Case Study: “I got sent home and didn’t get paid”

Rebecca* a GPT4 registrar arrives for work as rostered to discover that the GP training practice she works for has over staffed and there is no consulting room for her to use. Rebecca is sent home from what would have otherwise been a 10 hour shift seeing patients, from which she would likely have increased her billings from the days activity. She receives her payslip to find that her pay is way down on what she expected based on her previous pays. Rebecca presents to Libby* the payroll clerk to advise that she hasn’t been paid for the day that she was sent home. The payroll clerk checks her pay and it appears all is in order as far as the contract is concerned, but to double check Libby contacts GPSA for advice. On contacting GPSA, GPSA ask to receive a deidentified copy of the employment contract and relevant payslip.

On observation of the payslip GPSA observe the following:

It is important to note with this scenario that the impact of being sent home is likely to have been significant for the registrar. This fact is not the question a payroll clerk, nor GPSA will be attempting to respond to. Rather the decision tree GPSA will step a practice through is:

Further points to consider: A question of “fairness” and feelings

It is important to recognise that the registrar will likely feel they have been dealt with unjustly. Afterall, their pay has been afected through no fault of their own and they have budgeted their life around what they expect to earn. Yes they have been paid correctly in the contractual sense of the word. But this is not likely to make them feel any better about having lost earning potential. GPSA really cannot help practices navigate these feelings and psychological contracts other than to acknowledge that they do significantly impact upon your practice and the culture you establish in your practice. The registrar in this scenario may be forced to accept that contractually their pay is correct, but the psychological contract that “they be treated fairly” is very likely to be broken and as such they are unlikely to want to stay with your practice.

Remember psychological contracts are subjective. They are the unwritten contracts we make in our minds… that i will be treated “fairly” is a good example of a psychological contract. It’s not likely to ever appear written into a contract simply because it isn’t really specific or measurable enough to be enforced. “Fair” is subjective in so far as it reflects what the person who holds the belief perceives to be “fair”. Just signing a contract doesn’t really mean that the parties agree that the contract is fair. It simply means they agree to the terms set out in the contract. In this scenario a registrar might perceive that “fair” is that their pay should not be affected by someone else’s mistake. The payroll clerk following the contract and the NTCER might consider that processing payroll in accordance with an employees contract is also “fair”. And a practice owner might perceive that not paying billings that were never received and ensuring that the contractual obligations are met is “fair”. Actually all of these perceptions are understandable.

Your ability as an employer to “make good” and satisfy psychological contracts is the difference between positive or negative organisational culture, which will affect your bottom line regardless. Finding the right fit between you and staff and both parties making allowances for errors is important to the employment relationship. Fixing errors as they occur is also important.

You may never be able to service a registrars expectations or restore their faith, but what you can do is try to always get it right and be mindful of psychological contracts and their impact on organisational culture.

It is important to note also that a registrar who leaves your employ feeling they they have been dealt with unfairly will retain employment scars for future practices to deal with. Consider that the next time you are interviewing a registrar for employment and they are asking a lot of pointed questions or requiring very specific language be used in their contract. Chances are they have had an experience. It is useful to ask them about that experience and for both you and the registrar to acknowledge that the employment “baggage” exists and have a discussion about how you might navigate it in this new contract.

* Names and scenario details changed to protect equiry subjects.