Termination as a Per Diem Physician

I got this email from one of the telemedicine companies for which I did per diem work and thought I’d share it with you guys.

It was a blank email with this pdf attached which they have also snail-mailed to my house. It’s in response to my medical license having been suspended for 30 days in Oregon and California.

This is the first termination letter sent to me though I suspect there will be several others.

Reporting Medical Board Action

Unfortunately, it’s not easy to report a medical license suspension to any entity, whether employer, state medical board, CMS, or a malpractice insurer. If you don’t do it right you could create more trouble for yourself.

The reason I haven’t gotten around to this telemedicine company is because every single reporting process is quite involved. For each one I need to consult my lawyers – 3 of them, each from a different state. Each lawyer needs to review my employment contract with the medical group and then draft and appropriate letter explaining what exactly happened between me and the medical board.

It hasn’t even been a month and I got this curt letter from this telemedicine company. This tells me how little this medical group cares about their per diem physicians. It’s not a good feeling to be treated as easily dispensable.

I wasn’t offered a chance to explain the situation – only this cold termination letter.

Before putting in extra effort for an employer, ask yourself, will they value your efforts or kick you to the curb as soon as something comes up. I had a similar experience with Kaiser Permanente.

This isn’t true with every employer. Two other telemedicine companies are looking into my situation in order to decide if I should be allowed to continue practicing on their platforms.

Employment History

I have worked with them for a year. There was a lengthy onboarding process and I have picked up a ton of shifts with them.

My patient satisfaction scores have been 5/5 with nearly every patient. I never over-prescribed medications and never did anything against their protocol.

At one point I inquired about a full-time/part-time job and I was offered one right away. I didn’t take it because I didn’t want to give up working for other telemedicine companies, precisely in case something like this were to occur.

I take my income diversification even more seriously now, after the medical board license fiasco. Remaining per diem and having multiple clients is much safer than relying on a single income from a single employer.

The Term ‘Termination’

As for a telemedicine company for which you perform per diem work, what’s the purpose of them terminating a physician? They could just stop offering you telemedicine shifts. Termination is an extra and unnecessary step for them.

There are two main reasons to terminate a per diem physician who is obviously an independent contractor. One is retaliatory. This mars the record of the physician since they would need to report terminations on future applications.

The other is to protect yourself against a lawsuit or unemployment claim in the future.

If a telemedicine company wanted to play it safe then they would simply not offer you more telemedicine shifts. Numerous reasons could be used for that and nobody would be the wiser.

Taking the extra step of terminating a physician has more consequences for a company. It’s on the medical group to prove that you needed to be terminated. In our world that almost always requires them to prove that your clinical skills were subpar.

Treatment of Physicians

I was disappointed to receive a curt email from another physician with whom I had conversed quite a bit in the past. With all the talk of burnout and physicians getting harassed by medical boards, medical groups, and patients, I have higher expectations from fellow physicians.

If you’re a physician, don’t treat a fellow physician like shit. If every person in every profession does the same for their colleague, that’ll create a sustainable workplace for everyone. Don’t sell out just because of your paycheck or your position.

I’ll continue to diversify my income streams because I never know what will happen in the future. Even if I’m seemingly doing well at a particular job, external factors may threaten my position, employers may retaliate.

Telemedicine Per Diem Work

There are a lot of telemedicine companies out there, with new ones added every few weeks. As CMS and private insurers are increasing their telemedicine reimbursement rates, telemedicine is gaining more traction.

I miss seeing patients in person but don’t miss the risk of it. I have decided to resume my clinical volunteer work which I gave up in the light of all the medical board investigation drama.

As for earning an income from medicine, I find telemedicine gratifying and anticipate continuing with telemedicine work in the near future. The work is easy, the income is high, and there are plenty of companies to choose from.