Clowns

[WhatJobDoIPick]

One of the reasons I left my hospital employed job was the lack of any semblance of Leadership.

I might be off base, but I view the filling of shift holes to fall as the feet of the people who call themselves leaders (chair, etc) if no other coverage can be found.

How does it work at your shop?

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[Porfirio]

They look for anyone else to do it. Leadership is busy doing leadership things.

 

[JacobMcCandles]

It depends what kind of group you’re in. If you’re in an SDG then that falls on the owners so I view it as my problem. If I worked for a CMG, I wouldn’t view it as my problem. If I worked for a hospital, I might feel somewhere in between depending on the relationship.

 

[RuralEDDoc]

It also depends on baseline coverage. If you have quadruple coverage and someone calls in sick, I don’t expect anything to happen. It’s just triple coverage instead. Single coverage or high volume double coverage is a different story - leadership needs to get that shift filled.

 

[xaelia]

It also depends on baseline coverage. If you have quadruple coverage and someone calls in sick, I don’t expect anything to happen. It’s just triple coverage instead. Single coverage or high volume double coverage is a different story - leadership needs to get that shift filled.

Less so that "leadership needs to get the shift filled" overall, as the OP seems to imply – but that leadership needs to have thought it through and have a plan. It might be that it just gets left open if there's sufficient coverage to ensure safety, an explicit backup roster, or that overlapping shifts get extended, etc. Just needs to be a durable and achievable plan in place for the inevitable one-off, short-term, and long-term absences that inevitably occur.

 

[emergentmd]

Our SDG - fell on doc who needed coverage. If an emergency, fell on other partners via begging. If still no coverage, fell on the medical director.

CMG - Who cares. No docs feels obligated. Medical director should cover but if not, then who? Many times if there is double coverage, they just run short. When there is no ownership, then why would I lose my precious down time to cover for another doc unless I personally like him?

 

[Pudortu]

Currently a director for a CMG at multiple sites that are absolute dumpster fires for coverage. I feel zero obligation to pick up extra shifts. It’s the CMG’s duty to cover those shifts. I don’t share in their profits. My meager stipend is for all the admin BS I have to do. I have a life and it’s not my responsibility to be on sick call coverage. Otherwise I would want to be paid 500k just in admin stipends. One time one of my colleagues told me I have a duty to pick up a shift if someone was sick. I think they were genuinely shocked when I told them that was nowhere in my contract or my duties. I don’t think people realize that’s what you get with these CMGs and people just assume it falls to the director.

 

[WhatJobDoIPick]

Currently a director for a CMG at multiple sites that are absolute dumpster fires for coverage. I feel zero obligation to pick up extra shifts. It’s the CMG’s duty to cover those shifts. I don’t share in their profits. My meager stipend is for all the admin BS I have to do. I have a life and it’s not my responsibility to be on sick call coverage. Otherwise I would want to be paid 500k just in admin stipends. One time one of my colleagues told me I have a duty to pick up a shift if someone was sick. I think they were genuinely shocked when I told them that was nowhere in my contract or my duties. I don’t think people realize that’s what you get with these CMGs and people just assume it falls to the director.

Agree for CMG.

For hospital system where these admin jokers are working 1 day shift / mo, I think they could pick up a shift.

The amount of good will they would generate would be enormous.

 

[alpinism]

In my experience most admin become admin specifically cause they hate clinical medicine.

Its one of the huge problems with EM that most leaders don't even like to practice the specialty.

 

[RuralEDDoc]

Less so that "leadership needs to get the shift filled" overall, as the OP seems to imply – but that leadership needs to have thought it through and have a plan. It might be that it just gets left open if there's sufficient coverage to ensure safety, an explicit backup roster, or that overlapping shifts get extended, etc. Just needs to be a durable and achievable plan in place for the inevitable one-off, short-term, and long-term absences that inevitably occur.

+1
Thank you for artfully completing my thought

 

[EctopicFetus]

One of the reasons I left my hospital employed job was the lack of any semblance of Leadership.

I might be off base, but I view the filling of shift holes to fall as the feet of the people who call themselves leaders (chair, etc) if no other coverage can be found.

How does it work at your shop?

In my SDG we have a mix of a backup system in our group. Depending on the site we utilize this person or the site itself will figure it out. We don’t really put the burden on the sick doc as they are usually dealing with a family issue/illness.

 

[alpinism]

Perfect example of the lack of leadership in emergency departments:

So I was on nights last week and our chairman was scheduled to relieve me in the morning. Waited for about 10 min before we called him and he's apparently not coming in until noon and the vice chairman was supposed to cover but had forgotten. Had to stay for about 30 min until they convinced another night shifter to stay late and cover the beginning of their morning shift. Didn't receive a single apology and they still expected that I come back on time for the next shift. I confront him about it and he can't understand why I'm upset since "It's only a few min that's nothing" not to mention "Its part of being a team player that sometimes you have to stay late."

The best part is that of course he literally never works on nights or holidays.