Should I stay or should I go ? Please help

[scharnhorst]

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Current job has a lot of benefits biggest being healthcare for life upon retirement after 15 yrs of service ( I’m only 4 months in ) and pension 1/3 of pay at retirement
HOWEVER they expect me to manage a lot of conditions that pcp normally would not , really limit testing , yet expect excellent pt reviews and also not to use the ER .They expect troponin d dimer etc to be done in clinic , before sending anyone out.
Vs
My previous job which has good benefits and similar pay but no pension and no healthcare after retirement but I can practice however I want
Thanks under a lot of stress will much appreciate some feedback

 

[VA Hopeful Dr]

Current job has a lot of benefits biggest being healthcare for life upon retirement after 15 yrs of service ( I’m only 4 months in ) and pension 1/3 of pay at retirement
HOWEVER they expect me to manage a lot of conditions that pcp normally would not , really limit testing , yet expect excellent pt reviews and also not to use the ER .They expect troponin d dimer etc to be done in clinic , before sending anyone out.
Vs
My previous job which has good benefits and similar pay but no pension and no healthcare after retirement but I can practice however I want
Thanks under a lot of stress will much appreciate some feedback

That sounds awful.

You're a doctor, you should be able to afford a secondary insurance plan to pick up whatever costs you have after Medicare.

Plenty of places where you can still get a pension. If you're willing to move to SC I can get you a job with a pension right now without any of that BS except caring about patient satisfaction (that's very hard to avoid these days).

 

[Eysteve228]

Do these labs have a quick turn around time akin to being in an emergency department/hospital setting? You say they limit testing at your location yet want very time sensitive tests to be a standard there which raises an eyebrow for sure.

Ultimately comfort level is a huge part of it as well. If it's a location with few resources and expects full scope practice from you but you aren't necessarily trained/comfortable and well versed in that then... I'd get out as quickly as possible, personally. Would echo VAhopeful, plenty of opportunities similar to that that don't require you to practice nonsensically and to their guidelines (also known as letting YOU practice and make decisions as a physician within your scope of comfort and training).

 

[scharnhorst]

Do these labs have a quick turn around time akin to being in an emergency department/hospital setting? You say they limit testing at your location yet want very time sensitive tests to be a standard there which raises an eyebrow for sure.

Ultimately comfort level is a huge part of it as well. If it's a location with few resources and expects full scope practice from you but you aren't necessarily trained/comfortable and well versed in that then... I'd get out as quickly as possible, personally. Would echo VAhopeful, plenty of opportunities similar to that that don't require you to practice nonsensically and to their guidelines (also known as letting YOU practice and make decisions as a physician within your scope of comfort and training).

The turnaround time is quick, but the problem is that the patient while it’s waiting for troponins, etc., is not sitting in a facility staffed by ACLS certified personnel
That I believe in a huge problem in case the code, the question will arise why I didn’t transfer to the appropriate facility? If I knew it could be something life threatening

 

[scharnhorst]

That sounds awful.

You're a doctor, you should be able to afford a secondary insurance plan to pick up whatever costs you have after Medicare.

Plenty of places where you can still get a pension. If you're willing to move to SC I can get you a job with a pension right now without any of that BS except caring about patient satisfaction (that's very hard to avoid these days).

I have no problem in the past getting really good patient satisfaction scores, but they are at least I was free to practice an order as I feel appropriate
I feel like expecting a 10 out of 10 review from a patient while not ordering the testing that is needed for diagnosis or not referring them to the specialist if they desire a very daunting task

 

[VA Hopeful Dr]

I have no problem in the past getting really good patient satisfaction scores, but they are at least I was free to practice an order as I feel appropriate
I feel like expecting a 10 out of 10 review from a patient while not ordering the testing that is needed for diagnosis or not referring them to the specialist if they desire a very daunting task

It definitely can be. I'm guessing you work for Kaiser.

 

[sloh]

It definitely can be. I'm guessing you work for Kaiser.

lol my first thought after reading original post as well

 

[scharnhorst]

It definitely can be. I'm guessing you work for Kaiser.

lol my first thought after reading original post as well

Name of the organization might be similar to the title of the head of state of a central European country in the late 19th and early 20th century

 

[Ironheme]

There's a lot of options as an attending. I would not stick with a job that makes me run trops in an outpatient setting. Risking medical license there with bad outcomes. If first is negative, are you planning on running the next 2?

You spent all that time training, make it worth it where you can make your own medical decisions. It never made sense to me when someone with no medical knowledge would try to tell docs how to practice medicine in the name of patient satisfaction scores, cramming more patients into a schedule that takes away from the current patients without talking to the doc, etc.

 

[FrustratedFamDoc]

No way no how for no amount of money. My current job is awful, but what you have sounds like a bad outcome (that’s not your fault) waiting to happen… and you’re the one who has to live with it your conscience, always asking what if.

 

[B1GM0N3Y86]

Few things in an outpatient setting I would never consider ruling out.... ACS, CVAs, PEs.... If you have concern a patient has ACS, you know the answer. The patient should be directed to the ER for prompt eval/mgt. May want to consider giving the patient four baby Aspirins while your at it too if no contraindication exists...

 

[scharnhorst]

Update
Gave my notice
I know giving up great benefits and pension
But working twice as long atleast and four times the stress was not worth it
Hopefully not too much regrets later

 

[VA Hopeful Dr]

Update
Gave my notice
I know giving up great benefits and pension
But working twice as long atleast and four times the stress was not worth it
Hopefully not too much regrets later

I've yet to regret leaving a job

 

[cabinbuilder]

I've left, quit, been fired, been asked to leave, was terminated without notice due to name changes not done quickly enough - it happens, generally doesn't hurt you unless you are grossly negligent. There are plenty of jobs out there and more locum jobs than can be filled. Move on, be happier.

 

[Ironheme]

I've left, quit, been fired, been asked to leave, was terminated without notice due to name changes not done quickly enough - it happens, generally doesn't hurt you unless you are grossly negligent. There are plenty of jobs out there and more locum jobs than can be filled. Move on, be happier.

I have so many questions 🤔. I agree with the job security aspect though!

 

[dozitgetchahi]

I've yet to regret leaving a job

I’d agree. Every time I’ve left a job, I made more money and got treated better afterwards.

 

[cabinbuilder]

I have so many questions 🤔. I agree with the job security aspect though!

Yah, I never thought it would be so ugly to be employed as a physician. It takes time to find the right place where your personality meshes with the Evil admin empire over you. Even now where I'm pretty much left alone because I am their work horse here in West Texas where they can't recruit doctors I still get push back at times and have thrown down the "I quit" gauntlet at least 3 times in the last 8 years. Still employed, still fighting the admin battle. I have one person in admin who protects me for the most part. Every incident I document and forward to my lawyer (who does not live or work in the town I do). I have kept all my licenses active from my locum days (I have 7) so I know I can have a locums job in a week if I need to (any they know that too) so the threat of me getting fired or me walking out is a small one.

 

[Ironheme]

Yah, I never thought it would be so ugly to be employed as a physician. It takes time to find the right place where your personality meshes with the Evil admin empire over you. Even now where I'm pretty much left alone because I am their work horse here in West Texas where they can't recruit doctors I still get push back at times and have thrown down the "I quit" gauntlet at least 3 times in the last 8 years. Still employed, still fighting the admin battle. I have one person in admin who protects me for the most part. Every incident I document and forward to my lawyer (who does not live or work in the town I do). I have kept all my licenses active from my locum days (I have 7) so I know I can have a locums job in a week if I need to (any they know that too) so the threat of me getting fired or me walking out is a small one.

I think part of that is setting the bar of expectations. Even if the physician before you was terrible and you're great, they become complacent with the new standard. Then the thinking is if we push a little more, push the goal post a little farther, then we can look better, since you've already been so accommodating. They don't think each little push is a little more towards burn out, towards looking for other jobs.