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Considering leaving current role - want to make sure I'm not being unrealistic

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  • #16
    Originally posted by CordMcNally View Post

    You wouldn't laugh if it were a private group and that was also your income sitting out in the waiting room. Besides, the nurses are always busting their ****************** so I don't mind completely triaging and discharging a patient by myself. I'll even clean the room. I can't go to work and just sit there. It's better for the patients, it's better for business, and you'll find that you start getting stuff that you need done from other people quicker when they realize you're not above doing it yourself.
    I think you’ve misunderstood. I’m not saying I don’t get patients blankets, I’m saying that administration would never dream of asking me to do it.

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    • #17
      Originally posted by VentAlarm View Post

      I think you’ve misunderstood. I’m not saying I don’t get patients blankets, I’m saying that administration would never dream of asking me to do it.
      I see. We're not asked to do it, either, but still do for the above reasons.

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      • #18
        Academia here. We have 1:1 nurse:doc ratio. 1:4? no way. Even the worst of days it was 1:2 and still box coverage.

        1:4.
        No box coverage
        Poor productivity transparency

        You're 0.6 cFTE without need for benefits with wife providing that.

        ?: Is your center using Locums currently? If so - easy answer. Give shortest notice -- like 2 weeks.
        -Offer to do Locums at Locums rate AND negotiate the per diem living costs too.

        -Check out local competition too. There's no shortage of primary care positions available in our area and with the pandemic, believe you'll have options unless extremely rural area

        -If you stay - suggest these changes
        -officially state issues in writing to your supervisor about the lack of support; that you're helping but 1:4 is unacceptable and in ability to maintain current levels.
        -to this:
        -no further quality metrics can be done outside the constraints of the visit without support.
        -stop answering box work - 'book appointment' is the default answer.

        Comment


        • #19
          Originally posted by VentAlarm View Post

          I think you’ve misunderstood. I’m not saying I don’t get patients blankets, I’m saying that administration would never dream of asking me to do it.
          Sounds like OP is on the receiving end of a vicious environment; it the environment is impacting the care you can provide, then probably best to hoist anchor, shove off.

          As far as doing the more "menial" (not the best word) tasks, I see it like this: https://lh5.googleusercontent.com/pr...h630-p-k-no-nu
          The pilot didn't have to clean the windscreen, but he did it anyways to ensure an airworthy A/C.

          Personally, during my postdoc, my PhD program student health insurance was expiring, so I found a gig at the academic medical center decontaminating/sterilizing surgical instruments and decontaminating/Sterrad-ing flexible endoscopes for $14.50 an hour (and the health insurance that came with the job). It gave me a real inside experience on how cruddy the techs can be treated, even by other techs and LPNs/LVNs/MAs who are sent running all the way to the basement for a stat turnaround of some pump or whatever.

          So I see a line where it is nice for the "upper echelons" to help out a little bit with the work of the proletariat, but shouldn't be dumped all over the MDs/DOs to do it all...

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          • #20
            Staff shortages are not confined to staff.
            10 years in and dissatisfied, time to look for greener pastures. Your eyes are wide open. Locums, new job (with the non compete issue) will not change the outcome in the current situation.
            Hospital systems are not out of the woods financially. But they need physicians to turn the wheels. I suggest you actively test the waters and see what you find. Up to you whether give notice or wait until you see how the market is. You won’t find perfection, but I don’t think you are naive.
            Good luck.

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            • #21
              What does your contract say about support staff and clinic support? I would bet you could find a lawyer, if needed, to vindicate your concern of your employer being in breach of contract as a reason for you to get out of the non-compete. The other part of this is having this documented. I would write an email to your admin, expressing these concerns (if you haven’t already) merely as a means of getting in writing the shortcomings so when (not if) you pull the cord you’ve got your ducks in a row. Good luck in the job hunt!

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              • #22
                Originally posted by MaxPower View Post
                What does your contract say about support staff and clinic support? I would bet you could find a lawyer, if needed, to vindicate your concern of your employer being in breach of contract as a reason for you to get out of the non-compete. The other part of this is having this documented. I would write an email to your admin, expressing these concerns (if you haven’t already) merely as a means of getting in writing the shortcomings so when (not if) you pull the cord you’ve got your ducks in a row. Good luck in the job hunt!
                … and your concerns are regarding the key phrase of patient safety. Otherwise they’ll play the pandemic/labor shortage card on you and flip it back to you as not being a “team player”.

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                • #23
                  Originally posted by CordMcNally View Post

                  You wouldn't laugh if it were a private group and that was also your income sitting out in the waiting room. Besides, the nurses are always busting their ****************** so I don't mind completely triaging and discharging a patient by myself. I'll even clean the room. I can't go to work and just sit there. It's better for the patients, it's better for business, and you'll find that you start getting stuff that you need done from other people quicker when they realize you're not above doing it yourself.
                  I get your point . And I respect your work ethic .

                  But there has to be some buy in from the administration

                  I understand staffing shortage . But people stay if you treat them with respect . Money is very important, but lot of people would stay (and I am talking about staff , providers ) , if they see respect and value .

                  Comment


                  • #24
                    Originally posted by CordMcNally View Post
                    You wouldn't laugh if it were a private group and that was also your income sitting out in the waiting room. Besides, the nurses are always busting their ****************** so I don't mind completely triaging and discharging a patient by myself. I'll even clean the room. I can't go to work and just sit there. It's better for the patients, it's better for business, and you'll find that you start getting stuff that you need done from other people quicker when they realize you're not above doing it yourself.
                    Yes, true. That's not the OPs condition. Admin is clearly not supporting nor proactively trying to engage in improvement or offloading OP with nonessential tasks. this isn't pick-up-the-pail and start bailing water.

                    Comment


                    • #25
                      If you are short staffed then they have extra income to give. If you are not happy with RVU structure insist on flat salary model or leave. Then if you only see 4 patients a day because of their managing incompetence it hurts them not you.

                      Comment


                      • #26
                        Originally posted by Sampter View Post
                        I would give minimum notice required by your contract immediately and then leave when finished with that time. Your job is literally physician abuse. Sounds like you have the luxury of being able to quit without a new job lined up.

                        Plus/minus a letter to HR/department head/etc spelling out why you are quitting, including very specific details such as how long you have been short staffed/etc. They clearly are not holding up their end of the bargain. Is that enough to be safe from a non-compete? I would hope so, problem is that large organizations have lawyers on staff that have all the time in the world to make you sweat.

                        Good luck!
                        Thanks. It's been said by our physician leadership that it's basically take it or leave it - they get CVs all the time from others who want to work there (presumably new grads who don't know any better). I'm not sure I want to take legal action and burn the bridge in terms of references - though it might be worth at least consulting an attorney and getting a sense of what they thought the odds would be of me getting out of the non-compete

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                        • #27
                          Thanks to everyone for all the thoughtful replies and support. It's nice to see the consensus that I should get out ASAP. They are probably in breach of contract re: providing sufficient support staff but I don't want to completely burn bridges on my way out. I'd been holding out hope that the noncompete radius would become smaller with the next contract cycle (due to some unique circumstances that would probably make me identifiable so won't go into further) I have tried raising issues around patient safety (and it truly is unsafe on many occasions - results and vitals and vaccines not getting documented at all) and it never results in any lasting change.
                          I'm not at all above jumping in and doing non-MD work when it's needed (I've thought about opening a small direct care practice - I'm doing so much of it all myself anyway and have gotten pretty efficient at it!) I do really enjoy the academic role -and have some salary support for part of it but not enough to offset the dysfunction which is what has kept me there this long. Thanks again for all your support and good wishes.

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                          • #28
                            Your practice must be a money loser for the organization, or the person in charge has no idea what they are doing. Why would any competent administrator have a doctor due secretarial work or MA work that does not generate income. If you are getting paid by an RVU basis it makes no sense to stay from a financial stand point. If you have other non financial reasons for be there, it is different. I personally would not feel like I would owe them anything. Though working in private practice is a much different mentality, everything is your responsibility, you are just at liberty to find the best way to fix it for yourself.

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                            • #29
                              adding a voice here to the chorus that says you are probably just going to have to leave.

                              wouldn't hurt to have a very direct convo w/ your medical director w/ a clear timeline and deliverables before you do so.

                              this needs to be focused on patient care not your feelings.

                              that said, you might wait until the omicron wave has passed hopefully 6 weeks or so. if you pull this card now there is a good chance they can't do anything to help you even if they desperately wanted to do so.

                              Comment


                              • #30
                                From what it sounds like, there were these problems even before Covid, but correct me if I'm wrong. I wouldn't even ask to try and get them fixed, they will just string you along. I would just quit in a professional way without burning bridges. It may look bad to quit during Omicron, however, your job is going to be that much worse without support staff during this time.

                                In academics unless you are some superstar (research dollars, high powered proceduralist) they really don't care about you.

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