Kharma

This looks like it’s going to be a lengthy spiel. Hope y’all are ready!

Perhaps, in previous ramblings, I have touched on the assertion, I credit it to Ragnar Benson, relating that, if one were to consider the deaths and illnesses attributable to contaminated water supplies, it is not unrealistic to consider that it is entirely likely that plumbers, and assurance of safe water that is their stock-in-trade, have preserved more lives, and done more to alleviate human illness and suffering, than all the physicians ever born.

I remember this thought every time that I am credited with saving lives, or some such stuff. I am as good as I am, in large part due to the folks with whom I work.

And, then there is the lay-of-the-land aspects that can accompany cordial relations with your co-workers.

So, TINS©, TIWFDASL© in a walk in clinic in Da Nawth Country. It had been somewhat tumultuous , negotiating with my locums company, as they had contracted that I start on “Date A”, yet, 4 or 5 days prior to “Date A”, had informed me that things were not organized as needed, and some aspect of my credentialing was awry, and therefore I was not going to start on “Date A”. Therefore, I was not going to be getting paid, starting on “Date A”.

I acknowledged this tidbit. I asked when they anticipated my starting work, and starting receiving pay.

My recruiter could not tell me.

I noted that I had a contract stating that I would be working for The Locums Company, starting on “Date A”, and I anticipated starting to receive pay from The Locums Company, beginning on “Date A”.

The recruiter protested that, since I was not fully credentialed, I could not work, and therefore I would not be getting paid until all these wonderful things came together, and I was, indeed, working.

I set a limit. A hard limit. “Well, simply so that you understand how things will work, *SOMEBODY* is going to be paying me, starting on “Date A”. Your input into this conversation, is will it be The Locums Company, or will it be somebody else. And, just to make everything even plainer, whoever is paying me on “Date A”, will have my loyalty. That means that, if you folks are *NOT* the ones paying me, and you abruptly get your shit together, and invite me to start working at your client’s clinic, well, I am not about to pimp the folks who are providing me with a paycheck, simply because your organization is so grabasstic that you cannot get your credentialing in a group, by the date that *YOU* specified.”

He sputtered, “We have a contract! You have committed to work for us!”

I had read that contract. “Yep. You committed to pay me for my clinical services starting, oh, next Monday. Now come you, to inform me that you are not planning to pay me, starting next Monday. Now, I am not a lawyer, I do not play a lawyer on TV, and I did not stay in a Holiday Inn last night, but it certainly appears that you are proposing to breach one of the foundational elements of your contract, and thereby nullify the entire thing. If you are paying me, then my time is yours. If you have breached that contract by not paying me, then you can go piss up a rope.”

He continued to sputter. “I cannot simply approve paying you for not working.”

“Cool story. Howzabout you speak to somebody who can, indeed, authorize you to abide by the terms of your contract, and let me know how that turns out? As for me, I’m looking for work. If you get your shit together before I find other work, perhaps we can move forward in a mutually profitable way. If not, well, toodle-oo!”

The call terminated. I placed a call to Another Locums Company, with whom I had worked, and who had demonstrated that their stool was, indeed, in a pool. That recruiter and I had a cheery chat, and she promised to see what they had available, and call me back as soon as possible.

The next day, The Locums Company recruiter, who triggered this rant, called me back, breathlessly informing me that they *WOULD* pay me, as if I was working 40 hours, 9-5. In return, I would be on a 24 hour alert to report to the client clinic, upon The Locums Company’s notification that all had been ironed out. His tone was consistent with “…and don’t you try to weasel your way out of it!”

My response was, “Well, if you are paying me, then my time is yours, and I will be available to report for work as soon as is reasonable. 24 hours sounds reasonable.”

So, I hung around, puttering around, and after a couple of days, received The Call, shortly followed by a call from The Client Clinic. These worthies articulated concern. “Uh, you know we are up north, right?”

“Yep. I kind of had figured that out, in the course of the interactions with The Northern State Licensing Authorities. Those conversations led me to assume that this placement would be in The Northern State.”

“So”, they continued, “It’s January, and, well, we get snow here.”

“I had assumed that snow had something to do with your state’s reputation as a skiing destination.”

“So, have you ever driven in snow?”

This was surprising. If somebody had read, oh, the FIRST 6 INCHES of my FREAKING RESUME, it is exceedingly likely that this reader could figure out that I had spent considerable time in A Northern Fly Over State, wherein, every year, there was an abundance of snow on the ground for, oh, heck, 5 or 6 months of the year. My response did not, however, convey this surprise. “Uh, yeah, some.”

“Are you comfortable driving in snow?”

Another aside: it occurred to me that this particular line of inquiry might have been useful, say, during the freaking phone interview. Not the goddamned day before I was to drive my clinical ass up to start work. Again, my response was milder than my thoughts. “Yeah, I’m Ok with driving in snow.”

But, they were not going to let this go. “Are you sure? We really get a lot of snow, you know!”

I was over this line of conversation. “Look, I grew up in A Northern Fly Over State, we get assloads of snow every winter. If you have seen my resume, you will realize that, not only did I learn to drive in that state, I worked my way through Nursing school working for EMS in Da City in that very state. My children were born there, and every one of *them* learned to drive in the winter, in the snow. Since this is not Fairbanks Regional Medical Center, I am pretty sure that I have seen me some snow, and that I can handle it.”

I packed up my stuff, and set out for The Client Clinic.

I got oriented, and was introduced to the EMR. On my first day in clinic, I introduced myself to the registration staff, and the floor staff. Between patients, we swapped stories. This MA was prepping for Nursing school, that one was in undergrad for business. This other one was a survivalist, and prepping for The Zombie Apocalypse. (Kindred spirit, right there!)

A couple of weeks into the contract, things were tranquil. My MA asked me if I knew why my predecessor had quit, abruptly.

I allowed that I did not know all that much about it, simply that this soul had departed with inadequate notice.

Her eyes lit up. “Ahh! You need ‘The Rest Of The Story’!” She informed me that my predecessor had discovered that he, the clinician, had not been accredited with two of the most common third party payors in that area, and, since they were something like 70-80% of the payor mix, not receiving payment for care of those patients would present a cash flow problem of significant proportions.

It seemed that the clinic had elected to have this clinician’s visits billed as if another, credentialed, provider had in fact seen, interviewed, evaluated, diagnosed, and treated those patients. Since this was not exactly accurate, it potentially could get ugly. Very, very ugly.

When it appeared that this clinician would not see that situation remedied, right stat like, that clinician elected to remove himself from that particular pot of stew, immediately. Hence, the opportunity which featured me fighting disease and saving lives.

I spoke with my recruiter at once, and observed that, he either would provide satisfactory evidence that I was, in fact, credentialed with these payors, or I would unass that scene so fast that The Flash would ask, “What the fuck was that, that streaked right past me?” And, he did not have a lot of time to convince me that this was actually so.

An hour later, he not only effusively professed my actual credential-hood, he e mailed me copies of supporting documents, such that my black heart was grudgingly convinced that it was truff! (pronounced “True-ff”)

And that, boys and girls, is one reason that I treat my floor staff, and other co workers, nicely. That, and it is simply good manners.

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