What would happen if someone accepted an offer from a hospital, anesthesia groups ect

  1. to PAY for their tuition in exchange for a contract to work at their organization/facility and then decided or was not able to do so (for either a good or bad reason)? Wouldn't this amount to a simple "breech of contract"? Thus, the grants would in essence become loans which had to be paid back perhaps with interest, and maybe even some damages (although that would be difficult for the plantiff to prove). Wouldn't this be a possible option for someone who couldn't afford school on Stafford loans alone, and didnt' qualify for whatever reason for the private "Bank One" type loans? Even if the loaner required the "loanee" to sign a non compete agreement in exchange for the grant, these are usually not enforceable outside of a very limited geographical area. Furthermore, as I have pointed out before private debts (including most court judgements) are USUALLY dischargeable in Chapter Seven proceedings while student loans USUALLY are not (the common exception being in the case of permanent disability, and even then the Dept. of Education must "sign off" on the discharge which is not lock).

    What are the "downsides" to this analysis for someone in this position (which for the record doesn't include myself). I am not advocating this approach, but consider it to be a worthy intellectual exercise since it is a situation which has likely occured before and probably will again in various locales around this crazy world! To those who are still offended at the very concept being discussed I would quote Aristotle who said that "it is the mark of an educated mind to be able to entertain a thought without accepting it."
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  2. 65 Comments

  3. by   nilepoc
    My first reaction, is that anyone considering this should remmeber how small the anesthesia community is. You won't truly grasp this until you are in it, but it is small and I would say the degrees of seperation are no more than three.

    One of the contracts I looked at, required that the loan amount be payed back with interest, and within 30 days of breach. Additionally, if the breach is caused by you taking another position you owe an additional 10% of your yearly salary. Those are not trivial numbers.

    I wouldn't do it. You have a better chance of getting school loans and being able to keep your good name.

    Craig
  4. by   Athlein1
    A poor gamble.
    Nilepoc is right. The anesthesia world is small. Do someone wrong, especially in a situation as calculated as this one, and you are asking for a heap of trouble. Someone will know someone who knew you and how you pulled the rug out from under.
    Intellectual exercise? Hmmm, I'm not so sure. Regardless, the plan would not be a positive reflection of the person's character...at the very least.
    I do know a student that had an agreement with a group, and was supported throughout his program. When graduation rolled around (and granted, two+ years is a long time - things change!), circumstances were different for him, and he cancelled his contract. However, he did it with several months' advance notice, and he did not protest the pre-agreed fees and interest for payback. He bucked up and paid his dues. Fair is fair. And all ended well.
  5. by   KSCRNA
    What you are proposing is calculating and in my opinion unethical. The employer is basing their future employment strategy on your availability after graduation and in return they are paying you for that availability. You are denying a job to someone who may actually want to work for the group.

    As a professional in nurse anesthesia you will be expected to make ethical decision that your patient's rely on. If you start your career by being unethical how can a patient (or for that matter a co-worker) ever trust you.
  6. by   sjoe
    Quote from KSCRNA
    What you are proposing is calculating and in my opinion unethical. ...
    As a professional in nurse anesthesia you will be expected to make ethical decision that your patients rely on. If you start your career by being unethical how can a patient (or for that matter a co-worker) ever trust you.
    Well said.
  7. by   Roland
    Athlein, your own ancedotal story proves that such a concept could be utilized. The person that you referenced took the loans, reneged on his obligation, and paid back the money. Presumably, he did this over time since few people could just "write a check" for these sort of amounts. Did he go on to have a successful anesthesia career? If so then it lends credence to the notion that someone (perhaps a single person with a kid, but no spouse or significant other and bruised credit) COULD utilize this approach to attend school when they otherwise wouldn't be able to do so. Even if 50% of future job "prospects" refused to hire them on that basis (for their reputation) it would still leave many jobs out there which would. My mechanic which I use for my car is a convicted murderer who served time for killing someone about thirty years ago. However, he's cheap, does a good job, and is relatively quick so I use him anyway (to the angst of my wife, but the car runs!).
  8. by   gaspassah
    i believe this really boils down to professional ethics. if you dont really have any then this scenario works well for you. if you believe a professional contract is something to uphold, and was made between professionals based on the needs of both parties then this would not seem to be the best route.

    decide what is best for you, what level professionalism means to you, and if it matters, what your not taking the job does to the group counting on your services then make the decision.

    also i have to agree with the previous poster who stated there may be a person willing to take that job now but the group out of contractural obligation passes on them because of you. how does that affect you. i feel it's like the guy who blanket applies for anesthesia schools, has interviews at several, gets accepted to one, but does not notify the other programs he/she will not be interviewing. that is a spot someone else would kill for and missed the opportunity because the original applicant was not professional enough to notify the other schools they would not be coming to the interview.

    if you want to use group stipends as a "loan" i'm sure there are other groups who would pay that off or give sign on bonus that would cover it if you chose not to work for the original group.
    just my .02
  9. by   loisane
    This is an issue in which I see generational differences.

    Those of us in a certain generation were brought up to believe a contract is a personal committment. Such people would feel it unethical to enter into a contract with the plan to break it later.

    But, just to present an alternative view, I have noticed how young people increasingly do not hold this same view. It is a Gen-X thing. Business is business. A contract is just a business negotiation. If a better offer comes along, it is just good business to go for it. No one should take that as a personal insult, it is just business.

    Roland describes something I have seen done many, many, many times. At first, we were shocked. Why on earth would a student break a contract? Did they not agree to it in good faith? Shouldn't they honor that committment, no matter what?

    But that just isn't how everyone feels about these contracts. In fact, those that sponsor them are aware of this. The build it into the equation, and offer more contracts than they really need to, because they know that a predictable percentage of them will not be fulfilled. They will be bought out by another employer, or paid off by the graduate.

    I have to agree that anesthesia is a small community. And it is evident from the responses here, that this is still a controversial issue. There will be some people who will be offended by a deliberate contract breaker.

    But I predict that will occur less and less, as our workforce ages, and the next generation moves up to leadership positions. Just IMHO.


    loisane crna
  10. by   alansmith52
    I don't have anything profound to say regarding this issure, My mind was sparked (unusual occurence) when I read loislane's post. I am not sure If I am Gen-X or not. I might be. i am 28 so... But I sat here thinking, I do feel the way she is describing, its almost like in my mind buisness has become somthing that happens in another demention where people lie to each other daily. (sounds strange I know) I think of the times when CEO's offered carrot rewards to me as a nurse. or when the CEO or Manger comes by and they "act" like they really know who you or care about you. ( I am not getting mushy, I am trying to paint a picture) Well all that fluff: the barbeque, the turkey for christmas, the new bag with the hospital logo on it... none of it is real. do you follow? or at least not to me. its all a game. I know they sit in a meeting and think up all the ways they can dupe into. A) staying there longer. B) working harder. C) doing my part for joint commision ect. its all manipulation:
    Def: manipulation
    when one entity acts on another entity with the pure intent of making them do what you want by using POWER.
    Def: Power.
    all kinds, good and bad, power can be exerted by example, motivation, cohersion, bribery, money, good and bad conotations.

    so what. corperate business has become a game to me. and I think to others as well. its sad, It is a let down that there is no truth and good honest loyalty anymore. and so it has leaked across the table perhaps as the employee will now manipulate the employer.
    just my. " how you say" ponderment of the relevent issuse of my earthly pilgrimage.

    P.s. I plan on working one place as long as I can. I am tired of moving.
    Last edit by alansmith52 on Mar 24, '04
  11. by   WntrMute2
    This happened in my class. One of the students signed a contract for tuition and substantial stipend in return for 3 years commitment (at somewhat less salary than some other places). During school, this person divorced and met someone new and decided to move a drivable but substantial distance away, about 1 1/2 hour drive. They defaulted on the contract but was able to pay back at least most of the amount due with the sign on bonus they recieved. However, there are a lot of bad feelings on the part of both the group that paid and ESPECIALLY within the CRNA staff that put effort into training this person for their facility. This may or may not come back to haunt. Who knows. Ethically, I'm having a bit of a problem with you Roland. I feel that if someone in good faith signed a contract then they should live with it unless truly extenuating circumstances prevent the fufillment of the contract. To go into this knowing one is going to default seems wrong, just as running up one's credit cards knowing you will default. This is unethical behavior, once again Roland you are advocating beginging one's career with a big fat lie. Not a good way to start in a profession where trust is vital. Stop with the mental masturbation and get yourself in school. Although, after reading your POV on this BB, I'm not sure I'd be comfortable working along side you or administering my anesthetic.
  12. by   suzanne4
    Dave, I agree with you 150%.............................................. .
  13. by   Athlein1
    Roland,
    A clarification: The CRNA that I mentioned who cancelled his contract had EVERY INTENTION of working for the group post-graduation. It was not to take the money to support his family during school and then leave the group high and dry. He and his wife went through some very tough personal issues, and as they worked through them, they decided to move back to their home state to be closer to family. I know for a fact that he was fortright and honest with the group about his change of plans as soon as a decision was made, and I also know that he repaid the debt as stipulated in the contract down to the last penny.
    WntrMute2 has it right on. A lot less ruminating and computering would probably do you a lot of good. This thread is just plain weird.
    And Loisane, fear not! There are plenty of us Gen-Xers who still believe in commitment, honoring one's promises, and showing loyalty to those who have supported and helped us.
    Last edit by Athlein1 on Mar 24, '04
  14. by   CRHSrn
    OUCH WNTRMUTE2 ... that's pretty harsh. but you are entitled to your opinion. i can see both sides in this controversy. LOISANE summed it up best, IMHO. it is a generational thing. i'm 29 and seen people play the system both ways. personally, i ALMOST relying on an anesthesia group to 'sponser' me while i'm in school b/c i don't think i could afford it otherwise (i've gotta daughter and a stay-at-home wife) i HAVE consided renting out my body/suv/backpack/anything else you can post stuff on, for advertisments :chuckle

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