At this point, I accept my losses.
I also was told the PIP was more of a confidential review process, which is why I didn’t declare it as a disciplinary action in a new license application. My former employer when asked to fill forms from the new state board, Then said that I was indeed disciplined.

My specific questions are as follows:

-can a PIP and patient case review (whether there were things I could have done better or not) lead to denial of new state licensure? This never led to a NPDB report and I have no malpractice claims

-The new employer I signed a contract with, has started the credentialing process and have reached out to me about the PIP. They found out about the PIP from the board. I explained that since it was presented to me as a confidential review that wouldn’t lead to a npdb report, I didn’t believe I needed to report it. I explained my side of the story. How does this part PIP affect credentialing and starting this new job?

Please kindly resist the urge to not focus on the questions and instead, inform me how the issue must have been with me. I have dealt with the case for almost a year. Shoulda/coulda/woulda is of no use at this point. Complicated patient cases are seldom due to one person’s doings. No one has dissected every aspect of the case and what I ‘could’ have done more than myself. There are also parts of the situation I haven’t disclosed so I am not easily identifiable. The handling of the case was discriminatory/verged on scapegoatism; hence why i don’t feel adequately represented by my legal counsel. But that’s another story….

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[gutonc]

My specific questions are as follows:

-can a PIP and patient case review (whether there were things I could have done better or not) lead to denial of new state licensure? This never led to a NPDB report and I have no malpractice claims

"Can" they? Sure. Are they likely to? No

-The new employer I signed a contract with, has started the credentialing process and have reached out to me about the PIP. They found out about the PIP from the board. I explained that since it was presented to me as a confidential review that wouldn’t lead to a npdb report, I didn’t believe I needed to report it. I explained my side of the story. How does this part PIP affect credentialing and starting this new job?

The credentialing office asked you a question, which you answered honestly (I hope). That will likely be the end of it and you'll be off to the races.

What you've hopefully learned here is that you should always disclose anything like this, whether or not you think it will actually come up, or is relevant. The reason is simple human psychology. There are 3 possible scenarios here:
1. You disclose, prior employer says nothing. Outcome: Most likely new employer says it's nothing since old employer says it was nothing. They see you as someone who will report anything even remotely untoward. And every employer loves a narc on the staff.
2. You disclose, prior employer discloses. Outcome: You were honest, maybe they ask you a clarifying question, but since the stories are congruent and it didn't rise to the level of an NPDB report or tort claim, and assuming your professional references are fine, it's not a problem.
3. You don't disclose, prior employer says something. Outcome: "What else is @newnew24 hiding from us?" Now you're on the defensive. Again, the most likely outcome is that they ask you a bunch of questions, you answer honestly, and everything goes through.

I agree that your prior employer is being a hardass about this, but some other possibilities are that the new employer or state's form said something like "has this person every been on an internal probation or improvement program, whether or not it was reported to the NPDB or the state licensing board" (I've seen that one), or maybe it was a random office staff person who got the form dropped on their desk, looked in your file, checked the "yes" box for disciplinary action, dropped it on someone else's desk for a signature and nobody actually read anything.

In the end, you are where you are, and the most likely scenario is that you're going to get licensed and credentialed and everything will be fine.

If it makes you feel any better, I recently got a license in a new state and had to appear in front of a panel (fortunately via Zoom) to explain that most MD/PhDs have a hard time completing Step 1-->3 in 7 years. This is despite the fact that I have been licensed in a neighboring state for >15 years and that there are no gaps >3 weeks in my CV from day 1 of med school until today. That one stupid administrative flag resulted in an actual hearing on my application, and nobody took 15 seconds to ask if there might be an obvious mitigating factor.

 

[newnew24]

"Can" they? Sure. Are they likely to? No

The credentialing office asked you a question, which you answered honestly (I hope). That will likely be the end of it and you'll be off to the races.

What you've hopefully learned here is that you should always disclose anything like this, whether or not you think it will actually come up, or is relevant. The reason is simple human psychology. There are 3 possible scenarios here:
1. You disclose, prior employer says nothing. Outcome: Most likely new employer says it's nothing since old employer says it was nothing. They see you as someone who will report anything even remotely untoward. And every employer loves a narc on the staff.
2. You disclose, prior employer discloses. Outcome: You were honest, maybe they ask you a clarifying question, but since the stories are congruent and it didn't rise to the level of an NPDB report or tort claim, and assuming your professional references are fine, it's not a problem.
3. You don't disclose, prior employer says something. Outcome: "What else is @newnew24 hiding from us?" Now you're on the defensive. Again, the most likely outcome is that they ask you a bunch of questions, you answer honestly, and everything goes through.

I agree that your prior employer is being a hardass about this, but some other possibilities are that the new employer or state's form said something like "has this person every been on an internal probation or improvement program, whether or not it was reported to the NPDB or the state licensing board" (I've seen that one), or maybe it was a random office staff person who got the form dropped on their desk, looked in your file, checked the "yes" box for disciplinary action, dropped it on someone else's desk for a signature and nobody actually read anything.

In the end, you are where you are, and the most likely scenario is that you're going to get licensed and credentialed and everything will be fine.

If it makes you feel any better, I recently got a license in a new state and had to appear in front of a panel (fortunately via Zoom) to explain that most MD/PhDs have a hard time completing Step 1-->3 in 7 years. This is despite the fact that I have been licensed in a neighboring state for >15 years and that there are no gaps >3 weeks in my CV from day 1 of med school until today. That one stupid administrative flag resulted in an actual hearing on my application, and nobody took 15 seconds to ask if there might be an obvious mitigating factor.

Thank you for the thorough and informed response. Yes, this was a case of, I didn’t disclose and employer ( also most likely the admin staff filing the form) clicked yes to the ‘disciplinary action’ part… then board asked me to explain. Board also requested a copy of the PIP which I provided and which states ‘this isn’t an adverse professional review and we are NOT required to report to the npdb or state board’. The board is now waiting for a hearing on the case.
This is all within a year of my graduation from residency ( residency went seamlessly) so it’s been a source of much anxiety.
Thanks for the reassurance and for taking the time to read and respond.

 

[NotAProgDirector]

If the PIP was in fact a QA process and not disclosable, and if you were terminated "without fault" (which means you were laid off essentially), then they never should have checked that box / disclosed, and if you do run into any troubles you would have a legal action against them. Hopefully it will not come to that. I agree this will slow things down quite a bit, but likely to be OK in the end.

 

[dozitgetchahi]

A few months into my first hospitalist job post-residency, an adverse outcome patient case was reviewed.
While the cause of the adverse outcome was multifactorial and it is possible that extra imaging/quicker specialist consultation may not have made a difference, I was queried. Admittedly, there were points I could have improved on, like better documentation to reflect that I was aware of everything going on. Based on this, the hospital ended up
Proposing a voluntary PIP. I honestly was so naive, I had never heard of such. All I knew was that I was taught in residency to be quick to admit fault and appear ‘teachable’. I also didn’t know ( yes, medical training can be so sheltered), that often, PIPs are just ways to continue to document how much you suck and eventually terminate you. All I was focused on, was keeping the job and not having to move again, as well as not having to pay back the sign on bonus which I had already used to pay debt from relocation. I agreed to the PIP.
The situation ended in them continuing to complain about everything I did and blaming me for systemic issues and eventually terminating me without fault, after the PIP term was completed. There was no official feedback on the PIP itself.

I retained a lawyer which in hindsight, it is clear he has minimal experience in defending doctors or navigating employment issues as it pertains to physicians. At this point, I accept my losses.
I also was told the PIP was more of a confidential review process, which is why I didn’t declare it as a disciplinary action in a new license application. My former employer when asked to fill forms from the new state board, Then said that I was indeed disciplined.

My specific questions are as follows:

-can a PIP and patient case review (whether there were things I could have done better or not) lead to denial of new state licensure? This never led to a NPDB report and I have no malpractice claims

-The new employer I signed a contract with, has started the credentialing process and have reached out to me about the PIP. They found out about the PIP from the board. I explained that since it was presented to me as a confidential review that wouldn’t lead to a npdb report, I didn’t believe I needed to report it. I explained my side of the story. How does this part PIP affect credentialing and starting this new job?

Please kindly resist the urge to not focus on the questions and instead, inform me how the issue must have been with me. I have dealt with the case for almost a year. Shoulda/coulda/woulda is of no use at this point. Complicated patient cases are seldom due to one person’s doings. No one has dissected every aspect of the case and what I ‘could’ have done more than myself. There are also parts of the situation I haven’t disclosed so I am not easily identifiable. The handling of the case was discriminatory/verged on scapegoatism; hence why i don’t feel adequately represented by my legal counsel. But that’s another story….

Aside from what’s already been discussed, there’s another point I’d add both for yourself and others who read this…

- Never, ever, ever agree to a “voluntary PIP”, or in fact any PIP. Leave the job before you ever accept a PIP. We just had another post here recently where someone was proposed a PIP, and the near unanimous advice was for them to leave the job. Just leave.

 

[newnew24]

Aside from what’s already been discussed, there’s another point I’d add both for yourself and others who read this…

- Never, ever, ever agree to a “voluntary PIP”, or in fact any PIP. Leave the job before you ever accept a PIP. We just had another post here recently where someone was proposed a PIP, and the near unanimous advice was for them to leave the job. Just leave.

Wouldn’t that constitute ‘resigning to avoid investigation or discipline or resigning during an investigation’? I heard that’s the main red flag for credentialing

 

[Crayola227]

Wouldn’t that constitute ‘resigning to avoid investigation or discipline or resigning during an investigation’? I heard that’s the main red flag for credentialing

A PIP is not itself an investigation. You could try to argue that it's a disciplinary action, but this is another reason not to accept it (signing it, and resigning instead), because effectively not signing it, that's like your boss having one version and events, and you don't agree, and it is clear to you that it is the result of not seeing eye to eye, and THAT is why you left. Not the same as, you did wrong, you know you did, you signed that you did, and you let your employer spank you.

It's like, your gf comes to you and says wow you've been staying out late I think you're cheating on me, and instead of admitting fautl (you're not at fault and don't believe you are in this scenario), then the next response is logical: you're like there is nothing to this, now I know you are cray cray, so we are not going to be able to work this out so no need for further discussion I'm leaving.

Signing the PIP is admitting fault AND you are literally agreeing all the bad stuff is 100% true. Or why else would you sign? That is how that kind of thing always gets looked at in law. Signing is your legal agreement that the document signed is accurate.

I just dealt with something like this with my own attorney. Whenever someone sends you something in writing, and you don't correct or object to them in some way within a certain timeframe, or worse yet, you sign it, *legally* that is an admission in itself. (If unsigned you can argue you didn't agree, but it doesn't look good if there are no objections). So if you don't agree, the best thing to do, is don't agree and have documentation saying you don't you agree, that you give them.

Now I will have to defer to others how you check the boxes or play it off if you resign when presented with the PIP. You said you were queried about a case. That sounds like an investigation and so resigning in that case probably checks the box.

Vs in other situations, your boss and PIP might be full of BS like "late to work, frequently signs notes late, nurses complain" in which case this is not an investigation, there is more to argue "eye of the beholder" and that is the situation where you could resign without signing the PIP, and inform your employer that they are wrong and you don't agree with their assessment, and depending on wording not check certain boxes about resigning to avoid investigation or discipline or termination. But I'm not sure so others should answer that specifically.

I think it's another thing where, you have to consider how things look when you check certain boxes and what is the other party going to say, and then what do you have to say about that.

So resigning to avoid an investigation, if that was what this was about, not good. Resigning to avoid discipline, also not good. Not signing something your employer wants you to sign that you believe is wrong and unaccurate? Totally within your rights to do from a common sense standpoint. But depending on the boxes and what advice people have here, I don't know how that gets reported and how it affects things.

I just know refusing to sign and responding you don't agree and resigning, regardless of how that makes you checkbox an app later, is better because you have room to argue what happened. And never sign something damaging you don't believe. Unless an experienced attorney tells you to.

 

[HemeOncHopeful19]

OP every step of the way you said “in hindsight I should have used a lawyer with experience”

Go find a lawyer with experience dealing with the specific state medical board you are applying to TODAY and get off SDN, just come update us when it’s all over

 

[timpview]

Yep you get word a PIP is coming than I wouldn’t do anything with it.. not acknowledge or respond to it. I wouldn’t open the email.

The timing would just happen to coincide with a bad health issue in a family member that will now cause me to resign in order to deal with that personal tragedy.

 

[anonperson]

My specific questions are as follows:

-can a PIP and patient case review (whether there were things I could have done better or not) lead to denial of new state licensure? This never led to a NPDB report and I have no malpractice claims

-The new employer I signed a contract with, has started the credentialing process and have reached out to me about the PIP. They found out about the PIP from the board. I explained that since it was presented to me as a confidential review that wouldn’t lead to a npdb report, I didn’t believe I needed to report it. I explained my side of the story. How does this part PIP affect credentialing and starting this new job?

Please kindly resist the urge to not focus on the questions and instead, inform me how the issue must have been with me. I have dealt with the case for almost a year. Shoulda/coulda/woulda is of no use at this point. Complicated patient cases are seldom due to one person’s doings. No one has dissected every aspect of the case and what I ‘could’ have done more than myself. There are also parts of the situation I haven’t disclosed so I am not easily identifiable. The handling of the case was discriminatory/verged on scapegoatism; hence why i don’t feel adequately represented by my legal counsel. But that’s another story….

Please clarify:

Was the PIP put in place by your employer or by the department? Typically when there is a clinical issue, cases are brought for peer review to the department and it is reviewed by the chair etc. If this is just through your employer that is a different process.

Certain things get reported to the state medical board and the medical staff office at your prior hospital can tell you if this was reported to the state medical board

If it wasn't, then it shouldn't have greatly your impact in getting a new medical license.

The second part is getting privileges with a new hospital for your new job.

If this PIP was through your department, that will definitely come up on your application and it will be up to the discretion of the chair to approve your application or not. Most people are reasonable and if you adequately explain your situation, it should be fine.

To the others:
If there is a formal peer review process through the department and one decides to resign in the middle, that is not a good look. Hospitals will include that information on their application process and it will follow you around.

When I was chair, I rejected an application for this very reason. Hard to trust someone if they resign if there is a bad outcome.

--------------------------------------------------------------

To the others reading this, it is best to have some allies in your department.. Doesn't matter if it's a community hospital or academic place. It can be unfair, but if you are liked etc, you are less likely to run into issues like this. It's the reality of workplace politics.

 

[gutonc]

Please clarify:

Was the PIP put in place by your employer or by the department? Typically when there is a clinical issue, cases are brought for peer review to the department and it is reviewed by the chair etc. If this is just through your employer that is a different process.

Certain things get reported to the state medical board and the medical staff office at your prior hospital can tell you if this was reported to the state medical board

If it wasn't, then it shouldn't have greatly your impact in getting a new medical license.

The second part is getting privileges with a new hospital for your new job.

If this PIP was through your department, that will definitely come up on your application and it will be up to the discretion of the chair to approve your application or not. Most people are reasonable and if you adequately explain your situation, it should be fine.

To the others:
If there is a formal peer review process through the department and one decides to resign in the middle, that is not a good look. Hospitals will include that information on their application process and it will follow you around.

When I was chair, I rejected an application for this very reason. Hard to trust someone if they resign if there is a bad outcome.

--------------------------------------------------------------

To the others reading this, it is best to have some allies in your department.. Doesn't matter if it's a community hospital or academic place. It can be unfair, but if you are liked etc, you are less likely to run into issues like this. It's the reality of workplace politics.

QFT. Pretty much everybody is going to get some sort of "black mark" on their record at some point, most of them are BS, some of them are real, but they're all generally there to make sure that somebody else's butt is getting covered (not yours). The difference is that the people that nobody likes tend to accumulate more of them (BS and legit) and when push comes to shove down the road, those people won't have anyone willing to stand up for them and be the character witness they need.

 

[dozitgetchahi]

Please clarify:

Was the PIP put in place by your employer or by the department? Typically when there is a clinical issue, cases are brought for peer review to the department and it is reviewed by the chair etc. If this is just through your employer that is a different process.

Certain things get reported to the state medical board and the medical staff office at your prior hospital can tell you if this was reported to the state medical board

If it wasn't, then it shouldn't have greatly your impact in getting a new medical license.

The second part is getting privileges with a new hospital for your new job.

If this PIP was through your department, that will definitely come up on your application and it will be up to the discretion of the chair to approve your application or not. Most people are reasonable and if you adequately explain your situation, it should be fine.

To the others:
If there is a formal peer review process through the department and one decides to resign in the middle, that is not a good look. Hospitals will include that information on their application process and it will follow you around.

When I was chair, I rejected an application for this very reason. Hard to trust someone if they resign if there is a bad outcome.

--------------------------------------------------------------

To the others reading this, it is best to have some allies in your department.. Doesn't matter if it's a community hospital or academic place. It can be unfair, but if you are liked etc, you are less likely to run into issues like this. It's the reality of workplace politics.

There’s a difference between an actual peer review process and a PIP. I’m not sure we have enough details here to see what was actually going on.

OP, one thing you should do is request a full copy of your employee file from your previous hospital asap. This will give you the details of what transpired. In fact, I generally recommend that everyone request a copy of this when they leave a job. You want to make sure that everything in there is accurate, and if there is something questionable in there you want to be able to try to head it off before the credentialing process starts for the next job.

 

[dozitgetchahi]

OP every step of the way you said “in hindsight I should have used a lawyer with experience”

Go find a lawyer with experience dealing with the specific state medical board you are applying to TODAY and get off SDN, just come update us when it’s all over

That too.

It’s really important to have an attorney that knows exactly how to manage this. Not “just any” attorney is going to be helpful here.

 

[Crayola227]

I've found it helpful for any venture in life where an attorney might be useful (say I am getting licensed and will begin to practice in a new state) to do some homework and find say, a physician boarding and employment law attorney (they exist, usually at least one per state, even a firm or some such) and sometimes you need more than one, actually. Say one for a board, one for issues with the hospital and HR.

You track them down. It's a process. It can take a couple or weeks or so to do (calling around, having a consult), which is why I say to track one down proactively. If you don't have a pressing legal issue already they will often schedule you further out. Discuss the kinds of things you could see needing help with (credentialing, former/future PIP, board/hospital investigation, malpractice, PHP if you know you have mental health diagnoses, reviewing employment contracts). It may be more than one attorney to cover these bases. A lot of times you can get a free consult, and in any case it's free to ask them or their secretary what things they do, and if they don’t do it, do they have a referral. And their hourly rates or retainers. Any attorney is happy to have their phone number in your back pocket so don't feel silly shopping for one before you need them.

People easily make the case you want your new employment contract looked over by someone anyway. And make sure you already have a board attorney, you're always just a pissed off patient away from an investigation (not that you need an attorney for those sorts of bull **** complaints, still, it can get more serious even through no fault of your own).

Also, I then recommend you set aside as a goal, up to $10,000 as a legal fee fund. At least $2000 to begin with which shouldn't be too hard.

The reality is that for a lot of industries and jobs, it really makes sense to consider legal expenses as just a given part of your employment expenses and plan accordingly. People think they can do a lot of things in life and not suffer for a lack of legal advice. Lots of things in life, you will benefit from an attorney yesterday, so don't skimp out on getting an attorney proactively. An hour might be $250 but it's surprising how far that hour can go in preventing further problems.

 

[newnew24]

Please clarify:

Was the PIP put in place by your employer or by the department? Typically when there is a clinical issue, cases are brought for peer review to the department and it is reviewed by the chair etc. If this is just through your employer that is a different process.

Certain things get reported to the state medical board and the medical staff office at your prior hospital can tell you if this was reported to the state medical board

If it wasn't, then it shouldn't have greatly your impact in getting a new medical license.

The second part is getting privileges with a new hospital for your new job.

If this PIP was through your department, that will definitely come up on your application and it will be up to the discretion of the chair to approve your application or not. Most people are reasonable and if you adequately explain your situation, it should be fine.

To the others:
If there is a formal peer review process through the department and one decides to resign in the middle, that is not a good look. Hospitals will include that information on their application process and it will follow you around.

When I was chair, I rejected an application for this very reason. Hard to trust someone if they resign if there is a bad outcome.

--------------------------------------------------------------

To the others reading this, it is best to have some allies in your department.. Doesn't matter if it's a community hospital or academic place. It can be unfair, but if you are liked etc, you are less likely to run into issues like this. It's the reality of workplace politics.

My employer was the hospitalist group (that supplies hospitalists to the hospital)and the PIP came from the hospital. The peer review committee consisted of people from the hospitalist group, so it all overlapped.
Part of the reason resigning didn’t seems like a favorable option, was being accused in future of resigning to avoid discipline or resigning during an investigation.
I just started the job a couple of months before the specific patient case and never had a chance to have ‘allies’. I now know they had just suffered a lawsuit a couple of years earlier and it seemed that colored the handling of this case….felt really scapegoatish…

 

[newnew24]

There’s a difference between an actual peer review process and a PIP. I’m not sure we have enough details here to see what was actually going on.

OP, one thing you should do is request a full copy of your employee file from your previous hospital asap. This will give you the details of what transpired. In fact, I generally recommend that everyone request a copy of this when they leave a job. You want to make sure that everything in there is accurate, and if there is something questionable in there you want to be able to try to head it off before the credentialing process starts for the next job.

Are we always able to request an employment file?

 

[dozitgetchahi]

Are we always able to request an employment file?

Yes. Your attorney probably (hopefully) got a copy for themselves, but you want your own copy to review and for your records. With the employee file, you should be able to see exactly how they classified the PIP, whether an “investigation” occurred, if anything was reported to the state medical board, etc.

 

[newnew24]

There’s a difference between an actual peer review process and a PIP. I’m not sure we have enough details here to see what was actually going on.

OP, one thing you should do is request a full copy of your employee file from your previous hospital asap. This will give you the details of what transpired. In fact, I generally recommend that everyone request a copy of this when they leave a job. You want to make sure that everything in there is accurate, and if there is something questionable in there you want to be able to try to head it off before the credentialing process starts for the next job.

Do u mind clarifying how a peer review process is different from a PIP? The terms were often used interchangeably. It seems things moved quickly from peer review of a case to a PIP being offered then I signed.

 

[newnew24]

Yes. Your attorney probably (hopefully) got a copy for themselves, but you want your own copy to review and for your records. With the employee file, you should be able to see exactly how they classified the PIP, whether an “investigation” occurred, if anything was reported to the state medical board, etc.

I know nothing was reported to the state medical board. But u are right, can’t be 100% sure till I see with my own eyes. I would request the employee file.

 

[Crayola227]

It might be late now, but if you get into one of these nightmares with employers, HR, etc, when it's clear you're going out the door but before it's all a done deal, you can have the file looked over by your attorney, and if there are errors and whatnot in it, you can request they be corrected. It's damage control. You will not move them on everything but you would be surprised where they might back off. So yeah, always stay aware of your employee records because sometimes you can get ahead of BS in it and then leave and have affected what is going to follow you around.

Oh, I forgot, you can even request it be sealed if you are in an adversarial action with them depending on the case and if you have leverage with them.

Of course people will point out that this itself could be alarming to a future employer, and I'm not sure if such records can be unsealed with your permission or not.

It all sorta depends, but it's good to know what options even exist when this **** goes down. I write these posts even if they don’t fully apply to all situations because I know there are a lot of folks out there who may never post but they are reading.

 

[chessknt]

You said the hospital found out about the PIP from the licensure board? Go type your name in the state board website and see if you have any disciplinary actions listed there--this is public information in every state. You will be able to see if there is something that got reported and exactly how/what was reported.

Presumably this is in the same state since if you had applied for another state license this would have come out during that process instead of the credentialing process. You should have been notified by the board that an action was filed against you--is that what your lawyer botched? If that is the case then you are indeed stuck with this....

 

[Crayola227]

You said the hospital found out about the PIP from the licensure board? Go type your name in the state board website and see if you have any disciplinary actions listed there--this is public information in every state. You will be able to see if there is something that got reported and exactly how/what was reported.

Presumably this is in the same state since if you had applied for another state license this would have come out during that process instead of the credentialing process. You should have been notified by the board that an action was filed against you--is that what your lawyer botched? If that is the case then you are indeed stuck with this....

Sounds like the former employer mentioned it to the new state board, when the new state board had the former employer fill out forms. The former employer reported it as a disciplinary action, even though they told OP it wasn't one. Which is so ****ing common. They say one thing and it's another. The thing of which begins with the PIP (they say they want to help you improve when really they're firing you and minimizing their liability).

Ugh, what a nightmare. Wish he had had a better attorney, especially if there was a discrimination case to be made. Might have been better able to outline what exactly the employer was going to say when asked and made sure that this was treated as an internal thing that need not be reported to anyone as anything.

Even in that case, it's very difficult for HR and other entities to keep their mouths closed even when all the lawyers involved tell them they're supposed to.

Another reason why I keep telling people that when the writing is on the wall, they need to just go ahead and get an attorney involved and work out just what the file and the employer are going to say if possible. It might not work, but how does it make what they're going to say worse? "Oh hey at some point in this process they got an attorney because they didn't agree and didn't want me to run my mouth"? Your goose is cooked either way. But at least there might be less nasty surprises what your employer is going to say. (I understand why we tell residents not to go nuclear right off with an attorney, but that's a different scenario).

But take heart OP. You can still get your file, get a new attorney for this state and its board. There's a tiny chance you could try to take action against your old employer over this. It won't put the genie back in the bottle with the board, but it might help you in the future with other entities if you can change the story or else at least know what the bastards said.*

*someone will say how do I know they are bastards and why have I sided with OP. Because even if OP was actually a bastard and ****ed up, I still fully believe they were told "oh no don't worry it's not a big deal it's not a disciplinary action we won't report it to anyone," and they did that either on purpose or by accident, both of which, I consider that kind of misleading someone of such import to be bastardry. I get why they do it, but it still sucks.

 

[newnew24]

You said the hospital found out about the PIP from the licensure board? Go type your name in the state board website and see if you have any disciplinary actions listed there--this is public information in every state. You will be able to see if there is something that got reported and exactly how/what was reported.

Presumably this is in the same state since if you had applied for another state license this would have come out during that process instead of the credentialing process. You should have been notified by the board that an action was filed against you--is that what your lawyer botched? If that is the case then you are indeed stuck with this....

I signed a release for new employer to be able to help track my license with the board, since that’s all credentialing is waiting for. The board said the board will meet on the case in a couple of months.

 

[newnew24]

Sounds like the former employer mentioned it to the new state board, when the new state board had the former employer fill out forms. The former employer reported it as a disciplinary action, even though they told OP it wasn't one. Which is so ****ing common. They say one thing and it's another. The thing of which begins with the PIP (they say they want to help you improve when really they're firing you and minimizing their liability).

Ugh, what a nightmare. Wish he had had a better attorney, especially if there was a discrimination case to be made. Might have been better able to outline what exactly the employer was going to say when asked and made sure that this was treated as an internal thing that need not be reported to anyone as anything.

Even in that case, it's very difficult for HR and other entities to keep their mouths closed even when all the lawyers involved tell them they're supposed to.

Another reason why I keep telling people that when the writing is on the wall, they need to just go ahead and get an attorney involved and work out just what the file and the employer are going to say if possible. It might not work, but how does it make what they're going to say worse? "Oh hey at some point in this process they got an attorney because they didn't agree and didn't want me to run my mouth"? Your goose is cooked either way. But at least there might be less nasty surprises what your employer is going to say. (I understand why we tell residents not to go nuclear right off with an attorney, but that's a different scenario).

But take heart OP. You can still get your file, get a new attorney for this state and its board. There's a tiny chance you could try to take action against your old employer over this. It won't put the genie back in the bottle with the board, but it might help you in the future with other entities if you can change the story or else at least know what the bastards said.*

*someone will say how do I know they are bastards and why have I sided with OP. Because even if OP was actually a bastard and ****ed up, I still fully believe they were told "oh no don't worry it's not a big deal it's not a disciplinary action we won't report it to anyone," and they did that either on purpose or by accident, both of which, I consider that kind of misleading someone of such import to be bastardry. I get why they do it, but it still sucks.

Thank you!
I have been living in survival mode and was really just naive.
I do believe the case could have been reviewed and not led to a permanent record like a PIP, had the physician involved been one of their ‘longtimers’.
Too late now. The reassurance I have been getting that this delays will unlikely not lead to denial of new licensure or inability to get credentialed, has been helpful.
Only part making me nervous now is if old employer will continue to send disparaging data/stuff when credentialing reaches out to them…

 

[newnew24]

You said the hospital found out about the PIP from the licensure board? Go type your name in the state board website and see if you have any disciplinary actions listed there--this is public information in every state. You will be able to see if there is something that got reported and exactly how/what was reported.

Presumably this is in the same state since if you had applied for another state license this would have come out during that process instead of the credentialing process. You should have been notified by the board that an action was filed against you--is that what your lawyer botched? If that is the case then you are indeed stuck with this....

This case or pip didn’t involve the board at all. The new state board asked to see the PIP because old employer has now categorized it under ‘discipline’

 

[HemeOncHopeful19]

This case or pip didn’t involve the board at all. The new state board asked to see the PIP because old employer has now categorized it under ‘discipline’

Did you fill out licensing paperwork to the effect that you have never been disciplined in the past?

 

[newnew24]

Did you fill out licensing paperwork to the effect that you have never been disciplined in the past?

Yes

 

[Crayola227]

I signed a release for new employer to be able to help track my license with the board, since that’s all credentialing is waiting for. The board said the board will meet on the case in a couple of months.

Was the release required or optional?

Overall I would avoid that kind of thing if possible. One instance where the left hand not knowing what the right hand is doing might be better.

 

[HemeOncHopeful19]

Yes

You need a lawyer yesterday but you absolutely need one before that board meeting where they discuss the case in a couple of months.

 

[chessknt]

You need a lawyer yesterday but you absolutely need one before that board meeting where they discuss the case in a couple of months.

Yea now that I read it more carefully I agree with this--this is a big deal because if they deny you a license THAT is reportable forever as well. I thought this was a credentialing application. It might be overkill but get a competent lawyer to draft a letter to the board, add it to your file, and consult with him/her to see if their presence is needed for the board meeting as well.

 

[newnew24]

Yea now that I read it more carefully I agree with this--this is a big deal because if they deny you a license THAT is reportable forever as well. I thought this was a credentialing application. It might be overkill but get a competent lawyer to draft a letter to the board, add it to your file, and consult with him/her to see if their presence is needed for the board meeting as well.

Done already. We are now in the painful waiting phase

 

[Crayola227]

IAlso, I then recommend you set aside as a goal, up to $10,000 as a legal fee fund. At least $2000 to begin with which shouldn't be too hard.

The reality is that for a lot of industries and jobs, it really makes sense to consider legal expenses as just a given part of your employment expenses and plan acaccordingly.

So to piggyback on this, and it just occurred to me, when you start a new job with a signing bonus you need to do 2 things.

1) Hold onto that bonus in the painful scenario you have to give it back (although this was discussed elsewhere may be something you can get out of or reduce how much), at least until the period of time for giving it back ends. Although, you can make an argument for never spending it because:

2) Aside from general savings, emergency fund, going back to what I said about a legal fee fund, a lot of the time when you need lawyer money because you're getting ****ed by your employer, you will not have the benefit of getting your monthly salary.

So you need money to cover:
Legal fees so you don't get totally boned by the old employer
Living expenses
Moving expenses for the next job
Legal fees for the new contract
Mortgage until house sells
Mortgage and down for a new house

So yeah, the legal fee fund is something you have to have set aside or you'll wonder how to pay for it.

Consider the above list your, "My employer/the board totally ****s me somehow" money or you have some other interruption of income (FMLA for example).

It's shocking how quickly with the cessation of monthly salary how even an attending physician can be in financial hot water. Your first few months, and even before really focusing on paying down loans, needs to be having this chunk of change for protecting your livelihood and ability to pursue new jobs if **** goes south.

Everyone says oh just do your job and be good and this stuff will never happen to you. Until it does. You can't ever fully protect yourself against bad actors anyway (all kinds of reasons a hospital may let go an otherwise fine doc).

 

[Osteoth]

So to piggyback on this, and it just occurred to me, when you start a new job with a signing bonus you need to do 2 things.

1) Hold onto that bonus in the painful scenario you have to give it back (although this was discussed elsewhere may be something you can get out of or reduce how much), at least until the period of time for giving it back ends. Although, you can make an argument for never spending it because:

2) Aside from general savings, emergency fund, going back to what I said about a legal fee fund, a lot of the time when you need lawyer money because you're getting ****ed by your employer, you will not have the benefit of getting your monthly salary.

So you need money to cover:
Legal fees so you don't get totally boned by the old employer
Living expenses
Moving expenses for the next job
Legal fees for the new contract
Mortgage until house sells
Mortgage and down for a new house

So yeah, the legal fee fund is something you have to have set aside or you'll wonder how to pay for it.

Consider the above list your, "My employer/the board totally ****s me somehow" money or you have some other interruption of income (FMLA for example).

It's shocking how quickly with the cessation of monthly salary how even an attending physician can be in financial hot water. Your first few months, and even before really focusing on paying down loans, needs to be having this chunk of change for protecting your livelihood and ability to pursue new jobs if **** goes south.

Everyone says oh just do your job and be good and this stuff will never happen to you. Until it does. You can't ever fully protect yourself against bad actors anyway (all kinds of reasons a hospital may let go an otherwise fine doc).

I will echo this. Was given a PIP with a 3 month timeline, but about a month in a patients family complained about some nonsense and I was given the option to either resign or be fired with cause.

I thought my timeline was 3 months + another 3 months if I resigned per my contract, but it ended up being 1 month total.

Save that money folks.

 

[newnew24]

I will echo this. Was given a PIP with a 3 month timeline, but about a month in a patients family complained about some nonsense and I was given the option to either resign or be fired with cause.

I thought my timeline was 3 months + another 3 months if I resigned per my contract, but it ended up being 1 month total.

Save that money folks.

The dilemma is…. One is usually already in debt or gets into more debt due to the sudden job termination, so upon starting a new job, my instinct would be to get debt free or at least reduce my debt burden with my new income or sign on bonus. I was really naive to think, financial worries and job security would begin with being an attending…..sigh

On another note, pls give me a testimony I can hold on to, while I am waiting on the board’s hearing. How did the PIP affect your subsequent licensure and credentialing in other states/hospitals. Did your employer also report it as discipline to a state board or new employer? Any insight that you think would be helpful in navigating this or info you wish you were told would be helpful. We tend to keep these things to ourselves in medicine and everyone feels alone…

 

[Osteoth]

The dilemma is…. One is usually already in debt or gets into more debt due to the sudden job termination, so upon starting a new job, my instinct would be to get debt free or at least reduce my debt burden with my new income or sign on bonus. I was really naive to think, financial worries and job security would begin with being an attending…..sigh

On another note, pls give me a testimony I can hold on to, while I am waiting on the board’s hearing. How did the PIP affect your subsequent licensure and credentialing in other states/hospitals. Did your employer also report it as discipline to a state board or new employer? Any insight that you think would be helpful in navigating this or info you wish you were told would be helpful. We tend to keep these things to ourselves in medicine and everyone feels alone…

As far as I’m aware they did not report it to the board. I just checked my license and there’s nothing on there, so our situations may be a little different.

You live and you learn, first step at a new job is always to save the total repayment amount and put that in a semi liquid interest bearing account like a high yield savings account or a mutual fund to break glass. That’s in addition to an emergency fund.

 

[newnew24]

As far as I’m aware they did not report it to the board. I just checked my license and there’s nothing on there, so our situations may be a little different.

You live and you learn, first step at a new job is always to save the total repayment amount and put that in a semi liquid interest bearing account like a high yield savings account or a mutual fund to break glass. That’s in addition to an emergency fund.

There was no board reports apart from when I was applying for another state’s license and the former job clicked ‘yes’ to a question asking if I had ever been disciplined, hence bringing attention to the PIP