Maybe I feel that psychiatrists need a full damn hour for every followup. That doesn't matter.
If we devalue our opinion we can expect others to.
You have either (1) Vis being all hey you don't make no $ stop whining or (2) everyone else telling you to quit ==> (3) bemoan the crisis state of the American public mental health system
Get out or demand an appropriate standard of care.
I believe I have been clear in my advocacy for demanding an appropriate standard of care. I should have provided more constructive advice on how to achieve it. I am in full agreement with most Sluox's recommendations to that end. However, I would advise against anything that could be construed as unprofessional. Showing up late, leaving early, and ignoring poor performance evaluations is not going to encourage collaboration, and may impact your career going forward. In the situations where I find myself at odds with administration, I take the opposite tact.
If you are going to hang with the system you are in, you need to be impressing the people there with your work ethic. Show up early and stay late. You do not have to be "working," when you are not on the clock, but be there and be busy with something. This will reinforce your position to your colleagues, who probably understand deep down that 15 minute med checks are a travesty, and help you deflect accusations which inevitably ensue when you are not cranking out the productivity quota. If someone tries to hang paper on you, accept any
constructive criticism warmly while gently pointing out any blatantly derogatory/defamatory language as unacceptable. Do not sign any evaluation with such language.
Know that you may get the urge to turn adversarial when the inevitable administration ambush catches you off guard on a Friday afternoon. When you walk into a meeting, be prepared to see an array of suits trying to stage some twisted version of an "intervention." Don't engage in it. Give them some cathartic time to expressive their frustration, then excuse yourself. Stay professional, polite, and mild mannered. Despite the conflicts that arise, the physician and administration are usually on the same side in the end. Both generally want patients to get care. With that common ground, you can usually negotiate a mutually productive alliance.
However, you have to be willing to walk away if things get too ugly. Have an exit strategy in place. Raising the practice standard in a sub-optimal system is heavy lifting, and for a while you may find that the simplest thing you do at work is practice medicine. It is not easy, but it is worth it. Once you have established yourself as a compassionate physician who does not cut corners, you will often find that administration moves on to lower hanging fruit in their quest to pinch pennies. Furthermore, you will have demonstrated your professionalism and that reputation will serve you well down the road, opening more appealing practice opportunities. Then, you can find yourself in the enviable position of actually enjoying what you get paid to do.
