Wednesday, April 27, 2005

We are people, too.

I hope you saw the humor in my prior two posts. But, seriously, this is a very mild representation of some of the, well, face it, crap that an ER doc has to put up with. It is much worse at night. I guess it is because during the day you have greater resources available. You can call the primary, talk to consultants the patient has seen and you have greater access to hospital resources. At night, you can rarely get the specific doc who knows the patient and when you do, he doesn't have the chart.

ER docs have it worse than any others, I think. When you are seeing a patient in clinic and are treated poorly, or they treat your staff poorly, you can fire the patient. This, of course, may cost you this patient and a few that the angry patient may influence, but this won't even make an impact on your bottom line.

However, most hospital administrations don't want to lose a single patient. Even those who don't pay. The administrators figure that one angry patient will influence 10-15 others to avoid your ER. Good riddance, you may say, but the administrations take any patient complaint very seriously.

We have to work hard to prevent patient complaints. I used to work full time for a very large ER staffing company. The contracts they had with hospitals stated that the hospital could fire any doc at any time for any reason, without any notice. One hospital I worked in would fire a doc for ONE patient complaint, without even asking the doctor's side of the incident. The contract with the hospital was more important to the company than any of the docs, and the company had a large enough pool of docs to replace anyone quickly.

I know of more than one doc who was fired without notice at the end of a scheduling period. Imagine this: during July, you get a schedule for August and have 160 hours on it. Fine. Good for the budget. During July, the hospital tells the company they don't want you back. The company convinces the hospital to let you finish the July schedule, to prevent scheduling problems, but promises you won't be back in August.

But they don't tell you. Heck, you might just quit right away and then how would they fill the July schedule. So they let you think you are still employed and will have shifts in August. Meanwhile, they have a secret schedule that you don't know about on which they have filled your shifts with other docs.

You work the night shift of July 31. On the way home, your cell phone rings. It is the vice-president of the company. He notifies you that you are no longer employed. So, screw you, forget your mortgage, your family, anything else. You are out. Without even any notice at all to try to find another job. BOOM, gone.

This is NOT made up. This has happened to more than one doc I know that was with that company. Fired on the last day of the month without any notice and without any replacement job. How long does it take to get credentialled at another hospital. At least 60-90 days. I hope you paid attention to your savings.

So you see, ER docs have to put up with the feces served to them by the rudest of patients, day in and day out. I rarely defend myself, but have aggressively defended the nursing staff on numerous occasions.

Not asking for pity parties, just venting. Thanks.