Considering Becoming Permanent

Over 3 years ago, I started working as a locums for a geriatric practice that only accepts Medicare advantage plans. This company has clinics throughout the USA and continues to grow. Since then I have worked with them on and off because I truly admire their mission, and I like being accountable for my patient care. My most recent experience with them was in Chicago. I thought I was only going there for 3 months but kept extending because I really enjoyed it.

On day 1, the medical director was confident that he could convince me to become permanent. I laughed it off because that’s always the intention of sites, especially considering that his particular company has been trying to get me to go permanent with them for years now.

Surprisingly after my last extension, I was open to a discussion with him about going permanent with them. I was upfront about how I had previous offers from the company that didn’t match my needs. The medical director was also aware that it would be impossible for me to survive winter in Chicago.

Part of the offer was that I could spend 9 months out of the year in Chicago, and during winter months, I could work at one of their other markets in a warmer state. That seemed like a win-win to me.

There would definitely be a salary increase to make it worth it since my housing and car would no longer be paid for. I would also be eligible for quarterly bonuses since the particular clinic I work in is part of a shared savings plan. These bonuses can be up to $10k per quarter. In addition, if I made partner, which I easily could if I continued the way I have been practicing, I would qualify for an additional $5k bonus per quarter.

There is no time commitment, unless I want a sign on bonus. In that case I would have to commit to 1-2 years, which doesn’t seem like much.  

I was actually open to accepting the offer, considering the job only gets easier with time since you get to know your patients so well. And like I have said before, I have a special relationship with all of my patients here. However, once again it came down to PTO. When the chief medical officer of the company previously made me an offer (years ago), he would only provide 6 weeks PTO. I am used to taking 10 weeks off per year, so I could at most compromise to 8 weeks PTO.

The market president had a hard time fathoming how I would be able to provide great care to my patient panel if I am gone for 3 months (working in another market) and then gone for another 2 months (on PTO). I know it sounds ridiculous but in reality, I had already proved it can work. I accumulated my patient panel after winter (3 months of the year had passed). And throughout the 9 months I worked there I was gone for 8 weeks total for vacation.

I was still able to have the best patient outcomes in the market. I always had the least (if none) patients in the hospital. I had the highest Hedis score in the market. I was the first provider to have 80% and 90% of my patients flu vaccinated. I placed the least amount of referrals. And I was able to code high risk diseases well to get my overall risk panel significantly higher.

Since we couldn’t exactly come to an agreement, we decided to do a “trial period”. I was planning on ending my time in Chicago at the end of December due to winter. So I agreed to help them in one of their other markets for the next 3 months. The plan is for me to possibly return to Chicago in spring and pick up my patient panel there. This is a “trial” to see if we can actually make this permanent plan work.

This plan may seem a bit crazy but I honestly wouldn’t mind continuing to work in Chicago with my current patient panel. The medical director desperately wants to make it work since my clinic profited tons of money over the past 9 months thanks to me.

Stay tuned for where I am going next….