Do Doctors Have Bosses?

[hampster83]

My question is basically about a hospital's organizational structure. I was under the impression that doctors do not have bosses in the sense of an individual with the authority to fire you. Instead, doctors answer to a board/committee. Is this true? My pre-med friends have been giving me conflicting accounts.

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[Dienekes]

Yes, you most certainly can be fired (or more accurately have your admitting privileges revoked) even if you don't technically work FOR the hospital.

 

[CoolSpot7Up]

Yes, doctors can have bosses, depending on where they work. In some large hospitals, a doctor will work for a specific section (ie. Vascular Medicine) which has a Section Head (their first boss). The sections form Departments (ie. Cardiovascular Medicine) which also has a Head (their second boss). I'm not sure how it works higher than that, but I'm assuming there are Division heads and stuff, and of course the CEO/President runs everyone.

If you don't want a boss, open your own practice.

 

[hampster83]

I mean everyone is accountable to some group. By "boss" I meant a person who can tell you, "You're fired." CEOs can get fired by the board of directors, tenured professors can get fired by a review board, the president can get fired by Congress, but each doesn't really have a boss as we normally understand the term to mean. Is this the same way for doctors i.e. as a doctor can you get fired by say the director of your department or are you accountable only to a committee/board/group?

 

[Concubine]

Doctors do not have bosses! They are GODS!

 

[Lshapley]

If you have a private practice that you own solely, than you are the boss. If you have a shared practice, than it is a shared responsibility. More and more primary care docs are starting to work for larger corporations than own a bunch of practices, so the CEO will be the boss but you or another doc might run the practice you are working in. If you are hospital-based, than the boss is the CEO of the hospital. I am sure there are many other models as well.

 

[LizzyM]

Hospital organization is a very odd thing.

Very, very few physicians are employed by a hospital. Rather the physician is granted the privilege of admitting (treating) patients in that hospital. The Chief of Staff for the hospital (a physician) is, in a sense, a boss with regard to privileges and physician behavior in the hospital.

There was a time when some physicians (radiologists and pathologists come to mind) were employed by the hospital but more often, now, they are not paid salaries by the hospital but bill for their professional services separately from the hospital bill which covers the cost of the facilities (diagnostic imaging equipment, path lab, etc). In these cases (as with emergency medicine) a group of providers contracts with the hospital to provide services at that hospital. In that regard, a hospital could choose to fire the group by not renewing the contract and choosing a new group.

Some physicians don't have privileges but practice from an office setting only.

 

[JaggerPlate]

Of course doctors have a boss ... Dr. Bob Kelso, MD.

 

[Chuckwalla]

Of course doctors have a boss ... Dr. Bob Kelso, MD.

Who has two thumbs and doesn't give a crap?

Anyway, yes doctors do have bosses. That is unless you are in solo private practice, quite rare these days. Even more rare if you are a new doctor. Most doctors have another doctor as their boss. If goes up until the head doc is answering to a profit motivated MBA. Sad reality.

 

[limpkitty]

Many doctors work for large group practices. In this case, doctors do not have bosses, per se, but there are people above them in the hierarchy (heads of the department, members of the board, ceo's and presidents). But, no, doctors do not get fired, unless there is gross misconduct. And there's no boss behind you're shoulder telling you what to do and how to do it.

 

[Nasem]

Yes, you most certainly can be fired (or more accurately have your admitting privileges revoked) even if you don't technically work FOR the hospital.

You got me thinking about this....Can the hospital / committee revoke your medical license so you wouldn't be able to practice medince ?

 

[MassTransport]

I think medical licenses are issued by the state.

 

[drlisa0318]

You got me thinking about this....Can the hospital / committee revoke your medical license so you wouldn't be able to practice medince ?

No. A doctor's license can be revoked only by the entity that granted it in the first place (ie. state medical board.) As to the business setup, they are many and varied. You can be an actual employee (and receive a W2), an independent contractor (and receive a 1099), a partner....the list goes on.

 

[Law2Doc]

I think medical licenses are issued by the state.

Agreed. A hospital cannot revoke your license. They can, however revoke your practice privileges. And unless you are a solo practitioner or partner in a small partnership, you can be fired. Many doctors work for practice groups, where there absolutely will be a managing partner with authority to fire you. Some work for hospitals (eg hospitalists) and can be fired by hospital management. And many many doctors have day to day bosses (more senior attendings, etc), who might not actually be able to fire them, but certainly have the ability to "get them fired".

 

[km19]

just open your own practice and stop worrying about it too much?

 

[Drogba]

If you want a more thorough response to the organization of a Hospital and what levels physicians occupy and who they answer to why not try posting your question in of the forums that are frequented by practicing doctors (residents/attendings). They would be best suited to answer this question I'd imagine, since they experience the hierarchy first hand.