After the first week where I had the incident of the medical director micromanaging me, things went smoothly. I think the medical director realized I know what I am doing because he hasn’t bothered me since. In fact, he is constantly thanking me for my help and letting me know that I could stay as long as I want to.
The other PCPs are really nice too, they see their own walk-ins and even offer to see the walk-in that the nurse asks me to see. I only had one bad afternoon out of my entire first month. I had a packed schedule and was surprised to have a new patient show up at the end of the day with only a 20 min slot. Typically, our new patients are scheduled for 40 minutes, in reality they are at the clinic for 2 hours between the visit with me and all of the work up testing.
At that moment I felt very overwhelmed because I already had 4 patients in the clinic (some brought early due to transportation), and one of them was already a new patient. I asked the front desk how come the new patient was scheduled only 20 minutes and they said the clinic manager had approved it. Of course, the clinic manager wasn’t there for me to confront, so I told them they would have to reschedule the patient. Apparently one of the other PCPs had an opening so they transferred the patient to her.
The following day I couldn’t wait to ask the clinic manager why he thought it would be a good idea to schedule a new patient with me in only 20 minutes, especially since all of the patients are new to me and I can’t be efficient as I could be had I known these patients for months or years.
Before I even had the chance to approach the clinic manager, he came up to me and apologized for scheduling that new patient incorrectly and not talking to me about it beforehand. I was grateful for his apology and I took the opportunity to tell him I needed the last slot of my schedule blocked. As my patient panel is rapidly growing, I am beginning to become overwhelmed and need that time to return phone messages to patients I do not know (since I am covering for the newly retired PCP).
He said ok but later came to tell me that if he blocked the lost slot of the day, he would have to remove the block before lunch (that all of the providers including me have), in order for me to meet the expected amount of patients per day seen.
I told him that in my contract I have it listed that I am only supposed to see up to 16 patients per day – not the 18-21 patients per day that the full time PCPs are required to see. Considering I am a temporary PCP, this is the number I am comfortable seeing since the patients are complex geriatrics and I am only there briefly.
He said “oh sorry I had no idea!” and I told him it’s fine that usually I have more blocks on my schedule, but I am trying to be flexible since I know there are a lot of patients that need to be seen. But at the same time, I need him to work with me to make sure I don’t get burnt out and am not working too much overtime. It’s funny because I have been working with them on and off for the past 5 years, so I make sure to get everything I need listed in my contract before starting the assignment, to cover all bases.
At the end of the month I won an award for having no patients in the hospital during my first 4 weeks there. Out of 22 PCPs in the market it was just me and another nurse practitioner that got this award. Go figure. It’s about time they got a taste of what I am made of.
Good JOB!!
Thanks! My friend made fun of me for being pompous on the post 😂
Seriously, it must be quite nice to be able to say how many patients you want to see in a day, and to have this much control over your schedule. Even at the full time permanent job I had before going back to locums, I had NO say. The office manager was very poor; really, I’d say incompetent at best. At least when it came to working with the providers. I had to go to one of the MD’s on staff for advice on how to get them to listen to me to manage the patient load before I quit. I had to go part time just to keep up with documentation; eventually, just gave up the battle and quit.
This is the first locums position in 7 years. I’ve grown and learned a lot in that time, and was able to have some input into my schedule prefs this time, but not as much as you do. I’ve found what can make or break you is the support staff, and fortunately this clinic has a strong support staff (actual RN’s even!) that are great to assist a locums.
Also, am finding SO many recruiters not willing to license any more. If you’re licensed for your preferred assignment, no trouble, but no-one seems to be willing to present for any position without license in hand, even if it’s a few months out. Do you have any thoughts on this?
Yeah I feel like the recruiters have always been that way. They are only willing to license you in a state where they know they have opportunities there all of the time. For the most part I get licenses on my own and have them reimburse me when I accept an assignment in that state.
I think the only agencies willing to proactive license you are ones you worked for before.
In my dreams to only see 16-18 patients. Currently I am I am seeing 25-30 patients in my CA locum assignment. When they see you very efficient they load you more. Several times I saw 40 patients in 8 hour shift. At the end of the day, my shoulder and neck hurts. I thought most of the provider has that load. I didn’t even asked until I spoke with the NP perm provider. She only saw 25 patients/day. I ask them to why I was seeing 40 patients and they said I was too efficient and the other provider is very slow. WHAATT? that’s their reason hahaha. I cant wait to finish this assignment. In this clinic their goal is to see #### of patients with no quality of care! and your license is at stake! By the way this is Golden Valley health care system.
Wow! that’s horrible. You are so right they try to give you more when they see you are efficient. But I always put my foot down. I see 16-18 patients in geriatrics bc they are so complex. In regular primary care the most I would see is 22 patients. I choose my assignments based on the number of patients expected to see per day. I would never see more than that.
Sad to see that. What is a good way to negotiate this into the contract? Would love to know how one could get the recruiter to understand human limitations.
Or the office manager, who ultimately is the person who sets the schedule. Often with input from the medical director; but sometimes it’s just how it’s “always been done.”
Yah I only take assignments that are 20 patients per day or less. But in this case it is geriatrics so even less is better so I put in my contract my max patients per day is 16 and the site says they are fine with that.
The other locum did not last. She left in 3 weeks and the perm NP they had left without saying a thing. I would never agree to a contract to see 30-40/day. They just put more patients when they see you are done and completed your notes. Now I know how to play it right next time 🙂
The other locum did not last. She left in 3 weeks and the perm NP they had left without saying a thing. I would never agree to a contract to see 30-40/day. They just put more patients when they see you are done and completed your notes. Now I know how to play it right next time 🙂