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Call Schedule Shenanigans?

Home Practice Management Call Schedule Shenanigans?

  • Avatar wcinewbie 
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    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.

    #246831 Reply
    ACN ACN 
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    Our senior partners over 60 don’t take call and are not required to.

    Guess it depends on how many are taking call and how busy it is.

    If you're ever having a bad day, just remember in 1976 Ronald Wayne sold his 10% stake in Apple for $2,300.

    #246832 Reply
    Liked by JWeb
    Avatar jhwkr542 
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    It might or it might not be a breach of contract. That’d be a question for a lawyer, but you’d have to pursue legal action to get anything done (or at least bring it to attention but i doubt anything would be done about it). If you’re not compensated or it’s too much, the best course of action would be to leave.

    #246846 Reply
    Liked by Vagabond MD
    ENT Doc ENT Doc 
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    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.

    Click to expand…

    You need to diver deeper not only into your contract but what the group specifies as available physicians to take call.  If you’re compensated for it I wouldn’t put up much of a fuss.  But if by junior you mean anyone younger than, say, 45 I’d take issue with that.  I’d expect aging out of call to be a bit older than that.  Regardless, you should have been given a good idea of how much call you were taking and if it was compensated before you signed.  Is what you are experience different from what you were told?

    #246858 Reply
    jfoxcpacfp jfoxcpacfp 
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    If the contract specifically says “all physicians” with no other defining wording of “all physicians” and you are willing to leave over it, this could be worth seeing an attorney about negating any non-compete conditions included in the contract.

    Johanna Fox Turner, CPA, CFP: I am not your financial advisor; any responses are for general purposes only
    http://www.fox-cpas.com/for-doctors-only ~ [email protected]

    #246862 Reply
    Liked by Hank
    Avatar nephron 
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    Yes, I agree, it is odd that the group would not have made clear to you what the call schedule was going to be, who was going to be taking call, how often, etc.   It’s was in both of your interest.  My contract specifies that people over the age of 60 do not have to take weekend call as well, only applicable to one group member/the owner, but it was obviously disclosed.    Not much you can do at this point other then decide if you think that the system is fair enough, you aren’t going to be able to sue your senior partners into taking call with you, even if your contract does state that call is equally shared.  This is a good example of it doesn’t really matter what the contract says if your group is not listening to it, your options are either to take it or leave it so it’s a good idea to get to know the group before signing on.   My employers argument is that he used to take call every weekend or every other weekend when the group was first starting/first growing, so this is just the groups way of paying him back, it’s a reasonable argument up to a point.

    #246863 Reply
    Liked by Kamban, q-school
    Avatar DCdoc 
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    Did you ask about call frequency? Does it match what they told you while interviewing?

    #246869 Reply
    The White Coat Investor The White Coat Investor 
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    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.

    Click to expand…

    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.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #246923 Reply
    childay childay 
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    Joined: 01/09/2016

    How bad is your call?

    #246957 Reply
    Dreamgiver Dreamgiver 
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    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.

    MPMD MPMD 
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    Joined: 05/01/2017

    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.

    #247812 Reply
    Avatar wcinewbie 
    Participant
    Status: Physician
    Posts: 92
    Joined: 09/30/2017

    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.”

    #247835 Reply
    Avatar Michael Scarn 
    Participant
    Status: Physician
    Posts: 26
    Joined: 12/09/2018

    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!

    #247837 Reply
    Liked by jfoxcpacfp
    MPMD MPMD 
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    Status: Physician
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    Joined: 05/01/2017

    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.”

    Click to expand…

    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.

    #247874 Reply
    Liked by pulmdoc, Tim, Zaphod
    Avatar wcinewbie 
    Participant
    Status: Physician
    Posts: 92
    Joined: 09/30/2017

    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.

    #247879 Reply

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