Call coverage

~~Babied~~ Pampered new medical graduates are successfully dictating the call coverage they want:

One practice I met with was trying to recruit a pediatrician. The practice is in a small rural community, and the doctor it was negotiating with wanted to work only from 9 to 5″”no weekends, and no call. He also wanted a lot of time off.
The practice couldn’t offer that, so the doctor took a job in another small community that apparently was able to meet his terms. With the shortage of doctors in specific specialties and the difficulty in recruiting to small rural areas, we’re seeing all sorts of things that we didn’t see years ago.

Comments

Anonymous
Don’t hate the player, hate the game. Not to point out the obvious, but it’s an unattractive area of practice.
If there is so little to draw doctors there, then extraordinary concessions must be made. It appears that only a moral burden is keeping those currently practicing physicians there. It is not incumbent upon another physician to carry that moral burden for them.
Anonymous
My community we have a female OB/GYN who’s only doing GYN. She’s in her late 30′s. Completely outpatient practice and GYN surgery only. Not a seniority thing, just able to do it.
More power to her, though it irritates me to see patients claim she’s more “caring”, while those evil male docs are the ones on call when there’s a real emergency out there.
This sort of thing comes to mind when I see these fights over call. No one values call, so why should they do it? Heck, like this particular lady, she’s rewarded for NOT taking call. Nice and refreshed with a beauty sleep while the male down the street looks like he’s been up all night……because he has.
You want doctors to take call? Pay the doc what that after-hours work is worth. I know I have to pay through the nose for the plumber to show up after-hours for an emergency.
If the doc was able to negotiate a 9-5 job, I can’t blame the doc in the lease.
Anonymous
I used to fall for that “pampered” crap. There is absolutely nothing wrong with people sticking up for themselves. Name calling and guilt trips are no longer effective negotiating tools once someone fully matures.
Is it that they are “pampered” or that they are no longer so sequestered in the hospital during training that they graduate residency at 30 with the social maturity of 18 year olds?
DR. MARY JOHNSON
For years rural Pediatricians have been treated like dirt . . . and were regarded as “a dime a dozen” by the overpaid suits running some of these tiny/in-the-middle-of-fricking-nowhere hospitals . . . because there always was another naive/broke/trusting newbie coming out of training to take their place.
The suits would promise the world to get somebody there . . . then break every promise, work them like dogs and burn them out.
Many of these places have become revolving doors . . . and they DESERVE to be.
The “players” are getting smarter. Good for them!
Anonymous
I must have missed the last time someone called a CEO pampered for negotiating a luxurious benefits package.
Oh wait, because it has never happened in human history.
Buckeye Surgeon
Way to go. Let’s see how much we can tarnish the notion of the Doctor as a selfless, caring member of society. Kudos to you Mr Pediatrcian, ace-negotiator. I’m surprised he wasn’t able to get a weekly massage included in the package.
DR. MARY JOHNSON
Kevin is probably going to delete this one, but diving headfirst into public service in my small hometown . . . being “selfless and caring” (taking all the back-up call and cleaning up all the messes) . . . got me fired and sued for “libel” and swindled at settlement by those who WERE selfish and did not give a damn about anything but their corporate bonus.
During litigation, the lawyers all told me that (in economic disputes) the public generally did not empathize with doctors because we’re perceived as greedy snobs . . . “rich” and unworthy of sympathy. So much for Buckeye’s theory on society’s notions . . .
I sometimes wonder where I might be had I just negotiated a good deal with a private practice in a nearby larger town.
Anonymous
Sheesh Buckeye. Pediatricians are the lowest-paid of all physicians. Here’s a pediatrician who negotiates a little something better and you’s think the doc was Simon Legree.
Anonymous
More power to the pediatrician! Not until we begin to demand fair pay for previously “free’ services like being on-call will the hospitals cough up a smal fraction of the profits they make off our backs
Anonymous
Is this so outrageous? My family Doc. has been doing this for years on end. He works M-F from 8 am until 4:30pm, they are closed for a hour for lunch, and they have no one on call in the evenings or weekends. If you call there after hours you get a voice message saying to call back during business hrs., or if you have an emergency to call 911 or to go to the ER. His office has been like that for at least the last 6-7 years that I know of.
DR. MARY JOHNSON
Everyone expects Pediatricians in these places to take call 24/7 . . . or, in the instances they do have help, every other day or sometimes every third – including weekends. You cannot be more than 10-15 minutes from the hospital you’re covering as you’re usually expected to attend C-Sections (which now approach 30-40 percent of all deliveries in many places).
So all of the lovely locales your little town might be near (usually featured as “pluses” during recruitment) do not matter because you can NEVER leave town.
Add the fact that most of these hospitals refuse to offer any kind of meaningful after-hours answering service to triage calls – which means the Ped must answer every phone call (for which the doc is not reimbursed, but can most certainly can be sued over) from parents who want Walmart hours and who do not understand/appreciate/care what constitutes a true emergency (that would justify an interruption of the doctor’s private/down time).
The phone calls can be delightful. A Mother once threatened to have my privileges yanked at a small town hospital I was covering – because I did not call in antibiotics for her child’s sore throat on a weekend. I was covering a practice during a difficult transition and had never seen the child . . . moreover, an urgent care was open within reasonable driving distance (an option I suggested in lieu of a trip to the emergency room – I long ago stopped meeting people outside of regular office hours – it’s dangerous). The woman was vicious when she did not get what she wanted. I have never forgotten the call – it was one of those, “Why am I doing this?” moments.
The older docs snort and grunt and say they “always” provided comprehensive coverage – but in truth, they did not – at least not under the pressures and constraints and outside influences that exist now. Times have changed greatly.
Anonymous
pampered/babied?
1. you sound old
2. you sound mad that you didn’t/couldn’t negotiate something like that when you were younger.
we know we’re in demand, we’re gonna call the shots.
why not? we worked hard, we deserve it.
Anonymous
It has been said that medicine is a harsh mistress. She is now haggard and bitchy and the sex isn’t so good anymore–she is no longer worth 24/7 slavery.
Happyman
pediatricians get royally screwed by hospitals and insurers. in metro NY, the pediatric hospitalists (my wife is one) make $60/hr (WITHOUT benefits), which is on par with many nurses these days. many NPs i know make a lot more than that.
why all that responsibility, overnight work, etc. for so little???
pediatricians owe nothing to anyone except themselves. Their numbers are dwindling because nobody understands that except them.
Anonymous
I agree with Dr. Johnson. Unless I know the patient or know for certain they are a recent and regular patient of one of my colleagues, I won’t see them in the office after-hours, only through the ER. Opening the office after hours is dangerous and fraught with liability, especially when you don’t know the true condition of the patient or who may be with them when they arrive. If the patient is really unstable–medically–you seldom have staff support to get them to the ER. If they are mentally unstable that is potentially even worse. I always see the cops at the ER when I go in; at the office there is no security and I’m not sure how quickly the police would get there if there was a real need for them.
As for negotiating call, more power to them. It is one of the few things that doctors really have the power to accept or refuse, with so much of the payment determined by Medicare and private insurance tables.

Call coverage

Related Stories

More in Uncategorized

Comments

Site

Channels

Subscribe

Related Stories

More in Uncategorized

Comments

Site

Channels