Bad if I am starting to hate a new job I thought I would like?

[SomeOtherUser]

I started a new job recently, moved from a underfunded community place that never had enough staff and support in mid-Florida to a big center that is academically oriented and is a "brand" name closer to a city in Florida. Things that attracted me are a slightly higher salary, supposedly more potential, not having to do a lot of nonphysician work. Slowly finding out that I am not as happy as I thought I would be.

This is place cares a lot more about patient satisfaction than appropriate emergency patient care. Every little thing goes under a microscope. Patients can say anything and the doc gets **** on. VIP patients have to have their asses kissed or there will be 4-5 phone calls from admins, and we're forced to admit them for non-emergent things because they're "VIPs," while regular patients can't even get beds. It's very stressful. There is air of heaviness and superiority.

When I'm working I can get in the flow of patient care but it always seems like I'm doing more than I normally would because "the brand name," so patients get more non-emergent or unnecessary labs and imaging.

I'm also not getting the support I was under the impression I would getting. I was hired to start a simulation program. Is it bad that I would expect my boss to arrange meetings to see what what I need, and how my goals are going? I feel like if I were a chair and I hired someone to do a job and told them I'd support them, I would go out of my way to find out what they need. I currently have no supplies, no support, and I'm not even sure how to ask my boss for things because it seems like the few time they reach out its to address a bull**** complaint. I'm always afraid to open my emails because I'm worried it's gonna be another useless email about how the docs need to perform better and kiss patients ass more.

Sometimes in not even sure I made the right decision to switch, but I know I wasn't happy at my old place. What would you do? Thanks for any advice.

TLDR: Not happy about new job, not getting enough support and admin cares to much about patient satisfaction and VIPs. ED has very little power. Getting depressed.

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[DoctorJDO]

you gave way too many specifics about your job. I'd remove some of that detail or your boss might not be too happy about you calling them out in a public forum. I work at a similar place. I've noticed that the docs who survive just go with it. smile, click some lab orders, order some unnecessary meds, go back, tell them that they will be ok, and if they don't like it, just admit them. then you go back to your office or charting area, kick up your feet, and do it again. it's an easy life. you can make good money. It's not why a lot of us got into this. If you actually wanna do a good job or better humanity, you can't do that long-term. Maybe you could consider going pool/part time between both places, get the best of both worlds?

 

[kumatie]

Every job in EM sucks now. I have jumped around so much looking for the perfect job or at least a better job, and now finally realize it all sucks. I am with ya. It is Depressing as hell to come to this conclusion. I feel the same way with emails. Just opened one up that a patient complained that they saw me sneeze in the hallway. WTF?

 

[RustedFox]

Every job in EM sucks now. I have jumped around so much looking for the perfect job or at least a better job, and now finally realize it all sucks. I am with ya. It is Depressing as hell to come to this conclusion. I feel the same way with emails. Just opened one up that a patient complained that they saw me sneeze in the hallway. WTF?

QFT.

- and I like my present job.

 

[namethatsmell]

This is place cares a lot more about patient satisfaction than appropriate emergency patient care. Every little thing goes under a microscope. Patients can say anything and the doc gets **** on. VIP patients have to have their asses kissed or there will be 4-5 phone calls from admins, and we're forced to admit them for non-emergent things because they're "VIPs," while regular patients can't even get beds. It's very stressful. There is air of heaviness and superiority.

This is one of the tradeoffs for working at a more upscale/name brand place or most for-profit hospitals.

The more blue collar (especially rural) you go, generally the less of this **** you have to deal with.

You either need to decide if you can swallow it as part of the price for getting to do sim, or leave. From what you describe this will not get better.

Just opened one up that a patient complained that they saw me sneeze in the hallway. WTF?

Spectacularly lame. Your director either has no power or is weak. Name and shame this place once you've left.

 

[RustedFox]

I left "Country Club 90210 Medical Center" in 2020. Took almost a year away and did other things because I was so burnt out.

Now I work at White Trash General. It's way better (and pays more!)

I don't miss it one bit.

 

[EctopicFetus]

Regarding expecting your boss to ask you what you need? Dude (or dudette), this must be a difference in generational expectations.

It is your job to get done not someone elses to walk you through.

Figure out what you need, email your boss and ask them for your list. A wiser move to be honest would be to get this before you started cause now they have your a$$. hope my comments are helpful. Regarding the quality (or lack thereof) on shift your medical director sucks. Passing along stupid complaints is horrific for dept morale. I have heard of 2 complaints in my 7 years at my current gig. It isnt cause im super sweet or anything it is because stupid complaints get filtered and we dont hear about them. Legit complaints/concerns get passed along.

 

[Birdstrike]

I started a new job recently…. Getting depressed.

I was sold, and naively believed, many recruiting lies about EM when I was young. After working for a few years, I concluded that EM is like you describe, everywhere. Maybe that conclusion was wrong. Maybe it was premature. Maybe I should have tried a few more jobs. But I concluded that was likely to leave me constantly frustrated and disappointed.

My solution was to leave EM, anyway, anytime, anyhow I could. It took a couple of years to make happen. And there were many different ways I could have gone. One happened to stick and I got out. And I’m much happier for it.

I hope things get better for you either at this job or at another. But if they don’t, realize EM isn’t life. It’s not all “EM or nothing.” There are many ways you can utilize your EM career as a spring board to something else that doesn’t make you so miserable, whether standing on the shoulders of your EM career or totally separate from it. I did. Many others have. You might not need to. But if you do have to, realize you’re normal.

Things will get better. Because you’re going to make them better.

 

[turkeyjerky]

Just opened one up that a patient complained that they saw me sneeze in the hallway. WTF?

So utterly ridiculous but completely believable.

Passing along stupid complaints is horrific for dept morale.

So much this! Catering to this BS is completely antithetical to sound leadership and professionalism. I understand why CMGs follow this type of policy (in a semi-intentional effort to engender burnout through 'death by a thousand cuts' thus transforming us into burntout husks ripe for borg assimilation), but I cannot understand how otherwise normal chairs and directors, whose ostensible goal is to support a functional and stable department, would think this is anywhere close to appropriate.

 

[Saddleshoes]

I left "Country Club 90210 Medical Center" in 2020. Took almost a year away and did other things because I was so burnt out.

Now I work at White Trash General. It's way better (and pays more!)

I don't miss it one bit.

Love the "code names"!
I am stealing "White Trash General", it applies to my place from time to time.

 

[RustedFox]

Love the "code names"!
I am stealing "White Trash General", it applies to my place from time to time.

Yeah, admin at Country Club Medical Center really tried hard to trade on the name and acted like we *had the privilege* of working in such an exclusive place. It translated to a very poor hourly rate.

Eff that noise.

 

[EctopicFetus]

My ED is called the TPU which stands for Troll Processing Unit.

 

[SomeOtherUser]

you gave way too many specifics about your job. I'd remove some of that detail or your boss might not be too happy about you calling them out in a public forum. I work at a similar place. I've noticed that the docs who survive just go with it. smile, click some lab orders, order some unnecessary meds, go back, tell them that they will be ok, and if they don't like it, just admit them. then you go back to your office or charting area, kick up your feet, and do it again. it's an easy life. you can make good money. It's not why a lot of us got into this. If you actually wanna do a good job or better humanity, you can't do that long-term. Maybe you could consider going pool/part time between both places, get the best of both worlds?

Thanks, yeah I edited out any really identifying info. I guess I should be more like the other docs and just roll over those times. I just hate taking **** from people who have no idea what it's like to work in the ED and think the ED is there to solve every single problem a patient has... And then get mad they actually have to do work outpatient. Most just refer patients to the ED to abuse the system.

 

[bearstanley]

my guess is gainesville.

but honestly, this form of ****ty in a job doesn't sound that bad to me. so you admit some weaksauce and play customer service sometimes, who cares? i would give a kidney to be able to admit a patient, transfer a patient, book an ambulance, have enough glidescope blades, have any form of support staff or available consulting service. all i'm saying is, the grass is always browner. but that's just me.

 

[SomeOtherUser]

Regarding expecting your boss to ask you what you need? Dude (or dudette), this must be a difference in generational expectations.

It is your job to get done not someone elses to walk you through.

Figure out what you need, email your boss and ask them for your list. A wiser move to be honest would be to get this before you started cause now they have your a$$. hope my comments are helpful. Regarding the quality (or lack thereof) on shift your medical director sucks. Passing along stupid complaints is horrific for dept morale. I have heard of 2 complaints in my 7 years at my current gig. It isnt cause im super sweet or anything it is because stupid complaints get filtered and we dont hear about them. Legit complaints/concerns get passed along.

I'm not expecting someone to walk me through, but perhaps just making me feel included in her circle. In fact I already have an entire curriculum developed, supplies list, plan etc. I already have an entire plan of where I want the sim stuff to go in a year and two years. But there has been zero communication from the admin side. I don't want it to seem like I'm just asking them for stuff and then get annoyed etc. Or maybe I'm just being irrational, just afraid of push back and them thinking negatively of me for what I ask for. Admin seems to have an idea that we can just go things for free and work with old broken equipement etc. I guess my previous job left me with a distrustful attitude toward admin that I have to get over, but my current job isn't making it easier.

 

[Franzd'Epinay]

In fact I already have an entire curriculum developed, supplies list, plan etc. I already have an entire plan of where I want the sim stuff to go in a year and two years.

This is tangential to the conversation, but I'm surprised a fancy place like you describe doesn't already do simulations.

 

[EctopicFetus]

I'm not expecting someone to walk me through, but perhaps just making me feel included in her circle. In fact I already have an entire curriculum developed, supplies list, plan etc. I already have an entire plan of where I want the sim stuff to go in a year and two years. But there has been zero communication from the admin side. I don't want it to seem like I'm just asking them for stuff and then get annoyed etc. Or maybe I'm just being irrational, just afraid of push back and them thinking negatively of me for what I ask for. Admin seems to have an idea that we can just go things for free and work with old broken equipement etc. I guess my previous job left me with a distrustful attitude toward admin that I have to get over, but my current job isn't making it easier.

My experience and the stories from friends is admin wants everything but at a cost of $0. Lay out your asks. Say hey this is what we need for a top notch sim experience. Or at a minimum ask for a budget. Did you take a job and have a role and got no resources? That’s a recipe for misery and failure. I wish you the best but admin wants you to spend your time and money and ask them for nothing.

 

[bougiecric]

Every job in EM sucks now. I have jumped around so much looking for the perfect job or at least a better job, and now finally realize it all sucks. I am with ya. It is Depressing as hell to come to this conclusion. I feel the same way with emails. Just opened one up that a patient complained that they saw me sneeze in the hallway. WTF?

PGY 14. Changed jobs again within the past year. Thought it'd be better. Nope.

 

[evert1de101]

The real reason no EM work environment is sustainable is because nobody else in the system is willing to start doing their jobs. Let's imagine attorney generals taking the corporate practice of medicine ban seriously. Imagine consultants and hospitalists responding to patient care needs like they are paid to. Imagine admin that acknowledges the expertise and downstream revenue provided by specialist emergency physicians. Imagine a professional association that upholds rigorous standards for residency training. None of that is happening. None of that will happen. As a full time locums doc walking into another dumpster fire site, I am always confident that I am one of the few people in the building that is interested in doing my job. That's the sad part about all this.

 

[CoolDoc1729]

I started a new job recently, moved from a underfunded community place that never had enough staff and support in mid-Florida to a big center that is academically oriented and is a "brand" name closer to a city in Florida. Things that attracted me are a slightly higher salary, supposedly more potential, not having to do a lot of nonphysician work. Slowly finding out that I am not as happy as I thought I would be.

This is place cares a lot more about patient satisfaction than appropriate emergency patient care. Every little thing goes under a microscope. Patients can say anything and the doc gets **** on. VIP patients have to have their asses kissed or there will be 4-5 phone calls from admins, and we're forced to admit them for non-emergent things because they're "VIPs," while regular patients can't even get beds. It's very stressful. There is air of heaviness and superiority.

When I'm working I can get in the flow of patient care but it always seems like I'm doing more than I normally would because "the brand name," so patients get more non-emergent or unnecessary labs and imaging.

I'm also not getting the support I was under the impression I would getting. I was hired to start a simulation program. Is it bad that I would expect my boss to arrange meetings to see what what I need, and how my goals are going? I feel like if I were a chair and I hired someone to do a job and told them I'd support them, I would go out of my way to find out what they need. I currently have no supplies, no support, and I'm not even sure how to ask my boss for things because it seems like the few time they reach out its to address a bull**** complaint. I'm always afraid to open my emails because I'm worried it's gonna be another useless email about how the docs need to perform better and kiss patients ass more.

Sometimes in not even sure I made the right decision to switch, but I know I wasn't happy at my old place. What would you do? Thanks for any advice.

TLDR: Not happy about new job, not getting enough support and admin cares to much about patient satisfaction and VIPs. ED has very little power. Getting depressed.

I hate vip stuff.
And I work in the ‘hood and I still somehow get stuck with VIP stuff from time to time.

When the covid antibody treatment first came out there was an outbreak at corporate. We had a 18-24 hour wait all the time and still somehow were able to tie up several rooms at any given time so we could give the obese 62 year olds their regeneron. There were shifts that month that all I did was write for regeneron and intubate ICU holders. Irritates me just thinking about, almost 2 years later.

My coping method for that part of it, is just to figure out what they want as quickly as possible (they’re getting it, from you or someone else, there’s no point of fighting it, we already have a two tiered healthcare system) and move on. I’d so much rather talk to a working single mother than these entitled folks, and they won’t remember you in an hour as long as they get what they want and you could be the only person who’s tried to help working single mom with her health in the last 5 years and she will probably be grateful.

It also helps to work nights - the important people are sleeping, and on the off chance an Important Person wanders in, hopefully your chair and CMO won’t be awake to micromanage your care. That’s all I got. 😁

 

[RustedFox]

I hate vip stuff.
And I work in the ‘hood and I still somehow get stuck with VIP stuff from time to time.

When the covid antibody treatment first came out there was an outbreak at corporate. We had a 18-24 hour wait all the time and still somehow were able to tie up several rooms at any given time so we could give the obese 62 year olds their regeneron. There were shifts that month that all I did was write for regeneron and intubate ICU holders. Irritates me just thinking about, almost 2 years later.

My coping method for that part of it, is just to figure out what they want as quickly as possible (they’re getting it, from you or someone else, there’s no point of fighting it, we already have a two tiered healthcare system) and move on. I’d so much rather talk to a working single mother than these entitled folks, and they won’t remember you in an hour as long as they get what they want and you could be the only person who’s tried to help working single mom with her health in the last 5 years and she will probably be grateful.

It also helps to work nights - the important people are sleeping, and on the off chance an Important Person wanders in, hopefully your chair and CMO won’t be awake to micromanage your care. That’s all I got. 😁

Bro. This hurt me because I know.

 

[Saddleshoes]

I hate vip stuff.
And I work in the ‘hood and I still somehow get stuck with VIP stuff from time to time.

ME TOO!
I used to work in a state facility and we had VIP stuff forced on us often.
I dealt with it by starting all VIP notes like this...
"Mr. VIP was seen, as directed by Mr Big Shot, (naming the "boss" that brought in the VIP)...
No one seemed to care about that statement but I figured if some stuff ever hit the fan I might be excused.

 

[TooMuchResearch]

PGY 14. Changed jobs again within the past year. Thought it'd be better. Nope.

I have a sweet SDG job with very low turnover, and even my job is only sort of tolerable some of the time.

 

[gro2001]

I started a new job recently, moved from a underfunded community place that never had enough staff and support in mid-Florida to a big center that is academically oriented and is a "brand" name closer to a city in Florida. Things that attracted me are a slightly higher salary, supposedly more potential, not having to do a lot of nonphysician work. Slowly finding out that I am not as happy as I thought I would be.

This is place cares a lot more about patient satisfaction than appropriate emergency patient care. Every little thing goes under a microscope. Patients can say anything and the doc gets **** on. VIP patients have to have their asses kissed or there will be 4-5 phone calls from admins, and we're forced to admit them for non-emergent things because they're "VIPs," while regular patients can't even get beds. It's very stressful. There is air of heaviness and superiority.

When I'm working I can get in the flow of patient care but it always seems like I'm doing more than I normally would because "the brand name," so patients get more non-emergent or unnecessary labs and imaging.

I'm also not getting the support I was under the impression I would getting. I was hired to start a simulation program. Is it bad that I would expect my boss to arrange meetings to see what what I need, and how my goals are going? I feel like if I were a chair and I hired someone to do a job and told them I'd support them, I would go out of my way to find out what they need. I currently have no supplies, no support, and I'm not even sure how to ask my boss for things because it seems like the few time they reach out its to address a bull**** complaint. I'm always afraid to open my emails because I'm worried it's gonna be another useless email about how the docs need to perform better and kiss patients ass more.

Sometimes in not even sure I made the right decision to switch, but I know I wasn't happy at my old place. What would you do? Thanks for any advice.

TLDR: Not happy about new job, not getting enough support and admin cares to much about patient satisfaction and VIPs. ED has very little power. Getting depressed.

I sympathize with your point of view on every point, and have experienced all of the above at some point in various combinations. However, a lot of this is about framing and prioritization.

Most importantly, it seems you care about too many things. Caring about too many things is the fast track to burn out (because you have only so much energy/strength/attention/f***s to give) and/or being fired (because you stick out like a sore thumb about every issue). Pick one thing you care about, and just shrug your shoulders and go with the flow on everything else. Sounds like for you it may be the sim program. Great, for everything else just be middle of the road. Don't be the person that gets the most complaints because they are doing things too differently, or get stressed about the emails (I filter out like 99% of various departmental emails to bypass the inbox and go directly to archive; if it's important enough, I will hear about it from someone at sign out or at the next departmental meeting).

As for your projects: they are entirely your project. The chair hired someone to do it because they want it to fly on autopilot. They are paying you to take it off their plate. Yes, they will push back on resources because they have everyone coming asking for resources. It's your job to advocate why sim deserves more money (publications, quality improvement projects, educational grant money, etc). This is a classic junior faculty problem.

 

[Arcan57]

I'm not expecting someone to walk me through, but perhaps just making me feel included in her circle. In fact I already have an entire curriculum developed, supplies list, plan etc. I already have an entire plan of where I want the sim stuff to go in a year and two years. But there has been zero communication from the admin side. I don't want it to seem like I'm just asking them for stuff and then get annoyed etc. Or maybe I'm just being irrational, just afraid of push back and them thinking negatively of me for what I ask for. Admin seems to have an idea that we can just go things for free and work with old broken equipement etc. I guess my previous job left me with a distrustful attitude toward admin that I have to get over, but my current job isn't making it easier.

There's clearly a disconnect between your expectations and admins' expectations. In academics, a lot of the new generation is used to a very hands-on approach to their development from their supervisor. The expectation that you'll be part of the inner circle as a new hire or that you'll be given very specific step-by-step instructions or validation in your project is real and common, but rarely met. Your department head likely has too much on their plate (or doesn't care enough) to shepherd you. You need to be proactive about getting face time and asking for what you need, and then being aggressive about following through on those asks. That's what your department head is expecting you to do, and you're current trajectory is going to lead to you burning out both clinically and academically.

 

[cyanide12345678]

I have a decent job now, but i honestly respond to 25-30 percent of recruiter emails with the basic, ‘what’s the hourly rate, which emr etc’ questions. The day i find something better, i don’t have an issue jumping ship

 

[dchristismi]

That must be why they still email me.
Heh.

And I reply 25% of the time with a "I'm retired from EM, but you have seriously got to be kidding. You couldn't pay me enough to work in that dumpster fire. Seriously, meditech? Which must mean it's an HCA hospital..."

To which most recruiters actually reply with a (I can actually hear them sigh) "Yeah, I know..."

 

[Arcan57]

I have a decent job now, but i honestly respond to 25-30 percent of recruiter emails with the basic, ‘what’s the hourly rate, which emr etc’ questions. The day i find something better, i don’t have an issue jumping ship

I'd be shocked if a recruiter approaches you with a better job, unless your current one has the Corinthian as a director.

 

[Apollyon]

I'd be shocked if a recruiter approaches you with a better job, unless you're current one has the Corinthian as a director.

I don't know if that's a code word or what.

 

[BoardingDoc]

I don't know if that's a code word or what.

From Sandman. A nightmare creature living in the guise of man, with jaws in place of eyes, the Corinthian was "A nightmare created to be the darkness and the fear of darkness in every human heart. A black mirror made to reflect everything about itself that humanity will not confront."

 

[RoyBasch]

"A nightmare created to be the darkness and the fear of darkness in every human heart. A black mirror made to reflect everything about itself that humanity will not confront."

Sounds like the job description for “Emergency Physician”