Employment situation - What would you do?

[dirtbiker]

I am primary care physician working as a salaried employee. I've been in practice out of residency for about 3 years now. My working situation is rapidly going downhill unfortunately. The hospital I work for was bought out by a small family-owned private company, and it has been cut, cut, cut. They immediately canceled all our employment contracts, gave us new ones with lots of financial cuts (that I have not signed yet), stopped 401K matching, decreased compensation for supervising mid-level providers, increased the number of mid-level providers I am supervising, and immediately stopped my monthly student loan repayments, that I had nearly a year left of (which I only found out when I checked the balance on my loans). Several other providers have retired or quit, so the call schedule has been brutal as well. I also had to take over the full patient load of one of the physicians in addition to my own, so my working hours have increased as well.

On the plus side, I work a 4 day work week with long weekends. As long as I'm seeing patients and getting notes done on time, I don't have someone breathing down my neck, and I have a lot of freedom.

I've been looking at new employment due to the cuts and found one I really liked with a generous pay raise, great starting bonus, a good student loan repayment program, and much better call schedule. The downside is it is a large hospital system with a lot of oversight, and I suspect more people breathing down my neck.

I did the first interview and discussed the schedule, and they agreed to continue my current 4 day work schedule exactly as I have it now . I then did the second interview and was very happy with everything and was ready to sign on, but then (after I re-inquired) was told that what we had previously discussed regarding the schedule would not be available, and that I could have a middle-of-the-week day off. I know this may sound trivial to argue about what day of the week not to work, but I've grown accustomed to long weekends, and we take advantage of it with frequent cost-effective mini-vacations in our RV. This bait-and-switch also leaves a very bad taste in my mouth. In addition, with 21 years in the Army National Guard with four deployments and long, often 100+ hour work weeks throughout med school and residency, I've missed a lot, and am finally making up for it.

There aren't many other opportunities available without relocating or long commutes, which I'm not willing to do at this time. It's in a part of the country that people generally don't want to move to, and thus they generally have a hard time finding physicians, so I do have some power in this regard.

I already told them that the change in schedule is a deal breaker, and that I regrettably decline their offer as it stands. Do I stand my ground, even if it means I lose out on this job prospect? Am I making too much of a big deal about this day off? Every day that I stay I'm losing money - between student loan reimbursement, salary, and 401, I lose about $100k annually staying where I'm at.

 

[mystang52]

Personal time is valuable, and the long weekends you had was no doubt glorious to your lifestyle. But having never been a doctor, I would have a hard time turning down the job offer, especially since you mentioned that doing so will mean $100,000 less a year in disposable income.
If you have other possibilities pending, then you may want to roll the dice. If not, from my perspective I don't see much of a choice for you but to take the new offer. All in all, it still looks like a darned good deal.

 

[njhowie]

The market is driven by supply and demand. Simple as that.

If the situation limits supply, then maybe you have some leverage. On the other hand, if the hospital knows that you don't have any alternatives locally, then maybe they decide to put you on hold while they continue searching for someone who is not so unwilling to compromise on what they want.

If you believe that you're the only one who has the requisite skill and experience, then by all means, hold out for what you want. However, make no mistake, there are others out there who will fill the position willingly and make the concessions the employer is looking for, simply a matter of them finding the person - even if they need to look outside the local area and relocate someone.

DW is a physician and the mailers and phone calls come continually from the recruiters. Very professionally done mailers pitching opportunities - some just like yours, to places nobody really wants to go, with schedules which really aren't ideal. But, they are offering a very nice salary and benefits package, and they find folks who are willing to relocate to do it.

My view - you need to decide what's important to you. You sound like you're mid-career, maybe late 40's or early 50's. You're getting your 4 day work week - that's a big plus. So you don't get your frequent mini vacations, big deal - you'll have plenty of opportunity when you do retire, and the extra $100k/year can make it happen that much sooner. You're getting an extra $100k/year and what sounds like an excellent benefits package. You're still going to get your 4 weeks of annual vacation time, sick days, etc.

I'd reconsider, and call them back accepting their offer if they are still good for it. That's just me and knowing how DW's job searches have gone as far as an offer goes and then taking commute time into account. You have the most important things in your offer - number of days/week, the commute you want, and the salary and benefits you want.

Don't look a gift horse in the mouth.

 

[HarveyS]

Better they told you about the schedule issue before you took the job than a month later. Schedules can change, as well as (as you found out) all the other compensation items.

I'd take the job for the $100k, and work toward getting the schedule worked out in a year or two.

 

[RetireeRobert]

I would not give up on the potential new employer.

First, consider that you would still get weekends off. Not three days but two, and you can still do lots of quality activity with your loved ones on traditional two day weekends. Most working people have operated that way for decades. Bonus, you would get a middle of the workweek day off as well for some surprise activity/rest/relaxation/rejuvenation---this "besides" the weekend. Lots of people would kill for that.

So, how about this thought: approach the potential employer and ask "if you accept the 4-day workweek with Wednesday off and weekend off TO START, would you be able EVENTUALLY to get to a schedule with all three days off at the weekend, either Fri/Sat/Sun, or Sat/Sun/Mon?".

Leave the term "eventually" undefined in your question to the employer, and it would be really really easy for the employer to say---when can you start?

That way, you have a very good (albeit not "perfect") employment situation to enjoy for now. Plus the employer would be on record indicating you can change your schedule down the road, so that at some point, whether it is two years, or three years, or four years down the road, you can morph to what you now view as the "perfect" schedule. All the while reaping the extra $100,000 a year, the student loan repayment, etc.

And who knows, maybe you will grow to enjoy the advantages of that middle of the week day off in addition to traditional weekends.

Worth a try to garner a potentially "eventually" perfect employment situation!

 

[njhowie]

So, how about this thought: approach the potential employer and ask "if you accept the 4-day workweek with Wednesday off and weekend off TO START, would you be able EVENTUALLY to get to a schedule with all three days off at the weekend, either Fri/Sat/Sun, or Sat/Sun/Mon?".

Leave the term "eventually" undefined in your question to the employer, and it would be really really easy for the employer to say---when can you start?

If it's not written in to the signed employment agreement, it's meaningless what anyone says - and employer will not write this undefined "eventually" in to any employment agreement.

 

[disneysteve]

I'm a family practice physician too, except I'm nearing the end of my career instead of just getting started like you. I can tell you that there is no upside to staying in a job where you are unhappy. The way you have described your current situation raises a huge red flag that it's time to get out - probably past time.


Take the new offer, but that doesn't mean you have to stop looking. Sure, you might lose your 3-day weekends but you'll get a better call schedule which helps offset that. Plus you get better pay and other benefits.


One thing you didn't mention is PTO. At my current job, I get 7 weeks of PTO. My schedule is such that I have a 3-day weekend every other week. What I often do is take PTO on Thursday of that week which then gives me 5 days off since I'm also off on Wednesdays. So if I wanted to, I could do that 21 times a year and have 21 mini 5-day vacations.


I'm actually no longer in family practice due to all of the reasons I'm sure you can already think of. In April 2016, I started doing per diem work at urgent care. I liked it so in February 2017 I dropped my FP to part time and made UC part time. Then on September 28, 2017 I left my practice for the last time and have done full time UC ever since. My income doubled. My total compensation is fantastic. My stress level is next to zero. The hassle factor is almost entirely gone.


Take the new job. Then keep looking around, and be open to whatever is out there, even if it isn't a typical family practice setting. Maybe it's urgent care. Maybe it's doing case reviews for an insurance company. Maybe it's doing peer review for a legal firm. Maybe it's a medical director position for a nursing home. There are all kinds of opportunities for physicians beyond just going to an office every day and seeing 6 patients per hour.


Good luck. Keep us posted.

 

[RetireeRobert]

If it's not written in to the signed employment agreement, it's meaningless what anyone says - and employer will not write this undefined "eventually" in to any employment agreement.

Uh, really? You miss the whole point--which is for OP to have a hook to go back to this employer and get the job! A "verbal" hook that saves face for both parties.

And even if "verbal", who says in this case his schedule with this new employer cannot be eventually changed anyway, by whoever is in charge of scheduling, to what he wanted in the first place? Just because some legalistic mumbo jumbo was "not written" into an employment contract?

Chill a bit and let the OP get the new much higher paying job. The timing of that one day a week off will no doubt naturally work itself out after he is on the job awhile and the employer is satisfied with his performance.

 

[MarieIG]

I would take the new job - and keep looking while your loans are being paid down.

 

[Texas Proud]

The extra pay and benefits such as student loan payoff etc is MORE than enough compensation for working the extra day...


Now, if they said you were expected to work 60 to 80 hours a week then no I would not take it...

 

[RetireeRobert]

The extra pay and benefits such as student loan payoff etc is MORE than enough compensation for working the extra day...

As I understood OP's original post, he will "not" be working an extra day. He will still have a four day week. It is "which" day of the week he gets a third day off that is the issue. OP wants a three day weekend (i.e. gets off Fri/Sat/Sun, or Sat/Sun/Mon), but employer wants to give him a Tuesday or Wednesday or Thursday off "as well" as every weekend.

 

[CSdot]

I saw that one poster said take the job, but keep looking. That may be the answer, BUT ask to see what you will be asked to sign before you take the job. I draft and negotiate legal documents for medical/dental practices and doctors/dentists in my state. Sometimes I represent the practice, and sometimes I have the doctor. Most of the packages involve at least the ask by the practice for a 2-year geographic noncompete/nonsoliciatation agreement. I know in many states noncompetes are looked upon with disfavor (including mine), but they can sometimes cause your next employer to pause before hiring you out of fear of litigation.

*An interesting note, my state's Bar Association decided noncompetes are unfair to clients who should have the absolute right which attorney to hire, so law firms don't even ask lawyers to sign them as they would be unenforceable. Guess the hospital groups have too much sway over the medical licensing authorities, or doctors would have a similar prohibition.

 

[njhowie]

Plus the employer would be on record indicating you can change your schedule down the road, so that at some point, whether it is two years, or three years, or four years down the road, you can morph to what you now view as the "perfect" schedule.

If it's not written, employer is not on record for anything.

Uh, really? You miss the whole point--which is for OP to have a hook to go back to this employer and get the job! A "verbal" hook that saves face for both parties.

And even if "verbal", who says in this case his schedule with this new employer cannot be eventually changed anyway, by whoever is in charge of scheduling, to what he wanted in the first place? Just because some legalistic mumbo jumbo was "not written" into an employment contract?

Chill a bit and let the OP get the new much higher paying job. The timing of that one day a week off will no doubt naturally work itself out after he is on the job awhile and the employer is satisfied with his performance.

So, you believe going back and asking for something which could possibly happen in the future but there is no obligation to provide is saving face? Ok, as you like.

Enjoy yourself playing and recommending whatever kind of fantasyland game it is you're dreaming of.

If he wants the job, accept it as offered. If he wants to play games, by all means, you've given him superb advice.

I'm done here - carry on.

 

[disneysteve]

Schedules change. They just do. No verbal agreement or written contract will prevent that. Practices adjust their hours to suit the needs of their patient base and their business needs. My practice used to have evening hours twice a week. Then we cut it back to once a week. Then we eliminated them completely because they just weren't that popular, had a high no-show rate, and it wasn't worth keeping the office open for the handful of people who actually showed up.


At my current job, my Monday and Tuesday schedule got flipped last year. As new providers join and others leave, the schedule needs to adapt to the needs and availabilities of everyone. It's just the nature of the game.


I would not turn down a job just because they wouldn't give me the exact schedule I wanted. Even if they do, there's no guarantee that it won't change 3 months from now.


Non-compete clauses are an age-old problem. Enforcing them is quite difficult. My current one bars me from practicing within 10 miles. I mapped that out and it actually puts me into the next state. Considering that as competition is ridiculous. I signed it but if I ever had to contest it, I doubt it would hold up in court.

 

[RetireeRobert]

So, you believe going back and asking for something which could possibly happen in the future but there is no obligation to provide is saving face? Ok, as you like.

So you think OP's alternative, staying in his current job in which he is over worked, stressed out, and underpaid, rather than nailing down the new job with one day off "on the wrong day" (not "contractually" guaranteed) is the way to go?

He "saves face" by getting that new job with much higher pay, student loans repaid, and only one day off "on the wrong" (i.e., not his preferred) day of the week.

But it seems you would rather he blow it all and be miserable in his old job because he "insists" on a written contract with the new potential employer "guaranteeing" which day of the week that third day off is?

My friend, your legalistic approach to job hunting and job terms, in my opinion will only serve to keep OP unhappy in his current situation. Remember he said he works in an "out of the way" area with not many employment options. He seemed loathe to move from that geographic area.

Carry on.

 

[RetireeRobert]

If he wants the job, accept it as offered.

He already turned the job down "as offered". Hard to accept something which is no longer on offer.

 

[pacergal]

I would take the new job, it sounds like the compensation in the long run is more beneficial.
Perhaps you could negotiate having Tuesday or Thursday as your mid week day off, and add a vacation day on Mondays or Fridays when you want a longer time off.
You may find a mid week day off very positive, I know I did when I worked a four day work week in my younger years.
Good pay, sign on bonus, student loan repayment sound like a good deal.
If you are doing your job well, higher ups "breathing down my neck" as you stated, would not necessarily be bothersome. But it depends on what that type of oversight means.

 

[cyber888]

Take the Job ! Any new job will normally have a brutal schedule for new employees .. hey, you're new, and they give the new guys the worst schedule. That's what happens when you are newly hired. Prove your worth, then .. you can negotiate for a better schedule. The "breathing down your neck" is normal for any new job - all companies evaluate and scrutinize new employees with a hawk eye. I remember starting a new job 5 years ago .. all eyes are on you. Just part of reality.

 

[disneysteve]

The "breathing down your neck" is normal for any new job - all companies evaluate and scrutinize new employees with a hawk eye.

I think OP is referring to a different sort of "breathing down your neck". As a doctor in independent practice, you have free reign to treat patients as you see fit. When you join a large organization, though, there are often guidelines and protocols and quality metrics that you need to follow and meet even if you don't agree with them. You live and die by those metrics and by customer satisfaction surveys. Medicine has become very retail-oriented in that sense. It can be very disheartening to feel that you're doing what's best for the patients but getting survey scores that fall below the target that's been set for you.

 

[CSdot]

I just re-read OP's post. If the new owners can tear up your existing employment contract and renege on much of what you were promised when hired (401k match, school loan repayment, workload, hours, number of people you will supervise, etc), what guarantee do you really have that your current employer won't tell you they can no longer accommodate your long weekend schedule?

I would be inclined to jump ship. Sounds like your new boss is only interested in the balance sheet.

 

[RetireeRobert]

I've been looking at new employment due to the cuts and found one I really liked with a generous pay raise, great starting bonus, a good student loan repayment program, .....

There aren't many other opportunities available without relocating or long commutes, which I'm not willing to do at this time. ..........

I already told them that the change in schedule is a deal breaker, and that I regrettably decline their offer as it stands. ......

To recap:
1) you hate your current job
2) you found a job you really like in the area you wish to stay in
3) there aren't many other jobs available in that area
4) you already turned down offer because of "one wrong" day off midweek
5) if you don't take this job, stay at hated old job you lose $100k + year

Does not seem like a hard choice to me.

But given you already turned them down, you need some way to reopen the conversation in a way this employer can live with. They already backtracked on the midweek day off--they must have had good reasons to backtrack on that one condition, such as maybe they realized they could not honor it "at this time".

Put yourself in this employer's shoes. Figure out a way to reopen the conversation with them.

 

[jollystomper]

This situation falls into what I call the "you can't have it all" category. Life is about tradeoffs. The tradeoff for a higher salary and better working environment far outweighs the loss of a 3 day weekend. And as others have mentioned, in the long run things can change for the better in the job job, and things can change for the worse in your current. I agree with those who say to reopen the conversation with the potential new employer.

 

[dirtbiker]

Thank you everyone for your advice. It does seem that the general consensus is overwhelmingly to accept the offer. To be clear, when I turned down their offer, I didn't firmly turn it down; rather I left the door open for further negotiation, and they're still very much so reaching out to me to get me in.

I may have also over-emphasized how bad my current job is. The new financials aren't good, and I'm working more, but I still have a great schedule, and don't dread coming into work. I don't see myself here for the long haul, but I can also afford to be choosy about finding just what I want. In other words, I'm not desperate to leave where I'm at as fast as possible. 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.

This being said, when I read your comments that I've found the perfect job, but just have the wrong day off, it does seem rather silly to hold out. To be quite honest, it's probably more about principle at this point. 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. After the first interview, my wife and I were both very excited that I would be able to keep my same work schedule, and even after the second interview when I was ready to sign the contract, I was told that at worst case I would have Mondays off (instead of Fridays), only to be told 'sorry, it's not available any longer' after I pressed the matter. It was a bit of a gut punch honestly.

I'm still mulling over what I'm going to do. I'll be sure to report back once I make my decision.

 

[Athermos4u]

You're only three years out of residency, won't move or commute a "long" distance, and missing three day weekends are a deal breaker? What's kind of medical career do you think you signed up for? Your patients are going to need you when it's inconvenient for you on occasion. It's a little early in your career to already be [difficult - mod edit]. Take the money, or the lifestyle, but realize it may not be your choice further down the road.

 

[dirtbiker]

You're only three years out of residency, won't move or commute a "long" distance, and missing three day weekends are a deal breaker? What's kind of medical career do you think you signed up for? Your patients are going to need you when it's inconvenient for you on occasion. It's a little early in your career to already be [difficult - mod edit]. Take the money, or the lifestyle, but realize it may not be your choice further down the road.

Just curious, were/are you a physician? I do resent your insinuation that my work schedule concerns are making me unavailable to my patients. We have groups and call schedules to cover the days and times we don't work.