Thoughts on following Hospitalist job offer

[Kri139]

Hi,
Can you help to understand my first hospitalist job offer.

Standard 7/7 mostly day but will have swing shift 1 week per quarter.

Total 182 shift per year. No PTO.

Day shift 1400/shift, swing 1550/shift.

So base for 182 shift is approx. 255k.

Standard medical insurance, 401 k match up to 3%.

Productivity $10/wruv for per shift (wruv-26).

Quality bonus don't know any details.

No code, closed icu, no procedure.


Average 18-20 patient/shift mostly rounding.

30 mins from major NW metro city.

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[Osteoth]

How are admissions handled? Do you have to be in house all 12 hours?

Hourly is kind of low isn’t it? 1400/12=~$115

 

[Splenda88]

Not a bad offer since it's close to a major city. However, if I were you, I would counter with $1550/day and $1700/swing.

It's a solid job If you will end up making 280k+/yr with rvu included. However, 18-20 patients is not ideal, but not a deal breaker IMO.

 

[Kri139]

How are admissions handled? Do you have to be in house all 12 hours?

Hourly is kind of low isn’t it? 1400/12=~$115

Admissions are handled by 1 dedicated admitter - so approx. 3 weeks/year admit only shift. I assume need to be house all 12 hours. How much day time hourly salary do you think reasonable for NW region?

 

[Kri139]

Not a bad offer since it's close to a major city. However, if I were you, I would counter with $1550/day and $1700/swing.

It's a solid job If you will end up making 280k+/yr with rvu included. However, 18-20 patients is not ideal, but not a deal breaker IMO.

Thank you for the suggestion. I don't know much about RUV. Do you have idea how much yearly productivity bonus I can expect from this model and patients load?

 

[Splenda88]

Thank you for the suggestion. I don't know much about RUV. Do you have idea how much yearly productivity bonus I can expect from this model and patients load?

Been working as a hospitalist for only 2 months and my job is straight salary (no rvu). Maybe someone else can chime about the rvu part. I am giving you my advice based on my salary, my time on the job market a few months back, and offers I am still getting now.

 

[BorntobeDO?]

Thank you for the suggestion. I don't know much about RUV. Do you have idea how much yearly productivity bonus I can expect from this model and patients load?

5000 rvu is achieveable based on my friends. If they are giving you a flat 10 a wrvu without some sort of modifier (i.e. you dont get the 10 unless you see a certain amount or work a certain amounts of nights etc) plus 250k base I think thats actually alright. I agree 115 an hour is kind of low for a base salary if theres restrictions on the rvus. How quality bonus effect pay is important too.

 

[Osteoth]

5000 rvu is achieveable based on my friends. If they are giving you a flat 10 a wrvu without some sort of modifier (i.e. you dont get the 10 unless you see a certain amount or work a certain amounts of nights etc) plus 250k base I think thats actually alright. I agree 115 an hour is kind of low for a base salary if theres restrictions on the rvus. How quality bonus effect pay is important too.

5000 rvu or wrvu?

 

[collegestud2013]

Hi,
Can you help to understand my first hospitalist job offer.

Standard 7/7 mostly day but will have swing shift 1 week per quarter.

Total 182 shift per year. No PTO.

Day shift 1400/shift, swing 1550/shift.

So base for 182 shift is approx. 255k.

Standard medical insurance, 401 k match up to 3%.

Productivity $10/wruv for per shift (wruv-26).

Quality bonus don't know any details.

No code, closed icu, no procedure.


Average 18-20 patient/shift mostly rounding.

30 mins from major NW metro city.

Unless there's a decent sign-on bonus and quality bonus on top of what you've mentioned (and be careful about quality bonuses as many places write them so that it's very hard to get 100% of them) or unless you also have midlevels or residents helping you, the overall pay seems low for the workload and RVUs you would be generating. For the volumes you've mentioned I would expect low to mid $300ks in a W2 employed position.

Seems like you don't get any RVU bonus unless your wRVUs per shift exceeds 26. A good estimate for rounding shifts is around 1.8-1.9 wRVUs per patient encounter (weighted mix of mostly 99232, 99233, and 99239). So even if you were billing a bit more aggressively, and the patient volumes they are telling you are accurate, then that's about 1.9 wRUVs x 19 patients = 36.1 wRVUs per shift. $10 x (36.1-26) = $101 wRVU bonus per shift. Assuming you only did rounding shifts (or all your admitting shifts produce simiilar total RVUs per shift) $101 x 182 = $18,382 per year for your RVU bonus. Keep in mind that current CMS reimbursement for hospitalist E/M codes is around $52 per wRVU but they only paying you $10 per RVU above 26.

So you would be getting about $255k+18k =$273k per year or about $125 per hour. Even if you add the full 3% 401K match that only goes up to $281k, But the pay be still competitive for your local market if it's near a major city and in a desirable area. If it's in a desirable location that may be why they're trying to lowball you.

 

[collegestud2013]

5000 rvu is achieveable based on my friends. If they are giving you a flat 10 a wrvu without some sort of modifier (i.e. you dont get the 10 unless you see a certain amount or work a certain amounts of nights etc) plus 250k base I think thats actually alright. I agree 115 an hour is kind of low for a base salary if theres restrictions on the rvus. How quality bonus effect pay is important too.

There do seem to be RVU restrictions. If I'm interpreting what OP wrote correctly, this position doesn't give them until above 26 wRVUs per shift.

 

[Kri139]

There do seem to be RVU restrictions. If I'm interpreting what OP wrote correctly, this position doesn't give them until above 26 wRVUs per shift.

@collegestud2013 Your interpretation is correct.

 

[Kri139]

Unless there's a decent sign-on bonus and quality bonus on top of what you've mentioned (and be careful about quality bonuses as many places write them so that it's very hard to get 100% of them) or unless you also have midlevels or residents helping you, the overall pay seems low for the workload and RVUs you would be generating. For the volumes you've mentioned I would expect low to mid $300ks in a W2 employed position.

Seems like you don't get any RVU bonus unless your wRVUs per shift exceeds 26. A good estimate for rounding shifts is around 1.8-1.9 wRVUs per patient encounter (weighted mix of mostly 99232, 99233, and 99239). So even if you were billing a bit more aggressively, and the patient volumes they are telling you are accurate, then that's about 1.9 wRUVs x 19 patients = 36.1 wRVUs per shift. $10 x (36.1-26) = $101 wRVU bonus per shift. Assuming you only did rounding shifts (or all your admitting shifts produce simiilar total RVUs per shift) $101 x 182 = $18,382 per year for your RVU bonus. Keep in mind that current CMS reimbursement for hospitalist E/M codes is around $52 per wRVU but they only paying you $10 per RVU above 26.

So you would be getting about $255k+18k =$273k per year or about $125 per hour. Even if you add the full 3% 401K match that only goes up to $281k, But the pay be still competitive for your local market if it's near a major city and in a desirable area. If it's in a desirable location that may be why they're trying to lowball you.

@collegestud2013 sign on bonus 22K (need to stay for 3 years). But I am not a big fan of sign on bonus - if things don't work out, I will need to return ( might be with some tax penalty). Location is very to major city and airport. I am planning to counter offer with 130/h (1550/shift) base Salary. I am waiting for other offer - Do you think asking 2 weeks extension of deadline is reasonable?

 

[collegestud2013]

@collegestud2013 sign on bonus 22K (need to stay for 3 years). But I am not a big fan of sign on bonus - if things don't work out, I will need to return ( might be with some tax penalty). Location is very to major city and airport. I am planning to counter offer with 130/h (1550/shift) base Salary. I am waiting for other offer - Do you think asking 2 weeks extension of deadline is reasonable?

$22k for 3 years is essentially an extra $7333 per year for the first 3 years. Is the sign-on bonus is prorated if you leave earlier? If not prorated, then yeah you have to be more careful.

You can try the counter offer but it only works if they are desperate to find staffing there. I'm assuming you're still in residency so would be starting July 2022 at the earliest. If that's the case I would guess that most places are not that desperate yet for a position to start next July. And if this is near a major city it may be in a desirable area with lots of applicants for the position which makes it even harder to negotiate. But I think it's reasonable to ask for 2 wk extension.

 

[Splenda88]

The hospitalist market is killing some of the IM subspecialties (especially nephrology and PCCM). A few PGY3 that I know told me they will no longer pursue fellowship.

Having some idea about the hospitalist market right now, there is no way I would work for <280k regardless where that job is. Also, average census has to be ~18.

 

[Kri139]

$22k for 3 years is essentially an extra $7333 per year for the first 3 years. Is the sign-on bonus is prorated if you leave earlier? If not prorated, then yeah you have to be more careful.

You can try the counter offer but it only works if they are desperate to find staffing there. I'm assuming you're still in residency so would be starting July 2022 at the earliest. If that's the case I would guess that most places are not that desperate yet for a position to start next July. And if this is near a major city it may be in a desirable area with lots of applicants for the position which makes it even harder to negotiate. But I think it's reasonable to ask for 2 wk extension.

@collegestud2013 @Splenda88 usually, do hospital revisit rate/shift after 1/2 years? I don't have any expire date on the contract.

 

[NITRAS]

@collegestud2013 @Splenda88 usually, do hospital revisit rate/shift after 1/2 years? I don't have any expire date on the contract.

My pay has a base pay which is a percentage of the mean Hospitalist salary across 3 different measures. I don’t know how yours would work. It also takes a few years to learn how to bill accurately and efficiently.

 

[collegestud2013]

The hospitalist market is killing some of the IM subspecialties (especially nephrology and PCCM). A few PGY3 that I know told me they will no longer pursue fellowship.

Having some idea about the hospitalist market right now, there is no way I would work for <280k regardless where that job is. Also, average census has to be ~18.

Not sure if that's the case with PCCM, as they were the most competitive fellowship to Match last cycle with a 64% Match rate (https://www.nrmp.org/wp-content/uploads/2021/02/SMS_Result_and_Data_2021.pdf) and critical care still pays more per hr than most hospitalist positions (and they produce more RVUs too since they're billing critical care time for nearly 100% of their patient encounters).

But I do agree that some potential applicants are delaying or cancelling fellowship plans in the lower-paying IM subspecialities like ID or Endocrine or those with uncertain job markets like Nephro to pursue hospitalist.

 

[collegestud2013]

@collegestud2013 @Splenda88 usually, do hospital revisit rate/shift after 1/2 years? I don't have any expire date on the contract.

Most will revisit pay after a while, but it's usually done with all the hospitalists in the group at once than on an individual basis. So might not happen after just half a year there (or even several years). This is done if a place wants their pay to stay competitive within their geographic region.

 

[Kri139]

Most will revisit pay after a while, but it's usually done with all the hospitalists in the group at once than on an individual basis. So might not happen after just half a year there (or even several years). This is done if a place wants their pay to stay competitive within their geographic region.

Thank you. Sorry I intended to mean 1 or 2 years. So, I think it's better to ask for 2 years contract expiry date.

 

[Splenda88]

@collegestud2013 @Splenda88 usually, do hospital revisit rate/shift after 1/2 years? I don't have any expire date on the contract.

I dont think they do that where I am. I have the same salary with other hospitalist who have been at my shop for 3 yrs.

 

[BorntobeDO?]

5000 rvu or wrvu?

Wrvu, by his second year he was in the 6k to low 7s

 

[Kri139]

Update:

Shift pay isn't negotiable - same for everyone ( according to hr) .
401k Max is 6000.
Patient load average 20 only rounding 😓
Health insurance is costly.
Quality bonus upto 10k annually but didn't get the average payout number. Metric change every year.
Sign in bonus can be up to 33K ( for 3 years).

After 2 years - shift rate will increase 8-10% based on some metrics. Productivity bonus will be doubled ( 20 dollar after 26 WRVU per shift) .

No state income tax. I am still waiting for other offers. But my spouse job is 45mins from the hospital.

 

[collegestud2013]

Update:

Shift pay isn't negotiable - same for everyone ( according to hr) .
401k Max is 6000.
Patient load average 20 only rounding 😓
Health insurance is costly.
Quality bonus upto 10k annually but didn't get the average payout number. Metric change every year.
Sign in bonus can be up to 33K ( for 3 years).

After 2 years - shift rate will increase 8-10% based on some metrics. Productivity bonus will be doubled ( 20 dollar after 26 WRVU per shift) .

No state income tax. I am still waiting for other offers. But my spouse job is 45mins from the hospital.

Total pay for first 2 years probably comes out to a bit over $290k for the first 2 years (assuming average $11k sign on bonus per year for first 3 years and you you get about half the quality bonus, or $5k per year, $6k 401k, and before doing any extra shifts). Still a bit low considering the volume you would be seeing but sounds like it gets better if you stay long enough. If you're averaging 20 patients per 12 hr rounding shift, keep in mind you should be able to get paid in mid-$300ks in less desirable locations. Like pay for most jobs, hospitalist pay is very geographically dependent so what they're offering you may be still be competitive for the local area since this job is near a major city. And right now, hospitalist jobs are somewhat saturated in near the major cities. It seems like you're geographically restricted with your spouse, but only you can decide whether the pay cut is worth it to be near your spouse and in a larger city (I would estimate that pay for similar job would be $40-50k more per year in less desirable areas). But when you get other offers as well then obviously compare.

 

[tantacles]

Update:

Shift pay isn't negotiable - same for everyone ( according to hr) .
401k Max is 6000.
Patient load average 20 only rounding 😓
Health insurance is costly.
Quality bonus upto 10k annually but didn't get the average payout number. Metric change every year.
Sign in bonus can be up to 33K ( for 3 years).

After 2 years - shift rate will increase 8-10% based on some metrics. Productivity bonus will be doubled ( 20 dollar after 26 WRVU per shift) .

No state income tax. I am still waiting for other offers. But my spouse job is 45mins from the hospital.

****ty offer. 20 patients to round on is not good at all, and given that's what they're telling you, it's probably more like 22-23, honestly. Have them add that sign on bonus to your salary instead per year.

HR can say what they want, and fortunately, as an attending, you have the chance to walk away. I would.

 

[Kri139]

****ty offer. 20 patients to round on is not good at all, and given that's what they're telling you, it's probably more like 22-23, honestly. Have them add that sign on bonus to your salary instead per year.

HR can say what they want, and fortunately, as an attending, you have the chance to walk away. I would.

Thank you. Actually they told me 16-18 but during on site interview one attending told me avg. 20 I have received another verbal offer 1 hour and 15 mins from my spouse job location from kaiser. Have many benefits but base is 225K and 75k sign on bonus ( not sure about conditions). Anyone can provide some feedback about kaiser?

 

[tantacles]

Thank you. Actually they told me 16-18 but during on site interview one attending told me avg. 20 I have received another verbal offer 1 hour and 15 mins from my spouse job location from kaisser. Have many benefits but base is 225K and 75k sign on bonus ( not sure about conditions). Anyone can provide some feedback about kaisser?

Kaiser is an interesting situation. I can't speak for all Kaisers, but at least at the Kaisers that I worked at, the daytime people had extremely cush jobs, but their schedules could be very up in the air. At one site, the rounders maxed out at around 10 patients per day, but they were expected to work 8 hours per day x 20 shifts (Kaiser expects about 160 hours per month from its full time physicians). Benefits are excellent, but keep in mind that if you work for Kaiser as a career physician, you can not do anything else with your medical license or they can fire you and revoke your pension.

It can be a great gig if it's what you want, but just be mindful of what you're signing up for.

 

[Osteoth]

Kaiser is an interesting situation. I can't speak for all Kaisers, but at least at the Kaisers that I worked at, the daytime people had extremely cush jobs, but their schedules could be very up in the air. At one site, the rounders maxed out at around 10 patients per day, but they were expected to work 8 hours per day x 20 shifts (Kaiser expects about 160 hours per month from its full time physicians). Benefits are excellent, but keep in mind that if you work for Kaiser as a career physician, you can not do anything else with your medical license or they can fire you and revoke your pension.

It can be a great gig if it's what you want, but just be mindful of what you're signing up for.

YMMV the Kaiser by me is a slave ship for their generalists, including forcing you to switch from Hospitalist to PCP based on their staffing needs.

From what I’ve heard it’s a chill job as a sh specialist but as a generalist they really grind you, but I’m sure it depends on the shop.

 

[Kri139]

Kaiser is an interesting situation. I can't speak for all Kaisers, but at least at the Kaisers that I worked at, the daytime people had extremely cush jobs, but their schedules could be very up in the air. At one site, the rounders maxed out at around 10 patients per day, but they were expected to work 8 hours per day x 20 shifts (Kaiser expects about 160 hours per month from its full time physicians). Benefits are excellent, but keep in mind that if you work for Kaiser as a career physician, you can not do anything else with your medical license or they can fire you and revoke your pension.

It can be a great gig if it's what you want, but just be mindful of what you're signing up for.

Do kaiser have minimum stay time requirement for sign on bonus ? I saw someone mentioned about 7 years. Do the sign on bonus repayment (in case early termination) is pro rated?

 

[tantacles]

YMMV the Kaiser by me is a slave ship for their generalists, including forcing you to switch from Hospitalist to PCP based on their staffing needs.

From what I’ve heard it’s a chill job as a sh specialist but as a generalist they really grind you, but I’m sure it depends on the shop.

Definitely. Totally shop dependent as every single Kaiser operates differently, but there are definitely times when it can feel like a huge grind. Largely the rigor wasn't terrible, but it's very much managed care, which is my big complaint, and you sometimes feel unable to take care of patients in a patient-focused way given their extreme micromanagement of physicians.

 

[tantacles]

Do kaiser have minimum stay time requirement for sign on bonus ? I saw someone mentioned about 7 years. Do the sign on bonus repayment (in case early termination) is pro rated?

Sorry, not sure. I only did per diem shifts, albeit at multiple sites.

 

[Kri139]

The contract doesn't specify about the shift distribution ( number of swing/ night shifts per year). Is it normal for hospitalist contract. ?

 

[chessknt]

The contract doesn't specify about the shift distribution ( number of swing/ night shifts per year). Is it normal for hospitalist contract. ?

It is if they want to have you work the worst shifts in exchange for nothing and have no recourse.

 

[collegestud2013]

The contract doesn't specify about the shift distribution ( number of swing/ night shifts per year). Is it normal for hospitalist contract. ?

Not uncommon since many places want to have flexibility for staffing if someone leaves or they have coverage issues. Restricting you to a certain number of day shifts or nights can make it more difficult to staff. At least they should have a shift differential for night shifts so if you end up doing more nights you should be compensated as such.

 

[collegestud2013]

Thank you. Actually they told me 16-18 but during on site interview one attending told me avg. 20 I have received another verbal offer 1 hour and 15 mins from my spouse job location from kaiser. Have many benefits but base is 225K and 75k sign on bonus ( not sure about conditions). Anyone can provide some feedback about kaiser?

Very facility dependent but overall volumes are lower than most places but pay also tends to be on the lower side too. Not sure if they offer an RVU/productivity bonus but if not I would be very careful about taking such a position. They're also notorious for having some of the most restrictive contracts of all employers out there, including basically not allowing you to do a lot of certain work (both clinical and non-clinical) outside of Kaiser. And if it's outside California, they'll probably have non-compete clause as well (though I suspect these are going to be much harder to enforce under Biden's new executive order).

 

[Kri139]

Very facility dependent but overall volumes are lower than most places but pay also tends to be on the lower side too. Not sure if they offer an RVU/productivity bonus but if not I would be very careful about taking such a position. They're also notorious for having some of the most restrictive contracts of all employers out there, including basically not allowing you to do a lot of certain work (both clinical and non-clinical) outside of Kaiser. And if it's outside California, they'll probably have non-compete clause as well (though I suspect these are going to be much harder to enforce under Biden's new executive order).

No RVU but quality bonus 25k. Approximately 3 weeks PTO + 1 week CME + 1 week holiday + sick leave. No non compete clause. 2.5% increase in base salary per year. Pension +401k looking promising but honestly I don't understand how much it will be actually vested only can do extra shifts on kaiser facility.

 

[Kri139]

Not uncommon since many places want to have flexibility for staffing if someone leaves or they have coverage issues. Restricting you to a certain number of day shifts or nights can make it more difficult to staff. At least they should have a shift differential for night shifts so if you end up doing more nights you should be compensated as such.

Well night shifts rate are 20% higher than day but I don't prefer to do night shifts ( equal rotation among everyone is ok). But HR mentioned about fair share but didn't mention anything in the contract. I requested to add but don't want to negotiate

 

[Osteoth]

Well night shifts rate are 20% higher than day but I don't prefer to do night shifts ( equal rotation among everyone is ok). But HR mentioned about fair share but didn't mention anything in the contract. I requested to add but don't want to negotiate

Please god get a lawyer and negotiate. This is why doctors get taken advantage of.

 

[chessknt]

Well night shifts rate are 20% higher than day but I don't prefer to do night shifts ( equal rotation among everyone is ok). But HR mentioned about fair share but didn't mention anything in the contract. I requested to add but don't want to negotiate

If they won’t add it in it won’t be honored. Up to you to decide whether or not to still move forward but don’t need a lawyer to make that part clear.

 

[collegestud2013]

No RVU but quality bonus 25k. Approximately 3 weeks PTO + 1 week CME + 1 week holiday + sick leave. No non compete clause. 2.5% increase in base salary per year. Pension +401k looking promising but honestly I don't understand how much it will be actually vested only can do extra shifts on kaiser facility.

Sounds like pretty solid benefits, so decent offer if the patient volume is reasonable. I would be careful if there's no patient cap and also no RVU bonus; if there's a staffing issue (eg someone leaves) you may be asked to cover more patients with no additional pay. I would be very skeptical about quality bonuses since many places write them so that it's nearly impossible to get the full amount. And many places will calculate quality bonus as an entire group than individual so you have little control of how much you're getting.

 

[thathospitalist]

help, i signed contract and am now working at hospitalist job- was told verbally my census would be 15-18, then i get here and its 25+ per day for 270k bc the hospital got rid of staffing company and didnt renew 3 other hospitalist contracts “bc of new budget?!?”.
Now i feel like this is bait and switch. Ive already spent my sign on by moving and i have no idea what to do? Get an employment attorney? Hand in my notice?
Legit this feels like a scam.

 

[chessknt]

help, i signed contract and am now working at hospitalist job- was told verbally my census would be 15-18, then i get here and its 25+ per day for 270k bc the hospital got rid of staffing company and didnt renew 3 other hospitalist contracts “bc of new budget?!?”.
Now i feel like this is bait and switch. Ive already spent my sign on by moving and i have no idea what to do? Get an employment attorney? Hand in my notice?
Legit this feels like a scam.

Whatever is in the written contract is what will be followed. It probably says nothing about census and you are probably not paid by productivity so you definitely got scammed. Only you can decide if you want to stay but if you decide to leave asap...

Trigger your exit clause now (usually a written notice X days beforehand) and pay back the entire moving bonus before the end of the year or you get to eat **** on taxes (take a loan from your 401k tomorrow and hand a check back to the hospital HR department and get a receipt before the end of the year). Then start looking for another job immediately.

 

[thathospitalist]

Whatever is in the written contract is what will be followed. It probably says nothing about census and you are probably not paid by productivity so you definitely got scammed. Only you can decide if you want to stay but if you decide to leave asap...

Trigger your exit clause now (usually a written notice X days beforehand) and pay back the entire moving bonus before the end of the year or you get to eat **** on taxes (take a loan from your 401k tomorrow and hand a check back to the hospital HR department and get a receipt before the end of the year). Then start looking for another job immediately.

Thank you for your advice. Yes, figuring out who to get my 90 day notice to. Its been a painful mistake. Do you think an employment attorney could help me at all? Or bc census wasn't mentioned in writing then no? There are two other docs here that agreed that we were told 15-18, but theyve been here a few months and seem scared to speak up. Its seems crazy that they can straight lie to my face during interview and site visit and then there are no repercussions- except for me.

 

[Osteoth]

Thank you for your advice. Yes, figuring out who to get my 90 day notice to. Its been a painful mistake. Do you think an employment attorney could help me at all? Or bc census wasn't mentioned in writing then no? There are two other docs here that agreed that we were told 15-18, but theyve been here a few months and seem scared to speak up. Its seems crazy that they can straight lie to my face during interview and site visit and then there are no repercussions- except for me.

Why are the others scared to speak up? It’s that behavior that allows them to get you like this.

 

[rokshana]

Thank you for your advice. Yes, figuring out who to get my 90 day notice to. Its been a painful mistake. Do you think an employment attorney could help me at all? Or bc census wasn't mentioned in writing then no? There are two other docs here that agreed that we were told 15-18, but theyve been here a few months and seem scared to speak up. Its seems crazy that they can straight lie to my face during interview and site visit and then there are no repercussions- except for me.

Rookie mistake…always add 5-7 pts to what ever they tell you… though 25+ is excessive.
Would talk to a healthcare attorney to see if anything can be done and find the least painful way to get out… then get out.

Work locums until you find the right job…and make sure you have a contract attorney go over the next contract.

 

[chessknt]

Thank you for your advice. Yes, figuring out who to get my 90 day notice to. Its been a painful mistake. Do you think an employment attorney could help me at all? Or bc census wasn't mentioned in writing then no? There are two other docs here that agreed that we were told 15-18, but theyve been here a few months and seem scared to speak up. Its seems crazy that they can straight lie to my face during interview and site visit and then there are no repercussions- except for me.

Attorney is a waste of money in my opinion, just trigger the exit and be prepared to pay back the stipend on demand. If you can’t get it back to them before end of the year you get to pay taxes on it and have to refund the full amount

 

[thathospitalist]

-the two other docs wont say anything bc they are on visas and cant risk it- they said.

How is it a rookie mistake? Its a hospital employed position- they said contract was non negotiable- everyone gets same stuff.
How was i supposed to know that they would lie to my face about census?
Is it standard to get a hard pt cap in contract? Bc ive never seen it before.
Legit please tell me how to protect myself from this in the future.
Also, ive gotta pay 10k in tail for working two weeks, bc they dont cover that and Im out 30k in non refundable housing costs once i move.
Its a straight ****te show and im spending everything ive got to get outta here. Thats why i was wondering if an attorney would help soften the financial blow.
I cant believe hospitals get away with this.

 

[DrMetal]

How is it a rookie mistake?

Your rookie mistake was that you didn't read the contract closely, and you mistakenly took a verbal promise (of 13-15 patients) to be a solid rule. As @chessknt correctly pointed out, your contract probably states nothing about a census. (they can't promise that in any way . . .a colleague called out I today, I saw 27).

I cant believe hospitals get away with this.

Also a rookie notion.

It's happening all over the country. I've worked in 7 different systems on both coasts . . . we're being used and abused. The problem is, the pay can still be decent, and it's hard to quit when you have nothing else to do (and when you have a family, a mortgage, and a bad whiskey habit to support)

 

[chessknt]

-the two other docs wont say anything bc they are on visas and cant risk it- they said.

How is it a rookie mistake? Its a hospital employed position- they said contract was non negotiable- everyone gets same stuff.
How was i supposed to know that they would lie to my face about census?
Is it standard to get a hard pt cap in contract? Bc ive never seen it before.
Legit please tell me how to protect myself from this in the future.
Also, ive gotta pay 10k in tail for working two weeks, bc they dont cover that and Im out 30k in non refundable housing costs once i move.
Its a straight ****te show and im spending everything ive got to get outta here. Thats why i was wondering if an attorney would help soften the financial blow.
I cant believe hospitals get away with this.

Tail shouldnt be 10k for 2 weeks that is nuts--youre sure hospital wont cover tail? This should all be part of your calculus to stay I suppose depending on how long you have to eat **** before they take the pressure off. A drop in the bucket over the career but fresh out I feel you dude--it sucks getting raped by the big business of healthcare, now you know what they are. Be equally hostile during contract negotiation and be able to walk away.

 

[bronx43]

This kind of “bait and switch” will be the norm until everyone gets on productivity. Health systems are hurting financially as their labor and supply costs have gone parabolic. Screwing hospitalists over is the low hanging fruit for them. I would be surprised if most jobs in the country aren’t demanding more work for same or less pay.

Hospital medicine needs to follow suit with what outpatient medicine has been doing for decades - work for RVUs so that everyone is on the same page. If you see the RVUs then you get paid. If you don’t then you get nothing.

 

[bronx43]

I cant believe hospitals get away with this.

Get away with what? Exerting their market dominance over inpatient doctors who depend on hospital infrastructure to survive?

I feel for your situation. I’ve been on the crap side of deals like this in the past. Ultimately, if you don’t want to be exploited by hospital systems then you can always go outpatient and start up your own clinic. Sure, there’s risk and other headaches but there’s no free lunch in this world. Heck, with the way things are in the economy, everyone’s lunch is getting more expensive.