Tweet
Hello! I'm reaching the breaking point at my current job and want to make sure my expectations aren't unrealistic.
I'm about a decade out of training, currently working in academic primary care within a larger health system. I love my patients and working with/teaching the residents, but clinically I'm miserable. Our practice is chronically and constantly short staffed and it's just getting worse, sometimes with 4 MDs working with 1 MA or LPN in recent months. Due to "critical staffing constraints" we're consistently asked to room our own patients, do our own vitals, click all the QI boxes, do the whole telehealth visit from start to finish (eg no "virtual rooming" from staff). Additionally, every call or portal message gets sent directly to the doc - PA requests, referral requests, "my ear hurts what should I do", how do I get a COVID test, etc. We're expected to do all of our own lab/result callbacks. I'm paid at <25%ile of AAMC benchmarks (from 2017) for rank including my "productivity bonus " - which is unclear how it's actually derived and I see RVU numbers approximately q6-12 months and I question their accuracy. I'm one of the more efficient EHR users in our practice, usually get all my notes done same day and have one of the higher RVU #s when prorated for my FTE and have great patient satisfaction scores. Due to some other academic roles, my patient contact time is only about 0.6 FTE and it's still burning me out.
Financially we are doing just fine - secure but not yet fully FI, no debt aside from our primary mortgage and we live well below our means. Great benefits from my spouse's gov't job, so I don't actually need to work FT for health benefits, so I have a lot of flexibility. I've considered doing locums work for a while just to see some other practices and build up a bigger financial cushion, and at this point I don't want to jump from a bad job into an even worse one. I do have a significant non-complete clause (which is probably not really enforceable but am not really eager to find out the hard way) and we're tied to the area for another 12-24 months due to spouse's work.
Questions - are others in academics or working at large health systems dealing with the same staffing vacuum and lack of support? Is doing locums for a few months-years a big red flag, and are most of the locums primary care jobs equally miserable? Would I just be signing myself up for even more patient contact time with the same lack of support? Is this just what primary care is like for physicians these days?
Thanks in advance for all of the collective wisdom here!
I'm about a decade out of training, currently working in academic primary care within a larger health system. I love my patients and working with/teaching the residents, but clinically I'm miserable. Our practice is chronically and constantly short staffed and it's just getting worse, sometimes with 4 MDs working with 1 MA or LPN in recent months. Due to "critical staffing constraints" we're consistently asked to room our own patients, do our own vitals, click all the QI boxes, do the whole telehealth visit from start to finish (eg no "virtual rooming" from staff). Additionally, every call or portal message gets sent directly to the doc - PA requests, referral requests, "my ear hurts what should I do", how do I get a COVID test, etc. We're expected to do all of our own lab/result callbacks. I'm paid at <25%ile of AAMC benchmarks (from 2017) for rank including my "productivity bonus " - which is unclear how it's actually derived and I see RVU numbers approximately q6-12 months and I question their accuracy. I'm one of the more efficient EHR users in our practice, usually get all my notes done same day and have one of the higher RVU #s when prorated for my FTE and have great patient satisfaction scores. Due to some other academic roles, my patient contact time is only about 0.6 FTE and it's still burning me out.
Financially we are doing just fine - secure but not yet fully FI, no debt aside from our primary mortgage and we live well below our means. Great benefits from my spouse's gov't job, so I don't actually need to work FT for health benefits, so I have a lot of flexibility. I've considered doing locums work for a while just to see some other practices and build up a bigger financial cushion, and at this point I don't want to jump from a bad job into an even worse one. I do have a significant non-complete clause (which is probably not really enforceable but am not really eager to find out the hard way) and we're tied to the area for another 12-24 months due to spouse's work.
Questions - are others in academics or working at large health systems dealing with the same staffing vacuum and lack of support? Is doing locums for a few months-years a big red flag, and are most of the locums primary care jobs equally miserable? Would I just be signing myself up for even more patient contact time with the same lack of support? Is this just what primary care is like for physicians these days?
Thanks in advance for all of the collective wisdom here!
Comment