4 Top Complaints of Employed Doctors

Kenneth J. Terry, MA


May 08, 2013

In This Article

Not Being Able to Make Decisions About Staff and Personnel

Physicians who once hired and fired staff members in their own practices frequently have trouble getting used to the organization making those decisions. "In private practice, you decide whether the medical assistant (MA) is fired or not," says Hertz. "In a larger setting, sometimes the manager says, 'This MA isn't meeting our needs.' And you come in the next morning, and that MA is fired, and you had no idea that was happening."

This is a hot-button issue for many doctors, in part because the makeup of the staff can affect their own productivity and patient satisfaction scores -- both of which are often factored into physician compensation, Bohannon points out.

"If the receptionist is continually rude to patients, that's going to have an impact on the physician's patient satisfaction scores. If the scheduler is not adequate to make sure the slots are filled and patients are put in in the right order, or the nurse or MA is not capable of handling the throughput and turning patients over in the rooms, all of this has an impact on how much the doctor makes. If the doctor doesn't have control over those pieces, it could be a concern."

Some hospitals managed employed physicians directly, whereas others form separate physician groups with their own governance. The latter structure is often better for doctors, says Hertz, "because hopefully they'll have people who understand the dynamics of working with physicians and the importance of engaging physicians."

The devil is in the details, however. Physicians often can't keep their own office managers, Whaley notes, in some cases because those managers lack college degrees. Instead, the hospital group will assign a "site manager" to the office. A site manager may supervise 3 or 4 offices; if that's the case, Whaley notes, physicians may hardly ever see the manager. "A lot of communication is lost there," she says. "The doctors often feel that that administration is so far away."

These site managers have a lot of power over how practices are run. If they don't have proper training or are inexperienced, they may try managing the doctors like any other employee, Hertz notes. But Bohannon says that most site managers know that if physicians are unhappy, it will reflect poorly on them. "So they're going to try to make the doctors feel comfortable."