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I have never thought that I have any sort of authority over my doctors. I have built trust and rapport with them and they will often ask me what I think about something because we have a good relationship but at the end of the day I would never disrespect or talk down to any of our physicians.
You are probably the exception, not the rule
It’s never appropriate to talk down or disrespect anyone, of course. There are always different perspectives based on roles, and physicians duties are to care for the patient and admin duties are to ensure fiscal responsibility of the company. So a lot of times those two priorities frequently compete rather than collaborate.
Physicians that don’t want to play by practice rules (within reason) should just go self employed, IMO, bc businesses need admins to monitor and enforce certain practices in order for sustainability.
My last two physicians that refused to make small tweaks to their practice models left bc they weren’t profitable and basically broke even with their expenses. Healthcare is insanely expensive and in order to make ANY money you basically need to pump the patients out like cows through a slaughter house. It’s pretty crazy… and people that don’t manage the money won’t see any of that or understand why certain policies exist or certain practices are standard expectation. Everybody has a role and I think we all just need to respect each others roles and duties and realize that each one of us only is privy to a certain scope of the entire holistic entity.
Depends on what you mean by "tweaks".
I am sure an agreement can be made to increase productivity and not burn out physicians to the point of suicide.
And it is still extremely moronic from administrators to prefer to see their "problematic" physicians go (who have patients that warmed up to them and already have a relationship with) and spend MILLIONS on recruiting and training replacements on an endless cycle. You are losing more money for the company this way than to actually be a reasonable negotiator.
I left a Job I was in for two years because the administrators refused to negotiate ONE DAY of work from home/Telehealth to take care of my SICK KID. When I presented a resignation they were super petty about and didn't even do an exit interview. It was just a matter of pride, refusing to let go of their little power trip. 4 years later they STILL haven't found a steady replacement and are spending millions of dollars on expensive locums doctors. Nice going
It’s never ok to be disrespectful. But that’s a two way street. I have had many many many situations where a physician was ugly to me. (Essentially the same situation you describe but reversed).
If an admin’s role is oversight of a program or service or function that includes physicians then that is what defines the “authority” you speak of. How someone goes about that should not be disrespectful.
These situations you’re describing sound quite adversarial and run counter to my experience. I remember during my grad program (healthcare admin) there would often be these stereotypical scenarios of the way clinicians and administrators interact and often had opposing interests. However, I’ve been fortunate to work in organizations that really see it as a partnership and it’s the way I’ve operated. I work in a dyad leadership model and my clinician partners and I have fantastic relationships. One in particular taught me so much about approaching conversations and understanding the POV of many clinicians.
Now I’ve certainly had difficult individuals and relationships over the years, but generally I attribute that to the personality and not the profession. I will say one of the things I’ve observed in my career working with clinicians is how their own backgrounds impact their approach to the interpersonal relationships. Those that had little experience in the workforce prior to starting their careers often have a slower ramp up period to developing team-based skills and relationships with non-clinicians. Those that have worked, particularly in some form of service industry prior, tend to have an early leg up. I’m fortunate to also work with residents and do my part to help them with the transition to practice, often highlighting some of those soft skills that are important to a smoother transition.
You are choosing the wrong places to practice medicine.
That has not been the case in many places I have been. It is usually the other way around, where the physicians thinks its okay to belittle those who are working in the same dept.
That isn’t the case with all physicians. More like 3-5%
From what I have seen it absolutely seems like a power trip issue. Instead of working together, I see a lot of management taking a my way or the highway and it makes no sense. They would lose nothing to actually work with them and fix issues, but they just can’t be bothered to do that. I don’t know, hurts everybody in the long run.
I never thought that I have any authority over the providers but what I do have is authority over operations and unfortunately that includes procedures that ensure our patients are seen in a timely fashion. Some providers think because they're salaried or they're providers that they can just cancel an entire day because they feel like it, well no, you can't. Although some providers are contracted you still have an obligation as well. I only speak to my providers about why wouldn't they see a patient who was 16 minutes late and they already had 5 no-shows for their session. See someone that's late by one minute past their own (not organization) 15-minute time frame, don't turn patients. away. Those are the conversations that I've been having for the last 10 years, but I'm never disrespectful or authoritative.
For context, I have been an employed physician for over 15 years. Two of those as Locum Tenens (temporary assignments). I am to the point now that I immediately give my resignation notice if one of the admins or managers even looks at me the wrong way for advocating for myself and my time. I have that luxury (and I enjoy it). But a lot of physicians don't have that luxury (or don't realize it yet given the shortage of physicians), and end up burned out or even trying to commit suicide because of the relentless bullying and harassment.