Vituity

[clement]

I’m still finding ER psych (dedicated, not a component of CL) weirdly difficult to land in SoCal (mostly county places, of course). Maybe not that weird because SoCal employers seem slow to respond unless it’s an annoying outside recruiter with an undesirable job.

I still have to complete a year of PSLF payments.
Not sure if Vituity counts with qualifying employer rule changes in CA (topic for another thread). I don’t see a lot of old posts about Vituity, but anecdotally they (recruiters, directors) never seem to respond to inquiries. I heard a handful of people say, “Vituity used to be better” (they’re still employees and were skirting around the why). Probably quotas along the lines of 4 per hour.

Anyone have a recent scoop?

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[Celexa]

Are you SURE you don't wanna come to the northeast? I can hook you up with a ED-only faculty position with built in moonlighting/extra shifts and PSLF eligible in a heartbeat

**Looks outside at the literal freezing weather and snow coming down from the sky**

**frantically trying to think of a reason someone would move here from SoCal**


..... In 10-15 years we are still expected to have fresh water and a growing season despite global warming?

 

[clement]

Are you SURE you don't wanna come to the northeast? I can hook you up with a ED-only faculty position with built in moonlighting/extra shifts and PSLF eligible in a heartbeat

**Looks outside at the literal freezing weather and snow coming down from the sky**

**frantically trying to think of a reason someone would move here from SoCal**


..... In 10-15 years we are still expected to have fresh water and a growing season despite global warming?

I agree that weather isn’t everything.
For us former ER veterans, there comes a point where it’s harder to move around with littles or take on 16 hour shifts.
I was intent on avoiding the major telepsych companies based on these threads and anecdotal experiences. Just curious if at least Vituity might be better than corrections. Working from home is also tempting at the moment. Not so many tele employers offer ER psych and I’m not risk averse with video visits in that context…Especially if I don’t have to stretch my licensure across 12 states. I get that the subtleties of delirium can be missed etc and for some that’s a deterrent.

 

[splik]

Yes, from what I've heard they are not very responsive if you're not connected. Vituity may qualify for PSLF depending on the hospital you're working at. They do have some extremely well paying jobs. They don't go for quality. a vituity doc rx'd my drug seeking pt a month's worth of stims and benzos in the ER...

 

[clement]

Yes, from what I've heard they are not very responsive if you're not connected. Vituity may qualify for PSLF depending on the hospital you're working at. They do have some extremely well paying jobs. They don't go for quality. a vituity doc rx'd my drug seeking pt a month's worth of stims and benzos in the ER...

?Funny thing is they offer referral bonuses to their psychiatrists. I dutifully pinged two of their directors (I think even a cmo) through motivated individuals who already work for them or closely with them by affiliation. One replied with an enthused request that we speak but won’t reply to follow ups. The other just ignores Emails. Maybe the referral bonus slush fund is drying up.

 

[Atreides]

I spoke with their CMO about a potential inpatient/CL/psych ER position. I was left wondering why any psychiatrist would agree to take the job. Basically, the hospital contracted with Vituity to cover psychiatry. Responsible for a couple inpatient beds (can't remember the number but it wasn't big, maybe 4-6) as well as any psych consults from inpatient or ER. Now Vituity turns around and hires psychiatrists to cover the hospital. But all the work goes to the psychiatrists. Basically, you and the other psychiatrists are responsible for covering the service. Any time off is coordinated between you and the other psychiatrists. I was like, "Well, what happens if the other three doctors quit?" And he was like, "Yeah, then you'd need to find other psychiatrists to join and split the load with." 2 of the beds were child flex beds and he said we had to figure out child coverage on our own (none of the other prospective psychiatrists were child trained either). I have no idea what value Vituity added; I could contract myself with the hospital and take on all this risk and workload. The whole point of working for someone else is that this headache goes to them.

Asked him what the compensation was for all of this. He said between the stipend, hourly rate, bonus, etc it would come down to about $225-$240/hour. I

 

[clement]

I spoke with their CMO about a potential inpatient/CL/psych ER position. I was left wondering why any psychiatrist would agree to take the job. Basically, the hospital contracted with Vituity to cover psychiatry. Responsible for a couple inpatient beds (can't remember the number but it wasn't big, maybe 4-6) as well as any psych consults from inpatient or ER. Now Vituity turns around and hires psychiatrists to cover the hospital. But all the work goes to the psychiatrists. Basically, you and the other psychiatrists are responsible for covering the service. Any time off is coordinated between you and the other psychiatrists. I was like, "Well, what happens if the other three doctors quit?" And he was like, "Yeah, then you'd need to find other psychiatrists to join and split the load with." 2 of the beds were child flex beds and he said we had to figure out child coverage on our own (none of the other prospective psychiatrists were child trained either). I have no idea what value Vituity added; I could contract myself with the hospital and take on all this risk and workload. The whole point of working for someone else is that this headache goes to them.

Asked him what the compensation was for all of this. He said between the stipend, hourly rate, bonus, etc it would come down to about $225-$240/hour. I

I have the impression Vituity is far sweeter in the directorship capacity than as a worker bee with the illusion of being some kind of physician shareholder. I assume the tele piece is the draw for most prospects. And for hospitals, the perk of Vituity is getting coverage where (geographically) they may not easily seduce psychiatrists on their own (less populous inland SoCal or intense urban county ERs in the Bay Area). Or else places where they can’t convince the hospital cmo to bleed money for psych consults?
I know at least 1 site where it’s in person work and they seem filled to the brim.

Overall I’m not familiar with CA hospital employment arrangements in depth enough to know if these days a psychiatrists can easily proceed with video consults for floors or ERs as a 1099 independent contractor (the caveat being direct hospital employment is often not permitted)…but I see private groups doing this line of work and sometimes they monopolize community hospitals with their biller minions until retiring.

Private practice er psych work is of course not a practical model unless you want to rent a space in the mall (behind wetzels pretzels) and call yourself a crisis stabilization unit.

 

[TexasPhysician]

I would avoid this company and the vast majority of telepsych only jobs.

I’d say roughly 30-50% of psychiatrists do very little by way of significant contract negotiations, liability minimization, etc. The result is predatory organizations putting psychiatrists at high risk for low pay. Avoid these groups and advise others to do the same.

I know many psychiatrists that want to travel more and care less about money or liability. They are happy with the lifestyle, but it hurts our market.

 

[jbomba]

I spoke with their CMO about a potential inpatient/CL/psych ER position. I was left wondering why any psychiatrist would agree to take the job. Basically, the hospital contracted with Vituity to cover psychiatry. Responsible for a couple inpatient beds (can't remember the number but it wasn't big, maybe 4-6) as well as any psych consults from inpatient or ER. Now Vituity turns around and hires psychiatrists to cover the hospital. But all the work goes to the psychiatrists. Basically, you and the other psychiatrists are responsible for covering the service. Any time off is coordinated between you and the other psychiatrists. I was like, "Well, what happens if the other three doctors quit?" And he was like, "Yeah, then you'd need to find other psychiatrists to join and split the load with." 2 of the beds were child flex beds and he said we had to figure out child coverage on our own (none of the other prospective psychiatrists were child trained either). I have no idea what value Vituity added; I could contract myself with the hospital and take on all this risk and workload. The whole point of working for someone else is that this headache goes to them.

Asked him what the compensation was for all of this. He said between the stipend, hourly rate, bonus, etc it would come down to about $225-$240/hour. I

Out of curiosity, how would it fall on the doc to find more people to share the load? Couldn't the doc just say I'm not taking on any more work. Are they really going to fire their last remaining doctor? The doc has all the leverage in this scenario. If it were me I would use this opportunity to ask for more money and then walk to any number of different opportunities if they refused or were being unreasonable. I don't understand how people willingly take on more work just because they're asked to do so. Okay yes, psychologically I get it.. but we should all be better than that. If not for ourselves, then at least for each other.

 

[clement]

I mean the end game of every place I’ve ever been employed at, for profit or non, on site or remote, has been varying degrees of predation.

Vituity piqued my interest because I see some people stick around with them for 6-7 years and hear they are the lesser of tele evils— though I suspect my distant acquaintances are simply enjoying admin roles.

 

[TexasPhysician]

Out of curiosity, how would it fall on the doc to find more people to share the load? Couldn't the doc just say I'm not taking on any more work. Are they really going to fire their last remaining doctor? The doc has all the leverage in this scenario. If it were me I would use this opportunity to ask for more money and then walk to any number of different opportunities if they refused or were being unreasonable. I don't understand how people willingly take on more work just because they're asked to do so. Okay yes, psychologically I get it.. but we should all be better than that. If not for ourselves, then at least for each other.

Contract can specifically state that duties include covering site when other psychiatrists are unavailable or on leave. Contract can further state that as the managing physician any deficiencies are a fault of the physician as they are directing this site. Parent company is admin role only. Contract is 1 year with 4 months notice or physician pays locum costs until a replacement is found due to contract violation.

Constantly hire psychiatrists and replace them when they become disgruntled. Rinse repeat.

 

[clement]

Contract can specifically state that duties include covering site when other psychiatrists are unavailable or on leave. Contract can further state that as the managing physician any deficiencies are a fault of the physician as they are directing this site. Parent company is admin role only. Contract is 1 year with 4 months notice or physician pays locum costs until a replacement is found due to contract violation.

Constantly hire psychiatrists and replace them when they become disgruntled. Rinse repeat.

That sounds like a lot of inefficiency but maybe the margins justify or even promote it.

 

[TexasPhysician]

That sounds like a lot of inefficiency but maybe the margins justify or even promote it.

Happens all the time. Someone will negotiate covering an inpatient unit of 50 patients for a set price. Same person then finds psychiatrists to cover those 50 patients for 50-75% of the provided $. Keep 25-50% for the effort and managing changes in staffing.

 

[SeniorWrangler]

So Uber, but for psychiatry? Brilliant!

 

[jbomba]

Contract can specifically state that duties include covering site when other psychiatrists are unavailable or on leave. Contract can further state that as the managing physician any deficiencies are a fault of the physician as they are directing this site. Parent company is admin role only. Contract is 1 year with 4 months notice or physician pays locum costs until a replacement is found due to contract violation.

Constantly hire psychiatrists and replace them when they become disgruntled. Rinse repeat.

Guess this is why you need to really read (and not sign) your contracts.

Now, I wonder how this would all play out if the physician happened to get sick and was too ill to work?

 

[sophia502]

Where in SoCal? CMH in San Diego is usually always looking for docs.

 

[TexasPhysician]

Guess this is why you need to really read (and not sign) your contracts.

Now, I wonder how this would all play out if the physician happened to get sick and was too ill to work?

Exactly. Understanding the contracts is important. It “could” be the sick physician’s job to find a replacement or be charged with abandoning patients and contractual fines.

 

[calvnandhobbs68]

Contract can specifically state that duties include covering site when other psychiatrists are unavailable or on leave. Contract can further state that as the managing physician any deficiencies are a fault of the physician as they are directing this site. Parent company is admin role only. Contract is 1 year with 4 months notice or physician pays locum costs until a replacement is found due to contract violation.

Constantly hire psychiatrists and replace them when they become disgruntled. Rinse repeat.

I really cannot understand why anyone would ever sign a contract like that...but I guess people do.

With that kind of contract you might as well just be your own private practice contacting out to hospitals cause that's essentially what you're agreeing to. Wonder what would happen if you showed the hospital the actual contract their "staffing" company which is not actually guaranteeing staffing was having people sign.

 

[Atreides]

you might as well just be your own private practice contacting out to hospitals cause that's essentially what you're agreeing to.

Kid you not, that's what the CMO told me. His words, verbatim, were, "It's basically like running a private practice and we just provide some support." I'm thinking, yeah, all the downsides and none of the upsides of private practice.

 

[clement]

Where in SoCal? CMH in San Diego is usually always looking for docs.

Several hours north. Last I recall all their physicians were through locums companies which I think disqualifies PSLF payments from counting even in CA

 

[jbomba]

Where in SoCal? CMH in San Diego is usually always looking for docs.

whats CMH?

 

[clement]

whats CMH?

It’s the former name for a county psychiatric facility but now it’s called sdcph.

 

[jbomba]

It’s the former name for a county psychiatric facility but now it’s called sdcph.

That place is beyond fully staffed. I don't understand why they are still looking to hire more...