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the resistance starts with each of us. We have to push back. I was once asked by dept chairman why i did not make it to 7 am useless “meeting”. I said i cannot come that early outside of work hours due to personal reasons. Person seemed taken aback that someone would dare miss such an important meeting. Needless to say i am still employed. There is a power to saying no and we need to do this more. No 7 am, 5pm meetings, no lunch meetings. This is exactly what leads to burn out! I refuse to play “ball” with this sort of nonsense. If it “hurts” me so be it!
 
thecarbonionangle said:
the resistance starts with each of us. We have to push back. I was once asked by dept chairman why i did not make it to 7 am useless “meeting”. I said i cannot come that early outside if work hours due to personal reasons. Person seemed taken aback that someone would dare miss such an important meeting. Needless to say i am still employed. There is a power to saying no and we need to do this more. No 7 am, 5pm meetings, no lunch meetings. This is exactly what leads to burn out!
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Our bonuses hinged on attendance
 
smq123 said:
The article, as written, is excessively simplistic, kind of dumb, and honestly makes me wonder if any of the authors, or the person shilling it on Twitter, have kids. (Apparently at least one does, although a very young one). This is spoken as a female primary care physician, with two small children, who is married to a radiation oncologist.

Some of what you have proposed is, frankly, silly, and not the real obstacles to career advancement. Everyone acts like maternity leave is THE REASON that a woman's career stalls as a physician. That's kind of dumb - those 6-12 weeks that you took are not going to derail your career forever. It's everything that comes afterwards that derails your career.

How does someone advance their career in academic medicine? You participate in committees, go to national conferences and meetings, and publish, right?

Except those committee meetings always start at 5:30 or 6. Daycare closes at 6 (and, by the way, keeping your kid at the daycare for the extra half hour between 5:30 and 6 costs an extra $30 a day), and it is an extra $2 for each minute that you are late. So no, I'm not signing up for those committee meetings. I'm not going to tumor board to get the surgeons to know who I am. I'm in the carpool lane trying to get my kids before the daycare bankrupts me (that's as an attending; if you're on a resident salary, then the daycare has already bankrupted you because you have to pay extra to drop the kids off at 7 and to pick them up after 5:30).

I could probably figure out childcare for one big meeting a year, like ASTRO. But if you expect me to go to ASTRO AND a bunch of specialty/disease site specific meetings, then....no. Again, especially not on a resident salary.

Protected research time is hard to come by in any specialty - it's all about RVUs and seeing patients, etc. So when do you write your papers and grants, especially as a young investigator? On the weekends. But who's going to watch your kids on the weekend? If you're lucky, you have a spouse who is capable and willing to do that, but generally speaking, you're going to have to pay a baby sitter to get a few hours of productive work done. And again, if you're an attending, that's ok, but as a resident? Very difficult.

So what are the solutions?

Stop pressuring residents and junior attendings to participate in these kind of extracurriculars. You shouldn't have to participate in a committee to show that you're committed to the institution and therefore worthy of promotion. Or, crazy thought, hold those committee meetings during daytime hours.

Move more committee meetings and maybe national meetings to virtual meetings. I get the social aspect of the meetings, but maybe one big meeting a year is enough?

Hospital-based daycare centers that are affordable AND have extended hours. As a resident, a daycare next to the hospital that opens at 6AM and closes at 8PM would be a godsend, particularly in a surgical specialty. The hospital could subsidize that. Alternatively, subsidies for nannies or au pairs would be something else that might work.

More protected research time, but that's important for other reasons as well. You shouldn't have to sacrifice your weekends to write papers and grants.

I don't think that the solutions have to be crazy to make things more equitable.
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This post hits the nail on the head. It is everything that comes after the maternity leave that can derail your career. This continued publishing of editorials that state it is not equal for those that do the child-bearing is absurd and does nothing to move the needle. Federal standards would for 6 months of equal parental leave for each parent would be great, but since we are moving very rapidly towards Handmaiden's tale I gather this will never happen. I think physicians need to find some way to collectively demand these standards because no one is coming to help us.

I say this as a female radiation oncologist with a young child who is married to a non-physician, who sacrificed his part career to be a stay at home dad for a while and keep our kid safe during a pandemic. So even when you have an extremely supportive partner for the first part of your child's life things are challenging. Having a partner being able to go back to work supports their well-being (if that is what they desire) and when you are in a relationship with a physician, having a child makes that more complicated. I will emphasize, though that yes this is something we chose, but those extra committees and meetings you are "expected" to attend have a cost, and that cost is always going to be shouldered by your partner if you don't have daycare, because lets be honest finding daycare is incredibly challenging, forget a daycare that has extended hours. Those are the precious hours that you both get to spend with your child while they throw macaroni and peas on the floor while your partner gets time to themselves. So no, I don't want to spend my 6-7 pm hour listening to someone talk about physician resiliency or obscure hospital metrics about something related to primary care, but my bonus relies on attendance to these meetings.

And then there are those times that daycare is closed because small children are viral petri dishes, and when you are solo in an office and have to be physically present for stereotactic treatment or any treatment at all and therefore taking off time at the last minute involves some wild scheduling gymnastics that no one wants to deal with after being up all night with a sick kid.

I live in a state where I have (some) financial support from the state for parental leave and state protection for my job, but my lapse in productivity for the months while I was on leave, and actually re-building the practice back up to pre-leave productivity after my return from leave resulted in a huge financial hit since I was transitioning from a salaried to a RVU based contract.

Hospital based daycare would be HUGE. And it would also be incredibly helpful to have some system for when kids are sick, because as much as we wish we could be at home with our sick kids, working as a physician means that this isn't going to be a reality most of the time.

Oh and by the way, our daycare costs an extra $5 per minute if you're late.
 
I went through the ACR survey today

It literally says doctor needs to be on premises for all treatments.

For APEX, they reference the 2018 white paper, which says the same thing.

These organizations, with that message, are clearly anti-family, and because of disparate impact, anti woman. There is no safety benefit.
 
RealSimulD said:
I went through the ACR survey today

It literally says doctor needs to be on premises for all treatments.

For APEX, they reference the 2018 white paper, which says the same thing.

These organizations, with that message, are clearly anti-family, and because of disparate impact, anti woman. There is no safety benefit.
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Ken O on twitter a few years back went on a rant “cancer patients DESERVE to have a radiation oncologist in the building”

Deeply held beliefs
 
TheWallnerus said:
Ken O on twitter a few years back went on a rant “cancer patients DESERVE to have a radiation oncologist in the building”

Deeply held beliefs
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It's nice to be able to virtue signal on all sides of an issue, even if that means you're not ideologically consistent, because who cares about that these days? Let's be pro-woman, pro-family, etc, but also say it's necessary for radoncs to be physically present at all times because "ThAt MeAnS yOu cAre AbOuT yOuR PaTiEnTs".

This thread really hits home for me this week, as last week my wife was out with covid, so I was a full-time working doc and single dad at the same time (ponytails for everyone! Every day!). This career simply would not be possible for the long term with those parameters, unless you can afford two nannies...which is what my partner did. Her husband works long hours and so does she, so when her kids were little they needed two to be able to cover. Her husband was working on a startup company of his, so she funded the nannies at that time. She's fortunate she graduated at a time when good jobs were still available which allowed her to be able to afford that.

Yet another reason why Dr. Dennis Hallahan's idea to decrease RO power in the marketplace was inherently anti-family, as it decreased the ability for radiation oncologists to be able to both pursue their careers and raise their children at the same time.
 
OTN said:
It's nice to be able to virtue signal on all sides of an issue, even if that means you're not ideologically consistent, because who cares about that these days? Let's be pro-woman, pro-family, etc, but also say it's necessary for radoncs to be physically present at all times because "ThAt MeAnS yOu cAre AbOuT yOuR PaTiEnTs".

This thread really hits home for me this week, as last week my wife was out with covid, so I was a full-time working doc and single dad at the same time (ponytails for everyone! Every day!). This career simply would not be possible for the long term with those parameters, unless you can afford two nannies...which is what my partner did. Her husband works long hours and so does she, so when her kids were little they needed two to be able to cover. Her husband was working on a startup company of his, so she funded the nannies at that time. She's fortunate she graduated at a time when good jobs were still available which allowed her to be able to afford that.

Yet another reason why Dr. Dennis Hallahan's idea to decrease RO power in the marketplace was inherently anti-family, as it decreased the ability for radiation oncologists to be able to both pursue their careers and raise their children at the same time.
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I don’t care if you’re Elon Musk or Alan Musk, needing two nannies for a job is ridiculous
 
madchemist89 said:
A sick child or daycare closure are the worst. If we were not chained to the machine, our lives would be so much better. I can't go to the dentist or doctor myself because I have to be physically present all day.
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Departmental policy?
 
madchemist89 said:
Freestanding center with single doc. Machine shuts down for an hour at most at lunch. God forbid the therapists cannot beam on at exactly 1pm.
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Virtual has been the law of the land wrt CMS since covid.

www.astro.org

COVID-19 Coding Guidance - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

ASTRO has issued coding guidance to provide radiation oncology practices with information regarding proper coding for telehealth services during this public health emergency.
www.astro.org www.astro.org

If you are "immediately available" with a/v app from your phone and you aren't scheduled to be on vacation, you should be good to go
 
medgator said:
Virtual has been the law of the land wrt CMS since covid.

www.astro.org

COVID-19 Coding Guidance - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

ASTRO has issued coding guidance to provide radiation oncology practices with information regarding proper coding for telehealth services during this public health emergency.
www.astro.org www.astro.org

If you are "immediately available" with a/v app from your phone and you aren't scheduled to be on vacation, you should be good to go
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Should be but I’m way too paranoid of a potential whistleblower making it seem like I was gone the entire day just because I was gone the entire day!
 
RadOncDoc21 said:
Should be but I’m way too paranoid of a potential whistleblower making it seem like I was gone the entire day just because I was gone the entire day!
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Have heard of places doing that, seems a bit egregious, definitely have no qualms being virtually available if I'm at the hospital seeing a consult or got held up in traffic on the way to the center etc.

Impossible to manage practice otherwise at a single doc setup
 
OTN said:
It's nice to be able to virtue signal on all sides of an issue, even if that means you're not ideologically consistent, because who cares about that these days? Let's be pro-woman, pro-family, etc, but also say it's necessary for radoncs to be physically present at all times because "ThAt MeAnS yOu cAre AbOuT yOuR PaTiEnTs".

This thread really hits home for me this week, as last week my wife was out with covid, so I was a full-time working doc and single dad at the same time (ponytails for everyone! Every day!). This career simply would not be possible for the long term with those parameters, unless you can afford two nannies...which is what my partner did. Her husband works long hours and so does she, so when her kids were little they needed two to be able to cover. Her husband was working on a startup company of his, so she funded the nannies at that time. She's fortunate she graduated at a time when good jobs were still available which allowed her to be able to afford that.

Yet another reason why Dr. Dennis Hallahan's idea to decrease RO power in the marketplace was inherently anti-family, as it decreased the ability for radiation oncologists to be able to both pursue their careers and raise their children at the same time.
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I cannot for the life of me do the kids hair. I think this is the most impressed I've ever been with you.

OTN dad skills aside, the part that is so nuts to me is that if we had been more mindful, this could have been one of the PREMIER specialties for work life balance. There are almost no weekends/nights for most of us. The schedules tend to be on the lighter end for the median doc with 6 or so consults a week, 15ish on beam, and assorted number of follow ups. The work lends itself to flexibility - contours do not have to be done at work, nor does all the paperwork. If there are no consults, the on treatment patients are all that need managed, and most of that can be done remotely.

If you modernize the supervision rule - it doesn't have to be completely thrown out - but say something like "doc on site for SBRT/SRS, high dose 3D/VMAT, some random percentage of patient treatments" and we would have optimal safety and flexibility.

But instead, we have this draconian rule in place that does not benefit patients and creates a prison-like atmosphere, with department managers as wardens.
 
thecarbonionangle said:
the resistance starts with each of us. We have to push back. I was once asked by dept chairman why i did not make it to 7 am useless “meeting”. I said i cannot come that early outside of work hours due to personal reasons. Person seemed taken aback that someone would dare miss such an important meeting. Needless to say i am still employed. There is a power to saying no and we need to do this more. No 7 am, 5pm meetings, no lunch meetings. This is exactly what leads to burn out! I refuse to play “ball” with this sort of nonsense. If it “hurts” me so be it!
Click to expand...

The "meetings" are really what kills the QOL
By the time you add up tumor boards (in many places how many are really necessary), cancer service line meetings, Radonc department meetings, chart rounds, meeting meetings, plus any other random things the hospital wants you to do... you're at something at lunch four out of five days a week and quite often something at 7am or 4-5pm.

How many of those are really necessary, get anything accomplished, or improve quality care? Maybe 10%
I'm done with extra meetings and my default answer to anything is now "no"
That really is terrible about bonus being linked to attendance
 
metallica81788 said:
The "meetings" are really what kills the QOL
By the time you add up tumor boards (in many places how many are really necessary), cancer service line meetings, Radonc department meetings, chart rounds, meeting meetings, plus any other random things the hospital wants you to do... you're at something at lunch four out of five days a week and quite often something at 7am or 4-5pm.

How many of those are really necessary, get anything accomplished, or improve quality care? Maybe 10%
I'm done with extra meetings and my default answer to anything is now "no"
That really is terrible about bonus being linked to attendance
Click to expand...
Another plus for going private if at all feasible
 
smq123 said:
The article, as written, is excessively simplistic, kind of dumb, and honestly makes me wonder if any of the authors, or the person shilling it on Twitter, have kids. (Apparently at least one does, although a very young one). This is spoken as a female primary care physician, with two small children, who is married to a radiation oncologist.

Some of what you have proposed is, frankly, silly, and not the real obstacles to career advancement. Everyone acts like maternity leave is THE REASON that a woman's career stalls as a physician. That's kind of dumb - those 6-12 weeks that you took are not going to derail your career forever. It's everything that comes afterwards that derails your career.

How does someone advance their career in academic medicine? You participate in committees, go to national conferences and meetings, and publish, right?

Except those committee meetings always start at 5:30 or 6. Daycare closes at 6 (and, by the way, keeping your kid at the daycare for the extra half hour between 5:30 and 6 costs an extra $30 a day), and it is an extra $2 for each minute that you are late. So no, I'm not signing up for those committee meetings. I'm not going to tumor board to get the surgeons to know who I am. I'm in the carpool lane trying to get my kids before the daycare bankrupts me (that's as an attending; if you're on a resident salary, then the daycare has already bankrupted you because you have to pay extra to drop the kids off at 7 and to pick them up after 5:30).

I could probably figure out childcare for one big meeting a year, like ASTRO. But if you expect me to go to ASTRO AND a bunch of specialty/disease site specific meetings, then....no. Again, especially not on a resident salary.

Protected research time is hard to come by in any specialty - it's all about RVUs and seeing patients, etc. So when do you write your papers and grants, especially as a young investigator? On the weekends. But who's going to watch your kids on the weekend? If you're lucky, you have a spouse who is capable and willing to do that, but generally speaking, you're going to have to pay a baby sitter to get a few hours of productive work done. And again, if you're an attending, that's ok, but as a resident? Very difficult.

So what are the solutions?

Stop pressuring residents and junior attendings to participate in these kind of extracurriculars. You shouldn't have to participate in a committee to show that you're committed to the institution and therefore worthy of promotion. Or, crazy thought, hold those committee meetings during daytime hours.

Move more committee meetings and maybe national meetings to virtual meetings. I get the social aspect of the meetings, but maybe one big meeting a year is enough?

Hospital-based daycare centers that are affordable AND have extended hours. As a resident, a daycare next to the hospital that opens at 6AM and closes at 8PM would be a godsend, particularly in a surgical specialty. The hospital could subsidize that. Alternatively, subsidies for nannies or au pairs would be something else that might work.

More protected research time, but that's important for other reasons as well. You shouldn't have to sacrifice your weekends to write papers and grants.

I don't think that the solutions have to be crazy to make things more equitable.
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Well said.

As an aside, even as someone who DOESN'T have kids - you know what I don't want to spend nights AND weekends doing? Radiation Oncology. Guess I'll never be a great academic because I choose to only work 60 hours a week and limit 99% of my SDN exposure to when I am at work.

Where's my accomodations?!?!
 
metallica81788 said:
The "meetings" are really what kills the QOL
By the time you add up tumor boards (in many places how many are really necessary), cancer service line meetings, Radonc department meetings, chart rounds, meeting meetings, plus any other random things the hospital wants you to do... you're at something at lunch four out of five days a week and quite often something at 7am or 4-5pm.

How many of those are really necessary, get anything accomplished, or improve quality care? Maybe 10%
I'm done with extra meetings and my default answer to anything is now "no"
That really is terrible about bonus being linked to attendance
Click to expand...
Where are the non-inferiority trials for these activities???
 
evilbooyaa said:
Well said.

As an aside, even as someone who DOESN'T have kids - you know what I don't want to spend nights AND weekends doing? Radiation Oncology. Guess I'll never be a great academic because I choose to only work 60 hours a week and limit 99% of my SDN exposure to when I am at work.

Where's my accomodations?!?!
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yes, this is a great point.

Reasonable hours and limiting before/after work garbage should not be contingent on reproducing. You shouldn't have to use your kids (or pet or pet rock) as a reason that you don't want to sit through 7 am or 6 pm meetings.
 
RO28 said:
yes, this is a great point.

Reasonable hours and limiting before/after work garbage should not be contingent on reproducing. You shouldn't have to use your kids (or pet or pet rock) as a reason that you don't want to sit through 7 am or 6 pm meetings.
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Totally

My dates with tinder randos on the great wife search were not viewed the same as having a T-ball game.
 
evilbooyaa said:
Well said.

As an aside, even as someone who DOESN'T have kids - you know what I don't want to spend nights AND weekends doing? Radiation Oncology. Guess I'll never be a great academic because I choose to only work 60 hours a week and limit 99% of my SDN exposure to when I am at work.

Where's my accomodations?!?!
Click to expand...

+1 for people that don't have kids but still like balance 🙂 Im not sure if its academic versus community or just my personal experience, moving from former to latter I had a huge drop in meetings and email. Agree it takes up so much time and really crushes QoL, and so many are unnecessary. I do think 5 meetings a week that are patient related or very select committees/practice meeting is reasonable for our salary and balance.


RealSimulD said:
If you modernize the supervision rule - it doesn't have to be completely thrown out - but say something like "doc on site for SBRT/SRS, high dose 3D/VMAT, some random percentage of patient treatments" and we would have optimal safety and flexibility.
Click to expand...

I really like this suggestion as a starting point for a modern supervision rule.
 
metallica81788 said:
The "meetings" are really what kills the QOL
By the time you add up tumor boards (in many places how many are really necessary), cancer service line meetings, Radonc department meetings, chart rounds, meeting meetings, plus any other random things the hospital wants you to do... you're at something at lunch four out of five days a week and quite often something at 7am or 4-5pm.

How many of those are really necessary, get anything accomplished, or improve quality care? Maybe 10%
I'm done with extra meetings and my default answer to anything is now "no"
That really is terrible about bonus being linked to attendance
Click to expand...
Been there. I cancelled basically all department meetings. Why are we doing peer review when there are no peers? Cancelled. Chart rounds once a week where we do the physics check together as a group at lunch time? Cancelled. Group chart review every morning on every new patient coming in that day? Cancelled.

Freed up many wasted hours.
HOWEVER, what ended up happening is that staff went out of their way to try and find any little problem or error, no matter how trivial and attribute it to you cancelling meetings and run to admin with it as proof of how reckless you are and beg them (your boss) to mandate the meetings.
My point is that it is do-able, but everyone will hate you for it.

Curiously enough, the one meeting I wanted to have, where we go out every other week after work and I buy everyone apps and beers nobody wanted to do. What I have found out is that 99% of working age adults are totally fine with wasting as much time as possible between the hours of 7AM and 4PM. The more wasted time during these hours the better, especially the early ones. But the SECOND you try to encroach on someone's post-4PM time, oh man watch out. Even if you want to buy them beers and do team building. No. They have kids at home that will literally die at 4:15PM if they are not there.

As someone who will gladly stay in the office until 8PM but loathes arriving before 9AM, I have found that this is not the field for me in that way. I think I'm literally the only one.
 
Moonbeams said:
Been there. I cancelled basically all department meetings. Why are we doing peer review when there are no peers? Cancelled. Chart rounds once a week where we do the physics check together as a group at lunch time? Cancelled. Group chart review every morning on every new patient coming in that day? Cancelled.

Freed up many wasted hours.
HOWEVER, what ended up happening is that staff went out of their way to try and find any little problem or error, no matter how trivial and attribute it to you cancelling meetings and run to admin with it as proof of how reckless you are and beg them (your boss) to mandate the meetings.
My point is that it is do-able, but everyone will hate you for it.

Curiously enough, the one meeting I wanted to have, where we go out every other week after work and I buy everyone apps and beers nobody wanted to do. What I have found out is that 99% of working age adults are totally fine with wasting as much time as possible between the hours of 7AM and 4PM. The more wasted time during these hours the better, especially the early ones. But the SECOND you try to encroach on someone's post-4PM time, oh man watch out. Even if you want to buy them beers and do team building. No. They have kids at home that will literally die at 4:15PM if they are not there.

As someone who will gladly stay in the office until 8PM but loathes arriving before 9AM, I have found that this is not the field for me in that way. I think I'm literally the only one.
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Just took my staff out for 🍣 and 🍻 pretty recently. That's a shame, definitely a way to build up camaraderie in a place. No agenda, just eating, drinking and chilling
 
medgator said:
Just took my staff out for 🍣 and 🍻 pretty recently. That's a shame, definitely a way to build up camaraderie in a place. No agenda, just eating, drinking and chilling
Click to expand...

Moonbeams said:
Curiously enough, the one meeting I wanted to have, where we go out every other week after work and I buy everyone apps and beers nobody wanted to do. What I have found out is that 99% of working age adults are totally fine with wasting as much time as possible between the hours of 7AM and 4PM. The more wasted time during these hours the better, especially the early ones. But the SECOND you try to encroach on someone's post-4PM time, oh man watch out. Even if you want to buy them beers and do team building.
Click to expand...

Serious question….

Why is team building/camaraderie building that crucial to an outpatient clinic?
 
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Moonbeams said:
Been there. I cancelled basically all department meetings. Why are we doing peer review when there are no peers? Cancelled. Chart rounds once a week where we do the physics check together as a group at lunch time? Cancelled. Group chart review every morning on every new patient coming in that day? Cancelled.

Freed up many wasted hours.
HOWEVER, what ended up happening is that staff went out of their way to try and find any little problem or error, no matter how trivial and attribute it to you cancelling meetings and run to admin with it as proof of how reckless you are and beg them (your boss) to mandate the meetings.
My point is that it is do-able, but everyone will hate you for it.

Curiously enough, the one meeting I wanted to have, where we go out every other week after work and I buy everyone apps and beers nobody wanted to do. What I have found out is that 99% of working age adults are totally fine with wasting as much time as possible between the hours of 7AM and 4PM. The more wasted time during these hours the better, especially the early ones. But the SECOND you try to encroach on someone's post-4PM time, oh man watch out. Even if you want to buy them beers and do team building. No. They have kids at home that will literally die at 4:15PM if they are not there.

As someone who will gladly stay in the office until 8PM but loathes arriving before 9AM, I have found that this is not the field for me in that way. I think I'm literally the only one.
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well for everyone except the Rad Onc - they clock in and clock out.
 
smq123 said:
Why is team building/camaraderie building that crucial to an outpatient clinic?
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A good percentage of people really enjoy doing that stuff with the people they work with. We always get positive feedback from employees when we have "a night out."

Now myself.... I could NOT care less. I don't come to the clinic to make friends. I have plenty going on outside of work that I don't need to spend another moment with them. Caring for patients is team building enough for me. So certainly not necessary for functioning of the clinic... but more for morale.
 
smq123 said:
Serious question….

Why is team building/camaraderie building that crucial to an outpatient clinic?
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Spend a lot of time together at work... Almost becomes family like when the years add up, unless you've been switching jobs every few years.

Happy staff probably more efficient than unhappy/indifferent staff, but no RCTs to back me up on that one.

Certainly easier to get my patients on the consult or machine schedule quicker and run circles around the hospital when people aren't showing up to work hating their jobs/work environment, collectively.
 
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medgator said:
Spend a lot of time together at work... Almost becomes family like when the years add up, unless you've been switching jobs every few years.

Happy staff probably more efficient than unhappy/indifferent staff, but no RCTs to back me up on that one.

Certainly easier to get my patients on the consult or machine schedule quicker and run circles around the hospital when people aren't showing up to work hating their jobs/work environment, collectively.
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Yup.

Let your staff believe that you value them and see them as crucial members of the treatment team, even if you (somehow) don't.

You're probably going to spend more waking hours with these people than your actual family, why not try to make it fun?
 
Mandelin Rain said:
Yup.

Let your staff believe that you value them and see them as crucial members of the treatment team, even if you (somehow) don't.

You're probably going to spend more waking hours with these people than your actual family, why not try to make it fun?
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totally agree. got this advice in training.
I routinely buy lunch for my staff. it makes them feel valued and they are valued. we are a team and i wouldn't be able to provide good care without them.
I also try to learn about their life outside of work so we can make small talk when im reviewing a CBCT or hanging around sim.

most of my partners don't do any of this. Maybe i'm the sucker. who knows
 
radoncftw said:
totally agree. got this advice in training.
I routinely buy lunch for my staff. it makes them feel valued and they are valued. we are a team and i wouldn't be able to provide good care without them.
I also try to learn about their life outside of work so we can make small talk when im reviewing a CBCT or hanging around sim.

most of my partners don't do any of this. Maybe i'm the sucker. who knows
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100% agree

My staff is fantastic, and they need to know it. Makes my life easier, their jobs more rewarding, and the patients recognize it
Staff will also go extra mile for you, alter schedule, no problems adding on that same-day sim, etc when they know you are a team
As a satellite when others from the mothership come spend a day in cross coverage for any reason we are complimented at how this site is run
When my team has to work with other doctors or staff from mothership the relationship is much different over there - it comes from top down

Even if admin can make things frustrating the overall feel of the department, especially a small one with only one or two doctors, should come from us. It's not hard to not be an a$hole but some can't help themselves.
 
Yah,
radoncftw said:
totally agree. got this advice in training.
I routinely buy lunch for my staff. it makes them feel valued and they are valued. we are a team and i wouldn't be able to provide good care without them.
I also try to learn about their life outside of work so we can make small talk when im reviewing a CBCT or hanging around sim.

most of my partners don't do any of this. Maybe i'm the sucker. who knows
Click to expand...
they come over to our house for events
we do weekly lunch
holiday parties

we don’t have to be friends, we can still act like we like each other
 
metallica81788 said:
Staff will also go extra mile for you, alter schedule, no problems adding on that same-day sim, etc when they know you are a team
Click to expand...

This should really not be a concern as in an ideal world you write their checks and pushback and groaning would result in no longer writing checks.

Your boss tells you to do something, you do it. You shouldn't have to give them gold stars and throw pizza parties to make it easier to get them to do what you ask.

However, we do not live in this ideal world. In a hospital employment situation, very far from it. They see you as another employee and certainly not their "boss." Even in private practice, the labor market and our handout society has created a world of unrealistic expectations where people are not afraid to quit if they are offended. A real recession would change that. But as soon as that starts to happen, we will start printing money again to placate the masses. Watch.
 
Moonbeams said:
This should really not be a concern as in an ideal world you write their checks and pushback and groaning would result in no longer writing checks.

Your boss tells you to do something, you do it. You shouldn't have to give them gold stars and throw pizza parties to make it easier to get them to do what you ask.

However, we do not live in this ideal world. In a hospital employment situation, very far from it. They see you as another employee and certainly not their "boss." Even in private practice, the labor market and our handout society has created a world of unrealistic expectations where people are not afraid to quit if they are offended. A real recession would change that. But as soon as that starts to happen, we will start printing money again to placate the masses. Watch.
Click to expand...

The world continues to change and we are just all along for the ride. Its a runaway train for sure but at the end of the day we just react the to circumstances. We are so far from the ideal at this point Im not even really sure there's a way back.
 
Moonbeams said:
This should really not be a concern as in an ideal world you write their checks and pushback and groaning would result in no longer writing checks.

Your boss tells you to do something, you do it. You shouldn't have to give them gold stars and throw pizza parties to make it easier to get them to do what you ask.

However, we do not live in this ideal world. In a hospital employment situation, very far from it. They see you as another employee and certainly not their "boss." Even in private practice, the labor market and our handout society has created a world of unrealistic expectations where people are not afraid to quit if they are offended. A real recession would change that. But as soon as that starts to happen, we will start printing money again to placate the masses. Watch.
Click to expand...

Jerome Powell is not going to let runaway inflation occur, as he knows that causes the collapse of entire countries. He's also not going to let the US enter a sovereign debt crisis and lose it's status as the world's reserve currency. Going to be tough tightrope to walk, as servicing our enormous debt is going to get harder and harder as the interest rates increase, but I do believe that's the goal.

However, given the demographics of this country, we may have a relative shortage of labor for certain fields no matter what the overall economy does. That's why, even in situations like mine where I kind of am the boss, my staff knows that once they're in The Circle, I will fight vehemently for them in all areas at all times, give them the freedom they need to work at the top of their license, and demand they are treated with respect by our administration. Keeping good employees is absolutely critical to success IMO.

I don't do anything with them outside of work, as I want that time to be theirs. We've done it in the past, though, pre-covid, and I do think there was value to team building.
 
If you make it sound like they have to do it or get upset if they don't join, that's not a fun event. And intentional Team Building is bull****.

But, I personally get to know all of my team and they know me. So, it works out that we want to share some special times together.

I'm here all day. I want to be liked and I want to like my staff - joke around, have fun, work hard.

Went to a Lions' game with my nurse and her family, we gave them tickets. My front desk person's daughter watches my kids occasionally.

Nothing to do with being a good leader - it just makes the day go better.
 
OTN said:
Jerome Powell is not going to let runaway inflation occur, as he knows that causes the collapse of entire countries. He's also not going to let the US enter a sovereign debt crisis and lose it's status as the world's reserve currency. Going to be tough tightrope to walk, as servicing our enormous debt is going to get harder and harder as the interest rates increase, but I do believe that's the goal.
Click to expand...
Off topic but I'm not entirely sure he is going to have a choice. The pain tolerance of this country and its leaders seems more and more minimal. I am positioning myself for the acceptance of more entrenched inflation.

RealSimulD said:
Nothing to do with being a good leader - it just makes the day go better.
Click to expand...
Nobody wants a boss who is an ashole, but I am old enough to remember growing up in an environment where things like authority and hierarchy were pretty clear. The new generation can get their professor or boss fired if they are offended or make them work too hard. I know I can't change that, so I've just had to relearn and adapt to it. It's not worth the fight, let me buy you a beer. Oh, you just want to have a cushy time at work then go home? Well I tried.
 
medgator said:
Spend a lot of time together at work... Almost becomes family like when the years add up, unless you've been switching jobs every few years.

Happy staff probably more efficient than unhappy/indifferent staff, but no RCTs to back me up on that one.

Certainly easier to get my patients on the consult or machine schedule quicker and run circles around the hospital when people aren't showing up to work hating their jobs/work environment, collectively.
Click to expand...

So my question was mostly facetious (although partly curious). I've worked in a clinic setting for 10 years, and have participated in my share of "team building" happy hours/karaoke nights/parties/etc.

The double standard evidenced in the replies is interesting. Everyone agrees that when the hospital requires you to be at a meeting at 5:30 PM, then that's a total imposition on your personal life, whether or not your have children. But having a happy hour at 6 PM is important because it's "team building," and there is faint disapproval of people who don't go because "they use their children as an excuse."

Logistically speaking, there is no difference between me trying to figure out daycare pickup/kid's dinner/bathtime/bedtime whether I have a required committee meeting or whether I have a "technically optional but then you'll miss out on the team building!" dinner. I still have to "clear" it with my spouse several days in advance, to make sure that he's not on call or the late covering doctor that day. I still have to make sure that there is something to feed the children and that he knows where it is, what it is, and how to prepare it. I still have to try to rush home before bedtime because making one person try to put both kids to bed is cruel. And that means spending my spouse's goodwill on something that I may not really want to go to.

SimulD is right - as far as "team building" goes, these kinds of events are not useful. I have organized my fair share as an assistant medical director. They're just an excuse to drink alcohol and eat food on someone else's dime. They have a negligible effect on turnover. Staff happiness is multivariate and depends on a lot of factors - their personal life, how much the company is paying them, benefits, commute time, workload, etc.

Now, if you organize an event because you really want to hang out with your coworkers because you genuinely like that - awesome. Go ahead. But painting it as a "team building" exercise makes it sound not-quite-optional. And the culture of "not quite optional" events that happen after work hours is something that needs to change if you want to encourage people to have children AND pursue a satisfying career as a physician.
 
Moonbeams said:
Your boss tells you to do something, you do it. You shouldn't have to give them gold stars and throw pizza parties to make it easier to get them to do what you ask.

However, we do not live in this ideal world. In a hospital employment situation, very far from it. They see you as another employee and certainly not their "boss."
Click to expand...

I strongly agree with the quoted.
 
smq123 said:
And the culture of "not quite optional" events that happen after work hours is something that needs to change if you want to encourage people to have children AND pursue a satisfying career as a physician.
Click to expand...
Lots of doctors work evenings, nights, weekends, 12+ hour shifts, etc. This comment is pretty bizarre and my frustration with people who freak out at post 4PM activities unless you are saying the only way to have a family and a satisfying medical career is to go into a banker's hours outpatient specialty.

You can't attend a happy hour once a month or something? Having to stay at work until 6 or 7 occasionally is going to mess up your family that much? Come on. I am at work until 8 not infrequently and I'm a rad onc. Growing up my dad was gone during the week and my mom taught evening and night classes at the community college to help make ends meet. We were solidly middle class, but I still feel like I had a pretty privileges upbringing.

Yeah, raising kids is not easy, but was it ever if both parents wanted to/had to work? Maybe healthcare is not the right field people who always want to be present for kids after school activities. My parents certainly weren't always at my sports games in school and I often went to a babysitter after school when I was young, which I thought was normal, so maybe my perspective was warped.
 
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