The “90 Day Contract”

flying cadeuciiAt age 77, having been through all of the fun and games of dealing with the New Hampshire Board of Medicine, a predatory local Hospital CEO, and other adversaries, nothing should surprise me anymore. But, I am surprised that intelligent, well-educated physicians would sign a “welcome aboard” new employee contract, a contract that allows their employer hospital to fire them without stated cause and throw them, literally, out the door using the security guards to do so, and without even time to clean up their offices.

Most doctors, however, are now hospital employees, and have knowingly or unknowingly, signed exactly such a contract.

I am aware of no other country in the world where this type of chicanery takes place.

If, in fact, we as a country are genuinely interested in improving hospitalization outcomes, then a healthy debate about what went wrong and what to do about it, between the medical staff and the administration of a hospital  is the only method I am aware of that brings change. If you exclude anything approximating a differing opinion from that of the business school graduate who runs your hospital, and you are faced the threat of firing if you venture to propose an alternative to the status quo, then how does useful change occur?

I have the sense that this is a debate that is over, and that whatever I may think or say it is too little too late.

Perhaps I am wrong.

My advice  to any physician, currently or in the near future, who is graduating from a residency program, and applying for a position with a hospital (there are almost no other positions available) that you should read your contract very carefully, and tell the HR department that is so eagerly trying to get you to sign a contract, that you will not sign a contract with such a clause in it.

State clearly that if you are to be fired, it shall be with clear stated cause, and no other way.

Then, at least you can litigate a “wrongful termination”

America has sunk from the best medicine in the world on a WHO outcome analysis basis, to about 40th in the world, all in the past 7 to 10 years, or about simultaneous with the trend wherein  hospital corporations replaced friendly the local, genuinely “NonProfit”  hospitals which were operated by people that you knew, and whose goal was to serve the community they were in, not to take home the sevenfigure salaries and leave an enormous landscape alteration in their wake.

My local hospitals, when I came here 25 years ago, to semi rural Rochester New Hampshire, were all     so called “cottage hospitals”, which were small and had a limited number of beds, were staffed by local people who understood their contract with the community quite well, and referred cases beyond their scope down the road to the referral hospital.

That has all changed. Now the local hospital is trying to duplicate all of the machinery and all of the services that the referral hospital once offered.

If this is either an economy, or a means to improve hospitalization outcomes systematically, I am a monkey’s uncle.

A 90 day contract is the antithesis , a 180 degree corruption, of the original purpose of the hospital staff and administration purposes of not so long ago, which was to bring good doctors into a community, give good service, reward innovation, and dedication, and pass the torch on to the next generation.

Terry Bennett is a physician based in New Hamspshire.

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