Menu

Neurohospitalist Part III: The Saga Continues [Administrator shell game?]

Home Practice Management Neurohospitalist Part III: The Saga Continues [Administrator shell game?]

  • Avatar ChristopherMD20 
    Participant
    Status: Physician
    Posts: 192
    Joined: 10/31/2017
    FWIW I haven’t ever gone in high and played the meet somewhere in the middle game but rather tell the employer my requirements up front and if they are able to accomodate we have a deal.

    Click to expand…

    I think that is a better approach. In that vein, I actually sent an email earlier this morning listing what I want, gave them 10 business days to reply then said I will be exploring other opportunities and stepping down as medical director if the terms are not agreed to in the alotted time. I went all-in. I have “outs” if we are to continue with the poker analogy. I have updated my CV and am uploading to physician match and I am going to start calling my local contacts this upcoming week.

     

    Thank you to everyone on the forum who gave me the confidence and guidance to be assertive. Even if they say no I will be fine. I have plenty of options.

     

    Thanks!

    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 1093
    Joined: 03/18/2017

    You keep saying you don’t have access to mgma data. You realize you could change that, by paying for it? I mean its expensive but you’re negotiating for of tens or hundreds of thousands a year….

    You do have access to it, you apparently just don’t want to pay

    #241351 Reply
    Liked by octopus85, E5797
    Avatar ChristopherMD20 
    Participant
    Status: Physician
    Posts: 192
    Joined: 10/31/2017
    You do have access to it, you apparently just don’t want to pay

    Click to expand…

    Fair point.

    #241354 Reply
    Avatar ZZZ 
    Participant
    Status: Spouse
    Posts: 707
    Joined: 06/18/2018

    “I actually sent an email earlier this morning”

    Awesome. Proud of you. You’ve worked hard to get where you are and provide a valuable service, you deserve to be well compensated. Hope it all works out one way or another.

    #241357 Reply
    Avatar GPGP 
    Participant
    Status: Physician
    Posts: 186
    Joined: 05/02/2017

    At my institution, I just asked for it and they gave it to me. This was as our already-employed group was moving to an “everyone is treated the same” kind of contract.  I also used contract diagnostics, and they did give me a bit broader look at MGMA than my institution had.

    #241358 Reply
    Liked by StateOfMyHead
    wonka31 wonka31 
    Participant
    Status: Physician
    Posts: 701
    Joined: 03/24/2018

    Strong work, best of luck with this.

    #241366 Reply
    Liked by StateOfMyHead
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6197
    Joined: 01/12/2016
    Earnest refinancing bonus
    FWIW I haven’t ever gone in high and played the meet somewhere in the middle game but rather tell the employer my requirements up front and if they are able to accomodate we have a deal. 

    Click to expand…

    I think that is a better approach. In that vein, I actually sent an email earlier this morning listing what I want, gave them 10 business days to reply then said I will be exploring other opportunities and stepping down as medical director if the terms are not agreed to in the alotted time. I went all-in. I have “outs” if we are to continue with the poker analogy. I have updated my CV and am uploading to physician match and I am going to start calling my local contacts this upcoming week.

     

    Thank you to everyone on the forum who gave me the confidence and guidance to be assertive. Even if they say no I will be fine. I have plenty of options.

     

    Thanks!

    Click to expand…

    I didnt mean to advocate for that approach, its just what “the books” say. Tbh, I dont really feel that style works anymore or at least in most situations. Most of these styles operate on the premise of at least a slightly fair or reasonable counterpart, which seems to not be existent in medicine. Admin seems to have gotten a be extremely harsh and unwavering memo years ago, and largely they would be right. Otoh, kind of what docs need to do now in response.

    I was dealing with an interesting one, and they didnt give a damn, they had all the power, so I simply left. If you read these negotiation books theyre littered with people getting their rent reduced with simple appeals when the landlord was trying to raise it, etc…but this is of course survivorship bias, no mention of the likely many more that were evicted.

    We’ve evolved into a market based what can be beared as opposed to negotiated type prices, which is more true but less elastic.

    #241379 Reply
    White.Beard.Doc White.Beard.Doc 
    Participant
    Status: Physician
    Posts: 937
    Joined: 02/06/2016
    FWIW I haven’t ever gone in high and played the meet somewhere in the middle game but rather tell the employer my requirements up front and if they are able to accomodate we have a deal. 

    Click to expand…

    I think that is a better approach. In that vein, I actually sent an email earlier this morning listing what I want, gave them 10 business days to reply then said I will be exploring other opportunities and stepping down as medical director if the terms are not agreed to in the alotted time. I went all-in. I have “outs” if we are to continue with the poker analogy. I have updated my CV and am uploading to physician match and I am going to start calling my local contacts this upcoming week.

     

    Thank you to everyone on the forum who gave me the confidence and guidance to be assertive. Even if they say no I will be fine. I have plenty of options.

     

    Thanks!

    Click to expand…

    Wait, so you just sent an ultimatum in an email?  I am not sure if that is how I would have done it.  I might bring my request in writing to a meeting, discuss it and then hand it to the administrator.  By sending an email, you lost an opportunity to read the response.

    If the hospital administrator feels screwed by you, backed into a corner, do you think that might have an effect on how that administrator treats you in the future? Even if they agree to accept all of your demands?  I have always tried to be firm but nice, and at the same time I have worked hard to be present and to understand the other side’s position so that I can get much of what I want while also giving back some of what is important to the other side.

    Please be cautious, and here is a tale of why: A few years back a colleague does something similar to administrator when they are backed into a corner.  The physician is given what they demand by the administrator, but there is tremendous bad blood left over from how things were handled.  The administrator then secretly goes to a recruiter and hires another doc with credentialing completed several months later.  The original doc then gets terminated on the spot, escorted out of the hospital by security for “failing to abide by the terms of the original written contract” and is without a job or income for over four months (time spent securing a new position and then getting credentialed).  He did get a locums gig later during that dry spell, but paying the mortgage was tough.  It was quite stressful for him and his family.

    Remember, how you conduct yourself and how you make people feel is always remembered.  Pay back can be painful.  If I was in your shoes, I would go meet the administrator at the beginning of this week.  And I would walk into the office with a smile and frame it as a listening tour.  I might apologize and say that I have a hard time asking for what I need in person, so I put it in writing.  And then just listen and explore with some targeted questions the response to what you asked for.  “I asked for what I feel is reasonable.  Is the hospital able to come through with fair compensation for everything that I do?”  Reading the body language is as important as listening to the words.  I know we all have different negotiating styles, but be careful not to create hard feelings while at the same time asking for what is fair and what you need.

    Would you be in a tough spot if they were to say no and ask you to leave?  Or do you think they would allow you to leave on your own preferred timeline?  How long would it take for you to secure a better position?  When you give an ultimatum, it is important to think through all of your plan B beforehand.

    Being willing to leave puts you in a strong negotiating position, but only if you don’t damage relationships in the process should you end up staying, and only if you have a timely transition to a high quality position available if you end up leaving.  Try to make this into a win/win if at all possible.

    #241413 Reply
    Avatar ChristopherMD20 
    Participant
    Status: Physician
    Posts: 192
    Joined: 10/31/2017
    Wait, so you just sent an ultimatum in an email?  I am not sure if that is how I would have done it.

    Click to expand…

    I stand no chance while doing in-person negotiations. I am much too agreeable. This was consciously done in order to avoid screwing myself. Also, I did not want them drawing up paperwork on something that I was not going to agree to. I left the in-person meeting thinking that things went well, but did not realize until hours later that I was about to agree to what amounted to a 5% raise without any of the many other things I wanted including payment for medical directorship.

    If the hospital administrator feels screwed by you, backed into a corner, do you think that might have an effect on how that administrator treats you in the future?

    Click to expand…

    I do not think I do anything to make anyone feel screwed. I hope I sent a message that I am not going to be a pushover anymore.

    I would go meet the administrator at the beginning of this week.

    Click to expand…

    They already responded and asked me to come by.

    Would you be in a tough spot if they were to say no and ask you to leave?

    Click to expand…

    No. I would use my 457b as severance package. Mortgage is almost paid off. We are not making any large purchases until I have a secured contract somewhere. My wife works.

    Try to make this into a win/win if at all possible.

    Click to expand…

    I tried to frame it as such.

    #241446 Reply
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6197
    Joined: 01/12/2016

    I’m using the 457 as such an account as well. Building to a reasonable severance size and that’s it.

    Good luck.

    #241447 Reply
    Avatar billy 
    Participant
    Status: Physician
    Posts: 164
    Joined: 04/07/2016

    This is why even if you’re not truly FI yet, a 6 month emergency fund when starting out helps- its your mini FU money if you need to leave a job where you’re not happy. But hopefully this all works out for you

    #241453 Reply
    Avatar StateOfMyHead 
    Participant
    Status: Advanced Practice Provider
    Posts: 143
    Joined: 01/01/2019
    Wait, so you just sent an ultimatum in an email?  I am not sure if that is how I would have done it. 

    Click to expand…

    I stand no chance while doing in-person negotiations. I am much too agreeable. This was consciously done in order to avoid screwing myself. Also, I did not want them drawing up paperwork on something that I was not going to agree to. I left the in-person meeting thinking that things went well, but did not realize until hours later that I was about to agree to what amounted to a 5% raise without any of the many other things I wanted including payment for medical directorship.

    If the hospital administrator feels screwed by you, backed into a corner, do you think that might have an effect on how that administrator treats you in the future? 

    Click to expand…

    I do not think I do anything to make anyone feel screwed. I hope I sent a message that I am not going to be a pushover anymore.

    I would go meet the administrator at the beginning of this week. 

    Click to expand…

    They already responded and asked me to come by.

    Would you be in a tough spot if they were to say no and ask you to leave? 

    Click to expand…

    No. I would use my 457b as severance package. Mortgage is almost paid off. We are not making any large purchases until I have a secured contract somewhere. My wife works.

    Try to make this into a win/win if at all possible. 

    Click to expand…

    I tried to frame it as such.

    Click to expand…

    I  also hope it works out where you are and if not like you added you have options. Generally in life knowing where the exit hatch is located and keeping options available is a smart strategy. If push comes to shove I can point you in the direction of a well paying but rural location provided you are willing to drive 90 mins outside the metro.

    #241474 Reply
    White.Beard.Doc White.Beard.Doc 
    Participant
    Status: Physician
    Posts: 937
    Joined: 02/06/2016

    It sounds like you have thought through the many possibilities and are ready for whatever comes.  Negotiating can be challenging and everyone handles it differently.  You know yourself so you made your demands in a written form to avoid not asking for what you need, a good strategy if you are better in writing than in person.

    My daughter is typical for many young women, slow to ask for what she clearly deserves.  She likes to wait until raises and promotions are offered on a silver platter.  She has finally risen to a high level of leadership and a high level of pay, but it likely took her twice as long to get there due to her patience.  One thing I have had to work on is understanding that what works so well for me may not always work so well for others with different personalities and negotiating strengths.

    #241513 Reply
    Liked by Zaphod, q-school, Tim, billy
    Avatar ChristopherMD20 
    Participant
    Status: Physician
    Posts: 192
    Joined: 10/31/2017
    This is why even if you’re not truly FI yet, a 6 month emergency fund when starting out helps- its your mini FU money

    Click to expand…

    Yea. My wife and I were looking for a house, but stopped a few months back knowing that we were going to ask for more. We have $70k in Savings, $30k left on mortgage (monthly payment only $1k/month including PIMI + HOA) for our condo. We were planning to sell but we kept 10% in savings in case we have to make an offer not contingent on us selling our home. $40lk in 457b as potential severance package. If my wife quit her job in 3 months we would have enough to live here for years. She makes $120k so we are good. But I have 1 job that I know I could start in January if I called them today.

    I feel like I hold the cards and I pushed all-in. They only have 2 options now, fold or call.

    #241515 Reply
    Avatar ZZZ 
    Participant
    Status: Spouse
    Posts: 707
    Joined: 06/18/2018

    “I feel like I hold the cards and I pushed all-in. They only have 2 options now, fold or call.”

    Love it.

    #241520 Reply
    Liked by Peds

Reply To: Neurohospitalist Part III: The Saga Continues [Administrator shell game?]

In case of a glitch or error, please save your text elsewhere, clear browser cache, close browser, open browser and refresh the page.

Notifications Mark all as read  |  Clear