Quitting for fellowship

[Piebaldi]

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I started a new job after residency. Did not like the job. Decided to go into fellowship. Applied for and was offered fellowship which I accepted. I emailed my boss to give notice, boss says that they did not get the email. I talked to them about pursuing my dreams professionally, and gave them about 4months notice or so. Boss did not seem happy. I feel kind of bad. At the same time the job is far from what I thought would be. My schedule changes daily - there isn't a set schedule from week to week. Sometimes I cover 3 different facilities/hospitals in the same week. I have to learn 18-20 new patients daily at times. When I cover weekends I get no post call day off, so I essentially work 2 weeks straight with no break which for me is a killer. For vacations it seems that the requests have to be put in months in advance. I get no 401k. I don't want to in any way cause damage to the group but at the same time feel that the position was not as advertised. Numerous physicians have quit over the years. There is like a 20% attrition rate. Most recently someone who has been there a number of years also resigned/took a break. I know a number of other youngish recent grads that have all quit within 1 year. I also had a very critical situation with a family member so i asked for a few days off, which ultimately ended up being 1 day. Boss made me feel kind of bad about it telling me that the job is important, bla bla and reliability bla bla.
What else could I have done? Sorry for the long post guys.

 

[GoSpursGo]

Nothing. The crappy guilt-trip you're getting for a perfectly reasonable reason to quit, with more than enough notice, is further evidence of that this is a garbage job beyond the litany of insanely bad things you outlined in your post, and THAT is why they can't retain their docs.

 

[Piebaldi]

Nothing. The crappy guilt-trip you're getting for a perfectly reasonable reason to quit, with more than enough notice, is further evidence of why they can't retain their docs beyond the litany of insanely bad things you outlined in your post.

I think it is reasonable too. After all it's a fellowship. I will be able to do outpatient medicine which is really what I want to do. And I feel it's a switch and bait really. I did not want to go that route because I feel that will lead to bad blood and I am trying to politely and respectuflly leave for the fellowship without burning bridges.
I mean it seems that others in the group are not happy either. One of our midlevels recently quit too. I physically even don't feel capable of working 2 weeks straight essentially with no post call day to recharge. I don't know of other practices that do that. I was told before there would be leadership opportunities. There aren't. It seems like the one directorship that might have been a remote possibility is going to someone who has been there about a year. I can't believe there is no flexibility with personal situations. In 4 months I have taken 4 days off outside from weekends and I am being made to feel like I have taken a ton of time off!
I am afraid that if I have to give references in the future it will bite me in the butt. I don't have any ill will for the group just want to move on and wish them the best really.

 

[colbgw02]

As best as I can tell, there are (at least) three different things going on here.

1) Legal stuff, i.e., have you fulfilled your contractual obligations with respect to giving notice? It sounds like you have and, considering it was via email, then you can prove that you did. If they're bellyaching about it now, then ignore it. They have no legitimate recourse.

2) Being a new attending - working post-call, while not a lot of fun, is pretty common. There are no work hour restrictions anymore. And learning new patients/work flow is just part of it. It can take years to establish a steady patient census and become facile with how the systems work.

3) You chose a crappy job. Caveat emptor. You're not the first and you won't be the last, and it sounds like you've already course corrected. Don't feel bad about it, and certainly don't feel bad about moving on. Live and learn.

 

[Piebaldi]

As best as I can tell, there are (at least) three different things going on here.

1) Legal stuff, i.e., have you fulfilled your contractual obligations with respect to giving notice? It sounds like you have and, considering it was via email, then you can prove that you did. If they're bellyaching about it now, then ignore it. They have no legitimate recourse.

2) Being a new attending - working post-call, while not a lot of fun, is pretty common. There are no work hour restrictions anymore. And learning new patients/work flow is just part of it. It can take years to establish a steady patient census and become facile with how the systems work.

3) You chose a crappy job. Caveat emptor. You're not the first and you won't be the last, and it sounds like you've already course corrected. Don't feel bad about it, and certainly don't feel bad about moving on. Live and learn.

On my contract it says 4months. I have given that in terms of notice. The post call day is not for new attendings, it's for everyone, always, with no exception. There is simply no post call day off for anyone. Not about work hour restrictrions, I get that, but if I have to work 2 weeks out of the month every month then it is untenable. I also have no personal days, and no sick days. So when I have an urgency it's taken off vacation and it becomes a big deal. Things happen. That's life. It has nothing to do with reliability. If taking 4 days off in 4 months makes me a bad attending so be it.
I have only worked here for a few months so it will be less than a year when I leave. But nothing I can do. It would have been ideal if the job matched the position I actually interviewed for.

 

[colbgw02]

On my contract it says 4months. I have given that in terms of notice. The post call day is not for new attendings, it's for everyone, always, with no exception. There is simply no post call day off for anyone. Not about work hour restrictrions, I get that, but if I have to work 2 weeks out of the month every month then it is untenable. I also have no personal days, and no sick days. So when I have an urgency it's taken off vacation and it becomes a big deal. Things happen. That's life. It has nothing to do with reliability. If taking 4 days off in 4 months makes me a bad attending so be it.
I have only worked here for a few months so it will be less than a year when I leave. But nothing I can do. It would have been ideal if the job matched the position I actually interviewed for.

I wasn't saying that your practice had different rules for new vs. older physicians (although they might). I'm saying that several of the things you're complaining about are pretty common, and it sounds like you're just struggling to adjust to them as a new attending.

Again, working post-call or for two straight weeks just isn't that uncommon in my experience. I do it all the time. Same thing with personal or sick days; those don't necessarily exist in a lot of private practices.

It's not about being a bad or good physician. It's about getting your expectations to match up with your job's. It sounds like a lot of that is because your job stinks, but it also sounds like some of your expectations are off too. I mean, if they flat out lied to you about some things, then that stinks. Again, caveat emptor. But if you assumed you would get personal and sick days, then you should have taken a VA job.

 

[Piebaldi]

I wasn't saying that your practice had different rules for new vs. older physicians (although they might). I'm saying that several of the things you're complaining about are pretty common, and it sounds like you're just struggling to adjust to them as a new attending.

Again, working post-call or for two straight weeks just isn't that uncommon in my experience. I do it all the time. Same thing with personal or sick days; those don't necessarily exist in a lot of private practices.

It's not about being a bad or good physician. It's about getting your expectations to match up with your job's. It sounds like a lot of that is because your job stinks, but it also sounds like some of your expectations are off too. I mean, if they flat out lied to you about some things, then that stinks. Again, caveat emptor. But if you assumed you would get personal and sick days, then you should have taken a VA job.

Private practice jobs dont have personal or sick days? Perhaps I am wrong but most jobs I have seen do.

 

[colbgw02]

Private practice jobs dont have personal or sick days? Perhaps I am wrong but most jobs I have seen do.

To clarify, I'm talking about traditional, physician-owned practices where you're a shareholder. I don't consider being an employee of a private, i.e. nongovernmental, organization (e.g. Kaiser) to be PP. In the latter's case, then getting sick or personal days is largely a contractual issue. If you're a W2 employee, then what does your contract say?

 

[Piebaldi]

To clarify, I'm talking about traditional, physician-owned practices where you're a shareholder. I don't consider being an employee of a private, i.e. nongovernmental, organization (e.g. Kaiser) to be PP. In the latter's case, then getting sick or personal days is largely a contractual issue. If you're a W2 employee, then what does your contract say?

Right that's the kicker here - another "gift" from the practice. It is a private practice but not a partner. I was told by recruiter that there was opportunity potentially for that in the future but there isn't really. Recruiter again told me that sick days were not stipulated in contract but occasional sick days were a given - if something happened it would be a wash. How am I supposed to take care of my self, family, duties, etc with only 15 days a year when working 2 weeks out of the month every month. I think your point #3 is what's happened. I guess out of fear and pressure I took a job I should not have taken perhaps.

 

[colbgw02]

Right that's the kicker here - another "gift" from the practice. It is a private practice but not a partner. I was told by recruiter that there was opportunity potentially for that in the future but there isn't really. Recruiter again told me that sick days were not stipulated in contract but occasional sick days were a given - if something happened it would be a wash. How am I supposed to take care of my self, family, duties, etc with only 15 days a year when working 2 weeks out of the month every month. I think your point #3 is what's happened. I guess out of fear and pressure I took a job I should not have taken perhaps.

Yep, but the good news is that you don't have to live with that mistake for much longer. Also, I'll add - avoid recruiters if you can. If you can't, then do your own research on top of it. Speak to people who have both recently joined and left the group/practice. Inquire about turnover. If they won't give you that information, then that's a big red flag. Lastly, if it's not in writing and in the contract, then it's not real.

 

[Piebaldi]

Yep, but the good news is that you don't have to live with that mistake for much longer. Also, I'll add - avoid recruiters if you can. If you can't, then do your own research on top of it. Speak to people who have both recently joined and left the group/practice. Inquire about turnover. If they won't give you that information, then that's a big red flag. Lastly, if it's not in writing and in the contract, then it's not real.

Yeah, I agree. I have learned. I honestly thought that I asked a bunch of questions and felt that if the recruiter had mentioned it or clarified it it would be ok. I guess I should have been more skeptical. The fact that many younger attendings leave also should be a red flag altjhough i was not aware of that initially

 

[NITRAS]

Piebald, you should have known most these things about your job when you signed on.

I told my boss that I was considering fellowship when I first started, I didn't end up going. Personally, I would have told her that I was applying. We lose people to moving and fellowship every year. Hell, first jobs aren't suppose to last forever. I'll personally be better prepared to know what to ask for my next job, and I got a great job. This is a great learning experience.

As an aside, if you are a 1099, you can open a SEP or solo 401k. . . . just saying.

 

[dpmd]

Right that's the kicker here - another "gift" from the practice. It is a private practice but not a partner. I was told by recruiter that there was opportunity potentially for that in the future but there isn't really. Recruiter again told me that sick days were not stipulated in contract but occasional sick days were a given - if something happened it would be a wash. How am I supposed to take care of my self, family, duties, etc with only 15 days a year when working 2 weeks out of the month every month. I think your point #3 is what's happened. I guess out of fear and pressure I took a job I should not have taken perhaps.

Let this be a lesson for you in the future. If it isn't in the contract it doesn't exist. Recruiters are out to fill a position so i wouldn't rely on their words if it isn't backed up in writing.

 

[anonperson]

I started a new job after residency. Did not like the job. Decided to go into fellowship. Applied for and was offered fellowship which I accepted. I emailed my boss to give notice, boss says that they did not get the email. I talked to them about pursuing my dreams professionally, and gave them about 4months notice or so. Boss did not seem happy. I feel kind of bad. At the same time the job is far from what I thought would be. My schedule changes daily - there isn't a set schedule from week to week. Sometimes I cover 3 different facilities/hospitals in the same week. I have to learn 18-20 new patients daily at times. When I cover weekends I get no post call day off, so I essentially work 2 weeks straight with no break which for me is a killer. For vacations it seems that the requests have to be put in months in advance. I get no 401k. I don't want to in any way cause damage to the group but at the same time feel that the position was not as advertised. Numerous physicians have quit over the years. There is like a 20% attrition rate. Most recently someone who has been there a number of years also resigned/took a break. I know a number of other youngish recent grads that have all quit within 1 year. I also had a very critical situation with a family member so i asked for a few days off, which ultimately ended up being 1 day. Boss made me feel kind of bad about it telling me that the job is important, bla bla and reliability bla bla.
What else could I have done? Sorry for the long post guys.

Don't even sweat this.

The practice owner sounds like a jerk running a predatory practice. They are making money hand over fist on your hard work.

Let me guess. They aren't going to pay your malpractice tail either? Make sure you save up for that if needed.

This type of setup is common. Practices run by a dirtbag who churns through doctors in order to maximize dollars in their pocket. Quality be damned.

Just follow your contract terms for resigning exactly so they can't do anything to you.

A word of warning is that you should get work requirements in writing so they cannot pull this bait and switch. This may not happen at large health systems though as their contracts can be fairly standardized.

I know some people talk about working post call, but unless call is light, that should be a no go. I did it a few times and was physically destroyed with some brutal calls. Having to see 25 patients post call in the office was the icing on the cake.

In the future, know your worth. Don't take crappy job like this in the future. Look for a job with a better retirement plan as well. You need to maximize every dollar and employers should have a matching 401k at the very minimum.

 

[Piebaldi]

Piebald, you should have known most these things about your job when you signed on.

I told my boss that I was considering fellowship when I first started, I didn't end up going. Personally, I would have told her that I was applying. We lose people to moving and fellowship every year. Hell, first jobs aren't suppose to last forever. I'll personally be better prepared to know what to ask for my next job, and I got a great job. This is a great learning experience.

As an aside, if you are a 1099, you can open a SEP or solo 401k. . . . just saying.

When there were a lot of things that were unusual for me, so given that I am in a saturated area and I was afriad of not getting a job I kind of went for the first certain thing. I was also sold all these things that ended up not being true. No real outpatinet, i was told medical directorship would be possible, that was a bust. I was told I would have flexibility and ability to practice as I see clinically appropriate- we are micromanaged (not just me) but all of us to the nth degree. I see 20 patients they want more. I need to take a day here and there and it's a big nightmare.
I honestly was super totally busted and exhausted after residency so I opted for a job. Given how unhappy I am with the job and the fellowship offered I had a change of heart. I don't think it's the end of the world. The practice seems to lose a physician or so every 1-2 years. It just kind of happened for me.
No I am salaried with bonus potential, but I haven't even been told what I have billed/collected. So no clue. If i don't hit x dollar value I get nothing which sucks.

 

[Piebaldi]

Let this be a lesson for you in the future. If it isn't in the contract it doesn't exist. Recruiters are out to fill a position so i wouldn't rely on their words if it isn't backed up in writing.

You are absolutely right. It is a learning experience. If not written it does not exist.

 

[Piebaldi]

Don't even sweat this.

The practice owner sounds like a jerk running a predatory practice. They are making money hand over fist on your hard work.

Let me guess. They aren't going to pay your malpractice tail either? Make sure you save up for that if needed.

This type of setup is common. Practices run by a dirtbag who churns through doctors in order to maximize dollars in their pocket. Quality be damned.

Just follow your contract terms for resigning exactly so they can't do anything to you.

A word of warning is that you should get work requirements in writing so they cannot pull this bait and switch. This may not happen at large health systems though as their contracts can be fairly standardized.

I know some people talk about working post call, but unless call is light, that should be a no go. I did it a few times and was physically destroyed with some brutal calls. Having to see 25 patients post call in the office was the icing on the cake.

In the future, know your worth. Don't take crappy job like this in the future. Look for a job with a better retirement plan as well. You need to maximize every dollar and employers should have a matching 401k at the very minimum.

Again you are right also. I wouldn't say dirt bag, I do think there is a high emphasis on production and making money which is fine but if they expect me to bust my butt I would expect x amount after salary and expenses. And if I don't have any way of knowing what I make I dont see how I would make bonus. You are correct about the tail issue - that was in the contract but I was naive and did not really think it would be a big deal. I don't think if they truly know the contract so I don't know what they will enforce. I have given appropriate notice,will also fullfill restrictive covenant issue, etc. I have talked to some places where they told me that it is possible since I will have been working less than 1 year that they might be able to bring it in under a differnet policy and retroactively add it. I will see. I asked about work requirements and the clause was vast and there was all sorts of handwaving in terms of oh that doesnt mean much. lesson learned.

And this is EVERY post call - not the occasional post call, it's 2 weeks /4 weeks for the month every month. i dont think that's typical

 

[Piebaldi]

Don't even sweat this.

The practice owner sounds like a jerk running a predatory practice. They are making money hand over fist on your hard work.

Let me guess. They aren't going to pay your malpractice tail either? Make sure you save up for that if needed.

This type of setup is common. Practices run by a dirtbag who churns through doctors in order to maximize dollars in their pocket. Quality be damned.

Just follow your contract terms for resigning exactly so they can't do anything to you.

A word of warning is that you should get work requirements in writing so they cannot pull this bait and switch. This may not happen at large health systems though as their contracts can be fairly standardized.

I know some people talk about working post call, but unless call is light, that should be a no go. I did it a few times and was physically destroyed with some brutal calls. Having to see 25 patients post call in the office was the icing on the cake.

In the future, know your worth. Don't take crappy job like this in the future. Look for a job with a better retirement plan as well. You need to maximize every dollar and employers should have a matching 401k at the very minimum.

Are you in PP? Do you also just get vacay but no personal or sick days? What do you do if you are sick, need surgery, have a personal emergency, etc?

 

[dpmd]

You do have a way of knowing your production. It is called keeping a log of what you do. I was employed for a bit and was going to earn x per rvu after my guarantee. I tracked every rvu I did and then when I eventually got a report on what they had my rvus at it was different than what I had so I was able to question why they downcoded something or failed to credit me with a patient or a procedure. Simply relying on them to track this is a bad way to go.

 

[Piebaldi]

You do have a way of knowing your production. It is called keeping a log of what you do. I was employed for a bit and was going to earn x per rvu after my guarantee. I tracked every rvu I did and then when I eventually got a report on what they had my rvus at it was different than what I had so I was able to question why they downcoded something or failed to credit me with a patient or a procedure. Simply relying on them to track this is a bad way to go.

Well so I tried to do that. But it became very difficult. If I'm seeing20 pts/day, at least for me since I'm starting out it's hard to keep track. I asked for some assistnace with understanding billing and we met with the boss but did not get to it ultimately. my contract is also production based in terms of collections not rvu. A lot of learning experiences with this job.

 

[Piebaldi]

You do have a way of knowing your production. It is called keeping a log of what you do. I was employed for a bit and was going to earn x per rvu after my guarantee. I tracked every rvu I did and then when I eventually got a report on what they had my rvus at it was different than what I had so I was able to question why they downcoded something or failed to credit me with a patient or a procedure. Simply relying on them to track this is a bad way to go.

Since you seem to be knowledgeable about stuff, is it a good idea or bad idea to start looking for a job in my selected fellowship? there are a few reasonable jobs in the area that i'm interested. obviously fellowship does not start until summer - but just like residency i got the job before i finished. one recruiter provided a list of reasonable jobs. should i send my info in listing the fellowship and expected completion dates?

 

[dpmd]

Well so I tried to do that. But it became very difficult. If I'm seeing20 pts/day, at least for me since I'm starting out it's hard to keep track. I asked for some assistnace with understanding billing and we met with the boss but did not get to it ultimately. my contract is also production based in terms of collections not rvu. A lot of learning experiences with this job.

Start here and familiarize yourself with the coding rules and it should be easy to grab a facesheet or sticker and jot down your code on it. Then you can ask for reports regarding your collections for your patients and make sure stuff adds up.

 

[dpmd]

Since you seem to be knowledgeable about stuff, is it a good idea or bad idea to start looking for a job in my selected fellowship? there are a few reasonable jobs in the area that i'm interested. obviously fellowship does not start until summer - but just like residency i got the job before i finished. one recruiter provided a list of reasonable jobs. should i send my info in listing the fellowship and expected completion dates?

Might be a little early to start looking since you haven't even started fellowship yet.

 

[rokshana]

just do what your contract requires of you to leave your job and don't talk about the other issues...no one will (or should) fault you for leaving for further training.

first jobs usually are full of lessons...

 

[doc05]

Again you are right also. I wouldn't say dirt bag, I do think there is a high emphasis on production and making money which is fine but if they expect me to bust my butt I would expect x amount after salary and expenses. And if I don't have any way of knowing what I make I dont see how I would make bonus. You are correct about the tail issue - that was in the contract but I was naive and did not really think it would be a big deal. I don't think if they truly know the contract so I don't know what they will enforce. I have given appropriate notice,will also fullfill restrictive covenant issue, etc. I have talked to some places where they told me that it is possible since I will have been working less than 1 year that they might be able to bring it in under a differnet policy and retroactively add it. I will see. I asked about work requirements and the clause was vast and there was all sorts of handwaving in terms of oh that doesnt mean much. lesson learned.

And this is EVERY post call - not the occasional post call, it's 2 weeks /4 weeks for the month every month. i dont think that's typical

You joined a typical predatory private practice. Also, you didn't do your homework, and you signed a bad contract. Did you even have an attorney review it?

Stop whining over vacation days vs sick days. It's all the same, even in my hospital employed contract there's no distinction. If 15 days wasn't enough, you should have done a better job at negotiating.

Don't hold your breath in terms of the "bonus". I guarantee that you signed a contract that has unreachable bonus stipulations.

What specialty are you in that being on call is so onerous?

Don't worry about the tail coverage thing also. It's probably dirt-cheap unless you're a surgeon.

 

[Piebaldi]

You joined a typical predatory private practice. Also, you didn't do your homework, and you signed a bad contract. Did you even have an attorney review it?

Stop whining over vacation days vs sick days. It's all the same, even in my hospital employed contract there's no distinction. If 15 days wasn't enough, you should have done a better job at negotiating.

Don't hold your breath in terms of the "bonus". I guarantee that you signed a contract that has unreachable bonus stipulations.

What specialty are you in that being on call is so onerous?

Don't worry about the tail coverage thing also. It's probably dirt-cheap unless you're a surgeon.

Options for employment when i graduated were limited. I negotiated a higher salary because of that and will be getting out in total of less than 1 year so overall it will work out ok for me. Long term probably not so much.

Out of curiosity why do you say that it's a typical predatory pp? I'm not holding my breath, I just mentioned it. I won't be there 1 year so there's no way I could make bonus. It is reachable but challenging. what I mean is we work M-F, and cover 1 weekend a month where we round, do consults, etc. - can take a few hours or all day depending, and then work the entire following week. Tail is not that cheap.

 

[pathslides]

Don’t feel bad. You gave your notice and as long as your have the email showing you sent the notice, you are fine. They are lying to you to try and screw you by saying they didn’t get it. That boss seems like a total d bag. He/she is just pissed they won’t make money by abusing you anymore. Get the f out and do want you wanT, it’s your life. I hope you leaving makes your boss’ life harder.

 

[doc05]

Options for employment when i graduated were limited. I negotiated a higher salary because of that and will be getting out in total of less than 1 year so overall it will work out ok for me. Long term probably not so much.

Out of curiosity why do you say that it's a typical predatory pp? I'm not holding my breath, I just mentioned it. I won't be there 1 year so there's no way I could make bonus. It is reachable but challenging. what I mean is we work M-F, and cover 1 weekend a month where we round, do consults, etc. - can take a few hours or all day depending, and then work the entire following week. Tail is not that cheap.

Sounds like a PP internal medicine practice. Last I heard, there was a nationwide shortage.

Why do I say it's a predatory practice? Re-read your posts. You've noted that there isn't really a partnership opportunity, that multiple new attendings have left, that they misled you during recruitment, that you're overworked, there's no 401k, that the boss isn't supportive of you going to fellowship. Is ANYONE a partner?

Where's the boss' income coming from? What's the specialty? Why are you spending so much time in the hospital?

Tail isn't cheap? Is your tail over 100k?

 

[pathslides]

Stop whining over vacation days vs sick days. It's all the same, even in my hospital employed contract there's no distinction. If 15 days wasn't enough, you should have done a better job at negotiating.

Wow 15 days only? That is complete garbage. I had more than that as a resident.

 

[Piebaldi]

Wow 15 days only? That is complete garbage. I had more than that as a resident.

I had the same as a resident but we had up to 10 days sick days/personal days for stuff that might come up. But yes it is garbage. I would expect 4 weeks vacay and a few days personal/sick days.

 

[Piebaldi]

Sounds like a PP internal medicine practice. Last I heard, there was a nationwide shortage.

Why do I say it's a predatory practice? Re-read your posts. You've noted that there isn't really a partnership opportunity, that multiple new attendings have left, that they misled you during recruitment, that you're overworked, there's no 401k, that the boss isn't supportive of you going to fellowship. Is ANYONE a partner?

Where's the boss' income coming from? What's the specialty? Why are you spending so much time in the hospital?

Tail isn't cheap? Is your tail over 100k?

Boss' income i assume is coming from the other providers? not sure if they practice clinically or not. no one is partner - just an owner and we are employed. i feel bad mostly bc i joined the practice a few months ago only. well seeing 20inpts is not easy. i don't spend ridiculous amounts of time in the hospital but sometimes it gets busy. the killer is the 2 weeks that we work with no days off

 

[doc05]

I had the same as a resident but we had up to 10 days sick days/personal days for stuff that might come up. But yes it is garbage. I would expect 4 weeks vacay and a few days personal/sick days.

If "you would expect" more days, then you ask for more when you negotiate the contract. Live and learn, I guess.

 

[doc05]

Boss' income i assume is coming from the other providers? not sure if they practice clinically or not. no one is partner - just an owner and we are employed. i feel bad mostly bc i joined the practice a few months ago only. well seeing 20inpts is not easy. i don't spend ridiculous amounts of time in the hospital but sometimes it gets busy. the killer is the 2 weeks that we work with no days off

I'd recommend you quit even if you weren't considering fellowship. It's a terrible job. There's only 1 owner? Everyone's employed? - no one's a partner??

 

[Piebaldi]

I'd recommend you quit even if you weren't considering fellowship. It's a terrible job. There's only 1 owner? Everyone's employed? - no one's a partner??

That's correct. Hey like I said its a limited market. But yes I don't feel so terrible as I'm sure Im making them decent $$

 

[doc05]

That's correct. Hey like I said its a limited market. But yes I don't feel so terrible as I'm sure Im making them decent $$

What market is this?

 

[Piebaldi]

What market is this?

A saturated one

 

[anonperson]

Are you in PP? Do you also just get vacay but no personal or sick days? What do you do if you are sick, need surgery, have a personal emergency, etc?

I am employed.

I get PTO and CME time. No sick time per se.

I had a death in the family and had to attend a funeral unexpectedly.

I actually had cases in the morning and clinic in the afternoon the day of the funeral. I emailed the appropriate manager and told them I was not coming in due to this (literally told them the day before).

They made the necessary changes and rescheduled patients.

If the upper management didn't like it, they were welcome to fire me.

Life happens and jobs should be able to accommodate this.

 

[Piebaldi]

I am employed.

I get PTO and CME time. No sick time per se.

I had a death in the family and had to attend a funeral unexpectedly.

I actually had cases in the morning and clinic in the afternoon the day of the funeral. I emailed the appropriate manager and told them I was not coming in due to this (literally told them the day before).

They made the necessary changes and rescheduled patients.

If the upper management didn't like it, they were welcome to fire me.

Life happens and jobs should be able to accommodate this.

Exactly. This. Being a physician does not mean that crap does not happen. We are human. Things happen to us, to our loved ones, etc.

Btw - what do you do if you get sick? or if you say needed surgery and needed to be out for a bit

 

[anonperson]

Exactly. This. Being a physician does not mean that crap does not happen. We are human. Things happen to us, to our loved ones, etc.

Btw - what do you do if you get sick? or if you say needed surgery and needed to be out for a bit

Then I use my PTO days.

 

[anonperson]

Again you are right also. I wouldn't say dirt bag, I do think there is a high emphasis on production and making money which is fine but if they expect me to bust my butt I would expect x amount after salary and expenses. And if I don't have any way of knowing what I make I dont see how I would make bonus. You are correct about the tail issue - that was in the contract but I was naive and did not really think it would be a big deal. I don't think if they truly know the contract so I don't know what they will enforce. I have given appropriate notice,will also fullfill restrictive covenant issue, etc. I have talked to some places where they told me that it is possible since I will have been working less than 1 year that they might be able to bring it in under a differnet policy and retroactively add it. I will see. I asked about work requirements and the clause was vast and there was all sorts of handwaving in terms of oh that doesnt mean much. lesson learned.

The owner is a dirtbag. We all see this. This practice is set up to churn and burn through physicians. The untenable work conditions and poor benefits show that the owner is a dirtbag.

Don't worry about the bonus. You were never going to get it. In these types of practices, you have no access to the books so the owner can cook them and you will have no real recourse.

I was in a similar situation for my first job. I posted about it here .You can probably find it.

First thing, don't feel bad about leaving. The job sounds like trash.

Second, don't be dumb and take a job like this again.

With your next contract, pay the money to have a lawyer look over things. I suspect you skipped this.

Talk to current and former physicians.

Negotiate everything that is important to you and put it in writing.

Also, refer to my bolded. Trust me when I say that the owner knows their contracts. Don't be naive and count on them overlooking anything. Remember that this is routine for them

 

[Piebaldi]

The owner is a dirtbag. We all see this. This practice is set up to churn and burn through physicians. The untenable work conditions and poor benefits show that the owner is a dirtbag.

Don't worry about the bonus. You were never going to get it. In these types of practices, you have no access to the books so the owner can cook them and you will have no real recourse.

I was in a similar situation for my first job. I posted about it here .You can probably find it.

First thing, don't feel bad about leaving. The job sounds like trash.

Second, don't be dumb and take a job like this again.

With your next contract, pay the money to have a lawyer look over things. I suspect you skipped this.

Talk to current and former physicians.

Negotiate everything that is important to you and put it in writing.

Also, refer to my bolded. Trust me when I say that the owner knows their contracts. Don't be naive and count on them overlooking anything. Remember that this is routine for them

It's not so much that I was dumb, but there were limited options. Really it was only one of 2 or 3 jobs available. the other jobs werent great.

 

[NITRAS]

My advise: don't feel pressured to take a job (this applies to decisions in general). You will make bad decisions.

Work somewhere else. Work locums. You have mentioned or implied that you were forced to take to his job.

You weren't. You can always walk away till you sign.

 

[Piebaldi]

My advise: don't feel pressured to take a job (this applies to decisions in general). You will make bad decisions.

Work somewhere else. Work locums. You have mentioned or implied that you were forced to take to his job.

You weren't. You can always walk away till you sign.

I wasn't. I'm just saying there were limited options. This sadly was one of the better options

 

[doc05]

I wasn't. I'm just saying there were limited options. This sadly was one of the better options

This will happen again if you force yourself to take a bad job in a saturated market.

New York? LA? Those saturated markets suck for physicians. Stay away.

 

[Wordead]

Again you are right also. I wouldn't say dirt bag, I do think there is a high emphasis on production and making money which is fine but if they expect me to bust my butt I would expect x amount after salary and expenses. And if I don't have any way of knowing what I make I dont see how I would make bonus. You are correct about the tail issue - that was in the contract but I was naive and did not really think it would be a big deal. I don't think if they truly know the contract so I don't know what they will enforce. I have given appropriate notice,will also fullfill restrictive covenant issue, etc. I have talked to some places where they told me that it is possible since I will have been working less than 1 year that they might be able to bring it in under a differnet policy and retroactively add it. I will see. I asked about work requirements and the clause was vast and there was all sorts of handwaving in terms of oh that doesnt mean much. lesson learned.

And this is EVERY post call - not the occasional post call, it's 2 weeks /4 weeks for the month every month. i dont think that's typical

Im not an expert on contract law but even I know people don't just leave out tail coverage as a mistake. Cmon son. Thats like oh Im not sure if they know what their noncompete distance is I'm sure I can just take a job across the street.

 

[Piebaldi]

Im not an expert on contract law but even I know people don't just leave out tail coverage as a mistake. Cmon son. Thats like oh Im not sure if they know what their noncompete distance is I'm sure I can just take a job across the street.

Umm the group has like 8 or 9 docs and we all have the same basic contract. many groups dont offer tail btw in competitive markets.
the noncompete im not worried about - i'm good w that

 

[Old_Mil]

Numerous physicians have quit over the years.
What else could I have done? Sorry for the long post guys.

Physician turnover, along with the long term, persistent use of locums physicians, is *always* some form of an indictment of the job.

Tail coverage is industry standard; dont let anyone tell you it isn't and don't take a job without it. If for no other reason than should you take the job, love it, and get run over while you're riding your bicycle and end up disabled you don't want to be cutting five figure checks for an insurance policy.

 

[Piebaldi]

Physician turnover, along with the long term, persistent use of locums physicians, is *always* some form of an indictment of the job.

Tail coverage is industry standard; dont let anyone tell you it isn't and don't take a job without it. If for no other reason than should you take the job, love it, and get run over while you're riding your bicycle and end up disabled you don't want to be cutting five figure checks for an insurance policy.

No locums. Industry standard as in it's typically covered? Yeah I would imagine taht. Again not many options here so I can't do miracles.

 

[ThoracicGuy]

No locums. Industry standard as in it's typically covered? Yeah I would imagine taht. Again not many options here so I can't do miracles.

Why is your location so important that you can't look to other places for a job? No place is THAT good.

 

[Piebaldi]

Why is your location so important that you can't look to other places for a job? No place is THAT good.

Well my family is here and so is my husband's family.