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  • #16
    Originally posted by zlandar View Post
    If she goes to the CMO fine. Let the CMO get in the middle of this and referee between her and the referrers.
    yes, this is what you want and part of their role.
    “. . . And the LORD spake, saying “First shalt thou take out the Holy 401k. Then shalt thou save to 20%, no more, no less. 20% shall be the number thou shalt save, and the number of the saving shall be 20%. 25% shalt thou not save, neither save thou 15%, excepting that thou then proceed to 20%. 30% is right out . . .””

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    • #17
      I would be shocked the CMO would take the side of someone so abrasive who is universally disliked at the risk of alienating pretty much everyone else. Regardless of their relationship, the CMO will be looking out for #1.

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      • #18
        Originally posted by blippi View Post
        let her go to the higher ups. let them sort it out.
        How you deal with her is important. As a “team player” acknowledging the desire to improve her consult numbers is legitimate. A willingness to help her improve can be sincere. However, you have a problem with her proposed solution. Not responsive to the request nor necessarily in the best interests of the group. Above your pay grade. How else can her consults improve? If that objective needs attention from her personal point of view from the higher ups, you will be more than willing to seek guidance and help in anyway possible.
        Let any short comings be delivered by others. Don’t let her problem become yours, which she is attempting. Not the first and won’t be the last.
        You have every right to your referral consults.

        You don’t have a conflict with her. She has a conflict with the others.

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        • #19
          Sorry you are dealing with this. If she is truly "in" with admin, it may really help you to keep a simple log of this whole thing. Just a note on your phone or word doc with reminders of your conversations about this with her and your attempts to try to help. In particular, dates and names when you have encouraged the IM docs to use her and their response may really help de-escalate anything negative admin could have to say. Having dealt with some crazier people, I've learned the story that admin hears can be very different than what you experienced but if you have a way of having others corroborate your story, it really simplifies things.

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          • #20
            Tough place to be in, I empathize. No idea what to do though.

            I suspect people are right though. While admin do care about their friends, they care about the numbers more. Try not to get in the middle of it. If admin wants to get involved, let them referee between the narcissist and the hospitalists. Just keep your head down, smile, and nod.
            Helping those who wear the white coat get a fair shake on Wall Street since 2011

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            • #21
              Originally posted by Lizzie View Post
              Sorry you are dealing with this. If she is truly "in" with admin, it may really help you to keep a simple log of this whole thing. Just a note on your phone or word doc with reminders of your conversations about this with her and your attempts to try to help. In particular, dates and names when you have encouraged the IM docs to use her and their response may really help de-escalate anything negative admin could have to say. Having dealt with some crazier people, I've learned the story that admin hears can be very different than what you experienced but if you have a way of having others corroborate your story, it really simplifies things.
              Good advice!
              100% correct that admin can be completely hoodwinked or clueless as to actual situation and make idiotic decisions..
              I agree with above, unless CMO is this woman's relative or something then let CMO hash it out with hospitalists. Not your fault they think you're a good doctor. Assuming you are correct and most of the hospitalists feel as you say and would say same to CMO.. but tread lightly.
              If you start passing pts off to a subpar doctor they might just call the other docs instead of you or her.. I take it you are making RVU pay over your salary?

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              • #22
                Thank you everyone for all the thoughtful responses.

                To attenuate the tone of my original post (written in the heat of the moment and likely letting my own feelings towards this person leak out a bit), I perhaps make them sound excessively cancerous. Ultimately I would say that their interpersonal relationships with people are varied - some hospitalists/docs don't mind her as much -- like I mentioned, some said if you just chill out a bit we'll call you! -- and some have an irreversibly burned bridge and will likely never call. I do not think my coworker is actively dangerous to patients by any means, even though I disagree with their management in some cases.

                I appreciate the poster's advice to frame it as "hey I'm the new grad and trying to get myself established" angle - I think that's prudent. Likely will go back to coworker some time this weekend and try to respectfully empathize with their complaint but agree with the fact that we should get the higher ups involved. Almost tempted to email them myself to call her bluff.

                I'm not sure what kind of resolution will come about. I agree that at the end of the day it is about business, all they care about is the RVUs. On one hand that is a buoy to me since I'm sure I am looked upon favorably insofar as I am getting many consults that used to go to other docs outside of the group last year. On the other hand, I do worry that that line of thinking will lead them to say "Oh yeah, you should just pass off that consult info to her" so that it stays in the group - the "alienating a referral source" is not as big of an issue as I would like it to be since the hospitalists are mostly in the group so I can imagine the group leadership indeed agreeing with "deal with it."

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                • #23
                  If you're bringing in new business and voice your concerns of passing off that business to your group -- your group will side with keep the business and keep growing it for the group. Bottom line economics.

                  Now they may temper things like share the consults from old sources known to the group - especially if CMO is groupies with the other doc. I would counter that the CMO should reach out to established referral sources to gently remind them that you're a group and any standard consults can be shared among the group to equally load share the work (avoid burnout, rvu sharing, whatever excuse the CMO to do).

                  If you're NOT overburdened, are you expected to share and detrimental to your RVU and bonus structure? Is this expected for the rest of the group and rvu sharing underpinnings in the group for salary support? Your work and reputation garners these consults, right? If you're forced to share, what is your compensation for this?

                  It's the CMOs job to make the group equitable and successful overall.

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                  • #24
                    Originally posted by timtheenchanter View Post
                    Thank you everyone for all the thoughtful responses.

                    To attenuate the tone of my original post (written in the heat of the moment and likely letting my own feelings towards this person leak out a bit), I perhaps make them sound excessively cancerous. Ultimately I would say that their interpersonal relationships with people are varied - some hospitalists/docs don't mind her as much -- like I mentioned, some said if you just chill out a bit we'll call you! -- and some have an irreversibly burned bridge and will likely never call. I do not think my coworker is actively dangerous to patients by any means, even though I disagree with their management in some cases.

                    I appreciate the poster's advice to frame it as "hey I'm the new grad and trying to get myself established" angle - I think that's prudent. Likely will go back to coworker some time this weekend and try to respectfully empathize with their complaint but agree with the fact that we should get the higher ups involved. Almost tempted to email them myself to call her bluff.

                    I'm not sure what kind of resolution will come about. I agree that at the end of the day it is about business, all they care about is the RVUs. On one hand that is a buoy to me since I'm sure I am looked upon favorably insofar as I am getting many consults that used to go to other docs outside of the group last year. On the other hand, I do worry that that line of thinking will lead them to say "Oh yeah, you should just pass off that consult info to her" so that it stays in the group - the "alienating a referral source" is not as big of an issue as I would like it to be since the hospitalists are mostly in the group so I can imagine the group leadership indeed agreeing with "deal with it."
                    I like having evidence (paper trail) of my interactions with someone like your coworker so they can't lie about how you've responded to the situation and put you on the defensive. If I were in your shoes, I would send your coworker a polite but short email to recognize her concern (even if her own personal issue), but imply that you have been nicer than her which is why you are busier, and establish that you're not going to simply give her consults (and do so in a way that will make her feel and/or look ridiculous even asking for you to "share"). Something to the effect of:

                    "I understand your concerns with the disparity in consult numbers. As I have been working to establish my practice I have made myself very accessible to referring providers and have culminated relationships with them, much to the benefit of the practice. At this point I feel it would be inappropriate to decline consults for which I was specifically requested and risk damaging those relationships. I would be happy to be involved in a solution however, so please let me know what ideas you may have and what else I can do to help."

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                    • #25
                      Also a senior partner parsing out to a junior partner with clear equal dibs is very different from a new hire under guarantees and production model sharing consults, especially if not overwhelmed.

                      If OP is overwhelmed or suffering in responses thats a different issue.

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                      • #26
                        Originally posted by abds View Post

                        I like having evidence (paper trail) of my interactions with someone like your coworker so they can't lie about how you've responded to the situation and put you on the defensive. If I were in your shoes, I would send your coworker a polite but short email to recognize her concern (even if her own personal issue), but imply that you have been nicer than her which is why you are busier, and establish that you're not going to simply give her consults (and do so in a way that will make her feel and/or look ridiculous even asking for you to "share"). Something to the effect of:

                        "I understand your concerns with the disparity in consult numbers. As I have been working to establish my practice I have made myself very accessible to referring providers and have culminated relationships with them, much to the benefit of the practice. At this point I feel it would be inappropriate to decline consults for which I was specifically requested and risk damaging those relationships. I would be happy to be involved in a solution however, so please let me know what ideas you may have and what else I can do to help."
                        +1 esp on the paper trail

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                        • #27
                          I would just like to add that your employer has really done a good job setting up an incentive structure for everyone wanting to do more work. You both have the same employer and seem to be competing for patients. If one of my partners wanted to do more work (which they don't), I would welcome it and do everything I could to facilitate it.

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                          • #28
                            Originally posted by abds View Post

                            I like having evidence (paper trail) of my interactions with someone like your coworker so they can't lie about how you've responded to the situation and put you on the defensive. If I were in your shoes, I would send your coworker a polite but short email to recognize her concern (even if her own personal issue), but imply that you have been nicer than her which is why you are busier, and establish that you're not going to simply give her consults (and do so in a way that will make her feel and/or look ridiculous even asking for you to "share"). Something to the effect of:

                            "I understand your concerns with the disparity in consult numbers. As I have been working to establish my practice I have made myself very accessible to referring providers and have culminated relationships with them, much to the benefit of the practice. At this point I feel it would be inappropriate to decline consults for which I was specifically requested and risk damaging those relationships. I would be happy to be involved in a solution however, so please let me know what ideas you may have and what else I can do to help."
                            Great call. I will write them an email this weekend. This is doubly helpful as someone who is nonconfrontational and will likely be flustered enough to not say my piece properly in person haha. They always want to talk on the phone about stuff but it would be great to have a paper trail. Plan on empathizing with the discrepancy but I don't like feeling gaslit like this is somehow my fault when the larger issue seems to be one that they should reconcile with the people that don't want to call them. Will call their bluff and agree that the higher ups would be great to get involved.

                            Will update the thread if anyone interesting comes to light

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