Daily reminder to do the bare minimum

Started by GonnaBeADoc2222
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prolene60 said:
I constantly get the sentiment here with this particular thread of assuming some type vicious motive when our colleagues see patients. I’m part of a SDG but even when I was part of a CMG my goal was to help see and move patients. When I come on shift I will typically move to knock out at least 5 in that first hour who are waiting to be seen. I know that the docs before me are starting to get worn out and need to catch up on charts etc. I just want to help and Never once do I have the mindset of sh&&! “Look at all this RVU money I can make and steal from my colleagues”. I mean i assume my colleagues approach this the same way. Everyone constantly bi###es about the crazy business of medicine, but it seems we all add to this and take part in doing this to ourselves. Assuming that everyone is out for themselves is not the way to go about this. It just seems we all should not be doing the least possible and instead be doing the most to make the life of our fellow ER colleagues easier while on shift. EM is hard enough as it is, so why make it more difficult for others by doing less on shift.
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This depends. I work in an rvu model. It’s designed to get the results we get.

The concept of doing the bare minimum is the antithesis of what I do. I’m literally driving to a meeting that I’m unpaid for.

That being said doing modules the hospital or
Cmg require of me for 0 dollars gets 0 effort.

If you are a craptatsic doc then yes. That sucks. Also, the benevolence of em docs specifically is what the cmgs prey on.

Frankly many sdgs do the same. The non partners are much more nervous about saying no to asks because it may affect their partnership. Both sdgs I have been a part of had strict rules to prevent abuse because no matter how amazing you were as a group there is also 1-2 pos humans in the group if you have enough partners.

No trading shifts with new hires. All trades have to be initiated by them for the first 6 months. We had others but that’s a prime example.

Imo if there isn’t enough physician coverage the wrong solution for a flat rate job isn’t to pick up and see way more patients. It’s to demand proper staffing. The more we hide these problems the worse they become.

I’m an rvu system the docs can decide how busy they want to be.

I say this as a top5% rvu guy in my current group and a guy who was top 10% I’m productivity in my prior group where pay was hourly.
 
TooMuchResearch said:
I ignore the security training because it comes as an email from an external source which could be a phishing attempt. I should pass the training specifically because I won't open the training.
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Dude, let me tell you a story.

Last year, our CMO put out a boilerplate email supporting diversity. Shortly thereafter, an email was sent informing everyone that there was a new diversity training module to complete. The email looked completely legit. Ok, whatever, I clicked the link.

It was actually a fake email sent out by our IT department to “catch” anyone who somehow didn’t identify it as a fake email. I was told that I had to do the BS IT “security modules” again (I had just done them a few weeks beforehand).
 
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dozitgetchahi said:
Dude, let me tell you a story.

Last year, our CMO put out a boilerplate email supporting diversity. Shortly thereafter, an email was sent informing everyone that there was a new diversity training module to complete. The email looked completely legit. Ok, whatever, I clicked the link.

It was actually a fake email sent out by our IT department to “catch” anyone who somehow didn’t identify it as a fake email. I was told that I had to do the BS IT “security modules” again (I had just done them a few weeks beforehand).
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Doing the bare minimum involves not opening emails. I get "feedback" on trauma cases from the Trauma coordinator. They come as secured e-mails, which make me set up a log in with a password I can't remember, then have to spend 3-5 minutes just to read the "feedback". It's easier to hit delete.
 
dozitgetchahi said:
Dude, let me tell you a story.

Last year, our CMO put out a boilerplate email supporting diversity. Shortly thereafter, an email was sent informing everyone that there was a new diversity training module to complete. The email looked completely legit. Ok, whatever, I clicked the link.

It was actually a fake email sent out by our IT department to “catch” anyone who somehow didn’t identify it as a fake email. I was told that I had to do the BS IT “security modules” again (I had just done them a few weeks beforehand).
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Moral of the story? Report every email you get as a phishing attack.
 
At my main job we try and keep online modules at a minimum. Still amounts to 2+hr a year, but having physicians in leadership positions with some control over said modules keeps it from being insane. We don’t have ACLS, PALS, ATLS, or any sedation modules… really just the bare minimal emtala/ HR / sexual harassment stuff.

That being said, I had a per diem gig that wanted us to do pretty insane onboarding (8hr epic class, 12-16 hour of online modules) and annual training (8+ hour of online modules) and random other things (they had an emtala scare, wanted even the per diems to attend a 2hr refresher).

The kicker? They paid me my standard clinical rate, happily, to do these modules and online videos. You know what I am HAPPY to do? Sit by a laptop playing videos getting paid to answer quizzes about which fire extinguisher to use, and why I shouldn’t chew on the extension cord when blood has spilled onto it, for cash.
 
TooMuchResearch said:
I ignore the security training because it comes as an email from an external source which could be a phishing attempt. I should pass the training specifically because I won't open the training.
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Game Show Genius GIF by ABC Network
 
dozitgetchahi said:
My response was to basically stop reading 95% of my emails. And I told the CMO this too.
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I recently changed jobs from one giant hospital system to another (although my actual job is at a rural CAH in the giant system chain). In the prior giant hospital system I would routinely get 15-20 system/department/whatever generated emails a day. In my new giant hospital system I have to keep sending my work email self test emails from my personal email self to make sure my email still works because it's about 3 or 4 emails a week. I still mostly delete them after reading the subject line, but I'm saving literal minutes a week now.
 
gutonc said:
I recently changed jobs from one giant hospital system to another (although my actual job is at a rural CAH in the giant system chain). In the prior giant hospital system I would routinely get 15-20 system/department/whatever generated emails a day. In my new giant hospital system I have to keep sending my work email self test emails from my personal email self to make sure my email still works because it's about 3 or 4 emails a week. I still mostly delete them after reading the subject line, but I'm saving literal minutes a week now.
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God's honest truth, what is an oncologist doing at a CAH? At my rural, NOT CAH (because reasons), if you had the Big C, it was on you to get your ass to the city. The general surgeons would resect cancers (like the guy I found the colon cancer in, where the Nighthawk radiologist said "a circumferential irregularly edged lesion in the distal colon" - would not even speculate that it MIGHT be cancer), but, if you needed the drugs or to be burned, you had to move yourself with expedition. It was, maybe Erie (2hrs away), or Buffalo or Pittsburgh (3+ hrs).
 
Apollyon said:
God's honest truth, what is an oncologist doing at a CAH? At my rural, NOT CAH (because reasons), if you had the Big C, it was on you to get your ass to the city. The general surgeons would resect cancers (like the guy I found the colon cancer in, where the Nighthawk radiologist said "a circumferential irregularly edged lesion in the distal colon" - would not even speculate that it MIGHT be cancer), but, if you needed the drugs or to be burned, you had to move yourself with expedition. It was, maybe Erie (2hrs away), or Buffalo or Pittsburgh (3+ hrs).
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TBH , we’re only an hour away from “the city”, but people here would rather curl up on their porch and die than go there. It’s a “rural” location in the same way that Jackson Hole is “rural”.

I can manage about 90% of what comes my way with the resources I have. The rest either go into town or curl up on the porch and die. The oncology part is easy and portable. It’s the surgeons and the rad oncs that are hard to come by out here.
 
Actually, I forgot. If you to saw in the news a few weeks ago about the guy who escaped from jail in Warren, PA, I used to work there. Not rural, and about 1hr away from my rural place. (Actually, a very "small town America" place, very rustic.) They did have Med and Rad Onc, until they drove all of them away.
 
Apollyon said:
Actually, I forgot. If you to saw in the news a few weeks ago about the guy who escaped from jail in Warren, PA, I used to work there. Not rural, and about 1hr away from my rural place. (Actually, a very "small town America" place, very rustic.) They did have Med and Rad Onc, until they drove all of them away.
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Bro. You know I love you. Warren is rural AF.
 
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GonnaBeADoc2222 said:
Because my "bare minimum" is still more than most of my colleagues, who get paid more than I do.

That's why.

(Also why would you give free labor to a cmg?
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That’s the problem right there. The backwards way of thinking about the CMG first and then the docs second. No, I wholeheartedly agree not to give extra work to a CMG for free however I don’t agree on screwing over the team that’s working with me that day just for the sake of “not giving away free labor”. I don’t mean to sound like some hippy but what matters first on any given shift are the docs I happen to be with that day and the patients. I don’t give a sh## about the CMG or the SDG politics until AFTER I get home. It’s the wrong way to approach this by “doing the bare minimum” going INTO a shift. Yes I agree with ignoring all the pointless modules, sepsis fluid miss emails, etc. cause that’s usually just in my inbox that I check 2 weeks later that has nothing to do with my shifts.
 
prolene60 said:
That’s the problem right there. The backwards way of thinking about the CMG first and then the docs second. No, I wholeheartedly agree not to give extra work to a CMG for free however I don’t agree on screwing over the team that’s working with me that day just for the sake of “not giving away free labor”. I don’t mean to sound like some hippy but what matters first on any given shift are the docs I happen to be with that day and the patients. I don’t give a sh## about the CMG or the SDG politics until AFTER I get home. It’s the wrong way to approach this by “doing the bare minimum” going INTO a shift. Yes I agree with ignoring all the pointless modules, sepsis fluid miss emails, etc. cause that’s usually just in my inbox that I check 2 weeks later that has nothing to do with my shifts.
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What’s the solution when your colleague works at half your pace? If your normal is 2 and this slow doc is 1 do you ramp it up to 2.5 so the slow guy is ok? Do you do your standard? I don’t have the answer as im RVU based. A flat hourly in a high volume place would make me insane.
 
prolene60 said:
That’s the problem right there. The backwards way of thinking about the CMG first and then the docs second. No, I wholeheartedly agree not to give extra work to a CMG for free however I don’t agree on screwing over the team that’s working with me that day just for the sake of “not giving away free labor”. I don’t mean to sound like some hippy but what matters first on any given shift are the docs I happen to be with that day and the patients. I don’t give a sh## about the CMG or the SDG politics until AFTER I get home. It’s the wrong way to approach this by “doing the bare minimum” going INTO a shift. Yes I agree with ignoring all the pointless modules, sepsis fluid miss emails, etc. cause that’s usually just in my inbox that I check 2 weeks later that has nothing to do with my shifts.
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Yeah, this about sums it up. I doubt many of us are so effective at dichotomizing our mental and emotional energy that we could come to work with the mindset of doing the “bare minimum“ for the hospital, CMG, etc. and not simultaneously victimize our teammates. Moreover, I can‘t imagine a career that I hated so much where I had to actually remind myself this on a daily basis before going to work…much less encouraging others on the internet.

Having said that, I doubt that the OP is truly doing just the bare minimum. I could probably put them in any number of VA hospitals where the “bare minimum pros” could teach them a thing or two. I talking about places where the nurses put a mirror under the staff’s nose to see if they are dead or just sleeping.
 
EctopicFetus said:
What’s the solution when your colleague works at half your pace? If your normal is 2 and this slow doc is 1 do you ramp it up to 2.5 so the slow guy is ok? Do you do your standard? I don’t have the answer as im RVU based. A flat hourly in a high volume place would make me insane.
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Fire the slow guy…or gal.

All kidding aside, you work at your safe pace and see the number of patients that you can to the best of your ability. You partners know who is responsible when the waiting room is a wreck. You then make sure that you work for a group with good leadership that is effective at recognizing, reforming, or ultimately replacing habitual under performers.
 
prolene60 said:
That’s the problem right there. The backwards way of thinking about the CMG first and then the docs second. No, I wholeheartedly agree not to give extra work to a CMG for free however I don’t agree on screwing over the team that’s working with me that day just for the sake of “not giving away free labor”. I don’t mean to sound like some hippy but what matters first on any given shift are the docs I happen to be with that day and the patients. I don’t give a sh## about the CMG or the SDG politics until AFTER I get home. It’s the wrong way to approach this by “doing the bare minimum” going INTO a shift. Yes I agree with ignoring all the pointless modules, sepsis fluid miss emails, etc. cause that’s usually just in my inbox that I check 2 weeks later that has nothing to do with my shifts.
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ShockIndex said:
Yeah, this about sums it up. I doubt many of us are so effective at dichotomizing our mental and emotional energy that we could come to work with the mindset of doing the “bare minimum“ for the hospital, CMG, etc. and not simultaneously victimize our teammates. Moreover, I can‘t imagine a career that I hated so much where I had to actually remind myself this on a daily basis before going to work…much less encouraging others on the internet.

Having said that, I doubt that the OP is truly doing just the bare minimum. I could probably put them in any number of VA hospitals where the “bare minimum pros” could teach them a thing or two. I talking about places where the nurses put a mirror under the staff’s nose to see if they are dead or just sleeping.
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Again, my minimum is more than others' maximum.

Why should I increase to 2.5 pph when they're seeing 1 (and being paid more)?
 
ShockIndex said:
Fire the slow guy…or gal.

All kidding aside, you work at your safe pace and see the number of patients that you can to the best of your ability. You partners know who is responsible when the waiting room is a wreck. You then make sure that you work for a group with good leadership that is effective at recognizing, reforming, or ultimately replacing habitual under performers.
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Many impotent directors out there. I would go above and beyond for my partners. I don’t do anything extra for the hospital unless there is a benefit to my group or I’m getting paid.
 
bravotwozero said:
This actually does happen with certain CMGs, but not others, either due to things like cronyism, preferential treatment for seniority etc…
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I know. Came out of residency in the mid-2000s and took a part-time job with the “Physician’s Heart / Owner’s Mind” CMG before it became everyone’s least favorite behemoth. One of the physicians who was hired at the same time came from a reputable program but was nicknamed Molasses by the nurses. This was before the company embraced mid-levels, so we staffed the fast-track and that’s where it really showed. You can only order so many CBCs and blood cultures of febrile toddlers. Anyway, to make a long story short, I came back from one of my extended vacations and hommie was gone - like a fart in the wind. I’m told that he was allowed to stay in the company but moved to one of the low volume contracts in Nowheresville. Makes sense since he was a nice guy and was more of a performance misfit rather than values problem child. Rinse and repeat at least 3 or 4 more times in the 7 years that I was there (popped smoke right before they lost that contract and morphed into today’s ****show).

At my last EM job, a faculty hospital-employee model, it was much easier to hide clinical inefficiencies behind “academic prowess” and the overwhelming majority of attendings mainstreamed to the residents’ pace. It took far more than being slow to get fired or disincentivized enough to leave, but I recall it happening.

GonnaBeADoc2222 said:
Again, my minimum is more than others' maximum.

Why should I increase to 2.5 pph when they're seeing 1 (and being paid more)?
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A problem with people having your (to quote another member’s self-assessment) clinical “horsepower” is that it’s hard to contain that raw talent and ability when you’re twice as fast as everyone else. Thus, I remain unconvinced that you’re truly at your bare minimum. You may win me over if you can prove that you worked at a DMV for at least 5 years before med school and then spent your post-residency career being moved from one VA to the next across the Fruited Plain. Until then, I’m going with you’re one of those closet intellectuals who wanted everyone in med school to think that they got honors without studying. 😉

Now that I’m done pulling your chain a little, you can escape. There are ways. They’re expensive and require planning. However, if executed properly you will never need to ration your effort before work.
 
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EctopicFetus said:
Many impotent directors out there. I would go above and beyond for my partners. I don’t do anything extra for the hospital unless there is a benefit to my group or I’m getting paid.
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Indeed.

At some point we become responsible for choosing our own misery by working for impotent directors, with vindictive administrators, and in a thankless field. I suppose one coping strategy to such circumstances is to keep your nose down and do the bare minimum until retirement. Pack a Sickers given the economic uncertainty ahead…
 
ShockIndex said:
Indeed.

At some point we become responsible for choosing our own misery by working for impotent directors, with vindictive administrators, and in a thankless field. I suppose one coping strategy to such circumstances is to keep your nose down and do the bare minimum until retirement. Pack a Sickers given the economic uncertainty ahead…
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Every one day that passes retirement seems a little further away and I seem 1.5-2 days closer to death.
 
Brigade4Radiant said:
another reminder Apollo wants a group of docs to pay for the midlevel

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Un effing believable.

It’s amazing how CMGs treat attendings like children.

It’s like me telling my kids ‘hey do you want to take a bath now, or in an hour?’ Either way, they’re taking a bath.

Gave the docs two impossible choices and then just made the decision for them.

Screw Apollo and whoever their site medical director is there.
 
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bravotwozero said:
Un effing believable.

It’s amazing how CMGs treat attendings like children.

It’s like me telling my kids ‘hey do you want to take a bath now, or in an hour?’ Either way, they’re taking a bath.

Gave the docs two impossible choices and then just made the decision for them.

Screw Apollo and whoever their site medical director is there.
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Apollo challenging usacs for scummiest cmg.
 
greatnt249 said:
Especially if they're of the variety/quality that RustedFox has written about in the past.
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I wish you hadn't reminded me.
I'm so... SO glad that I don't work at Country Club Medical Center anymore.
Our MLPs are actually kinda serviceable at the new shop.
I'm also minimizing MLP exposure by only working nights and (if available) solo shifts at the FSED.
 
RustedFox said:
Blasphemous 2 comes out in 3 days.
This is my most highly-anticipated game.
Take all the macabre features of Inquisition-era Catholicism and make 2D platform hack-and-slash metroidvania game.
That's "Blasphemous".
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Ill have to try first one. Its like 6 bucks now lol.

Recently finished Hollow Knight. Was 15 bucks.

I love Steam.
 
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ScepticSkeksis said:
My go-toos are Valheim, and Stellaris at work. Those two games can absorb days of your time and you can put them on pause at a moment's notice. Also do some Hims charts for extra $$$ at work if I'm feeling motivated.
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GonnaBeADoc2222 said:
How is it? Picked up a steam deck recently and currently playing RE4 remake, but almost done and looking for my next game.
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Its awesome. Highly recommend. Well worth it.
 
RustedFox said:
During the summer months here (several years ago, back before the Exodus of northeasterners to Florida) I was working at a HCA FSED on overnights and had enough time to totally finish Chrono Trigger.
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There was a sleepy little single coverage ED I worked at where I would go hours not seeing anyone. Many hours of Scythe were played.

At current dystopian shop, i get tattled on for even playing music.
 
I can't wait until Starfield comes out next month. That's going to absorb a major amount of my downtown at work. Especially in the last 2 hours when I don't pick up new patients.
 
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