Final thoughts:
Talking in percentages and analyzing "quarterly results" makes me feel like a corporate sleazeball.
i know everyone here knows this, but those clipboards warriors DGAF about what is going on on the floor- the only focus is polishing the metrics. it is infuriating. Moreover, so many meetings I go to are just people waiting to talk about their project. the rest of the hour is free time (myself included). bronx43 said it best in post #11
Earlier in this thread, there was mention that it looks as if the cuts in healthcare are only affecting the bottom feeders. Well, no longer. several bigwigs at my system have been asked to resign (including my direct supervisor and their boss, both of whom are on a first name basis with the CEO of the whole system). the roles of department directors/managers who are retiring have dissolved and are are being redistributed among existing people. Prior to this job, i had no idea 99% of these people existed. I assure you similar cuts are happening at your shop. There is emphasis on keeping whatever phleb techs, RNs, etc they can as morale is in the toilet and people have a hair trigger to quit. I still believe my specific health system is a good actor overall and we have top quartile rates of retention and bottom quartile rates of travelers.
the preceding paragraph makes me think about my job security but not in any serious capacity. There are 4 of us in my exact role in a medium/large system and we each pay for our salary within the first 6 months of the year- either through peer to peers, operationalizing a buncho of CMS mumbo jumbo (inpt v. obs, patient safety indicators, cardiology metrics, massaging readmission, etc). It is a testament to our healthcare system that me becoming a paper pusher and excel jockey generates more money than seeing patients.
the data continues to be garbage. if it exists in powerbi/tableaux, no one questions it. It is very difficult to dig deeper and you are met with suspicious eyes if you try.Just recently, person X at my job was trying to dump some blame on the hospitalists. took a lot of digging and elbow grease but I was able to show their assertion was stupid af. they just moved the goalposts a bit and made their complaint more nebulous. I took this as a personal affront because generating and wrangling that 9000 row and 20 column spreadsheet took a lot of work for a one-off issue. Furthermore, everyone only reads the top line or executive summary. Forget about communicating nuance. No worries...by next quarter no one cares about previous results anyways.
as the wise dr. metal commented above in post #10, the people management is annoying. I work with a lot of people who insist on being notified on the result of every interaction and meeting I have. superiors, people below me, people next to me. just do your damn job and stfu.
work is gonna get tougher through the years. your payment is gonna have more shared risk with the hospital. audits are going to be more merlicess and more common. you will have more and more of a "value" component in your pay instead of straight FFS. Pt complaints regarding the chart are rising and rising and it will get worse come October. (see USCDI version 3/4 section in the cures act). Even the chads in ortho, cards, and NSGY are getting hit. They no longer have license to just pound out procedures and not care about anything else.
surprisingly, my fellow physicians have warmed up to me. Even if i show up in a suit (rare), they can tell by general disgruntled attitude and straight talk that I am on their side. I don't have a point here...only to say that I really am on their side. People that knew me from "before" are surprised I can string together several sentences in a row without an F bomb.
Some people expect me to be clinically brain dead. dude...I listen to like 4 medical podcasts and read at least NEJM JAMA every week. I read more now and in greater depth in this job than I ever did as a hospitalist.
I am still doing this job and grinding away at a few others. the rotation of work helps keep things interesting and gives me an overall greater appreciation of how the different part of the healthcare system fit togehter. Fit is a bad word....how they are cudgeled together into a poorly differentiated abomination
this will probably be my last update as I feel i have hit a steady-state in this job. thanks for reading and a more general thank you to everyone on SDN. I hope I was able to imbue you with equal parts enlightenment and despair. Back to my meeting