Dysfunctional office. Is it like this everywhere??

[Lithium]

As much as I dislike administrators, I kinda wish we had some post here so I understood their perspective. I work at an HCA hospital but tomorrow is my last day. They say they have no CNA’s for one to one supervision for the whole hospital. So our charge nurses and therapists do it instead. People like me quit in droves left and right because we pull our hair out over this.

I’d honestly like someone who balances the ledgers to explain to me why paying the CNA’s and RN’s below market rate and keeping a thin bench is anything but penny wise and pound foolish.

[ENT Doc]

Have you broken down your processes and examined them for inefficiency and redundancy? For example, what value add do the MAs have now that the E&M has changed? Wasn’t that the point?

[Dontgetthejab]

Tim- good thoughts. I’m primary care. If I were to go out on my own I’d likely do quite a bit of home visits with Medicare pts, reimbursement is pretty good. I’d also do some telemedicine or other things to supplement. But your right, I don’t know yet if it’s worth the headache....bc as bad as my support staff /admin is, I’ve already learned how to be almost self-sufficient

[MaxPower]

Hatton- after completion of 5 yrs, the buy out ends so I can leave without owing anything. Although I can pay my buyout now, it’s only $11,000.....and technically I could potentially litigate my way out of it as they are in breach of my contract by not providing adequate staff

I would start documenting stuff now, particularly any and all correspondence with administration, about the terrible working conditions and then start looking. For $11,000 I’d be out of there in a heartbeat, but I’m betting there is something in your contract about your employer being required to provide you with adequate staffing. You doing your own vitals and rooming your own patients means you aren’t adequately staffed.

[Lordosis]

Well on a positive note you made me feel a little bit better about my administration's hiring practices. However I agree with the others that the sounds as if you are in a rather toxic environment and probably should leave as soon as financially feasible. I work primary care as well and I hate when we are forced to work with a ratio less than one to one. Luckily our hiring practices allow for it but we are frequently short due to holes and illnesses and such.

[Dontgetthejab]

I should mention the Only thing keeping me around is autonomy.....no one really bothers me as there is so much dysfunction around me. No one from admin bothers me about quality metrics, nor does admin say anything when I cap my schedule for the day. I can cancel my schedule day of and it’s ok. Took 1 wk vacay last mth and on last day stretched it to 2 wks. Middle of pandemic I cut down from 35hrs to 26hrs (m,t,f 10-5; w thur 1-5) and I’m actually on pace to make 250k this yr which is more than precovid(primary care). I cut back to help at home w my special needs son. Im on rvu compensation model so “eat what u kill” . I’ve maximized my efficiency, bill very aggressively, and took advantage of telemedicine early on in pandemic. There’s a medical director but admin does not listen to him either, although he does get a few grand per month to supervise midlevels.

doesn’t seem realistic to find another employed job where I can keep same hours and not have a medical director on my back.

[Dontgetthejab]

Have you broken down your processes and examined them for inefficiency and redundancy? For example, what value add do the MAs have now that the E&M has changed? Wasn’t that the point?

yes I have, that’s how I’ve been able to earn more this yr despite less staff. Although every time I get my own vitals, do my own prior auths, or make my own follow ups that takes away from patients I could be seeing or takes time away from spending time w my kids/wife.

[childay]

yes I have, that’s how I’ve been able to earn more this yr despite less staff. Although every time I get my own vitals, do my own prior auths, or make my own follow ups that takes away from patients I could be seeing or takes time away from spending time w my kids/wife.

Seriously? Sounds like a shitshow

[ENT Doc]

yes I have, that’s how I’ve been able to earn more this yr despite less staff. Although every time I get my own vitals, do my own prior auths, or make my own follow ups that takes away from patients I could be seeing or takes time away from spending time w my kids/wife.

Getting your own vitals? Maybe it’s because I’m a specialist but I don’t remember the last set of vitals I looked at from clinic. A place like you describe doesn’t deserve more of your time.

[hebel]

Employed by major health system south tx. Things seem to be unraveling. I’ll try to paint an accurate picture....
- phone systems stink. Patients call, on hold for 30-60min. We had 3 staff answering phones but also trying to check in, check out, schedule appts. Got new system last mth that takes all calls for “questions for doctor” to the MA phones in the back...problem is we’re short MAs so they can’t answer. After so many rings it takes them to an answering service that’s sends message to a bucket . Takes messages hours to get routed to me, sometimes 1-2days.told this is thr best admin can do
-always short MAs. 3 docs, 2 midlevels. We all mostly see 20 per day. Only have 3 MAs to room pts, vitals, do prior auths, referrals. It’s impossible for them to keep up. One day This wk 1 was sick, so had 2. Then one of the 2 leaves after lunch and doesn’t come back. So I had 16pts that afternoon and roomed/vitalizad almost all of them....office manager usually comes in to help on those occasions(happens usually once per wk) but this time she was “in meeting w admin?!?!?!).
I guess all the issues stem from lack of support staff. We tell admin we need to hire ASAP, they say they can’t find anyone. Supposedly had 10 interviews scheduled Friday, nobody showed up? Maybe bc the pay is bad, think $12/hr although w benefits, insurance.

are all you employed guys having them same issues?? I can’t stomach the fact that they take 50% for overhead yet I don’t get adequate support!

I've been employed by a hospital system for about a year, and i've witnessed similar (but not as bad) issues with support staff. Maybe I'm naive, but I think that admin doesn't seem to grasp that you have to spend some money to make money.

To their credit, I think it's hard lately to find MA's and LPNs to hire. Overall I'm fine with the setup because these issues make my schedule pretty relaxed and I'm not paid based on production. I'm still surprised at how amateurish the whole thing feels though.

[GastroMastro]

yes I have, that’s how I’ve been able to earn more this yr despite less staff. Although every time I get my own vitals, do my own prior auths, or make my own follow ups that takes away from patients I could be seeing or takes time away from spending time w my kids/wife.

I’d take a >20% pay cut to avoid vitals and prior auth.

[Sundance]

my thoughts...

MAs are hard to get in our neck of the woods too..

admin cares more about arbitrary budget numbers than appropriately staffing clinics

i Hate not being able to hire or have staff answer to me but the life we live in many employees gigs

i have no idea why they haven’t figured out hiring 20 year old girls isn’t a great solution

my two cents that we should give priority to post menopausal women that have been in the community for 10-20 years was not taken well

[braindoc]

Employed by major health system south tx. Things seem to be unraveling. I’ll try to paint an accurate picture....
- phone systems stink. Patients call, on hold for 30-60min. We had 3 staff answering phones but also trying to check in, check out, schedule appts. Got new system last mth that takes all calls for “questions for doctor” to the MA phones in the back...problem is we’re short MAs so they can’t answer. After so many rings it takes them to an answering service that’s sends message to a bucket . Takes messages hours to get routed to me, sometimes 1-2days.told this is thr best admin can do
-always short MAs. 3 docs, 2 midlevels. We all mostly see 20 per day. Only have 3 MAs to room pts, vitals, do prior auths, referrals. It’s impossible for them to keep up. One day This wk 1 was sick, so had 2. Then one of the 2 leaves after lunch and doesn’t come back. So I had 16pts that afternoon and roomed/vitalizad almost all of them....office manager usually comes in to help on those occasions(happens usually once per wk) but this time she was “in meeting w admin?!?!?!).
I guess all the issues stem from lack of support staff. We tell admin we need to hire ASAP, they say they can’t find anyone. Supposedly had 10 interviews scheduled Friday, nobody showed up? Maybe bc the pay is bad, think $12/hr although w benefits, insurance.

are all you employed guys having them same issues?? I can’t stomach the fact that they take 50% for overhead yet I don’t get adequate support!

Its worse where I am. I'm almost a year into my practice and I was given 1 MA, 1 front desk person (both currently out sick) and no APP. I have a 5 month wait for visits because they refuse to hire another MA and scheduler because of a hiring freeze.

[StateOfMyHead]

Bmac- yea I hear u. I’ve taken over doing my own PAs due to the lack of staff. Although they are pretty quick since I know all the answers, before the MAs would have to wait around to find me to help fill out.

Problem is the more you are willing to do the more you will have to do.

[Dontgetthejab]

Problem is the more you are willing to do the more you will have to do.

Yea true.