Earn 6-digits while moonlighting? Nahanap ko na

Hindi clickbait yung title ko. Totoo yan. Gulat din ako when I knew. Pero this is more of a vent than a job offer.

So there's this IM JCON post in a hospital in Parañaque that offers only 6K base pay for an IM JCON. I repeat, 6K.

*sorry, long post ahead. I just need to explain the system and context para magets

For IM JCONS please be careful in getting this post kung reliever ka lang, because really the "senior" GP regulars there have rigged the system in favor of them -- both sa workload and payout. Initially I thought, sige baka benign naman yung post kaya siguro ganito lang yung PF kasi may kasama ka namang GP ROD sa ER. But eventually after several times I relieved there, I have slowly been able to connect the dots and eventually saw the politics between the senior regular GPs and JCONs doon. Out of all hospitals I dutied in, this one had a very interesting and questionable system. Let me break it down to you:

The IM duty team is composed of the following:

ER - 1 ROD, 1 IM JCON

WARD - 1 ROD, 1 IM JCON

In the ER, if a patient comes in na known patient na ng consultant, dapat JCON agad yung titingin regardless of the complaint, then irerefer to the consultant. The ROD handles only raw walk in patients and essentially decides on his/her own in disposing patients. JCON din hahawak kapag for admission, JCON din kapag toxic ang patient, which is understandable naman. Pero kahit yung walang katorya toryang complaint na basta known patient lang ng consultant, JCON agad ang dapat tumingin. Understandable naman kung bakit need irefer kasi nga patient naman ng consultant at alaga na niya yung patient. Ang hindi ko lang maintindihan is bakit kailangan JCON agad yung tumingin kahit basic and benign lang naman ang problem? The ROD is just as qualified to refer to a consultant lalo na kung hindi naman talaga emergency ang case. Hindi naman yan competency lang ng JCON as that's a competency of any doctor in general. And nahahalata ko din na because of that rule, yung mga regular ROD there sometimes pinipilit talaga na may kakilalang doctor kahit many many years ago na last nag check up para lang "maipasa" na agad sa JCON kahit cough lang naman ang complaint. Worse, minsan literal na may 'kakilala' lang sila na consultant, deck to JCON na yan.

Karamihan ng patients doon loyal na sa hospital at may known doctor doon. Kaya kahit cases na kaya naman na dapat ng ROD, sa JCON pa din dinedeck, kahit very simple OPD case lang. The work becomes tedious for the JCON kasi sa lahat ng patients mo refer ka pa ng refer. Tapos yung ROD pa yung nakakadispose ng patients without referring to a consultant? Ito lang din yung bukod tanging JCON post na naencouter ko na may kasama kang ROD tapos yung JCON ang gigisingin sa madaling araw para lang sa walang katorya toryang sore throat while the ROD is sound asleep.

If that's a strict policy ng hospital, sige gets naman. Pero napakaunderpaid ng 6K for a JCon considering na karamihan pa pala ng patients doon ay puro patients na ng consultants sa hospital.

So thats the ER system. Let's go to ward. Which is much more interesting.

So may IM JCON and ROD sa ward duty.

Simple lang naman, as JCON, on call ka for all ward concerns --  mga nagtotoxic at mga referrals to other IM specialties. Actively nagiisip ka kasi kapag irerefer patient sa other specialties, then youll have to study the case para madiscuss sa consultants. Hassle kapag ang tagal na nakaadmit yung patient tapos as reliever, first time mo lang makikita patient. And alam naman natin sa IM, pag nag toxic minsan ang patient, isang bagsakang refer to the world yan. Sooo, wala naman actually problem. Gets naman. We all know thats the job. But then napatanong lang ako, nasan lagi yung ward ROD ko? Haha ayun nandun lang siya sa quarters gumagawa ng paperwork. Yun daw ang job description ng ward ROD doon -  puro DS, CF4, Abstract, etc.. ang pinaka clinical role lang nila ay taga declare lang kapag may nag expire na patient. Kapag may nagtotoxic na patient or may basic concern ang patient, never iistorbohin ang ROD diyan at JCON agad yan kaya complete bed rest sila without any worry.

And then I discovered na nasa paperwork pala kasi ang bulk of incentives. Kada isang dokumento, may patak na ng incentive yan. So binabayaran yung base pay nila para lang gumawa ng paperwork na may incentive pa bawat kibot. Literal na iniipon nila yung pending na paperwork ng ospital at halos yun lang gagawin nila buong duty. Para siyang office job and since matagal na sila doon, they made a system na iniipon nila ang pending paperwork at yun lang gagawin nila buong day. Saan ka nakakita ng ROD na magpapaperwork lang, may 4k na agad na base pay, tapos may sandamakmak na incentives pa, tapos yun lang literally yung ginagawa mo the whole day kasi the JCON naman is there to cover for the clinical work. Just imagine the additional payout guys kung maka 50-100 ka in a day, lets say 100 lang per document yan haha. Habang yung JCON nagkanda ugaga mamasyente buong day. Daming nagpopost dito sa subreddit na gusto niyo ng 6-figure na kita as moonlighter? This is it guys. Infiltrate the ward ROD post there dahil nakaka 100k+ na sila in just 15 days just for the tambak na pending paperwork dahil literal na iniipon nila at hinohoard ang incentives at yun lang ang ginagawa nila. Then can do straight duties kasi nga literal na office job lang siya with complete bed rest kasi JCON naman ang namamasyente. Kaya pala nung sinearch ko, never nagkaron ng ward ROD posting sa facebook in that hospital. I think never nababakante yung post na yun haha at JCON ang lagi nilang hinahanap to cover for the clinical ward work para they can spend their time mag katching katching with paperwork the whole day. If you ask me, I honestly think it's exploitatively brilliant. Haha

Samantala yung base pay pa lang ng IM JCON, gamit na gamit ka na. Ang incentive mo lang ay kapag may inakyat na patient from ER tapos gagawa ka ng admitting history or kapag may intubation. Walang any incentive yung bawat referral mo sa ibang specialties na eeffortan mong aralin isa isa para lang mairefer ng maayos. Hindi naman sa mukha akong incentive, at alam ko namang intrinsically part ng job yun. Pero nung nalaman ko yung extent ng incentives na natatanggap ng ROD, nakakagag* lang. Kasi they made the system in a way na concentrated ang incentives sa ROD with almost minimal to no clinical work.

And ito na nga, I found out na yung pinaka matagal nang regular doon na parang pinaka "senior" na, who decides on the system, arranges the schedule and everything is an ROD. And siya din yung gumagawa lang ng paperwork all night long as ward ROD. Katching katching lang habang namamasyente ang JCON na kasama niya. It doesn't take too much for me to eventually connect the dots and realize the system is deliberately rigged in favor of the RODs, especially kasi nga may mga beteranong GPs na matatagal na doon who are even older than the JCONS who eventually earned na the power to decide on the systems and manipulate the politics for their advantage.

Just to be clear ah, I have nothing against RODs, and definitely don't look down on them. Naging ROD din ako, at MARAMING MAGAGALING AT KA-RESPE RESPETONG ROD. Pero I'm just dumbfounded by the system in that hospital and cannot tolerate the imbalance. I love what I do, nageenjoy ako tumingin ng patients and mag analyze ng cases, pero lahat tayo napapagod. And kapag pagod ka na, minsan hindi mo masikmura na may kasama ka naman sana na pwedeng tumulong sayo, pero tulog lang siya at mas malaki pa ang kinikita niya sayo because of the concealed enormous incentive pay that is rigged in favor of them.

Ayun lang. Kung alam niyo ang hospital, yun na yun. Sinabi ko lang ito kasi as JCON, lugi ka talaga, boy. Pero kung okay lang sa inyo yun, nasa sa inyo naman yan. Kung gusto niyo yung 100k ++, alam niyo na yung dapat niyo iinfiltrate na post haha. But I'm never taking any reliever posts there anymore and I'm hoping no one also succumbs to this kasi maeempower lang ang system.