Employment situation - What would you do?

[disneysteve]

I also want to find a job I can stay in for the next 20 years, rather than having to build another patient panel, only to leave them again. It is frustrating to grow a practice and build relationships with my patients, only to up and leave.

Sadly, medicine in general and especially primary care just doesn't work like this anymore. As we've transitioned from independent practices to a corporate and retail model for healthcare, the expectation that you'll be in the same place for decades has gotten increasingly unrealistic. On the patient's side, the likelihood that you'll have the same provider for decades is largely a thing of the past.
I work for a large healthcare system now. In the 5 years I've been with them, I've seen them open, move, and close many different offices in a variety of specialties. Everything is focused on the bottom line. I've seen new practices close in under a year if they weren't hitting whatever targets were set for them. I've seen providers shuffled around between locations. I've seen two locations merged, closing one of the sites. I've seen active, successful practices moved to new locations. And I won't even get into the changes that have happened as a result of COVID.


To be clear, I'm not saying any of that to discourage you. I LOVE my job and where I work now. It is worlds better than the 24 years I spent in private practice. You just need to go into it with realistic expectations.

 

[RetireeRobert]

..................
If they had been open and honest about the schedule from the very beginning, rather than giving me lip service to get me in (at least that's how I viewed it), I would have probably already signed with them. ................
I'm still mulling over what I'm going to do. I'll be sure to report back once I make my decision.

So, having Fri or Mon off is NOT deep down all that important to you---you said you "probably" would have signed "if" they had been direct about the schedule to start with.

Hard to tell what the office politics are on their side. Maybe the person you were interviewing with did not have the final say when it came to written contracts and scheduling. Maybe their legal eagle reviewed what clauses (such as guaranteeing a particular day off) would be advisable to put in a written contract, and nixed that idea as not wise from their legal standpoint. Or maybe Senior Emeritus Doctor Big who controls that practice thought a newbie getting bonuses/raise/debt repayments/and 4 day week was going a bridge too far on "which" weekday off be guaranteed in writing as well.

Very hard to say the dynamics on their side.

You only know whether you are willing to die on this hill or not---"I want Fri or Mon off guaranteed in writing."

If it were me, I would reenter the discussion with them, discuss what flexibility they "might" have in future about some later accommodation of your preferred schedule preference of Mon or Fri off.

Give them a chance to say "yes, a schedule change to your preferences might be open in the future". In the future AFTER you have been on the job awhile, proven yourself to them, worked your butt off for them, and you are a proven quantity to them. AFTER you are a proven quantity to them, "they" (whoever the powers-that-be are in that practice) might move heaven and earth to be accommodating to one little modest change in your schedule.

But that's just me. It is your life.

 

[dirtbiker]

The more I thought about it, the more I decided I didn't need to compromise. I have a high paying job, albeit with issues, that I don't need to run from right away. I find it hard to imagine myself where I'm at in the long term, but for now I can afford to be choosy. I did turn the offer down at the current terms. We both left the conversation on good terms, and I expressed my continued interest if the situation changes. I can think back to all the generous job offers I've received over the past few years in this area that I've turned down. The right offer will come up, I'm sure of it. If not, I won't have many regrets looking back knowing I've bet on myself. I'll report back if anything changes.

Despite not taking most people's advice here, I do thank you all for chiming in and giving me your advice.

 

[dirtbiker]

Update: I accepted a position with the same company I interviewed with in the OP. Same pay and benefits, but closer to my house and the work schedule I requested. I'm glad I held out.

 

[pacergal]

Glad it worked out for you.

 

[ExFlyBoy5]

Update: I accepted a position with the same company I interviewed with in the OP. Same pay and benefits, but closer to my house and the work schedule I requested. I'm glad I held out.

Good news, glad to hear it!

 

[jollystomper]

Update: I accepted a position with the same company I interviewed with in the OP. Same pay and benefits, but closer to my house and the work schedule I requested. I'm glad I held out.

That is great news! Congrats!

 

[dirtbiker]

Thanks everyone! I start there in just under a month, with only a couple of weeks left working here, and that can't come soon enough. It keeps getting worse at my current job, and they're squeezing every last bit of work they can by loading my schedule, including putting new patients on, which does the patient a disservice to meet a new primary care doc only to find out I will be leaving soon.

They also won't allow me to use my sick days since I put my notice in (and I've literally used zero sick days in the last two years). I have two weeks of sick time saved up. I came down with rhinovirus (lab confirmed), which I most likely picked up from work, and had to take a few days off so that I wouldn't pass it along to patients. My sick time that I took got taken out of my vacation bank, so now the two weeks I was going to take at the end turned into one week.

Because this company had canceled my contract, I was under no obligation to give any sort of notice if I didn't want to. However, I gave them over two months notice to make the transition easier for everyone. They also informed me that I was not allowed to tell any of my patients that I was leaving. The hospital CEO informed me that those patients are not patients of mine, but patients of the hospital. Ugh. T-minus 9 working days until I'm done here.

 

[pb4uski]

If you're under no obligation to give them notice and they are being jerks, perhaps you should update your last day to today.

 

[dirtbiker]

If you're under no obligation to give them notice and they are being jerks, perhaps you should update your last day to today.

I've considered it, but I can't move my first day up with my next job, so I'd lose out on nearly a month of salary. If I was going spend a month of salary, I'd do it on a new motorcycle or a European vacation!

So I'll just stew and complain for the next couple of weeks. Lol.

 

[pb4uski]

A month less of having to put up with current employer + a month of R&R

vs

A month of pay at current job.

Only you can decide.

 

[RockyMtn]

I would tell them to pound sand and walk out at the end of the day. Remember, as the CEO said they are the companies patients...not yours. Let the company take care of them!

 

[Golden sunsets]

If your coworkers or patients would be adversely affected by your early departure, then I wouldn't leave early. Take the high road.

 

[Brat]

If you do tell a patient that you are leaving what are they going to do, fire you?

 

[Texas Proud]

Not sure what state you live but I would complain to the state workers board that they are NOT paying you sick leave that you accrued.


It is illegal to just say 'no' here... there is no obligation to pay it when you leave, but if you are sick you get the pay...




I would tell them to give me my sick pay or today is my last day... I could care less about one months pay...


I would also say not to give me any new patients...



YOU have the power, so use it to your benefit.

 

[citrine]

Absolutely! Report them to the State Labor Dept...this is not kosher. This is when FU money comes in handy....I would tell them to stuff it and take a month off just chillaxing before the next job. Go on a few road trips, hang out and do some projects, and work on my tan!
I am glad you held out and got the exact schedule that you wanted! Onward to better things

Not sure what state you live but I would complain to the state workers board that they are NOT paying you sick leave that you accrued.


It is illegal to just say 'no' here... there is no obligation to pay it when you leave, but if you are sick you get the pay...




I would tell them to give me my sick pay or today is my last day... I could care less about one months pay...


I would also say not to give me any new patients...



YOU have the power, so use it to your benefit.

 

[Kerfuffle]

If you already declined, not sure what you can do, but I'd have used it as an opportunity to negotiate. Can't have the days off we discussed? Then how about additional PTO? (people do this more often than you might realize in job negotiations) Or additional $$? But if you already declined, I think you leave it at that and enjoy your continued long weekends. Everyone here is focused on that additional $100k, but without knowing your total compensation package, it's impossible to know how meaningful that $100k really is to you.