September 16, 2015
Many already-employed doctors are too quick to start job hunting. They’re convinced things will be better someplace else, that a new job will offer the autonomy-including control over staff relationships-they’d have if they worked for themselves.
Unfortunately, that’s a myth. Unless the circumstances are intolerable, it’s usually preferable to stay in the job you have; the devil you know is better than one you don’t. No job will be perfect, and discontented doctors often find that they’ve hopped from frying pan to fire in a quest for professional nirvana.
Worse, the more they move, the less salable they become. Employers want doctors who’ll stay around, not leave after a year or two. So they may shun doctors with “jumpy” résumés.
That said, there are legitimate reasons to put out feelers. Consider these scenarios:
You can’t stand your colleagues
“Hell is-other people!” wrote Jean-Paul Sartre. No matter where you work, this is at least somewhat true. But if your colleagues, as a group, irritate you beyond words, if they habitually show you no consideration, if you’ve reached the point that you hate being around them-you can probably do better elsewhere.
One family physician who came to our search firm told of a colleague who’d phoned him from the airport. “I’m off on vacation for two weeks,” the caller announced happily. “My plane’s leaving in a few minutes. Do me a favor and take call for me until I return.”
The FP was stunned. But he felt he had no choice; the other physician outranked him in seniority. Such thoughtlessness, multiplied many times over by many people, is a legitimate reason for jumping ship.
Your day is constant conflict
If you routinely argue with administrators, nurses, and other doctors, it’s probably time to make a move. If you’re convinced everyone else is wrong and you’re right, and you have a history of combativeness on the job and in other areas of life, professional counseling could help. Even so, you may have alienated enough people at work that a fresh start somewhere else is the wisest course.
A powerful enemy is out to get you
Every organization has its big cheese. Rub that person the wrong way-you’re not deferential enough, you hold contrary opinions, your values clash-and your career growth there will probably come to a screeching halt. If you’re ambitious, leave.
You’re perpetually out of the loop
Perhaps because you lost a key political battle, you’re frozen out of the organization’s information circuit. That doesn’t mean just the office grapevine. News that you should be privy to as a valued staff member of the group or hospital is routinely kept from you.
Always the last to learn that your employer has signed a contract with a new payer, acquired a new group, opened a branch office, decided on a new computer system, or appointed a new medical director? If so, the organization is sending you a message. A doctor who’s valued is always kept in the loop.
You’re fed up with hassles
Doctors who’ve sold their practices to hospitals and remained as employees often make this complaint. They expected their professional lives to get easier once the institution took charge of payroll, billing, personnel, and much of the paperwork. But the reverse happened.
Recently, I watched as an orthopedic surgeon walked to the podium to address the medical leadership council of a large integrated delivery system. He didn’t look happy.
“You guys bought my practice,” he told the assemblage, “and the next thing I knew, you fired my best physical therapist. Your accounting department did some analysis that supposedly showed how using one of your PT people would be more cost-effective. But my therapist got patients with lower back pain out of the office faster than anyone, and they sang her praises. Her replacement is paid less, but she works slower and doesn’t do nearly as good a job. You didn’t look at results; you just looked at money. And now my patients are complaining.
“As if that wasn’t enough, you then switched me from a company that handled my billing efficiently to some schlock outfit that only collects about 65 percent of the bills.”
He cited other snafus that were wearing him out. “When I sold my practice, you told me that we’d be partners,” he continued bitterly. “Never use the word ‘partner’ around me again. Partners don’t treat each other the way you’ve treated me.”
One thing was clear: It was time for that doctor to move on down the road.
Your great idea was a disaster
Let’s say you were instrumental in convincing your organization to build a costly facility in a market where it hadn’t established a presence. Now it’s a year later, and the operation is hemorrhaging money.
That can mean slow death for you professionally. While you may not be fired, you may find yourself frozen out of important committees, with your advice no longer sought. If you want to be more than just another drone, an exit may be in order.
You lost your cool, big-time
Some doctors throw such tantrums that recovery is impossible; their only option is to move on. At one clinic, a hot-tempered surgeon phoned the administrator to locate the chart of a patient who was due momentarily for an office consult. That record, the administrator replied, was one of several the medical director had selected at random for utilization review.
The surgeon erupted. “Tell that blithering idiot to give you my chart-stat!” he roared. “Then you personally hustle it on down to my office!”
After you’ve blown a fuse like that, getting your résumé in shape is the logical next step.
The board fails to support you
Clashes often occur among doctors in big groups over organizational policy on what can and can’t be done for patients.
Suppose you’re a young doctor, trained to provide treatment that’s both good and cost-conscious within a managed-care environment. Now you’ve joined a group where the doctors are paid a salary and productivity bonus. You discover that some of your colleagues continue to order lab work, X-rays, and other tests liberally-as if the practice of medicine hadn’t changed dramatically.
Even though your productivity is high, your annual bonus is paltry because the group’s revenues are only a fraction of what they could be-a problem that you point out to the group’s board. As senior partners, however, their shares of the bonus pool are generous. As far as they’re concerned, nothing’s amiss. They see you as a doctor who wants to skimp on patient care in order to make a buck. On the other hand, you see them as people who line their pockets with profits earned by your sweat.
That’s your signal: It’s time to leave.
You simply dread going to work
Each morning, you struggle just to get out of bed. You’re not tired from working hard; you’re suffering from professional malaise. You feel chronically depressed-and unbearably bored with your job. When you trudge to the bathroom and stare into the mirror, you think, “I can’t keep doing this.”
Such terminal ennui is common among primary-care physicians doing menial triage in urgent-care centers. They’re especially vulnerable if they’re nearing a significant milestone-a 40th or 50th birthday, for example. “I’m better than this,” they tell themselves. “It isn’t what I went into medicine to do. I have more to offer.”
If you’re in this situation, not even a sabbatical or long vacation will help. There’s only one antidote for long-term drudgery-a new job.
This article was published by Cejka & Company and originally appeared in Medical Economics Magazine. Copyright by Medical Economics Company Inc. at Montvale, NJ 07645. All rights reserved.