Dysfunctional office. Is it like this everywhere??

[Tim]

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.

Bonuses.Straight from the BOD.
https://www.beckershospitalreview.co...for-execs.html

[Zaphod]

Seems everyone forgot what admin actually knows.

They know if they understaff or provide less than necessary, 99.9% of doctors will simply do it themselves with little guff. Its no different and cheaper.

[jfoxcpacfp]

Good tip for anyone interviewing - ask about the ratio history of support staff to providers and to document in contract.

[Dontgetthejab]

Seems everyone forgot what admin actually knows.

They know if they understaff or provide less than necessary, 99.9% of doctors will simply do it themselves with little guff. Its no different and cheaper.

Aunt that the truth

[ACN]

Another reason not to work for the hospital. Zero control.

Ya, you are severely understaffed. We have 15-20 physicians and about 10 PAs. Each Dr has their own MA and scribe.

I think our call center has 10 answering about 2k phone calls per day. Probably another 100 employees doing xray, vitals, front desk, etc.

Even with all this, I feel like we're still understaffed!

[AR]

Good tip for anyone interviewing - ask about the ratio history of support staff to providers

You can ask (and you should), but they will lie. Or at least grossly misrepresent the situation. Any periods of understaffing will be rare exceptions in their minds.

and to document in contract.

I guess the utility of this is specialty dependent. I also think it is hard to have something written that covers all the possibilities. The main one is that (at least in my case) if your practice grows, you're gonna need more staff, and it (at least in my case), doesn't scale linearly as volume increases. However, I don't disagree that it's worth trying for something like this if you can get it.

[Dontgetthejab]

Good tip for anyone interviewing - ask about the ratio history of support staff to providers and to document in contract.

my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it

[Tim]

I guess the utility of this is specialty dependent. I also think it is hard to have something written that covers all the possibilities. The main one is that (at least in my case) if your practice grows, you're gonna need more staff, and it (at least in my case), doesn't scale linearly as volume increases. However, I don't disagree that it's worth trying for something like this if you can get it.

In academic and in some private practices there are situations that the "political pecking order" can seriously hamper your production. If you have wRVU incentives, it can be a huge problem. Two MA's, 2 PA's and a scribe with residents and fellows assisting and block time definitely can handle a greater volume than a doc with an MA.

The response of "normally 5 years we consider adding ...." solves nothing. I suppose the best way is to play the political game, For sure incentive comp metrics are in great detail, not so much the staffing support needed to achieve the targets. I would have no idea how to put something like that in contract language. The comment about not scaling linearly is so important. The staffing level supports a range of production before headcount makes sense.

[ENT Doc]

my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it

1. Find another job
2. Inform your current job in writing that they are in breach of contract. Use objective data and clear examples.
3. When they don’t correct after #2 use that as your means to get what you are owed under an employer breach.
4. Leave for #1

[CordMcNally]

my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it

That's a pretty broad line that I feel like would be pretty tough to prove. I'm not a lawyer but I would think their legal team worded it that way for a reason.

[ENT Doc]

That's a pretty broad line that I feel like would be pretty tough to prove. I'm not a lawyer but I would think their legal team worded it that way for a reason.

Hopefully there’s a reasonableness clause. It’s not reasonable to ask a physician to room their own patients, take their own vitals, etc. - especially for an extended period.

[CordMcNally]

Hopefully there’s a reasonableness clause. It’s not reasonable to ask a physician to room their own patients, take their own vitals, etc. - especially for an extended period.

I agree but I feel like the phrase 'pandemic' may come up.

[ENT Doc]

I agree but I feel like the phrase 'pandemic' may come up.

Lol true. But I’d expect these problems can be identified as occurring prior to 2020.

[jfoxcpacfp]

my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it

This would be worth asking for specificity and/or clarification in the final document in the future. I don’t think you did anything wrong - just one of those sections of boilerplate language. I’ve ready many contracts with same and never thought to ask for definition but will in the future, so consider your taking the time to post your story as a contribution to others’ future negotiation activities. When an admin says that “we cannot define that”, the job candidate can say, “here’s why it matters to me...

[AR]

my contract has that one liner “the practice provide the physician with adequate equipment and staff”....which they’re in breach of at this point.

id think most contracts from big employers have similar language. But just bc they have the language in it doesn’t prevent them from breaching it

Unfortunately that degree of generality is completely useless. What is "adequate"? You say it is not; they say it is. Trying to sue them for breach is gonna be real tough. I'm not a lawyer, but I'm certain if I could craft a reasonable argument for just about anything being adequate. Or at least I could do enough to confuse a bunch of lay people.