I sort of knew that when I started working in the Chicago clinic. But this observation was confirmed once I started working in their Kentucky clinics.
The Chicago physicians would only see less than 15-16 patients per day, and acted like they were exhausted after that. Not to mention they would finish late. Meanwhile the Kentucky PCPs and other sites I have been, see at least 21-23 patients a day, and finish on time.
The patients at the Chicago clinic weren’t as sick and complex as the ones I had seen in Kentucky and Virginia. Realistically, the Chicago PCPs shouldn’t have had patients in the hospital on a regular basis. I often witnessed them send their patients to the ER for mild things such as an abscess that could have been treated with oral antibiotics or for a cough that could have been evaluated further with an in house chest x-ray (pre-covid).
Now let’s talk about walk-ins. The PCP lead of the Chicago clinic would flip out if she had to see one walk-in per day. I thought the walk-ins were rather light at that clinic. On an average day there were only 2-5 walk-ins. In comparison, I worked at one of their Virginia clinics and there were 20 walk-ins per day there! In Kentucky, there is a decent amount of walk-ins but the PCPs see their own walk-ins. This makes sense since the PCP knows their patients best. This is different from Chicago, where the physicians would always ask me to see their walk-ins, since I was always more efficient than them.
So why are the doctors in Chicago spoiled? Because they are seeing less patients than Kentucky/Virginia – less patients that are also less complex and sick – and still have the nerve to get upset when they have a walk-in or if I don’t offer to help them.
It used to be challenging for me to keep a straight face when one of the physicians would not see her 4pm walk-in but then when the patient went to the hospital, she would tell leadership she doesn’t know why the patient went there because she already told the patient to call her if she needs anything.
A big corporate management problem costing them lots of money. Maybe you could contract as a consultant by the head medical director and CFO to visit all the facilities, undercover as an NP, to audit the patient care management of each clinic, then write a factual report of what goes on. Seems like the Virginia clinic was more profitable than the Chicago clinic. Maybe you could be a corporate employee to oversee the clinics instead of a provider.
Haha that’s funny because all of my coworkers think I do that under cover!
After just having one of the worse clinical days of my life, due to the scheduling of pts with multiple co-morbidities, I’m so burnt out.
I’ve been a CPNP for 24 years. Yesterday, every crazy kid with suicidal ideation came to the office. These pts were scheduled in a ten minute time slot! Of course, I was the only provider in the office. Factor in the fairly new MAs who don’t know how to read the Ga registry of immunizations, and I was burnt early in the a.m.
When they pre-populate the order set with bizarre immunizations, I always make them show me the GRITS record.
I don’t have time for this crap, plus they run to the ‘clinical MGR’ (An MA) to see if my orders are correct! I have never been wrong, in the past 4 mo at this job. WTF. Who’s the provider here? I promise you, after 24 years, I know the immunization schedule!
We are having a provider meeting this coming Tuesday, 8/25, to discuss this crazy scheduling.
Just bc a mom calls, the front desk needs to find out more info – don’t just put one dx down, in a 10 min time slot. Especially when they are new pts, and have an extensive psych history, want meds. NO! Back up. Let’s get a Hx by the phone girls.
I’m so tired of going in, in a ten minute slot, with a mom who has 5 C/O. I’ve now started saying, pick the most important to you, and we’ll deal with that, then RTC for other c/o. I’d never accept that from my internist!
Yesterday’s moms, new PT, no PMH on file, dx with ‘benign infantile myoclonus’ . No Neuro work up. Mom states s/s getting worse. Had a ton of other questions/concerns. Baby was due for 15 mo WCC. We’ll address other issues at that time. Mom agreed. When I tried this later on in the day, mom was not having it!
I don’t have time to do a thorough job. Yesterday I was alone in the office. Saw 27 pts, plus 3 telehealth that were scheduled at the same time as in-person visits. The MGR was up my butt about seeing the telemedicines. What do u want me to do? Walk out on PT I’m with, whose also waited, just to deal,with telemedicine vs?
I’ve been a CPNP for 24 years, a nurse 18 yrs before that. I’m not a young newbie, nor do I expect me, or the newby to be treated disrespectively. I’m used to working quickly, but I don’t have time to review a kids PMH until I’m in room., which then throws me way behind, if a lot of pathology.
I am not about to compromise my in-depth, standard of care at this point. I don’t see myself being here for long. They also have ‘allergic rhinitis’ RTC in 2 wks for ‘follow up’. That’s only one follow up. They have many that ‘require’ recheck in 1 week. Money makers is how I see them.
My biggest c/o? Giving 5 immunizations vs giving Pediatrx, bc the practice gets more per shot breaking them up into their individual Components. Yesterday, when I said I ‘wanted’ Pediatrix, my MA ran to ‘clinical’ MGR to see if I was correct. She had the nerve to question me in front of Everyone.
The pt in question had private insurance, so I prevailed. We have pediatrix for MC pts, but then he doesn’t get the Doc didn’t get the individual immunizations admin fee!
I think I’m going back to locums work. It’s so much more fulfilling. I don’t get caught up in the day to day BS, which I don’t anyway, bc I’m busy charting during my lunch hr.
Was told this week, not paying me 9 hrs per day (even tho I punch in by 0720.) paying me for 8 hrs/day. Yeah, idt so! Supposed to discuss this at our provider meeting this Tuesday, 8/25.
Sorry to go on, but I’m So pissed, I could spit nickels! (And probably cause a nickel allergy in a kid)!
Wow that’s awful! If they don’t make any changes then definitely run!
Hey Sophia, is there any way to get my last name off my post above? I put too much info into my rant, and then saw my last name. Not good!
Thanks,
Karen
Ok just edited it