Having worked in over 20 different healthcare settings – I wonder, is there such a thing as a perfect job? I’ve had quite a few jobs that were amazing. The clinic in Maine; the community health center in Washington; the employee clinic for American Airlines; and perhaps even the geriatric clinic in Virginia.
The thing with the geriatric clinic in Virginia, is that the company continues to expand, and with that comes micromanagement. I guess in order for a company to flourish, they need to make sure their mission and goals are aligned and enforced. Although I have continued to work for this geriatric clinic, I have started to become turned off by the micromanagement.
Take for instance my current position in Florida. I enjoy working at the clinic. The patients are very nice and appreciative. The staff is friendly and communicative. My schedule had been fair until I started to be overbooked.
The PCPs should see 18-20 patients per day, as these are all follow ups. Considering I don’t know these patients, I should only be seeing about 14-15 patients per day. One day I saw 21 patients. I was furious because my schedule was full and they still expected me to help with walk-ins. I discussed this with my supervisor and he told me to meet with the front desk daily to review my schedule.
I normally do this, but when I left the day prior I only had 10 patients scheduled and returned the following day with 17 patients scheduled. The staff stayed late that day to add more people on my schedule to meet the rubrics (if they were beyond a 30-day appointment etc.). Even though I have told the front not to double book me several times, there are often double bookings on my schedule and the front desk leadership insists that those patients HAVE to be seen.
Almost every day there is a New Patient that walks in to be seen for an acute visit. Meanwhile, management expects us to do the entire full new patient work up (labs, EKG, screenings etc.) even though this patient doesn’t have an appointment and we are fitting them in in between patients. Management keeps track of what percentage of patients are missing annual labs and screenings per PCP and displays them at weekly meetings.
At this company, everything is being micromanaged. From how many patients a day you are seeing, to how many of your patients are in the hospital, to how many referrals you are placing each day, to how many flu shots you are giving, to how much your patients enjoy coming for their visits etc.
Anyways, the point of this blog post is to remind myself why I would want to retire early. I enjoy working in healthcare and helping patients but I am not a fan of the business side of healthcare. I am not a fan of being micromanaged and having to meet all of these metrics. And I do not like having no control over my own schedule. I know the quality of care I give is good, and I don’t need all of these metrics to prove it. Unfortunately, if healthcare in the USA continues to be a business, they will lose a lot of good providers.
In 15 yrs as an NP in Urgent Care, Primary Care, Geriatric Health Assessments, Employee /Occupational Health, I found that the best is Occupational Health with the next of Employee Health Clinics with large employers. These positions don’t have a business side to them. I’m on my last locums (am retiring) with Occupational Health for a large company. New employee physicals (any problems to follow up with PCP), respirator physicals and fittings, with minor injury care. Major injuries go to the Emergency Department directly.
After many tries, while I stayed on for 6 months as a locums, they found a permanent hire. I consider Occupational Health/Employee Health Clinic the ideal position. Sorry Primary Care.
Haha true that’s why physicians often leave primary care too. I did work at an employee health/occupational health clinic before and there was some business aspect as far as the employer complaining if you give their employees too much time off etc… A lot of physicians advise me to specialize as to not get burnt out but I would be bored doing the same thing all day.
Yes! So true! I have been an NP for 12 years and a nurse for 20 and it has changed tremendously- we not only have to be NP’s but in my position we have to be social workers, marketing, public relations- it distracts from taking care of the patient ( which is what we want to do) . The last 5 years of healthcare I have loathed because like you they are so concerned w numbers instead of quality of life for the patients. I plan to retire in 13 years ( if I can make it that long lol)
The business and PR side of medicine is depressing and it isn’t getting any better.
I have been working at a primary care Pediatric office since May. They were down to 1/2 days, no late days/Saturdays during the spring and summer.
Now my schedule is packed with well-child checks. I have talked until I’m blue in the face that yes, I understand pts cancel, but when they don’t, and I’m scheduled for triple or quadruple WCC’s, from the same family, in the same 20 min slot (WTH)!!, the pt’s who are scheduled following these clusters have to wait. I can’t be in 2 places at the same time.
Then throw in the late arrivals, and it is just not fair.
Then come the days where everyone cancels, or my schedule is so light, I see 8 kids all day. This is the rationale for packing my schedule – my light days.
Sorry, it doesn’t work like that!!
IDK, I’ll be 66 in Jan, can’t imagine doing anything else, but will be looking for another position soon. Have to give 2 mo notice, otherwise they will withhold any income I would have generated from my last paycheck!!
Wow crazy! I also can’t stand when a parent scheduled one Child for WCC and then ask if we can fit in their siblings… um no. Definitely look into doing travel since you are so close to retirement.
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