Thoughts on CMG controlling shifts

[deleted206819]

Working as an IC for TeamHealth and just got an email telling us:

• Limit our ability to take days off if the number of people asking for off is full
• Give advanced notice for approval if we are going to take more than 5 days off
• Going forward if there is a hole on a day you entered each shift because it was full you will be asked to open that date up

As an IC, I thought that they could not control our availability and ability to work certain days and the contract does not stipulate what they can and can’t control.

At the same time, if I speak up and make an issue they are well within their right to give me 0 shifts going forward as well.

What are your thoughts?

---

Members don't see this ad.

 

[Tenk]

Assuming you guys aren’t having a big problem filling shifts all the time, this is prolly due to holidays or other single events (spring break, etc) causing problems with coverage.

If you like where you work I’d just ignore this and see how it plays out for you. It might be a non issue for you in practice. If it turns out to be an annoyance then just threaten to leave or leave.

Overall, CMG will CMG and won’t give a single crap about you either way.

 

[hopeful22213]

Working as an IC for TeamHealth and just got an email telling us:

• Limit our ability to take days off if the number of people asking for off is full
• Give advanced notice for approval if we are going to take more than 5 days off
• Going forward if there is a hole on a day you entered each shift because it was full you will be asked to open that date up

As an IC, I thought that they could not control our availability and ability to work certain days and the contract does not stipulate what they can and can’t control.

At the same time, if I speak up and make an issue they are well within their right to give me 0 shifts going forward as well.

What are your thoughts?

My understanding is if you're an IC they cannot control your schedule like that. Cursory google search seems to confirm the same. You're right though that if you raise the issue, it could impact future scheduling especially if they aren't having problems getting folks to cover shifts.

10 Legal Rights of Independent Contractors and 1099 Employees

Learn the 10 legal rights of independent contractors, often referred to as 1099 employees. Understand which rights you have to ensure you are treated fairly and legally.

www.mbopartners.com

 

[Fox800]

As an IC, they cannot control your schedule. In the real world, you dictate when you work and how you work. This is how it works at my other (non-EM) work - I tell them when I work, and that's the final word, 100%. No arguments, no pushback.

However, if you raise a stink against the group culture or threaten to report them to the IRS for misclassifying you as an independent contractor, I suspect they're likely to just terminate your contract/"let you go".

 

[JacobMcCandles]

The IRS has very specific guidelines for being an independent contractor. I would make sure that you and your colleagues are aware of this.

 

[deleted206819]

As an IC, they cannot control your schedule. In the real world, you dictate when you work and how you work. This is how it works at my other (non-EM) work - I tell them when I work, and that's the final word, 100%. No arguments, no pushback.

However, if you raise a stink against the group culture or threaten to report them to the IRS for misclassifying you as an independent contractor, I suspect they're likely to just terminate your contract/"let you go".

This I understand very well and if I do go down this route, then I would do it anonymously for the entire group and not my specific site.

 

[thegenius]

Working as an IC for TeamHealth and just got an email telling us:

• Limit our ability to take days off if the number of people asking for off is full
• Give advanced notice for approval if we are going to take more than 5 days off
• Going forward if there is a hole on a day you entered each shift because it was full you will be asked to open that date up

As an IC, I thought that they could not control our availability and ability to work certain days and the contract does not stipulate what they can and can’t control.

At the same time, if I speak up and make an issue they are well within their right to give me 0 shifts going forward as well.

What are your thoughts?

Not work for TH?

All of this should be in your contract. If they are modifying the terms of your contract, then perhaps they are in violation of their contract?

 

[EctopicFetus]

Not work for TH?

All of this should be in your contract. If they are modifying the terms of your contract, then perhaps they are in violation of their contract?

Most of the time they retain the right to change the deal on your contract. TH is daring you to sue them. They dont care. They need you much much less than you need them. This is really true in some markets and how USUCKSscrews people. Have a big azz chunk of the market and then slash pay.. dare people to move. USACS wins. They can pay 2x rates with their firefighters longer than you can not work or travel 3 states over to work.

 

[GonnaBeADoc2222]

In any job ive had either with a CMG or W2 hospital employed, I've treated schedule "requests" not as requests, but as my notification to the employer of when I will not be at work. They can plan for that certainty, or not.

If I were you, I'd be working on credentialing at a few more places to increase leverage and options.

Unfortunately, as IC for TH (trust me, I've been there) they don't give a rat's ass about you and will cut you the second you rock the boat.

 

[southerndoc]

You could always report their email to the IRS. By controlling your shifts, they can no longer classify you as an independent contractor. The IRS would love to call them out on that. IRS standard as an IC is that you tell them what days you are available.

 

[goodoldalky]

Your employer is classifying you as 1099 but treating you like it’s a W2. Lots of groups do this, especially in the CMG realm, since it saves them money. It’s not totally by the book as others have alluded to, but they will likely replace you (if they can) if you don’t play by their rules.

If you think you can deal with it, try, if not, work on another job.

 

[Siggy]

My understanding is if you're an IC they cannot control your schedule like that. Cursory google search seems to confirm the same. You're right though that if you raise the issue, it could impact future scheduling especially if they aren't having problems getting folks to cover shifts.

10 Legal Rights of Independent Contractors and 1099 Employees

Learn the 10 legal rights of independent contractors, often referred to as 1099 employees. Understand which rights you have to ensure you are treated fairly and legally.

www.mbopartners.com

Let's be honest, if we applied a strict reading of employee vs independent contractor status, then there would be very few legitimate 1099 physicians. The thing is that when both the employee and the employer are happy (and smart enough to understand the consequences, in contrast to say gig economy workers) who is going to complain about the setup?

...and when a 1099 takes a position that puts the employer at risk, the squeaky wheel doesn't get grease... it gets replaced.

 

[deleted206819]

Let's be honest, if we applied a strict reading of employee vs independent contractor status, then there would be very few legitimate 1099 physicians. The thing is that when both the employee and the employer are happy (and smart enough to understand the consequences, in contrast to say gig economy workers) who is going to complain about the setup?

...and when a 1099 takes a position that puts the employer at risk, the squeaky wheel doesn't get grease... it gets replaced.

The issue is that when you are being exploited to the tune of 30% from billing for management expenses but they cannot manage staffing and scheduling because of “reasons” all the while seeing 2.4-2.6 pph.

Why should we have to bed over backwards for their idiocy? They get to take the benefits of us being ICs but we get to take the drawbacks of ICs as well as W-2 employees.

 

[Siggy]

The issue is that when you are being exploited to the tune of 30% from billing for management expenses but they cannot manage staffing and scheduling because of “reasons” all the while seeing 2.4-2.6 pph.

Why should we have to bed over backwards for their idiocy? They get to take the benefits of us being ICs but we get to take the drawbacks of ICs as well as W-2 employees.

How many 1099s will give up their s-corp, especially if looking at a per-diem or second job?

 

[EctopicFetus]

The issue is that when you are being exploited to the tune of 30% from billing for management expenses but they cannot manage staffing and scheduling because of “reasons” all the while seeing 2.4-2.6 pph.

Why should we have to bed over backwards for their idiocy? They get to take the benefits of us being ICs but we get to take the drawbacks of ICs as well as W-2 employees.

Why? Cause they control access to the gold
Mine and you may not like it. They need you much less than you need them and they know it.

Em residency applications up 30% for this year.

So yeah. We can be mad. We can complain but until we act (and let’s be real we won’t) no one will gaf.

Edited to add: talk is cheap.

 

[ScepticSkeksis]

I like 1099. If you aren't worried about health insurance, then it's better overall. I can set aside way more for 401K with 1099 money than the measly "employee contribution" in a W-2 1099 plan.

 

[Apollyon]

in a W-2 1099 plan.

??

 

[Siggy]

??

Probably meant 401K and not 1099.

 

[EctopicFetus]

FWIW if you are in an SDG you have a bunch of options including deductions most notably once you load up your retirement you could pool funds and do a defined benefit plan. For a mid 30s doc you could do 80ish, for a mid to late 40s doc you are close to 150k a year after your 401k/PSP. You can do that as an IC but the costs are not tiny.

 

[Mbekweni]

Also look at unrelated income if you get into admin, consulting etc. Each job source gets its own retirement plans. Defined benefit plan can put aside quite a bit (40k-300k or more a year pretax) but you are limited to 6% of post DBP salary as company contribution to 401k. I’m 39 and was able to get 160k a year into DBP I just designed. This combines with a solo 401k that allows a bit over 16k in pre tax company aka myself contribution and the rest turns into mega backdoor Roth at $52k to meet the full qualified limit of 69,000 for 401(k). That’s one job. My main job is 40k DBP and 69k 401k pretax. 7k regular backdoor Roth and that’s a lot of qualified space to pack up at over 300k. Access to the right plans makes such a huge difference, I happen to live in a high-tax state of California, but find that it is not that big of a deal if you can defer a ton of taxes. You can always move if you want to come retirement or choose your withdrawal tax rate for a large number of years given the combination of Roth, pretax and taxable accounts.

 

[Brigade4Radiant]

If anything happens to me at my job I’ll send the emails where they have the rules and changed our hours to 12s to the irs I’ll get a tax attorney to contact them

 

[Brigade4Radiant]

I also find a hilarious that everyone in here is like the IRS will turn a blind eye to labeling employees as independent contractors. But a doctor using a home office deduction that’s way dangerous.

 

[JacobMcCandles]

I also find a hilarious that everyone in here is like the IRS will turn a blind eye to labeling employees as independent contractors. But a doctor using a home office deduction that’s way dangerous.

As someone who thinks most people in EM misuse the home office deduction, the risks between the two things you described are different. The risk of mislabeling an employee is with the employer. The risk of misusing a home office deduction is on you. People generally don't care about things that pose no risk to them.

 

[Brigade4Radiant]

As someone who thinks most people in EM misuse the home office deduction, the risks between the two things you described are different. The risk of mislabeling an employee is with the employer. The risk of misusing a home office deduction is on you. People generally don't care about things that pose no risk to them.

The risks aren’t different because you’re the one being mislabeled as an independent contractor. So you’re already taking risk. By being able to be fired while being controlled.

Also, the Office deduction is fairly supported if you have a good accountant, you could do telehealth various other operations, CME and other things.

 

[JacobMcCandles]

The risks aren’t different because you’re the one being mislabeled as an independent contractor. So you’re already taking risk. By being able to be fired while being controlled.

If they want you gone then you're going to be gone whether you're a 1099 or W2.

 

[Brigade4Radiant]

If they want you gone then you're going to be gone whether you're a 1099 or W2.

Yeah but W2 has unemployment benefits and you can sue for unjust firing

 

[timpview]

Yeah but W2 has unemployment benefits and you can sue for unjust firing

Aren’t all these w2 contracts laced with 90 day out clauses? Guess they’re stuck with you for three months but it’s not like it’s trying to fire a tenured professor.

 

[Brigade4Radiant]

Aren’t all these w2 contracts laced with 90 day out clauses? Guess they’re stuck with you for three months but it’s not like it’s trying to fire a tenured professor.

I believe if you quit it’s 90 days but they can fire you immediately. Technically at an at will state you can quit immediately

 

[JacobMcCandles]

Yeah but W2 has unemployment benefits and you can sue for unjust firing

You can absolutely sue but the chance you'll have a collective case will likely be slim but it can be done, though.

Unemployment benefits are state dependent but will pale in comparison to an ED doc's wage. Using that as a benefit should be an afterthought.

My point is that people don't care because those who are financially savvy can typically make 1099 work be more lucrative for themselves over comparable W2 work since they have greater control over their benefits. This is worth more to them than being controlled.

 

[JacobMcCandles]

Aren’t all these w2 contracts laced with 90 day out clauses? Guess they’re stuck with you for three months but it’s not like it’s trying to fire a tenured professor.

Yes, but that's typically 'without cause'. Most contracts will probably contain something about being terminated 'for cause' effective immediately.

 

[Groove]

Working as an IC for TeamHealth and just got an email telling us:

• Limit our ability to take days off if the number of people asking for off is full
• Give advanced notice for approval if we are going to take more than 5 days off
• Going forward if there is a hole on a day you entered each shift because it was full you will be asked to open that date up

As an IC, I thought that they could not control our availability and ability to work certain days and the contract does not stipulate what they can and can’t control.

At the same time, if I speak up and make an issue they are well within their right to give me 0 shifts going forward as well.

What are your thoughts?

What's the big deal with these stipulations? We had something similar at Apollo.
1) As a scheduler, you can't have everybody asking for certain days off. So, usually in the scheduling software, you specify how many docs can request to have each particular day off. If it's over 3-4, it will not allow you to take that day off because it will be difficult if not impossible to staff the holes. So, it's on a first come, first serve basis and it should provide an incentive to put in your requests as soon as the scheduling block allows. If I'm wanting to take 5 days off and I notice that there are already 3 or more docs requesting several days on a particular week well then I need to pick another week where there are fewer requests.

2) We did advanced notice for over 7 days. I usually required people to give me at least 3 months notice because that's how long it takes to identify if a staffing hole is not going to be filled by existing docs and/or local PRN people and I can give notice to the CMG and they can fly in locums to staff the hole. It's just courtesy man....scheduling a bunch of 5-7 day blocks with only a month and a half notice is a nightmare. There's no way I would have been able to chance that 2-3 docs might all have the same idea about taking a week off during a particular month.

3) I don't understand that one. It sounds like people are tricking the scheduling software and it's not allowing you to request the entire day off (because too many people have asked off for the same day) so people are selecting individual shifts that they are unavailable to get around the restriction if I'm interpreting that right. If so, the CMG is saying if all that tomfoolery results in the scheduler not being able to staff that day, they can require you to make the day available and require you to work it. (Because you never should have been able to take it off in the first place.)

As a previous scheduler for more years than I care to count, all that stuff sounds very reasonable. Scheduling is a hard job man. I don't get any sort of malignant vibes from the email and reporting something like this to the IRS is beyond ridiculous. It absolutely would get your black listed by TH which is completely not worth it. Talk about a Pyrrhic victory.

 

[Siggy]

What's the big deal with these stipulations? We had something similar at Apollo.
1) As a scheduler, you can't have everybody asking for certain days off. So, usually in the scheduling software, you specify how many docs can request to have each particular day off. If it's over 3-4, it will not allow you to take that day off because it will be difficult if not impossible to staff the holes. So, it's on a first come, first serve basis and it should provide an incentive to put in your requests as soon as the scheduling block allows. If I'm wanting to take 5 days off and I notice that there are already 3 or more docs requesting several days on a particular week well then I need to pick another week where there are fewer requests.

Yes, but then you need more W-2s and not independent contractors. If you're mandating an independent contractor work a certain day, then they're not an independent contractor and should be classified as a W-2. Again, physicians get away with it because it's normally in everyone's interest when someone decides to be a W-2. Also we're considered smart enough that people aren't going to consider employers to be pulling one over on us (unlike Uber, as an example) by classifying us as a 1099.

 

[Groove]

Yes, but then you need more W-2s and not independent contractors. If you're mandating an independent contractor work a certain day, then they're not an independent contractor and should be classified as a W-2. Again, physicians get away with it because it's normally in everyone's interest when someone decides to be a W-2. Also we're considered smart enough that people aren't going to consider employers to be pulling one over on us (unlike Uber, as an example) by classifying us as a 1099.

They are forcing him to work because he tricked the scheduling software into giving him a day off that normally wouldn't be allowed, lol. He never should have had that day off in the first place and rather than be an ass and take it back by default, they allow him to have it unless it becomes impossible to schedule anyone on that day. It sounds very common sense to me and is similar to scheduling requirements at just about every job I've had as an attending. How else are you going to schedule everyone to work? Do some of you guys only give 12 days that you are available out of the month and you request off for the other 19? That's crazy talk. The only jobs I've ever seen where this is even remotely possible would be a locums gig. I mean, if you're flying out once a month and you block off a certain week. I get that, but local FTE 1099s working for a CMG?

 

[Mount Asclepius]

Be an owner. If you can become a physician you are allowed autonomy just like your patients. Seize back control.

 

[Siggy]

They are forcing him to work because he tricked the scheduling software into giving him a day off that normally wouldn't be allowed, lol. He never should have had that day off in the first place and rather than be an ass and take it back by default, they allow him to have it unless it becomes impossible to schedule anyone on that day. It sounds very common sense to me and is similar to scheduling requirements at just about every job I've had as an attending. How else are you going to schedule everyone to work? Do some of you guys only give 12 days that you are available out of the month and you request off for the other 19? That's crazy talk. The only jobs I've ever seen where this is even remotely possible would be a locums gig. I mean, if you're flying out once a month and you block off a certain week. I get that, but local FTE 1099s working for a CMG?

...but that's the point. For a true IC relationship the IC says, "I can work these dates, take them or leave them." If the CMG is saying, "You have to work these dates" then it's not an IC relationship. What you're describing is a W-2 relationship. The fact that the employee and the employer prefers the 1099 relationship is irrelevant, especially if someone is expecting the required flexibility of an IC job. If you want to force someone to work a certain day, they need to be a W2... or get the IRS to change the definition of an independent contractor.


"Instructions – if you receive extensive instructions
on how work is to be done, this suggests that you are
an employee. Instructions can cover a wide range of
topics, for example:
• how, when, or where to do the work
• what tools or equipment to use
• what assistants to hire to help with the work
• where to purchase supplies and service"

https://www.irs.gov/pub/irs-pdf/p1779.pdf

 

[Groove]

...but that's the point. For a true IC relationship the IC says, "I can work these dates, take them or leave them." If the CMG is saying, "You have to work these dates" then it's not an IC relationship. What you're describing is a W-2 relationship. The fact that the employee and the employer prefers the 1099 relationship is irrelevant, especially if someone is expecting the required flexibility of an IC job. If you want to force someone to work a certain day, they need to be a W2... or get the IRS to change the definition of an independent contractor.


"Instructions – if you receive extensive instructions
on how work is to be done, this suggests that you are
an employee. Instructions can cover a wide range of
topics, for example:
• how, when, or where to do the work
• what tools or equipment to use
• what assistants to hire to help with the work
• where to purchase supplies and service"

https://www.irs.gov/pub/irs-pdf/p1779.pdf

Right, but what's your solution? EM has been replete with 1099 docs from the incipience. How are you going to staff an ED when your 6 FTE docs ask for 20 days off each month? All overlapping each other. The whole fixation on the IRS and federal definitions of IC employment seem to negate the practicality that is required to physically and responsibly staff an emergency department with able bodied personnel. Do you want to make them all W2? You'd have a massive outcry from docs perfectly happy with 1099 employment.

OP, do what you want but think long and hard before pissing off one of the largest CMGs in the country.

 

[EctopicFetus]

FWIW if you are in an SDG you have a bunch of options including deductions most notably once you load up your retirement you could pool funds and do a defined benefit plan. For a mid 30s doc you could do 80ish, for a mid to late 40s doc you are close to 150k a year after your 401k/PSP. You can do that as an IC but the costs are not tiny.

Be an owner. If you can become a physician you are allowed autonomy just like your patients. Seize back control.

frankly easier said than done.

 

[Siggy]

Right, but what's your solution? EM has been replete with 1099 docs from the incipience. How are you going to staff an ED when your 6 FTE docs ask for 20 days off each month? All overlapping each other. The whole fixation on the IRS and federal definitions of IC employment seem to negate the practicality that is required to physically and responsibly staff an emergency department with able bodied personnel. Do you want to make them all W2? You'd have a massive outcry from docs perfectly happy with 1099 employment.

OP, do what you want but think long and hard before pissing off one of the largest CMGs in the country.

So... um, yea... you don't think employment law should be factored into discussions on employment?

The company has a choice. They can decide not to give a 1099 shifts if they don't play ball. They can decide to hire more W-2s to fill in the gaps left by the 1099s. However you can't complain that a 1099 is taking a liberty that employment law says a 1099 has. Are you going to complain that an employee blew up the schedule by taking FMLA?

 

[ScepticSkeksis]

For me the biggest problem at sites I work at is that there isn't a significant bonus for holidays. One site I work at pays 1.5X salary for Holidays, so guess what? I picked up Thanksgiving and Christmas there as the amount is worth it. This is for 1099 work.

Just pay $1000 extra per shift at Christmas, Thanksgiving, Memorial Day, Labor Day and watch your scheduling issues vanish.

 

[southerndoc]

Right, but what's your solution? EM has been replete with 1099 docs from the incipience. How are you going to staff an ED when your 6 FTE docs ask for 20 days off each month? All overlapping each other. The whole fixation on the IRS and federal definitions of IC employment seem to negate the practicality that is required to physically and responsibly staff an emergency department with able bodied personnel. Do you want to make them all W2? You'd have a massive outcry from docs perfectly happy with 1099 employment.

OP, do what you want but think long and hard before pissing off one of the largest CMGs in the country.

The IRS doesn't care about the ED staffing challenges. If the SDG/CMG says only so many docs can take off a particular day, then it's an employee relationship in their eyes. If every doc is an IC and if every doc wanted off Christmas, and if the SDG/CMG tries to block them from asking off or forces them to work, then tough crap, the IRS considers it an employee relationship now.

Now that doesn't prevent the group from saying "hey everyone asked off for Christmas. If someone is available we'll pitch in $2500 bonus."

 

[Groove]

So, let me get the straight....we're on track to have 10K too many docs in about 7 years further saturating an already over competitive job market and some of you guys want to revolt over not being able to take off every holiday out of the year and not being able to ask off 20 days out of the month? And you think the IRS has either the resources or the interest to investigate the poor 1099 physician abuse across our nation where docs aren't allowed to ask off as many days as they want? We're supposed to drum up public sympathy for the poor rich doctors who can't have off every Fri through Sunday and every major holiday because they have to take care of sick people in the ER? Man, good luck with that. Talk about bad optics. I like my job, I'm treated fairly, I get to take off up to 10 days out of the month, I'm guaranteed 140 hours and I'm paid very well for it. We have a round robin holiday system where everyone votes on holidays. The majority of us are incredibly happy with 1099 status because we get paid more for our services. If we've got a doc that slacked on putting in requests until the last minute (which happens all the time) and ended up pulling a stunt like OP describes where they trick the scheduling system to take off on a day that shouldn't have been allowed in the first place and then gets forced to work it....man I would completely support the CMG in that decision or any employer for that matter. If he/she wants to execute themselves by reporting something like that to the IRS then get ready for that pink slip. Good luck finding any employer anywhere who would allow those types of shenanigans. I think some of you are all talk and I seriously doubt that you are making these big demands under the guise of 1099 status. You'd simply get replaced on the schedule in a heart beat if you're remotely close to a competitive market. Nobody would get away with that where I'm at and I've also never observed it in any job I've ever had within the industry and have worked for CMGs my entire career.

The only people who can get away with that kind of stuff are remote Locum gigs to dumpster fire EDs and they can stipulate all their demands on the front end. I've never remotely seen something similar in a local CMG FTE gig.

 

[Siggy]

I’m w-2 and if an IC wants to die on that hill I’m sure that they’ll find either a department of labor or the IRS to investigate.

…but if you want to roll the dice the other way, go ahead.

 

[Groove]

The schedules have been remarkably fair in my experience working long term gigs for the major CMGs in the SE including TH, ApolloMD and Schumacher (whatever their new name is...SCP?) I can't speak to everywhere else but man....as a CMG scheduler there was always that 1 or 2 docs that would never put their requests in on time and you had to spam text every week to put them in or suffer the consequences and occasionally (very rarely) I'd have to refuse a day off or deny their holiday and/or vacation request. Imagining any of them reporting something like that to the IRS is beyond absurd. That's just insane unless they are wanting to leave their job and the industry in a blaze of glory.

We had one doc at a job site that sued one of the major CMGs for what he felt was lost wages during his termination. He got black listed across all sites in the country and took a job in our city with another CMG. As luck would have it, his old CMG took over the contract and everyone kept their job....except him. He got axed immediately and had to move out of the city to find another job. Man, I get some of these legal arguments but damn...some battles are just not worth fighting.

 

[goodoldalky]

This got bogged down in the weeds. The punchline is people are annoyed at CMG behavior, and this 1099 nonsense is another example.

Their habit of using 1099 is simply to save them money. It’s really not because it’s better for the doctors and they do it out of the goodness of their hearts. No benefits, no half of social security and Medicare taxes, no workers compensation, no unemployment benefits, no red tape or employee W2 protections if you want to can someone… let’s make them 1099! But make them do all the W2 stuff we expect to fill a schedule.

It’s emblematic of the CMG modus operandi, so it’s going to get flamed.

 

[southerndoc]

So, let me get the straight....we're on track to have 10K too many docs in about 7 years further saturating an already over competitive job market and some of you guys want to revolt over not being able to take off every holiday out of the year and not being able to ask off 20 days out of the month? And you think the IRS has either the resources or the interest to investigate the poor 1099 physician abuse across our nation where docs aren't allowed to ask off as many days as they want? We're supposed to drum up public sympathy for the poor rich doctors who can't have off every Fri through Sunday and every major holiday because they have to take care of sick people in the ER? Man, good luck with that. Talk about bad optics. I like my job, I'm treated fairly, I get to take off up to 10 days out of the month, I'm guaranteed 140 hours and I'm paid very well for it. We have a round robin holiday system where everyone votes on holidays. The majority of us are incredibly happy with 1099 status because we get paid more for our services. If we've got a doc that slacked on putting in requests until the last minute (which happens all the time) and ended up pulling a stunt like OP describes where they trick the scheduling system to take off on a day that shouldn't have been allowed in the first place and then gets forced to work it....man I would completely support the CMG in that decision or any employer for that matter. If he/she wants to execute themselves by reporting something like that to the IRS then get ready for that pink slip. Good luck finding any employer anywhere who would allow those types of shenanigans. I think some of you are all talk and I seriously doubt that you are making these big demands under the guise of 1099 status. You'd simply get replaced on the schedule in a heart beat if you're remotely close to a competitive market. Nobody would get away with that where I'm at and I've also never observed it in any job I've ever had within the industry and have worked for CMGs my entire career.

The only people who can get away with that kind of stuff are remote Locum gigs to dumpster fire EDs and they can stipulate all their demands on the front end. I've never remotely seen something similar in a local CMG FTE gig.

I'm not advocating for it at all. I'm just simply stating how the IRS views it. The IRS has and will continue to investigate this. I know of one CMG who had its relationship tested within the past 10 years. The IRS has a lot to gain from reclassifying ICs as employees. It gets tax revenue on a more steady basis.

On another note, I'm not so sure that we're still on track for a 10K surplus. I believe some market forces have changed.

 

[EctopicFetus]

I'm not advocating for it at all. I'm just simply stating how the IRS views it. The IRS has and will continue to investigate this. I know of one CMG who had its relationship tested within the past 10 years. The IRS has a lot to gain from reclassifying ICs as employees. It gets tax revenue on a more steady basis.

On another note, I'm not so sure that we're still on track for a 10K surplus. I believe some market forces have changed.

Which market forces have changed ?

Are you referring to tons of docs leaving?

The counter there fwiw is younger docs won’t be leaving or retiring at the pace that the later study mentioned where they cited higher attrition. It’s proof of a study with an end goal in mind in lieu of something useful and meaningful.

I am curious why you think we don’t get there. I can tell you that in my local market people can’t find work within an hour of the urban center.

 

[southerndoc]

Which market forces have changed ?

Are you referring to tons of docs leaving?

The counter there fwiw is younger docs won’t be leaving or retiring at the pace that the later study mentioned where they cited higher attrition. It’s proof of a study with an end goal in mind in lieu of something useful and meaningful.

I am curious why you think we don’t get there. I can tell you that in my local market people can’t find work within an hour of the urban center.

Unfortunately, I don't have research to back up my assumption (other than hearing talk from administrators).

I believe the attrition rate is higher than what was reported, and the number of candidates being produced from residency programs will start to fall.

Only time will tell though.

 

[GonnaBeADoc2222]

Be an owner. If you can become a physician you are allowed autonomy just like your patients. Seize back control.

I was waiting patiently for the "just be an owner" trope. You never fail to disappoint.

 

[EctopicFetus]

Unfortunately, I don't have research to back up my assumption (other than hearing talk from administrators).

I believe the attrition rate is higher than what was reported, and the number of candidates being produced from residency programs will start to fall.

Only time will tell though.

Appreciate the insight. I figure it was just an opinion but I respect your opinions so wanted to hear your perspective.

 

[Mount Asclepius]

I was waiting patiently for the "just be an owner" trope. You never fail to disappoint.

You’re right. Better to voluntarily give up autonomy and then subsequently complain about having no control.