COVID, Contracts, and Changes

[BigSib]

I don't really have any questions but just want to complain so others, especially younger providers, can read a realistic situation. It has been an interesting year here to say the least. We are a small, largely physician run, hospital system in a rural area.

1. "Stay at home." Shut down March 2020. Didn't see hardly anyone for 2-4 weeks. A week or so in more telehealth visits happen which has its limitations.
2. I spent a great deal of time after this discussing various covid related issues for a countless number of hours in meetings. Helped put out a lot of fires. Basically we had 1-2hr of meetings per day, every day. Day after day. Day after day after day. It would take me forever to explain this in detail. One surgeon wanted to line the surgical locker room and OR hall with tinfoil from Home Depot and place several disinfectant UV lights in the middle. That would have apparently allowed them to do more surgeries. Another wanted to drill tiny holes in every exam room window and jury rig a box fan outside so as to create a negative pressure room. True stories, but a small tidbit of the bull**** I had to muddle through on a daily basis. None of that was compensated of course bc hey nobody planned for the pandemic.
3. COVID hit locally big time Nov-Dec 2020. My hospital and sister hospital was on bypass for 2-3 weeks; we made NPR about the rate of rise at least. Things were bad. Emergency privileges were granted at the nearby institution. Staff filled in when necessary. People were starting to get desperate as we didn't have enough basic staff (RNs primarily but also CNAs, janitors, etc). The desperation in those moments cannot be described easily. Regional news and politicians were talking about a bad nursing home outbreak which was par for the course for the other several care facilities in the area that had no mention in the news around this time.
4. Just when you think things will settle down: ransomware attack Feb-Apr 2021 with zero access to EMR, no CT scanner [yes really for 3 mo], any plain film done you had to physically go to rads and look yourself on the little screen, and lingering issues like random results coming through months later. Basically it was like another lock down from my perspective as we barely saw anyone, didn't know who was scheduled, and even if we did we had no means to contact them. 'What meds are you taking?' 'Huh isn't that in the chart?' [staff calls pharmacy again and cue the sighs]... Anything scanned at this point (August 2021) takes weeks to show up in the EMR. There's a very large room full of papers stacked to my head they're still scanning in...

RVUs have been down big time over the past year. I make up for a lot of this through newborn rounding and hospitalist work, so overall this hasn't affected me a whole lot. TO TOP THIS OFF our hospital system has bought the next town over's hospital system: hospital, multiple clinics, etc. The deal went through before the pandemic but the transition has been delayed for the above reasons. They're actively consolidating but have not really included physicians in the decisions as they had before. Everything is being done behind Oz's curtain in secret. No questions can be answered. Recently the decision was made to shut down our inpt care, ER turning into 'urgent care,' OR becoming a same day surgical center, and many other changes. Up to this point every major decision was made by physicians on staff in committee. All of this has been unsettling to say the least, and most every provider I know feels the same way.

Many older physicians have retired or are retiring within a 30 min radius. One within the building is in their 80's with thousands of pts; they set a retirement date, yet there isn't any discussion about a transition plan to care for the many pts in house. I'm not aware they're recruiting. No new blood for at least 3 yrs and I'm the newest Dr in the system other than two specialists (several PCPs have left).


Other than head for the hills, what would you do?

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[deleted87716]

Holy ****, dude...

If you otherwise like the area and aren't keen on leaving, the fact that everyone else is may give you some negotiating clout with the suits. Maybe. If not, GTFO.

 

[FrustratedFamDoc]

Yeah, that's pretty terrible. Besides my numbers being down and the mild annoyance of masking all day, things have been largely business as usual for me.

I have a soapbox regarding the hospital staff shortages. This has been a long going, and unfortunately purposeful. Why pay for more people when you can squeeze the existing staff a little harder and throw a trivial raise their way every once in a while to shut em up? It's just now the hospital systems who insisted that staff just see more patients and stop complaining, have been outed and are woefully unprepared for when the fit hits the shan.

 

[Sushirolls]

You have experienced a flavor of the koolaid served by Big Box Shops. Congratulations. Time to strike out on your own and create your own private practice.

Silence by admins only means pending decisions are extra hurtful.

Move on before you enter the fold of burn out.

 

[Sushirolls]

Positively though, assuming no non-compete, you can open up shop right where you are and as people scramble from the sinking health system you'll be there to welcome them to your practice.

 

[anonperson]

I don't really have any questions but just want to complain so others, especially younger providers, can read a realistic situation. It has been an interesting year here to say the least. We are a small, largely physician run, hospital system in a rural area.

1. "Stay at home." Shut down March 2020. Didn't see hardly anyone for 2-4 weeks. A week or so in more telehealth visits happen which has its limitations.
2. I spent a great deal of time after this discussing various covid related issues for a countless number of hours in meetings. Helped put out a lot of fires. Basically we had 1-2hr of meetings per day, every day. Day after day. Day after day after day. It would take me forever to explain this in detail. One surgeon wanted to line the surgical locker room and OR hall with tinfoil from Home Depot and place several disinfectant UV lights in the middle. That would have apparently allowed them to do more surgeries. Another wanted to drill tiny holes in every exam room window and jury rig a box fan outside so as to create a negative pressure room. True stories, but a small tidbit of the bull**** I had to muddle through on a daily basis. None of that was compensated of course bc hey nobody planned for the pandemic.
3. COVID hit locally big time Nov-Dec 2020. My hospital and sister hospital was on bypass for 2-3 weeks; we made NPR about the rate of rise at least. Things were bad. Emergency privileges were granted at the nearby institution. Staff filled in when necessary. People were starting to get desperate as we didn't have enough basic staff (RNs primarily but also CNAs, janitors, etc). The desperation in those moments cannot be described easily. Regional news and politicians were talking about a bad nursing home outbreak which was par for the course for the other several care facilities in the area that had no mention in the news around this time.
4. Just when you think things will settle down: ransomware attack Feb-Apr 2021 with zero access to EMR, no CT scanner [yes really for 3 mo], any plain film done you had to physically go to rads and look yourself on the little screen, and lingering issues like random results coming through months later. Basically it was like another lock down from my perspective as we barely saw anyone, didn't know who was scheduled, and even if we did we had no means to contact them. 'What meds are you taking?' 'Huh isn't that in the chart?' [staff calls pharmacy again and cue the sighs]... Anything scanned at this point (August 2021) takes weeks to show up in the EMR. There's a very large room full of papers stacked to my head they're still scanning in...

RVUs have been down big time over the past year. I make up for a lot of this through newborn rounding and hospitalist work, so overall this hasn't affected me a whole lot. TO TOP THIS OFF our hospital system has bought the next town over's hospital system: hospital, multiple clinics, etc. The deal went through before the pandemic but the transition has been delayed for the above reasons. They're actively consolidating but have not really included physicians in the decisions as they had before. Everything is being done behind Oz's curtain in secret. No questions can be answered. Recently the decision was made to shut down our inpt care, ER turning into 'urgent care,' OR becoming a same day surgical center, and many other changes. Up to this point every major decision was made by physicians on staff in committee. All of this has been unsettling to say the least, and most every provider I know feels the same way.

Many older physicians have retired or are retiring within a 30 min radius. One within the building is in their 80's with thousands of pts; they set a retirement date, yet there isn't any discussion about a transition plan to care for the many pts in house. I'm not aware they're recruiting. No new blood for at least 3 yrs and I'm the newest Dr in the system other than two specialists (several PCPs have left).


Other than head for the hills, what would you do?

Unless you are part of the decision making process/inner circle there is nothing you can do other than leave.

It's a sign of terrible leadership when there is a lack of communication with employees.

I am experiencing that with my current job and have given notice and am leaving.

The good news is that most physician specialties are in demand, so it's easy enough to find a better job.