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New Contract a worse deal?

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  • wonka31 wonka31 
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    The only other thing to keep in mind is that although this hospital seems to be stable, a new group may not be. This situation seems a bit fishy as more posts come in, especially the part that EMS directs uninsured patients to certain hospitals. The hospital will then filter only the highly insured out of this already supreme pool of patients to the ‘new group’. This sounds like a weird set up, assuming it’s accurate. As Tim mentioned above, the other groups getting patients from the lower payor mix will inevitably be unhappy with this. If these are private groups, you can almost assume that some or all will pull out when their contracts are done, assuming it’s not a set rate and is based on billing. This may or may not affect you or the ‘new group’, however it’s something to take into consideration. Some of these details will be difficult/impossible to tease out, but it sounds like they’re selling you on an amazing opportunity which may not end up being super duper amazing.

    #216311 Reply
    Liked by Tim
    ACN ACN 
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    Sounds like a typical hospital system. Bringing in their own physicians and kicking out the local private guys.

    Short sighted by hospitals imo.

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

    #216315 Reply
    Liked by wonka31
    CordMcNally CordMcNally 
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    @cordmcnally

    I’m not sure exactly. But the way it usually works is we have a pretty big medical center. And when patients come in via EMS the uninsured patients are usually directed to certain hospitals. And the insured patients come to this and a couple of other particular hospitals. However that wouldn’t stop a homeless person from walking into the ER… perhaps the uninsured may be given to academic teams

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    This sounds shady at best and highly illegal at worst. Does the ambulance come to the hospital and then that ED decides which ED they go to (you state when the patient comes in via EMS)? How does this work exactly at this place?

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
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    #216316 Reply
    Liked by wonka31, childay
    Avatar cher25 
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    Splash Refinancing Bonus
    with the exception of the commute. 

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    I would take a paycut to avoid a 2+ hour commute every day.  How much of a paycut?  Hmmm

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    but I would probably take a 40 K pay cut if I could cut my commute by 1 hour each way.

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    I swear I’m losing life on this drive! I was under this false assumption/fantasy that I’d leave before traffic daily keeping the commute down to roughly 40 min each way. And that this would be a lovely time to catch up on podcasts. I easily spend 1 hour and with accidents 1 hour 15 min every single day except weekends driving each way! And half the time I’m too stressed from bumper to bumper traffic to listen to the podcasts! lol I can’t move near work because it would be 60 miles from family which would really suck on my off weeks! The 5 mile drive to the new job is one of the most appealing aspects. The commute got old very quickly! I’m glad I tried it though. Now I know that I am not willing to do that and will absolutely take this into consideration for any future job.

    #216319 Reply
    Avatar cher25 
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    This sounds shady at best and highly illegal at worst. Does the ambulance come to the hospital and then that ED decides which ED they go to (you state when the patient comes in via EMS)? How does this work exactly at this place?

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    I may be misstating things but we have such a huge medical center that in general when someone is coming in via EMS it’s established prior to arrival what insurance they carry. This determines which one of the 5-6 hospitals in the 5 mile radius that they go to. 2 of which are county hospitals, one VA. Of course, I’m sure if someone uninsured landed in the hospital they’d have to see them. This is the way it works at my current job which is outside of the major metro medical center.

    #216322 Reply
    Avatar cher25 
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    Thanks again to everyone for your input

    #216325 Reply
    childay childay 
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    your current job sounds like crap. 18 pts a day is a lot

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    Was wondering about that also.  Anyone comment on average daily load for hospitalists?  Assuming no APRN or residents etc.

    #216326 Reply
    childay childay 
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    And half the time I’m too stressed from bumper to bumper traffic to listen to the podcasts!

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    Not all commutes are created equal, even aside from time.  I know when I used to do it in heavy traffic similar timeframe I would be so pissed, showed up at work hating humanity.  A nice leisurely drive it was not.  I usually took the train instead..

    #216328 Reply
    Liked by cher25
    fatlittlepig fatlittlepig 
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    your current job sounds like crap. 18 pts a day is a lot 

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    Was wondering about that also.  Anyone comment on average daily load for hospitalists?  Assuming no APRN or residents etc.

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    Avg 10, 0 admits.

    #216337 Reply
    Liked by Peds, childay
    Avatar cher25 
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    childay wrote:Was wondering about that also.  Anyone comment on average daily load for hospitalists?  Assuming no APRN or residents etc.

    This is actually a reasonable load for my market. We typically start our day with 15-16 and take 2 to 3 admits during the day. I find I’m averaging 18. My worst day I saw 21. Other private groups and hospitals are easily seeing 20 – 25.

    #216366 Reply
    Avatar ZZZ 
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    “we have such a huge medical center that in general when someone is coming in via EMS it’s established prior to arrival what insurance they carry”

    Your EMTs are confirming insurance and directing the destination based on that. So they go scoop someone off the highway from an MVC, quickly stabilize them, then rifle through their wallet to find their insurance card.

    Color me skeptical.

    #216399 Reply
    Liked by MPMD, Panscan
    Avatar mxg67 
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    I’d consider taking a leap of faith just for the commute alone.  If it doesn’t work out you can find another job, it doesn’t seem like hospitalist jobs are terribly difficult to find.

    Irrelevant to the OP’s decision, but I find this hospital change interesting, certainly seems like a power/money move with repercussions that’ll affect plenty of doctors (mainly the PP folks).  It’ll be interesting when this takes hold, how it’ll play out.  Having lived in texas w/ some connections still there, I think I know which hospital is job #2, the uninsured thing caught my attention.  Not illegal I think but certainly shady and probably nothing I’d worry about being a simple hospital worker bee.

    #216408 Reply
    Liked by Zaphod, cher25
    Avatar DCdoc 
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    More money (potentially a lot more), benefits, PTO and no hellish commute. Seems like a no-brained. If you take it, please update us in a year. I always see posts like this about potentially changing jobs weighing pro/con but never see follow up.

    #216420 Reply
    Liked by cher25
    Avatar Tim 
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    Having lived in texas w/ some connections still there, I think I know which hospital is job #2, the uninsured thing caught my attention. Not illegal I think but certainly shady and probably nothing I’d worry about being a simple hospital worker bee.

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    Dallas and Houston have “county hospitals” and “non-profits” Level 1’s. Parkland and Ben Taub are subsidized for the “indigent care”. That being said, I am sure EMS is cognizant of that but does not give a flip. Their role is “transport or Life Flight” and can they drop off at the nearest hospital. From the hospital system standpoint, capacities and wait times would be the “metrics” dispatch would be used based on the severity of the condition. Some one’s preference would be honored, but these places are packed. The “metrics” would be influenced by the hospital system, NOT by EMS digging into a pocket for a health insurance card. I don’t know if “insurance” is even allowed in the data collection. When you move down the line of Levels, local would be the primary factor. Get the EMS group back as available. An EMS making a decision based on an “insurance card” appears to be a “conspiracy theory”.

    I personally have my preference, no “county hospitals”, period. But I have insurance.

    #216431 Reply
    Avatar Tim 
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    This is Houston. You will never beat the traffic. You need to move or change jobs. Family commute time is flexible compared to daily “rush hour”. Yes, everyone in the MedCenter works your schedule too. You started on comp, but the location is a huge problem.
    The point is your current job is unsustainable. Deal with it. There are other options both now and later. Private group turnover is replaceable as well. No shortage of competition. Patient mix is what it is.

    #216459 Reply

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