Being "Bossed Around by Less-Educated Admins"
"The toughest transition is that the provider no longer has the final say in decisions affecting the logistics of practice," one physician who preferred to remain anonymous told Medscape. "I now have to deal with the human resources department, and unmotivated and sometimes less-than-competent employees. They work for the institution and not me. It is exasperating, but at the end of the month the paycheck shows up. I am no longer the last to get paid."
Some doctors report that hospital administrators treat them with a lack of respect. One female doctor said, also on condition of anonymity, that her biggest challenge on her job was "how to handle nonphysician high school grads bossing you around when they function as your 'superiors' in your employer's organization. They manage their insecurities by bullying physicians and through passive aggressiveness, but always seem to gain the upper hand with those at the top."
Linda Brodsky, MD, a pediatric otorhinolaryngologist who counsels female doctors about their careers, says that gender discrimination plays a role in some of these situations. But regardless of whether a physician is male or female, she notes, "physicians are being increasingly targeted when they get in the way" of hospitals' agendas.
She cites a cardiologist who sold her practice to a hospital and got a 3-year employment contract. Before hiring her, the hospital promised it would support her plan to upgrade the quality of its cardiac program. But it turned out that all the institution wanted was her patients. Because she declined to drop her demands for quality improvement, the hospital let her go at the end of her contract term.
Of course, many hospitals treat physicians far better. "The facilities that have been doing this longer manage their physicians differently," notes Tommy Bohannon, Senior Director of Recruitment and Development Training for Merritt Hawkins & Associates. "They go out of their way to involve physicians more on committees, decisions, recruitment, and policy-making. But at the end of the day, it's still an employer/employee relationship. And if I as an employer feel the dynamic doesn't work for me, I'm going to make a change."
Older physicians who have been practicing on their own for a long time have an especially hard time adjusting to the corporate culture of a hospital or a healthcare system, Bohannon says. When they think about switching jobs because they're unhappy with how they're being treated, he says, "it almost always boils down to the feeling of the loss of autonomy. That's the hardest thing for a lot of the older generation of physicians to get past."
Mary Pat Whaley, a practice management consultant in Durham, North Carolina, agrees. "When you get into this corporate style of medicine, it's a real shock" to doctors who have been practicing 15-20 years on their own, she says.
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Cite this: 4 Top Complaints of Employed Doctors - Medscape - May 08, 2013.