My boss casually asked me the other day how come my patient outcomes haven’t been as good as usual during my first 3 months in Kentucky. I just told him it was because I am the only provider seeing new patients so most of them are disasters and haven’t had a PCP their entire lives. A lot of them are often hospital discharges aka frequent fliers too.
I thought about it more later and considered sending a more thorough response. I have only met most of the patients only once or twice. Thus, I am not a miracle worker. It usually takes about 6 months establishing with a new patient panel before there is significant improvement, based off of my previous experiences.
In addition, my boss (a physician) has never actually treated any of the patients in the Kentucky market. He is regional chief medical officer so oversees Kentucky, Chicago, and some of our other markets. He has no idea how the patients here are absolute train wrecks (as stated in my “Complex Patients” post).
I decided not to follow up with him because I knew my anger would subside. There was really no point in explaining my case. The reality is that I have done so well previously, that now all they expect from me is perfection. I always try my hardest in whatever I do, and that is all I can commit to.
The other reality is that I am just a locums. There is no incentive for me to out perform my peers. The full time physicians will be getting quarterly bonuses depending on their patients outcomes. I won’t be getting anything. I think I need to learn how to obtain the same mentality as the other PCP’s. Let things come in one ear and out the other, without taking things so personally….
Update: I reviewed my performance in Kentucky and there was noticeable improvement after my first 3 months. I also did better in my first 3 months there than some of the physicians that have had the same patient panel for years. My boss made it seem like I did horrible, which is not true. I just didn’t have no patients in the hospital for months at a time like I did in Chicago.
