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Call Schedule Shenanigans?

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  • Eye3md
    replied










    In our big democratic group everybody shares call equally. If you do not want call anymore, you enter a specific retirement track, which requires you to be phased out of the call schedule over 4 years, at which point you must retire. Can stay on as a PRN moonlighter after that with no guaranteed shifts.
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    This is great. Personally, I think it’s ridiculous that you can quit call at a certain age. If you are still doing surgery then you should still be taking call. For me, i hate being on call but it would feel very odd to quit taking call and push that burden on my younger colleagues while I was still enjoying a full busy surgical practice.
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    Exactly!  I recently tried unsuccessfully to remove age based restrictions from call.  I felt as call is a tax for the privilege of operating.  If you decide to stop operating, then you can stop call.  It did not go over well.
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    N our practice, we have it where you must take call if you do surgery. And, if you decide you no longer wants do surgery, then you must also give up partnership and become an employed doc instead. With our ownership interests in multiple surgical facilities and real estate, the idea of changing from a full partner to employee would mean a very substantial financial hit.

    Leave a comment:


  • saildawg
    replied







    In our big democratic group everybody shares call equally. If you do not want call anymore, you enter a specific retirement track, which requires you to be phased out of the call schedule over 4 years, at which point you must retire. Can stay on as a PRN moonlighter after that with no guaranteed shifts.
    Click to expand…


    This is great. Personally, I think it’s ridiculous that you can quit call at a certain age. If you are still doing surgery then you should still be taking call. For me, i hate being on call but it would feel very odd to quit taking call and push that burden on my younger colleagues while I was still enjoying a full busy surgical practice.
    Click to expand...


    Exactly!  I recently tried unsuccessfully to remove age based restrictions from call.  I felt as call is a tax for the privilege of operating.  If you decide to stop operating, then you can stop call.  It did not go over well.

    Leave a comment:


  • SLC OB
    replied







    This is a big bummer…. but what is the burden? Did you go from one call/month to two/month?

    Or did you go from 4 calls per month to 10 calls/month? That would be a BIG deal!

    Call burden is real…

    Next time, I’d encourage you (and anyone!) to know exactly the number of calls required prior to signing anything.
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    Unfortunately doesn’t matter what they say or even what’s written.  Thank god there is no non compete.
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    You asked




    Any thoughts on what I should do?
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    Well.... my answer would actually depend on the burden. It does matter what is required, what was said, etc.

    A non-compete only matters if you plan to bail and stay in the same area.


    Unfortunately, as the hospitals do not currently pay any of our specialty for call and hospital privileges are not required to practice, the remaining doctors not in the group are moving to stop taking call as well.  I have already brought up the idea of asking the hospitals to pay us for call but the idea has been shot down for fear of angering the hospital systems.  I’m hesitant to even mention my contract terms for fear of being labeled a typical “millennial.”
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    Doesn't make any sense that the hospital pays you nothing but that you all have to cover 24/7 when hospital privileges are not required.

    Yet you are talking about a non-compete... so you would stay in the same area but not take call for this same hospital?

    This does not make any logical sense.

    Leave a comment:


  • Eye3md
    replied




    In our big democratic group everybody shares call equally. If you do not want call anymore, you enter a specific retirement track, which requires you to be phased out of the call schedule over 4 years, at which point you must retire. Can stay on as a PRN moonlighter after that with no guaranteed shifts.
    Click to expand...


    This is great. Personally, I think it's ridiculous that you can quit call at a certain age. If you are still doing surgery then you should still be taking call. For me, i hate being on call but it would feel very odd to quit taking call and push that burden on my younger colleagues while I was still enjoying a full busy surgical practice.

    Leave a comment:


  • Tim
    replied
    •Is this group policy inconsistent with the language and spirit of my contract?
    Yes.
    •Unfortunately doesn’t matter what they say or even what’s written.
    Yes it does.
    The distribution of work is significant without compensation. Your career is greatly impacted. Your time is valuable as well. You will take a financial hit changing jobs, probably more than anticipated. What is it going to cost you to change employment?
    •Thank god there is no non compete.
    Yes the is great. What about the rest of the contract? Are they going to try to claw back $$ for signing, relo etc? Notice required will you take call for free? Will they reimburse you for your attorney fees? Will this be a friendly goodbye or how will they handle the separation?
    •The real question is whether the model is sustainable or fixes can be achieved that make it desirable for you long term. The “reward” for taking call on behalf of the senior physicians needs to be “worth it” and “sustainable”.
    • Compensation, job, location. It makes a huge difference whether you and your employer really have an understanding that will last. Contract only serves as words , many solutions are available. How big of a problem is it and what fix is acceptable?
    It matters greatly what they say and do. Then you have to make significant decisions. Don’t get hung up on principle of equal, make choices on the impact on you both short term and long term.

    Leave a comment:


  • wcinewbie
    replied




    This is a big bummer…. but what is the burden? Did you go from one call/month to two/month?

    Or did you go from 4 calls per month to 10 calls/month? That would be a BIG deal!

    Call burden is real…

    Next time, I’d encourage you (and anyone!) to know exactly the number of calls required prior to signing anything.
    Click to expand...


    Unfortunately doesn't matter what they say or even what's written.  Thank god there is no non compete.

    Leave a comment:


  • SLC OB
    replied
    This is a big bummer.... but what is the burden? Did you go from one call/month to two/month?

    Or did you go from 4 calls per month to 10 calls/month? That would be a BIG deal!

    Call burden is real...

    Next time, I'd encourage you (and anyone!) to know exactly the number of calls required prior to signing anything.

    Leave a comment:


  • wcinewbie
    replied
    Definitely not great but the grass is always greener on the other side? Most of the other doctors are more or less great colleagues who are honorable and do good ethical work. Unfortunately over the years I've seen much worse situations. "Fortunately " the call is after hours so should not affect billable work.

    Leave a comment:


  • MPMD
    replied




    Approximately 1/3 of the physicians have already aged out of call with many more looking forward to it in the coming years.  As mentioned previously, the hierarchical nature of the call was an issue for a number of previous junior physicians and the issue blew up in their faces when they tried to change it.   The call situation unfortunately worsened for everybody else after they left.

    Unfortunately, as the hospitals do not currently pay any of our specialty for call and hospital privileges are not required to practice, the remaining doctors not in the group are moving to stop taking call as well.  I have already brought up the idea of asking the hospitals to pay us for call but the idea has been shot down for fear of angering the hospital systems.  I’m hesitant to even mention my contract terms for fear of being labeled a typical “millennial.”
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    This all sounds...... very bad.

    Unless there are other things about this job (amazing location, incredible pay, etc) with the limited info above I don't see this working out.

    Increasing and objectively unfair call burden and oh by the way call is unpaid? Are you also going to end up making less b/c your call days mean you have to cancel other billable work?

    Again.... this is not good dude.

    Leave a comment:


  • Michael Scarn
    replied
    OP - is this contract with a private practice? If so, regardless of what your contract says, it seems you were misled since I assume you asked how the call worked prior to signing.

    If this is an employed position and you’re sharing call with other physicians outside of your group, this is a different story. The hospital probably signs individual contracts with each provider who will be taking call and it’s possible that your contract may be the only one that has that statement. Often the folks agreeing to your contract are not the ones who would be aware of a specific call situation such as physicians aging out.

    I think it comes down to what your end goal is. If this is a practice that you want to remain a part of, I feel like you were probably stuck following the rules that are in place regardless of what the contract says. However, if you are looking for a way out, this seems like it could work for that.

    On the other hand, if this is an employed position, there is room for negotiation. If you otherwise like the opportunity aside from the call, I would try and negotiate. You could add up the difference between what your call would be in the contract versus what they are asking you to take and then ask for extra compensation for those days. If you are getting a call stipend, you could ask for a locums rate for the additional days. If you’re not already getting a call stipend, you could ask for a stipend for these days.

    Good luck and keep us in the loop!

    Leave a comment:


  • wcinewbie
    replied
    Thank you all for the advice thus far.  I'll refer the issue back to my contract lawyer who reviewed the original agreement to see what he thinks.  I don't think it was purposely presented to me as a bait and switch but it certainly feels like it.

    I did not previously ask the question of whether senior partners retired out of call but I think it would have been reasonable to think equal meant everybody.  There was no objection to the addition of the clause specifying that call be equally shared.  At this point, it seems unlikely I would be able to have the equal call responsibilities specified in my contract.  Approximately 1/3 of the physicians have already aged out of call with many more looking forward to it in the coming years.  As mentioned previously, the hierarchical nature of the call was an issue for a number of previous junior physicians and the issue blew up in their faces when they tried to change it.   The call situation unfortunately worsened for everybody else after they left.

    Unfortunately, as the hospitals do not currently pay any of our specialty for call and hospital privileges are not required to practice, the remaining doctors not in the group are moving to stop taking call as well.  I have already brought up the idea of asking the hospitals to pay us for call but the idea has been shot down for fear of angering the hospital systems.  I'm hesitant to even mention my contract terms for fear of being labeled a typical "millennial."

    Leave a comment:


  • MPMD
    replied




    In our big democratic group everybody shares call equally. If you do not want call anymore, you enter a specific retirement track, which requires you to be phased out of the call schedule over 4 years, at which point you must retire. Can stay on as a PRN moonlighter after that with no guaranteed shifts.
    Click to expand...


    that seems very reasonable.

     

     

    OP, yikes. Agree with what others have said depends on the burden and how it's being compensated. But without knowing all of the details it seems like a big thing to forget to mention to a new hire coming on doesn't it? I'm with other people that think that if you want out I think you could fairly easily get a lawyer to call this a contract breach. It wouldn't take a lawyer to find a clause saying call ends at 60.

    Leave a comment:


  • Dreamgiver
    replied
    In our big democratic group everybody shares call equally. If you do not want call anymore, you enter a specific retirement track, which requires you to be phased out of the call schedule over 4 years, at which point you must retire. Can stay on as a PRN moonlighter after that with no guaranteed shifts.

    Leave a comment:


  • childay
    replied
    How bad is your call?

    Leave a comment:


  • The White Coat Investor
    replied




    My negotiated and signed employment contract specifically and purposefully states that I will share call with the other physicians on an equal basis but after starting learned that the general group wide call is limited to junior physicians only (senior physicians have aged out of call).  Is this group policy inconsistent with the language and spirit of my contract?  My contract is probably an outlier and nobody else knows about it.  Apparently call was an issue with junior physicians in the past and was to some extent a reason why some left.  Any thoughts on what I should do?  I’m not sure what I would have thought if I had known about this before starting.
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    Sounds like a bit of bait and switch to me. I think it's a contract violation. The older doc thing should have been spelled out in the contract. Now...should you do anything about it....that's up to you.

    Leave a comment:

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