Concerns about my supervisor and hours verification

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NerdDoc

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I have found myself in a concerning situation. I am in a private practice setting. It is a well respected group practice in the area and I was very excited to be doing my post-doc here. My supervisory experience has not been great and there have been some issues. My supervisor (SV) started out amicable at first but became very short and dismissive with me when I ask questions. I have been instructed to take the lead during interviews with clients but she cuts me off after one or two questions and takes over. I will be given feedback on reports that is vague. One example was my reports were too technical. I asked specifically how and what I should do to change it. I was told to reread my reports and think about what I should do. I made my reports more accessible for a reader with less technical jargon. I was then told my report was too plain and simple and it needed to be more technical. Contradicting herself has been a common theme. I will be told to do X, Y, and Z then next meeting I am being questioned why I did X, Y, and Z. When I respond that she had told me to do it, I am then told I misunderstood her. Part of what drew me to this practice was the opportunity to receive training from many different psychologists and was told to do so. Anytime I work with another doctor I am questioned by my SV what I am doing. If she sees an appointment on my schedule with another doctor she gives an irritated sigh. There is much much more. I have 4 typed pages of problems and issues.

My first official review by head of the practice occurred 7 1/2 months in. I was told I was not progressing as fast as I should and I need to step it up. She provided me with specific actions that would help like putting in more hours (I originally worked 8-5 so I began working 7-6). My SV questions me why I come in so early and stay so late. I was told to reach out to the other doctors more. I approached a doctor about working on a very interesting and unique case. She told my it was not a good idea and that my SV wouldn't like it. She even reviewed some of my reports and provided some feedback on how to improve them. My SV took out all the changes I made based on that feedback. I have tried to just keep my head down and do what she wants of me the best I can.

So now I bring us up the the present and my main problem. I had another review at the 9 1/2 month mark into my post-doc. I was told I am am unfriendly in the office (I love talking with the other doctors and office staff). I am providing sub-par work. They feel I should not have even started postdoctoral work as my education and training were poor. I was informed this is a business and the reason they took on a postdoc was they would lighten the SV workload so they would be able to make more money. As such I am costing them money. She said if she was ever contacted for a reference she will tell them I should not be allowed to practice unsupervised and I could not produce competent or ethical work. I felt like a was punched in the stomach. This came directly out of left field. I asked if this meant they would not sign my hours. I was told I had worked the hours and they would verify I had completed the required 2,000 hours at the end of my year there.

My main concern is at the bottom of the form there is a box she will mark yes or no asserting that I am fully ethical, professional, and qualified for licensure. So she can technically sign off that I have completed my hours but I am not qualified for licensure. If she marks that I am not, will my hours then not count and I will not be licensed? Is this an automatic denial or is a review then completed? (this is in FL btw). Also should I raise my concerns over the quality of my supervision with the head of the practice or will this only cause more issues? She is not mean or unfriendly but she is stern and does not like complaining.

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Not knowing about your training or any previous issues you've encountered in your clinical work, it's hard to recommend a course of action. But it's striking to me that you're a postdoc and your supervisor is sitting in the room with you. Who decided to do that?

Have you reached out to faculty and supervisors from your previous training for advice? I think it's reasonable to meet with the head of the practice but I feel as though there's more to this than you've revealed so far.

As for their concerns about your readiness for postdoctoral training, the decision to hire you was theirs, so I'm not sure what they expect you to do about that. If they had simply wanted someone to generate revenue they could have hired someone with a license.
 
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It's very common for supervisors to directly observe interviews and feedbacks in neuropsych assessment work at times.
Oh no, it's every single evaluation. All 100+
I had more autonomy during internship and practicum
 
I feel as though there's more to this than you've revealed so far.

I know I'm far from innocent in all of this. I could always work harder, be more proactive, clarified issues with her more in the beginning, etc. In retrospect I should have insisted on a supervision contract in writing with clearly defined purpose, goals, and objectives including formal reviews and a remediation plan if necessary. I just wanted to illustrate some of the issues and the progression from being not quite where I should be to where I should not have even graduated and cannot be competent in a span of 2 months. Just to put the situation into context.

My main concern is if they sign off on my hours but mark down I am not qualified, what happens? Also what recourse do I have? This is not a formal postdoc so I do not have any governing body or authority to contact with concerns.
 
Could you call the FL licensing board and ask (anonymously) what would happen if they do not check that box?

(I also have a friend who is a postdoc in FL and had to have the supervisor sit in on intakes...some sort of regulation there).
 
Could you call the FL licensing board and ask (anonymously) what would happen if they do not check that box?

(I also have a friend who is a postdoc in FL and had to have the supervisor sit in on intakes...some sort of regulation there).

I know that some states require the licensed supervisor to be present in order to bill for the service, but if the postdoc is expected to multiply the supervisor's productivity then that doesn't really add up, unless it only applies for assessment and not for intervention.

That's not altogether uncommon, either, in some settings.

That's interesting. I didn't know that some neuropsych fellowships were structured that way. That seems like it would be hard to sustain without dedicated time for teaching or a training grant.
 
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My main concern is if they sign off on my hours but mark down I am not qualified, what happens? Also what recourse do I have? This is not a formal postdoc so I do not have any governing body or authority to contact with concerns.

Sure you do. Like CheetahGirl said, clinical supervision issues are within the purview of the state licensing board. It sounds like a good idea to call them.
 
Hopefully, for you your supervisor had the knowledge and experience to create a detailed contract dealing with everything FL and most states require for licensure, financial issues, time/hrs, etc. The contract will specify what recourse you have or do not have. Ethically we are tightly bound to protect patients and somewhat the profession but (unfortunately) for the most part we can screw over residents in many ways and they are at our mercy. One issue I often see is that the resident is expected to grow a practice and many go in and sit all day waiting on patients to call (this is very true of students from a particular FL program). It just doesn't work that way in many private practices.

The FL licensing board will want to see your contract, evaluations, and case samples IF you decide to pursue a complaint, but FIRST they will tell you to approach the supervisor and discuss the issue and see if things can be resolved.

I've not signed off on one resident because she failed to meet the standards set forth, but it was known by the both of us that I wouldn't sign off and ultimately the person couldn't pass her EPPP and decided a different career was in store. She had an excellent background, great recommendations, etc but when it come to testing and reports and just plain self management she was not competent.

Good Luck and seriously if at all possible work this out with your supervisor before getting others involved.
 
That's interesting. I didn't know that some neuropsych fellowships were structured that way. That seems like it would be hard to sustain without dedicated time for teaching or a training grant.

Some VA settings. Generally more time allotted for training/supervision. I observe all of my interns interviews and feedbacks. I observe the first several of my postdocs, and then maybe some here and there sporadically.
 
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I observe my fellows in the beginning (utilizing a developmental approach to supervision), then share parts of the intake, and then eventually transition the lead and responsibilitues to the fellow. I still pop in to initial intakes with my fellows here and there, though by year two...it tends to me just following up w the pt (part of my state's supervision req. and good practice). The model is such that we discuss all of the cases, but the fellow eventually takes the lead on conceptualizing the case and eventually doing everything soup to nuts.

It is definitely a more "hands on" approach than some other styles, but I find it ensures competency and there aren't any surprises at the end of the rotation/year/fellowship. It takes more work on my part and I can bill less of the time, but prividing a solid training experience is part of my academic mission as faculty.
 
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