Just start up a Podcast where you share your thoughts on life and stories about EM. I bet we'd all sign up, and you can live off the ad revenue.
I take your point on risk-avoidance, but what do you accomplish by suing a small SDG?
I would sue these asshats for that much any day of the week and then set up a booth at ACEP showing everyone how I did it with the title:
No, I mean if you’re going to sue someone better for it to be a non private equity corporate entity. It would take something pretty egregious for me to sue anybody. In general I don’t believe in burning bridges. This specialty is smaller than people think. I just don’t think it was worth it from what I’ve read in the above case but that’s me.
I don’t know the merits of the suit but if we don’t stand up against the CMGs we will continue to be pushed out and squeezed individually and collectively.
I mean it doesn’t sound like he had much else going on taking up his time. 30-40k compared to nothing ain’t bad.
Yes.
I guess I'm talking about abandoning your shift. Blockbuster worker or barista is not such a big deal but ED doc? Aren't there potential hospital/state board repercussions? Talk about bad optics. Anyway personally, I'm kind of tired of seeing EPs with 3 COVID vacation holidays a year because they retest every time they develop a sniffle and then bam...out for 10 days while the rest of the group shoulders the weight. It's like working with a bunch of pregnant colleagues all taking maternal leave at the same time. (No offense to any pregnant ladies in here...)
I hear you man and trust me...I would love to purge our specialty of private equity and corporate interests but we can't even mobilize our ranks enough to combat encroaching MLPs. Hell, we can't even all agree on which medical organizations to support much less galvanize a base to effectively lobby in our best interests on a state or federal level. Private equity is here to stay and like it or not, they control the majority of jobs in the U.S. I just don't think it's worth losing your career and ability to provide for your family in a case such as the one above. If anyone wants to sue the CMG and crucify themselves as a martyr...make sure it's time for retirement and there's enough funds in the bank to cover all those legal expenses...
Agreed. These folks perhaps decided on a job at the VA or are quitting who knows. Yes it takes balls to do and there is risk. I assume they sorted that out.
I think this was delta-era COVID where Methodist's standard of care was that symptomatic docs did not take care of patients unless an internal state of emergency had been declared, which it hadn't. These 2 docs work hard, seeing legit 20+% crit care, with most of the non-crit care being done in the waiting room because the entire ED is admitted holds and they were not looking to dodge shifts. They are being ballsy but APP is also crushing them currently (violating their contracted pay, making them pay for scribes when they don't actually have a scribe,etc) so they probably feel like they don't have a ton to lose.
CMGs gotta CMG.
This is what all PE looks like when things aren’t producing massive profits or growth. They were stunningly under-organized given their size but were offering good pay and promise of keeping the local organization the same. Now they’re still administratively a cluster but they’re also trying to deliver profits their contracts can’t provide just by raising revenue.
Major financial squeeze. As said cmg gotta CMG. They all start with whatever nonsense needs to be said to grow. Then whoops. Finances look rough. Then squeeze money every which way possible. APP will likely be the first chip to fall. $500m in debt for an over leveraged company in a market with soaring rates and lack of ability to see patients because hospitals won’t provide nurses is a recipe for default.
www.kcur.org
Disagree w/ most of your other posts on this thread, as I think these docs are undertaking an heroic action. But I do agree w/ the notion that we need to move past the paradigm of keeping folks w/ coldvid home from work. However, the correct way to do so is to make this official policy, not to require doctors to surreptitiously violate official policy.
It's ok man, we've all got valid opinions in here. Mine might be unpopular and that's cool. I guess my point is that we've all been coming to work with flu and all sorts of viral URIs for our entire careers. Why are we treating COVID now so differently? Have you ever felt viral while at work and asked to go home? I would wager not. While I agree with the sick day concept, I've always felt after working in corporate America that we as physicians are held to a higher standard. Is that due to our training culture? Perhaps, but again...it's going to be difficult convincing the public that a doctor making almost half a million dollars per year needs to take 12 sick days or whatever the corporate norm.
Yeah, my point was basically that I agree that we should go back to a policy of 'work unless you're too sick to', but that needs to actually be the policy.
But I think the signs at the hospital are mostly for the nurses and ancillary staff. Probably if 1 out of 47 nurses on shift has covid they should not work given they usually have more closer contact with patients than we do. And probably the lab tech coughing covid onto the covid tests would be less than helpful. But there’s almost always a barebones staffing for the ER physicians. I haven’t purposely gone to work with covid , but I’m sure I had it at some point in the last 2.5 years, and unless your shop has a call system, there isn’t really a way to get shifts covered at the last minute. I’m sure the hospitals are looking at it From a liability sense - if someone gets covid from the nurse that spent an hour changing them I think that would be a big deal for the hospital. Surely most of us can double mask and take a Sudafed and do our 90 second assessment without getting people sick, I’d think.
Man. 2 million should be doable for all EM docs within 10 years. The problem is the moving goalposts. 2 quickly becomes 3,4,5…10
Maybe we should address those problems in ways other than making docs work while sick?
There’s sick and then there’s sick. Probably even having a fever would impact my ability to think clearly , but if you truly just have the sniffles? I think most people can make it through the rest of their 8-12 hour shift even if they start having URI symptoms halfway through. I will say that my group has been fairly stable over the last 10 years (now our CMG and hospital both pissing us off and about 1/3 have quit in the last year) and we have all covered and needed coverage for significant illness requiring hospitalization, premature deliveries, or deaths in the family - I remember getting a weekend midnight shift covered with 3 hours notice when my dad died and no one even expected me to find coverage. Every group has to find the balance. Some will set up a call schedule. Personally I don’t want to be on call several extra days per month ; I don’t want to pay someone else to be on call ; I don’t want to be told to stay late or come in early to cover someone ; I don’t want to make significantly less per hour to increase coverage ; so I’m not sure what the answers are.
It could be made to work. Pay someone 50% of a shift to be on for 24 hours for illness or volume. Problem solved. People don’t want to pay. In EM we have a very strong incentive to be at work. We get no sick pay (with rare exception).
The problem is that an appropriately set up system for calling in sick makes everybody a little bit angry. The doc on call is going to be angry because it's a day they can't f$%# off to the mountains/rivers/ocean and can't reliably schedule anything during on top of their (likely) already crushing normal load of shifts. The people paying for the sick call aren't going to be happy because it either cuts into the profits of the CMG/oligarch(s) or it cuts into the revenue pool that the SDG pays out. Best system is having a truly massive group where everybody has 1-2 days a month of call, with/without a call stipend. 2nd best solution is having a director that's not working much clinically who just covers if they're a call out. You either have to concentrate the pain in one place or distribute it out so wildly that nobody really notices it.
Having a director take 24/7/365 call is a little much. The group would have to pay a massive stipend for that and even then it’s probably not worth it. Your first option seems much more viable.
I think that not paying to cover a reasonable call schedule is just hiding the cost and putting it on the docs. If you work in a CMG and elect to do that to yourself, well that's one thing. But if you're working for a hospital system or a CMG, they should pony up the cost of making the job safe and sustainable...what else are they getting paid for?
They’re getting paid to create value for their shareholders or to enlarge the assets under management of their non-profit. A one time bonus (even if there’s 4 or 5 of them) versus the same $$$ amount on a fixed line item on the budget isn’t a contest. Every expense you can move from reoccurring to a one off is a win in corporate world.
A lot of this depends on scale. Massive groups can pay One doc to cover multiple sites. Pay half of what u normally make in a shift and then if called in pay 2x hourly.
