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MUSC plans to change the way doctors are paid and the doctors are 'livid'
Saw this story today, thoughts?
Saw this story today, thoughts?
At the MUSC Board of Trustees meeting Thursday, Medical University Hospital CEO Pat Cawley acknowledged that some doctors are nervous about the changes.
"High producers," Cawley said, who are meeting their goals won't be penalized, but doctors who have not been the most "clinically productive" are "going to have a tough time."
"Everybody has to be accountable to this clinical productivity," he said.
Yes but academic places traditionally put much less emphasis on it for the obvious reasonarent most systems RVU based already? a combination of base salary plus location plus malpractice multiplied by output
Yeah I mean this with all sincerity MUSC has been mentally on my "wish list" for programs i would look at for a job.
I love Charleston and their new surgery chair had been making a big push to expand their research footprint and make the department more academic. This would, at face value at least, torpedo that effort.
I can't claim to know much about the inner workings of MUSC (though we do need more academic strength here in SC), but I do like Charleston quite a bit tooYeah I mean this with all sincerity MUSC has been mentally on my "wish list" for programs i would look at for a job.
I love Charleston and their new surgery chair had been making a big push to expand their research footprint and make the department more academic. This would, at face value at least, torpedo that effort.
How will this affect the residents there?
That's disgustingly sad. I thought residents were there to learn, and not to churn out cases? (paging @madjack, @therestofthecrewthatlovestobeslavelabor).Additionally, I would worry that this continue to push would sacrifice education in the name of productivity.
Where I train in dermatology, during the last two years of residency the hospital administration was pushing very hard to increase the number of patients and clinic hours worked by everyone, including residents. It doesn't matter that an academic institution attracts more complicated cases, and precepting with attendings on complex medical derm patients takes time.
It's all about quantity, quality has no place in the discussion anymore.
Yes, one place that puts emphasis on productivity totally invalidates all of post graduate medical education.That's disgustingly sad. I thought residents where there to learn, and not to churn out cases? (paging @madjack, @therestofthecrewthatlovestobeslavelabor).
No, we really don't.Reason number 1293812948147 why we need physicians unions.
No they're not. Look at pathology.No, we really don't.
If you're an MUSC doc and this really pisses you off, then leave. Its pretty simple and doctors are always in demand.
OK, then look at FM, IM, surgery, OB, cardiology, dermatology, EM, and psych.No they're not. Look at pathology.
You're the one who said doctors are ALWAYS in demand.OK, then look at FM, IM, surgery, OB, cardiology, dermatology, EM, and psych.
Pathologists aren't really doctors though...You're the one who said doctors are ALWAYS in demand.
No, we really don't.
If you're an MUSC doc and this really pisses you off, then leave. Its pretty simple and doctors are always in demand.
Uhh, it kinda doesBeing in demand doesn't negate the need for a union...
Pathologists aren't really doctors though...
Uhh, it kinda does
Reason number 1293812948147 why we need physicians unions.
Unions are traditionally used when workers are mistreated and/or there is a massive power differential between workers and management. Neither of those apply to us.With all due respect, that makes 0 sense. The landscape of american medicine has changed drastically in the last few decades and physicians are nowhere near the helm of the changes. Who's supposed to be offering physician input and leadership at this time? The AMA? Lets be serious.
There's got to be a way for physicians to unionize and actually direct change (or form a solid PAC instead) without being labeled as spoiled brats. It doesn't make one immune to changes, but certainly can lead to larger impact. It's hard to put a label on what physicians think since there are as many opinions as there are specialties, but there has got to be some common ground through it all, even if only regional.
The 'oh this wont really ever have an effect on me' trope is going to be played out pretty soon, especially if changes like this start having a domino effect. Nurses have been extremely successful using patients to act as surrogates and physicians should learn from them to do as much.
Oh c'mon now, that's just not right... even nurses are overqualified to do primary careas a pathologist, i use what i learned in medical school every day. if i wanted to practice primary care, i would have become a nurse.
Oh c'mon now, that's just not right... even nurses are overqualified to do primary care
Unions are traditionally used when workers are mistreated and/or there is a massive power differential between workers and management. Neither of those apply to us.
First, with a few exceptions, the job market for physicians is still insanely good. If you aren't being treated like you want to be, then you can very easily find a new job that treats you better. The ability to leave a job is very powerful because it forces administration to find a replacement (which is very expensive) and get someone to do your job temporarily while they find said replacement - either with locums (very expensive) or by having other existing doctors pick up the slack which results in markedly increased wait times. There is a reason that hospitals are spending so much effort on physician retention and why on the whole our salaries do increase yearly.
Second, physicians actually do have a fair bit of power even beyond that. Its not universally true, but on the whole if we present our viewpoints calmly and with sound reasoning we are usually listened to. We may not always get what we'd like, but I've found that this approach will at least get an explanation as to why something is the way it is.
Now let me ask you something: what would you like a physician union to do? What battles do you think we need to fight, win, and risk pissing off the public over? After all, unions are only effective because of the threat of a strike and the general public will not be sympathetic to a bunch of doctors going on strike.
Im just defensive because im about to get replaced by a pigeon
No thanks.Reason number 1293812948147 why we need physicians unions.
Zing.Pathologists aren't really doctors though...
So a few easy points first. Educating the public about our education, loans, hours, whatever won't help. Think about it: doctors complain about how much other doctors make. If internists get mad at how much money ortho makes (despite sharing part of the same education), why on Earth should a school teacher or a plumber not get mad about how much any doctor makes?If a physicians union builds and presents itself in a way that it wants to ensure that doctors get to spend time with their patients and to ensure that they would fight against schemes such as the one discussed here to ensure that quality of patient care wasn't replaced by an assembly line mentality, then I think the public would rally behind that. Who you make the 'enemy' is completely based on how good you are with getting your message across. Americans right now hate insurance and they hate big business lets call it the 'insurance/hospital industrial complex' because that's what my liberal arts education makes me think is a reasonable term for it...
Yeah, physicians can't strike, but I don't think nurses have really done so recently have they? I know the Brigham in Boston has a nursing union since I used to go there for meetings back in the day. It earns them bargaining power.
The public has an us vs them mentality against physicians because they see doctors as the reason their bills are so high. With the change in the landscape of care, that's changing.
You don't have to threaten a strike. You just have to have a common front to earn public favor. Show the people you're working for them and their best interest. Most often, that lines up with the best interest of the future of physicians too.
I'm pretty sure that everyone thinks that doctors work really hard but are still overpaid. Just more public education regarding the cost to become a physician would do wonders to change the mindset. Then add in more crap about how much administration etc costs and where the patients money actually goes and you have something going. There's already a push back with colleges since folks are starting to catch on that education is suffering and administration is booming.
I know much of what I said is probably naive, but hell, I'm a second year. I just know it's frustrating to me that there isn't any sort of decent physician advocacy agency. I think the AMA is kind of meh...
If the solution is more local groups, or state wide groups since there are difference by state, then so be it, but there's no unified physician presence from what I've seen and that troubles me.
Crypto got you too, huh?
Im just defensive because im about to get replaced by a pigeon
I see a great new thread topic: Which is worse when it replaces you, a nurse practitioner or a pigeon?Im just defensive because im about to get replaced by a pigeon
I see a great new thread topic: Which is worse when it replaces you, a nurse practitioner or a pigeon?
I have an in-office dispensary, I've already replaced youAt least you guys will get displaced by actual living beings. We're going to get replaced by Watson-powered vending machines and Amazon drones.
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At least you guys will get displaced by actual living beings. We're going to get replaced by Watson-powered vending machines and Amazon drones.
Sent from my iPhone using SDN mobile