Vacation Infraction?

[ask1288]

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I am an MS4 who just matched. During my interview at the place I matched, we were told that we had 3 weeks vacation + EBM week (see below). I just received a vacation preferences document from the program i matched at and it says we get 2 weeks + EBM week (for which we have to stay in the city). Any advice on what i should do? don't wanna respond and be looked down upon even before I start, but hey its one more week, and its misrepresentation. (This was also one of the reasons, i ranked this program first)

PS: After my interview i had asked the chief who gave to powerpoint presentation to send me the PPT and he did. I looked over the PPT and here's the details:

Under the slide titled: PGY-1 schedule:
1 month of Vacation and EBM (3 wks & 1 wk)

Under the slide titled: Other Aspects of the Program – Benefits
3 weeks of vacation
1 week of “EBM” (Evidence Based Medicine)
4 additional days off either Christmas or New Year’s

Any advice would be sincerely appreciated

 

[Winged Scapula]

Why not call the program coordinator and ask her why the discrepancy?

They may have changed it since you interviewed, the Chief or the PC may be wrong, maybe only senior residents get 3 weeks of vacation, etc.

 

[John Deere Gree]

Why not call the program coordinator and ask her why the discrepancy?

They may have changed it since you interviewed, the Chief or the PC may be wrong, maybe only senior residents get 3 weeks of vacation, etc.

Agree with WS (what a surprise). I'd call and ask questions...

speaking of which I need to call and ask about some benefit stuff...

 

[BigRedBeta]

You should have gotten a sample contract (I'm pretty sure this is an ACGME or NRMP requirement) during your interview - check that. If there's a discrepancy, then you have a legitimate complaint, and it's possible there is an error in the vacation preference documents...

 

[Elfy]

They may have changed it since you interviewed, the Chief or the PC may be wrong, maybe only senior residents get 3 weeks of vacation, etc.

If (according to the OP) the info was presented on slides without any of the above caveats, doesn't this equate with a retroactive change, and how ethical is that?

Candidates are always being advised on this forum to be truthful to programs so the reverse should apply.

I think the OP was quite sharp in the game requesting a hard copy of the vacation schedule as advertised before the match and is in a great position to point inconsistencies. This way the program can't claim the candidate didn't read the small print, nor is it X's word against Y's.

 

[SoCuteMD]

If (according to the OP) the info was presented on slides without any of the above caveats, doesn't this equate with a retroactive change, and how ethical is that?

Candidates are always being advised on this forum to be truthful to programs so the reverse should apply.

I think the OP was quite sharp in the game requesting a hard copy of the vacation schedule as advertised before the match and is in a great position to point inconsistencies. This way the program can't claim the candidate didn't read the small print, nor is it X's word against Y's.

The powerpoint doesn't matter, it's the sample contract that does.

 

[Winged Scapula]

If (according to the OP) the info was presented on slides without any of the above caveats, doesn't this equate with a retroactive change, and how ethical is that?

Candidates are always being advised on this forum to be truthful to programs so the reverse should apply.

I think the OP was quite sharp in the game requesting a hard copy of the vacation schedule as advertised before the match and is in a great position to point inconsistencies. This way the program can't claim the candidate didn't read the small print, nor is it X's word against Y's.

1) Who ever said residency was fair or ethical? Academic medicine is rife with violations that would never fly in the real business world.

2) My point wasn't that the OP doesn't deserve a extra week of vacation but rather the slides might have been wrong, the new contract might be wrong, whatever. Its most likely a mistake. I know my fellowship contract arrived with the wrong salary (ie, for a lower PGY than I was); I pointed it out, it got corrected, I signed and all was hunky dory. Perhaps the GME office that sent the contract sent him the wrong one (not all residencies in the hospital get the same benefits, vacation, etc. Its pretty easy to mix them up, especially if the OP has a common name).

3) Who ever said residency interviews were always truthful? While not fair (see 1 above) candidates and programs have been known to lie.

 

[ask1288]

To make things even more complicated, the sample contract given to us says 15 work days 🙂.

I guess, I'll email them and enquire, and hope for the best.

Thanks for all the responses!

 

[ask1288]

1) Who ever said residency was fair or ethical? Academic medicine is rife with violations that would never fly in the real business world.

3) Who ever said residency interviews were always truthful? While not fair (see 1 above) candidates and programs have been known to lie.

So are you saying it happens all the time, so why should it not happen now? They all lie, so lying is fine, they all said the earth was flat, heck it must be flat, they all said bacteria could never live in the stomach, so H.Pylori must never exist. ??

 

[Winged Scapula]

So are you saying it happens all the time, so why should it not happen now? They all lie, so lying is fine, they all said the earth was flat, heck it must be flat, they all said bacteria could never live in the stomach, so H.Pylori must never exist. ??

Good Lord. I'd appreciate it if you and the poster above would not put words into my mouth.

My comment should be taken as it stands. Some programs lie. Not all do. Just because some programs lie doesn't mean that the Chief resident you interviewed with did or that the PC is. But you must have thought it otherwise you wouldn't have posted here inquiring about the discrepancy.

And I never said lying was fine. If you reread my comment above, you'll see that while I mentioned this as a possibility, the most likely explanation is that it was a mistake.

 

[Winged Scapula]

To make things even more complicated, the sample contract given to us says 15 work days 🙂.

Well, then that solves it.

Residency contracts and salaries are generally based on the 40 hour, M-F week, regardless of what days or hours you actually work.

15 work days = 3 weeks of vacation in academic medicine. Whether or not they choose to give you the bumper weekend(s) is entirely up to your program. Most do (give you at least 1 weekend).

 

[Drawing Dead]

OP, I would get ready to find out that you can only take your vacation during certain rotations as well. My program stipulated 3 weeks of vacation, and then I get here and its 5 days during any rotation except ICU or Peds, which is an out rotation. 5 days during elective (of which I got one, and besides, electives are vacations within themselves). and a week during the holidays (we got either Christmas or New Years week).

What was even worse, I had my elective in December, so I had 2 weeks off of Optho, which was by far my easiest rotation.

My program doesn't stipulate that you get your weekends off around your vacation, but if you schedule it right, maybe a rotation that doesn't require weekends, then you can pull it off. Unfortunately, these are the more lax rotations.

 

[gutonc]

OP, I would get ready to find out that you can only take your vacation during certain rotations as well. My program stipulated 3 weeks of vacation, and then I get here and its 5 days during any rotation except ICU or Peds, which is an out rotation. 5 days during elective (of which I got one, and besides, electives are vacations within themselves). and a week during the holidays (we got either Christmas or New Years week).

What was even worse, I had my elective in December, so I had 2 weeks off of Optho, which was by far my easiest rotation.

My program doesn't stipulate that you get your weekends off around your vacation, but if you schedule it right, maybe a rotation that doesn't require weekends, then you can pull it off. Unfortunately, these are the more lax rotations.

This is pretty much the rule. My program scheduled vacations only on non-ward, non-ICU, non-ER months. As an intern, this means you have 2-4 months (depending on your schedule) during which you can take vacation. My current fellowship program let's you take vacation during elective months and consult months IF you can find someone to cover you while you're gone.

 

[ask1288]

Good Lord. I'd appreciate it if you and the poster above would not put words into my mouth.

Relax, no heat intended. But seriously you'd think a powerpoint presentation to applicants would not have mistake like that? I mean think of amistake like "oops, sorry we meant urology not neurology 🙂"

 

[SocialistMD]

Relax, no heat intended. But seriously you'd think a powerpoint presentation to applicants would not have mistake like that? I mean think of amistake like "oops, sorry we meant urology not neurology 🙂"

Did you not read her last reply?

Residency contracts and salaries are generally based on the 40 hour, M-F week, regardless of what days or hours you actually work.

15 work days = 3 weeks of vacation in academic medicine. Whether or not they choose to give you the bumper weekend(s) is entirely up to your program. Most do (give you at least 1 weekend).

 

[Winged Scapula]

Relax, no heat intended. But seriously you'd think a powerpoint presentation to applicants would not have mistake like that? I mean think of amistake like "oops, sorry we meant urology not neurology 🙂"

This isn't Apple or some other big corporate entity.

Its academic medicine with Power Point presentations drawn up by tired residents. He probably did it the night before, or borrowed the presentation from a former Chief without reading it through. Academic medicine is sloppy, full of these kinds of things.

 

[dragonfly99]

I would not call them and complain. This cannot help you and could only hurt you. Your contract says 15 days of vacation (which = 3 weeks) and that is that. You can expect they might prefer or make you take your vacation during easy months like an elective or outpatient month...this is common and standard practice for residency programs. At my program we got zero educational days, 2 weeks vacation during intern year, and 4 weeks during the rest of the years. It definitely sucked to get less vacation as an intern...I would have rather had 3-3-3...you basically get whatever vacation your program wants to give you.

The chief resident likely screwed up the Powerpoint, thinking that the educational leave was separate when it either didn't exist as a separate week/leave, or has been done away with. Sometimes programs will let people off for up to a certain number of days/year if they have to be somewhere out of town to give a presentation of research or something...perhaps that is why there was educational leave of up to 1 week mentioned on the Powerpoint you saw?

 

[SocialistMD]

The other thing is that sometimes programs offer vacations that are not in the contract. For example, my program has been able each year that I've been here to give us off 3-4 days for one of the winter holidays (Christmas, New Years, +/- Thanksgiving). That does not appear in our contract because (a) it isn't guaranteed (although we always manage to make it happen) and (b) it isn't an official policy, but rather something nice the chairman/program director allow us to do.

That said, it could be worse. As pointed out, some places only give their interns two weeks vacation, and some don't let them choose the time of their vacation (I received all three weeks of my vacation four weeks after the start of my intern year). I don't think a clarification call to the GME office would hurt, but as pointed out by others, 15 days is three weeks and academic medicine is sloppy and in constant flux, so things that you heard my no longer be true.

 

[Elfy]

At least Winged Scapula suggested the OP call and inquire with the PD to clarify (happily solved, it seems). From what DragonFly is suggesting the OP should waive even this right. And DragonFly isn't the only one to hold this view. Another poster in some position of authority wrote the other day that any interviewee who as much as inquires about work hours (even over dinner with residents) automatically is ranked lower in their program than a candidate with similar academic credentials. I am not suggesting all you guys are wrong, I do realize you're all just being realistic and I do appreciate your frankness as well as what you take away for your own free time to help us out here regularly.

However, the way I see it, it rather comes to: what kind of changes could attendings (who have been through this unfair process themselves) help implement so it would be fairer and more ethical for future generations?

I do realize the Match is getting more and more competitive and many candidates are keen enough to find a position that they'd even accept an uncompensated position in terms of vacation. Someone who didn't match in a coveted specialty even asked on this forum recently if they could work as a resident for free. I do realize that there is an increased tendency to waive one's rights to monetary or time compensation in order to get ahead in academic medicine.

I personally wouldn't have a problem with anything a program would tell me upfront, as long as I get accurate, updated fair warning before I sign up, not afterwards. This way I could at least feel it is my decision to waive my rights, not someone else's.

 

[dragonfly99]

good luck, elfy.
The residency programs are holding all the cards, not you.
There will always be more residents, even if the residents aren't treated great.
Anyway, I don't see this situation as being a big deal and in this economy I think we're all happy to have jobs, are we not? I think it would be very whiny to call and complain to the PD about this. VERY whiny.

 

[roflcakes887]

OP: you are eligible to as much vacation as your contract stipulates and I encourage you to take every vacation/sick day you are entitled to.

a powerpoint, or what your program director says means nothing. your written, signed contract is all that matters.

 

[BlondeDocteur]

OP: you are eligible to as much vacation as your contract stipulates and I encourage you to take every vacation/sick day you are entitled to.

And when you get canned for not having the right esprit de corps or whatever they call it these days, you know who to look for.

He'll be sitting in a lecture hall in Durham, North Carolina.

 

[Elfy]

good luck, elfy.
The residency programs are holding all the cards, not you.
There will always be more residents, even if the residents aren't treated great.
Anyway, I don't see this situation as being a big deal and in this economy I think we're all happy to have jobs, are we not? I think it would be very whiny to call and complain to the PD about this. VERY whiny.

It looks like you did not appreciate my efforts to write a nuanced and thoughtful message since you gave me such a stereotypical answer.

Here is again what I wrote:

I am not suggesting all you guys are wrong, I do realize you're all just being realistic and I do appreciate your frankness as well as what you take away for your own free time to help us out here regularly.

Please tell me how that could be misconstrued as disrespectful to residency programs or to more experienced posters.

I do realize the Match is getting more and more competitive and many candidates are keen enough to find a position that they'd even accept an uncompensated position in terms of vacation. Someone who didn't match in a coveted specialty even asked on this forum recently if they could work as a resident for free. I do realize that there is an increased tendency to waive one's rights to monetary or time compensation in order to get ahead in academic medicine.

It is obvious from what I wrote that I did already understand that residency programs are in a position of authority, not residents.

If someone chooses to work for free in medicine, they certainly have the right to their choice. I for one am in no position to work for free in medicine since I've got bills to pay and have other qualifications that can earn me a living. Certainly, I'd be happier in medicine for a lifetime. But I would be dead without food and shelter shortly.

If you think that calling to clarify vacation and benefits at a place that intends to hire you is "whiny", you certainly have the right to your opinion. I for one have been raised to make sure I fully understand a contract before I sign it. Your message implies that knowing one's rights and obligations well and being raised to work hard are somehow mutually exclusive. Let me assure you they aren't.

However, the way I see it, it rather comes to: what kind of changes could attendings (who have been through this unfair process themselves) help implement so it would be fairer and more ethical for future generations?

Now that was the core question in my post. If you choose to elude it, that is your prerogative. But I would appreciate it if you wouldn't misread it.

 

[docB]

However, the way I see it, it rather comes to: what kind of changes could attendings (who have been through this unfair process themselves) help implement so it would be fairer and more ethical for future generations?

You've gotta remember that most of us did residiency before work hour restrictions so our estimation of how bad you have it when it comes to working conditions isn't something you'll be too happy with. As the years go by and there are more and more attendings who only worked 80 hour weeks (or so😉) you'll get more sympathy. Note too that at that time you'll be out of residency and the issues of resident fairness and working conditions will not be high on your radar unless you're a program administrator.

 

[Winged Scapula]

You've gotta remember that most of us did residiency before work hour restrictions so our estimation of how bad you have it when it comes to working conditions isn't something you'll be too happy with. As the years go by and there are more and more attendings who only worked 80 hour weeks (or so😉) you'll get more sympathy. Note too that at that time you'll be out of residency and the issues of resident fairness and working conditions will not be high on your radar unless you're a program administrator.

In addition to the excellent point above, bear in mind that many of your attendings and residents may also not see working fewer and fewer hours while the medical knowledge database increases as a good thing. Many of us are fearful about being treated in our old age by residents who worked 56 or fewer hours per week and care more about what time their shift ends than whether or not their patients need them.

 

[roflcakes887]

You've gotta remember that most of us did residiency before work hour restrictions so our estimation of how bad you have it when it comes to working conditions isn't something you'll be too happy with. As the years go by and there are more and more attendings who only worked 80 hour weeks (or so😉) you'll get more sympathy. Note too that at that time you'll be out of residency and the issues of resident fairness and working conditions will not be high on your radar unless you're a program administrator.

so because working conditions were wrong back then, people today shouldn't complain even though working conditions are still wrong today because we didn't have it as "tough" as you?

wrong is wrong no matter when it is.

residency should be 60 hours a week capped and resident pay should be vastly increased.

hospitals use residents to exploit them for cheap labor, nothing more.

 

[roflcakes887]

In addition to the excellent point above, bear in mind that many of your attendings and residents may also not see working fewer and fewer hours while the medical knowledge database increases as a good thing. Many of us are fearful about being treated in our old age by residents who worked 56 or fewer hours per week and care more about what time their shift ends than whether or not their patients need them.

Medicine is a job, why should I not know when my shift ends?

If you are not happy with one physicians skills or expertise, you are free to see another physician.

This is America.

The fact is, resident hours are completely unacceptable, resident pay needs to be vastly increased and hospitals need to stop using residents as a source of cheap labor and exploiting them.

 

[Winged Scapula]

Medicine is a job, why should I not know when my shift ends?

Because patient's illnesses are not on a schedule and with few exceptions, medicine is not shift work where you clock out and your responsibility ends.

If you are not happy with one physicians skills or expertise, you are free to see another physician.

This is America.

Thanks for the civics lesson but I'm not sure what this has to do with work hours.

The fact is, resident hours are completely unacceptable, resident pay needs to be vastly increased and hospitals need to stop using residents as a source of cheap labor and exploiting them.

docB and I don't disagree with you here. I'm sure he agrees that resident physicians are underpaid and that hospitals take advantage of that. Its patently obvious to all of us that this is true. Nor do we think necessarily that just because we did it means that everyone else who comes after needs to be treated poorly (although those attendings DO exist). But there is a good reason why medical training is long and arduous.

However, you might wish to wait until you are a resident and then tell us how it goes over when you try to leave a crashing patient because your "shift" is over or that you feel unprepared to handle everything because you only worked 56 hours per week. I appreciate your input but there is a sea change between medical school, residency and completing your training which you cannot understand now.

 

[Winged Scapula]

Medicine is a job, why should I not know when my shift ends?

Because patient's illnesses are not on a schedule and with few exceptions, medicine is not shift work where you clock out and your responsibility ends.

If you are not happy with one physicians skills or expertise, you are free to see another physician.

This is America.

Thanks for the civics lesson but I'm not sure what this has to do with work hours.

The fact is, resident hours are completely unacceptable, resident pay needs to be vastly increased and hospitals need to stop using residents as a source of cheap labor and exploiting them.

docB and I don't disagree with you here. I'm sure he agrees that resident physicians are underpaid and that hospitals take advantage of that. Its patently obvious to all of us that this is true. Nor do we think necessarily that just because we did it means that everyone else who comes after needs to be treated poorly (although those attendings DO exist). But there is a good reason why medical training is long and arduous.

However, you might wish to wait until you are a resident and then tell us how it goes over when you try to leave a crashing patient because your "shift" is over or that you feel unprepared to handle everything because you only worked 56 hours per week. I appreciate your input but there is a sea change between medical school, residency and completing your training which you cannot understand now.

 

[roflcakes887]

Because patient's illnesses are not on a schedule and with few exceptions, medicine is not shift work where you clock out and your responsibility ends.



Thanks for the civics lesson but I'm not sure what this has to do with work hours.



docB and I don't disagree with you here. I'm sure he agrees that resident physicians are underpaid and that hospitals take advantage of that. Its patently obvious to all of us that this is true. Nor do we think necessarily that just because we did it means that everyone else who comes after needs to be treated poorly (although those attendings DO exist). But there is a good reason why medical training is long and arduous.

However, you might wish to wait until you are a resident and then tell us how it goes over when you try to leave a crashing patient because your "shift" is over or that you feel unprepared to handle everything because you only worked 56 hours per week. I appreciate your input but there is a sea change between medical school, residency and completing your training which you cannot understand now.

My responsibility is to my contractual obligations outlined in the contract signed between myself and my employer. Patients are merely consumers who purchase the services provided by aforementioned entities.

The civic lesson had to do with when you said you wouldn't want a 56-hour work week resident taking care of you. I responded to that saying that if you're not happy with the care you are receiving from the above physician, you are free to seek medical care from another provider.

If my shift is over, then my replacement would pick up where I left off for the crashing patient. Or, physicians should be able to invoice their employer for the amount of time they had to stay past their shift to provide care.

Again, all of these hypothetical situations can and should be explicitly discussed before any contact is signed between the physician and his/her employer.

 

[OTD]

My responsibility is to my contractual obligations outlined in the contract signed between myself and my employer. Patients are merely consumers who purchase the services provided by aforementioned entities.

The civic lesson had to do with when you said you wouldn't want a 56-hour work week resident taking care of you. I responded to that saying that if you're not happy with the care you are receiving from the above physician, you are free to seek medical care from another provider.

If my shift is over, then my replacement would pick up where I left off for the crashing patient. Or, physicians should be able to invoice their employer for the amount of time they had to stay past their shift to provide care.

Again, all of these hypothetical situations can and should be explicitly discussed before any contact is signed between the physician and his/her employer.

I honestly hope you either never make it through medical school or have a serious change of heart.

I can complain with the best of them, and I agree that many times residents are abused, but patients are NEVER "merely consumers" they are human beings that trust you with their life. You don't run out on them when they are in trouble because your shift ends. Medicine is a profession, although if many people with your attitude make it through it won't be that for long.

If you do make it through medical school with that attitude I hope you are never responsible for a living patient.

Attitudes like above will do more to destroy medicine than Congress or the powers that be ever could.

 

[highvoltage]

I honestly hope you either never make it through medical school or have a serious change of heart.

I can complain with the best of them, and I agree that many times residents are abused, but patients are NEVER "merely consumers" they are human beings that trust you with their life. You don't run out on them when they are in trouble because your shift ends. Medicine is a profession, although if many people with your attitude make it through it won't be that for long.

If you do make it through medical school with that attitude I hope you are never responsible for a living patient.

Attitudes like above will do more to destroy medicine than Congress or the powers that be ever could.

While I am impressed with your ideals I dont agree with you at all. If medicine is a profession why are they employees? If you dont want someone to have an employee's mentality; dont make them employees. You are idealistic and you will quickly be stripped of your idealism. This is a business period. Nobody cares about you. You are interchangeable with the next guy with an MD. Sad but true.

 

[roflcakes887]

While I am impressed with your ideals I dont agree with you at all. If medicine is a profession why are they employees? If you dont want someone to have an employee's mentality; dont make them employees. You are idealistic and you will quickly be stripped of your idealism. This is a business period. Nobody cares about you. You are interchangeable with the next guy with an MD. Sad but true.

Could not have said it better myself.

Medicine is a business. Period.

Whether you like it or not, that's how it is.

 

[highvoltage]

The fact is, resident hours are completely unacceptable, resident pay needs to be vastly increased and hospitals need to stop using residents as a source of cheap labor and exploiting them.

the nrmp is the problem. BOYCOTT the nrmp and bingo you will get everything you want. Hours, vacation perks. etc etc..

 

[OTD]

While I am impressed with your ideals I dont agree with you at all. If medicine is a profession why are they employees? If you dont want someone to have an employee's mentality; dont make them employees. You are idealistic and you will quickly be stripped of your idealism. This is a business period. Nobody cares about you. You are interchangeable with the next guy with an MD. Sad but true.

No, I won't.

I worked in the real world for years before going to medical school.

I have worked for 3 years as a surgical resident, already been through intern year.

I will be in private practice. I never said medicine wasn't a business, just said that patients were never "merely consumers" to be abandoned when the "doctor" feels like it.

Just becasue I am defined as an employee now doesn't change the fact that those patients trust me with their life, and only no decent person would just leave them in a time of crisis.

I have never advocated just hanging around, and will indeed leave when the opportunity presents, but I won't compromise patient care to leave and I surely won't leave while a patient is crashing.

Medicine is still a profession, at least it is in my area where my attendings, even after all these years of surgery beating them down, still stay and get the job done in the intrest of patient care.

 

[michaelrack]

so because working conditions were wrong back then, people today shouldn't complain even though working conditions are still wrong today because we didn't have it as "tough" as you?

.

That's exactly right. You got it.

 

[michaelrack]

My responsibility is to my contractual obligations outlined in the contract signed between myself and my employer. Patients are merely consumers who purchase the services provided by aforementioned entities.

.

In most states you will have some type of medical license (usually a training license at first) during residency. The medical license creates obligations between you and your patients that goes beyond any employee/employer contract.

 

[roflcakes887]

That's exactly right. You got it.

Exactly.

My point is older physicians such as yourself let yourselves be taken advantage of. That's your problem, not mine.

Young physicians need to start demanding higher salary, more vacation etc... just like nurses lobby the government for these things, physicians need to spend more time lobbying and fighting for their interests.

As we are "taking care of patients", nurses and others are chipping away the distinctions between us and them and making inroads into our domain.

We need to spend less time with patients and more time lobbying and fighting for our salary etc...

 

[roflcakes887]

the nrmp is the problem. BOYCOTT the nrmp and bingo you will get everything you want. Hours, vacation perks. etc etc..

Exactly.

The problem stems from the NRMP having a strangle-hold and monopoly on the residency application service.

Just like NBME and Step 2 CS.

Another way to exploit people and take their money.

 

[michaelrack]

While I am impressed with your ideals I dont agree with you at all. If medicine is a profession why are they employees? If you dont want someone to have an employee's mentality; dont make them employees.

Too many doctors today are employees. I have talked too a lot of residents and fellows who are seeking sleep and/or psychiatry careers. It seems that nearly all of them want a guaranteed salary.
I detest being an employee. Currently less than 5% of my income is W-2 income, the rest is 1099 or K1 income. In the future I hope to have 0% W-2 income.

 

[roflcakes887]

Too many doctors today are employees. I have talked too a lot of residents and fellows who are seeking sleep and/or psychiatry careers. It seems that nearly all of them want a guaranteed salary.
I detest being an employee. Currently less than 5% of my income is W-2 income, the rest is 1099 or K1 income. In the future I hope to have 0% W-2 income.

I agree with this. Doctors today are willing to let CEO businessman run the clinic/hospital while they get put on salary as a "hospitalist" or something.

We are letting our profession be destroyed everyday from multiple angles and just standing here and taking it, or we are "too busy taking care of patients."

This is why we need to spend less time with our patients and more time fighting for our salaries/vacation/etc... because if we don't, we will lose it.

 

[michaelrack]

Exactly.

My point is older physicians such as yourself let yourselves be taken advantage of. That's your problem, not mine.

...

Nobody is taking advantage of me. For about 98% of what I do, I am not an employee.

 

[highvoltage]

Exactly.

My point is older physicians such as yourself let yourselves be taken advantage of. That's your problem, not mine.

Young physicians need to start demanding higher salary, more vacation etc... just like nurses lobby the government for these things, physicians need to spend more time lobbying and fighting for their interests.

As we are "taking care of patients", nurses and others are chipping away the distinctions between us and them and making inroads into our domain.

We need to spend less time with patients and more time lobbying and fighting for our salary etc...

The problem is there are too many factions in the profession. Every specialty is a different faction with a different voice. We(physicians) need to conglomerate into an entity that the govt dare not mess with. The size of a fortune 100 company. Thats when we would see respect. We need to put our ideals ( idont have any anymore) aside for a moment and fight like the nurses union. the government will crush a group of about 10 family docs but they wont a group of 100,000 docs fighting for the same thing.

 

[highvoltage]

Too many doctors today are employees. I have talked too a lot of residents and fellows who are seeking sleep and/or psychiatry careers. It seems that nearly all of them want a guaranteed salary.
I detest being an employee. Currently less than 5% of my income is W-2 income, the rest is 1099 or K1 income. In the future I hope to have 0% W-2 income.

I agree but we have to agree on the same things and if you walk out I have to walk out as well. Look I assume you have a contract with someone to provide medical services somewhere. If you have a contract that says you will provide services 4/1-5/1 2009. and when 5/2 comes around you dont show up, i dont think you abandoned anybody. There are patients who wanna see you but hey your contract is not valid anymore soo they will have to see someone else. Thats not abandonment, thats reality. This post is not meant so much for you but for a poster above who states that physician patient relationship is stronger than a contract. The BUsiness contract is between the patient and the insurance co not between the patient and the physician.

 

[highvoltage]

.. because if we don't, we will lose it.

we already lost it my friend as much as i hate to say it. the only people who havent lost it are the plastic surgeons.

 

[docB]

My responsibility is to my contractual obligations outlined in the contract signed between myself and my employer. Patients are merely consumers who purchase the services provided by aforementioned entities.

The civic lesson had to do with when you said you wouldn't want a 56-hour work week resident taking care of you. I responded to that saying that if you're not happy with the care you are receiving from the above physician, you are free to seek medical care from another provider.

If my shift is over, then my replacement would pick up where I left off for the crashing patient. Or, physicians should be able to invoice their employer for the amount of time they had to stay past their shift to provide care.

Again, all of these hypothetical situations can and should be explicitly discussed before any contact is signed between the physician and his/her employer.

Holy crap! This is just wrong. Even if you and I disagree about work hour restrictions you need to know that you are dead wrong on this point. Your obligations to your patients are NOT outlined by your contract with your employer. You are a professional. You have a fiduciary duty to your patient. If you walk out on someone who is crashing or someone who crashes because you walked out you are guilty of abandonment. You. Not your employer. Please don't take out your alienation with the current medical education system on your patients. Be angry with me, all the attendings that came before us, God, whoever but don't abandon your patients just because you think you're a punchcard worker.

 

[John Deere Gree]

Please realize that rolfcakes is...

a) a second year medical student at Duke
b) an idiot when it comes to patient care. Seriously, when a patient crashes and the clock strikes five you're going to leave? I hope you have some great malpractice insurance. If you did this during residency I'd hate to see the end result. You have so much to learn during your clinical years.
c) just here to stir the pot and annoy us with his/her assnine remarks.

 

[highvoltage]

Holy crap! This is just wrong. Even if you and I disagree about work hour restrictions you need to know that you are dead wrong on this point. Your obligations to your patients are NOT outlined by your contract with your employer. You are a professional. You have a fiduciary duty to your patient. If you walk out on someone who is crashing or someone who crashes because you walked out you are guilty of abandonment. You. Not your employer. Please don't take out your alienation with the current medical education system on your patients. Be angry with me, all the attendings that came before us, God, whoever but don't abandon your patients just because you think you're a punchcard worker.

you are wrong

 

[exPCM]

I agree with much of what ROFLCAKES has posted. It is good to see a med student who is not a passive wimp. I find the medical profession is filled with many students and residents who are chumps. I have seen program directors say that we (meaning the residents but not the attendings) have to make sure to get all the work done no matter how long it takes and the residents go along with it like they are making a noble sacrifice. Meanwhile the PD is living large and saving money by not having to hire PAs or get more help since the residents are happy to take more and more on without any protest.

 

[nancysinatra]

Holy crap! This is just wrong. Even if you and I disagree about work hour restrictions you need to know that you are dead wrong on this point. Your obligations to your patients are NOT outlined by your contract with your employer. You are a professional. You have a fiduciary duty to your patient. If you walk out on someone who is crashing or someone who crashes because you walked out you are guilty of abandonment. You. Not your employer. Please don't take out your alienation with the current medical education system on your patients. Be angry with me, all the attendings that came before us, God, whoever but don't abandon your patients just because you think you're a punchcard worker.

I am a med student and even I know that this is 100% correct. I am shocked at what people are saying here. It is one thing to protest against working hours and pay but another thing to talk about not having a duty to patients. I knew that I would have a fiduciary responsibility to my future patients even as an MS1. How could anyone NOT know this and be in medical school? Why would you GO to medical school if you feel no obligation to patients? What are you going to do, walk out on them when they are suffering and dying? That is shocking and horrible.