Missed Connections: Administrator Seeks Pit Doc

crispydoc Uncategorized 3 Comments

Craigslist runs a Missed Connections column where would-be romantics (and unsubtle sex seekers) anonymously confess sightings of potential mates that got away in often mundane settings, a wonderful place to explore vulnerable admissions by folks who regret not having voiced their feelings in the lost moment.

One of the finest adaptations I've seen of this column is the artist Sophie Blackall's book of the same name, where she illustrated her favorite submissions to the genre in her unmistakable style.

A recent post by Reflections of a Millennial Doctor beautifully captured star-crossed docs and administrators who almost but couldn't quite hear each other. It got me thinking what a pensive administrator might write that doc in the wonderful and peculiar Missed Connections format.

"Saw you across the conference table at today's QI conference - I was running the powerpoint while you walked in late, head hung, and headed straight to the coffee after an on call shift.

"We haven't spoken much, but I know of you. Your patients adore you for listening to their frustration with the medical system and looking at photos of their grandchildren.

"We are understaffed, and our new EMR has turned you and your cohort into docretaries. What used to be patient interaction is now a documentation marathon, and it continues well beyond the hours you get paid for.

"You thought cost-shifting was making the patient shoulder a greater burden of the cost of their medical care, but I see it differently. The more we can shift your documentation hours from employee paid time to your personal after-hours unpaid time, the quicker my rise through the ranks.

"I know it sucks, but if I have to choose between putting my kids through college or yours, the incentive speaks for itself.

"The best I can do is make you and the other unfortunates who have no choice work harder. Increased productivity.

"When someone breaks from the strain, we'll single him out as a bad apple and let him go. When one of our docs is admitted for an overdose, we'll have a mindfulness expert return t explain how your resilience can be expanded. Because its your lack of resilience that is the problem, rather than our system.

"Thankfully you all took out student loans and mortgages before you knew what this job truly entailed, so I have you by what my father (who cursed like sailor) might call 'the short hairs.'

"The moment one of you decide to leave we'll need to pay 1.5X your salary to hire a locums replacement, and my job will be on the line.

"The doc who can say no will have me by said short hairs. In my experience, thankfully, that doc does not exist."

Comments 3

  1. I was responsible for contract negations. We had been running a man down for a couple years requiring locums. We were largely responsible for the locums. We had to bill etc and we managed the cost as best we could. My last contract I put in a line that said the hospital would be responsible for Locum cost over run, and then proceeded to use the locum like a partner. The grip of the short hairs changed. On Memorial day in 2010 we got notice our contract was terminated. The hospital owed us about 250K, a number that would have cost us 250K to collect. Now they had us by the short hairs. The hospital made a mistake. I guess they presumed Anesthesiologist just sit around on couches all day waiting for a job. On Tue they were slated to open their operating room with no Anesthesia. The OR is the cash machine of the hospital and ripping out Anesthesia is like ripping out the aorta at the aortic valve. Sure you still have a heart, BFD. I wrote the admin telling them we had 6 available anesthesiologist who even had privileges at their hospital, willing to come on board and rebuild their aorta for 75K/wk plus overtime and we wouldn’t even charge them for cars and hotel and travel. The short hairs once again changed hands. We of course could no longer work there permanently but we made a deal they pay us the 250K and we would stay till they could make arrangements. Mutual short hair release. In the mean time we put together a surgery center 2 miles down the road, which opened 5 months after our departure, 2 of us stayed. The surgery center took away 40% of their surgical business, the paying 40%, the short hairs were once again firmly in my fist, and I didn’t let go till I retired.

    The physician doesn’t always get the shaft. The arrogance of the admin was palpable as was the stupidity. When you ain’t got nothin’ you got nothin’ to loose. Don’t mess with the Zohan.

    1. Post
      Author

      That’s one impressive game of chess. To read the moves and see the contours of battle in the way an admin would, then plan accordingly, is awfully impressive for “just a doc.”

      There’s an up side to being underestimated.

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