Tips for dealing with big box shop admins?

[nexus73]

Aside from "just don't work there" I was hoping to get some tips about how to deal with hospital administrators. In my limited experience, I've found a very useful tip is to at all costs avoid drawing comparisons between psychiatry and any other specialty. For some reason admin loves to do this, and psych tends to be on the losing end of the comparisons...e.g. "ICU docs can see 30 patients per day"...or "cardiology comes in at 2am when they're on call", both of course completely unreasonable for psych. So any other tips or words of wisdom for psychiatrists dealing with administrators?

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[Sushirolls]

Psychiatry is usually treated differently, at times bad, but at times better. The less its under the radar the better. I've seen a psych department completely do their own thing on numerous system wide policies that every where else was doing, simply because it was the psych department and no one really wanted to mess with it. Neglect by admin can be a positive too, but that depends on the mid manager and the doc director to be in sync and striving for the positives of this inherent admin neglect.

Support staff are supposed to always wear xyz, turn a blind eye and let them wear what they want. Support staff supposed to ask ridiculous questions per protocol, 'Have you traveled... have you X... have you Y... Have you Z...." just let them skip it. This same type of thing can also apply to the docs. Need a dentist appointment? Cancel out the necessary patients for that afternoon, and go do it. No need to count that as vacation or sick days as long as the department understands it's cool - this type of thing is more likely to work with an wRVU heavy pay setup.

 

[Sushirolls]

If you aren't the medical director in a Big Box shop, don't try to change anything. I was a slow, slow learner on this lesson.

 

[nexus73]

Psychiatry is usually treated differently, at times bad, but at times better. The less its under the radar the better. I've seen a psych department completely do their own thing on numerous system wide policies that every where else was doing, simply because it was the psych department and no one really wanted to mess with it. Neglect by admin can be a positive too, but that depends on the mid manager and the doc director to be in sync and striving for the positives of this inherent admin neglect.

Support staff are supposed to always wear xyz, turn a blind eye and let them wear what they want. Support staff supposed to ask ridiculous questions per protocol, 'Have you traveled... have you X... have you Y... Have you Z...." just let them skip it. This same type of thing can also apply to the docs. Need a dentist appointment? Cancel out the necessary patients for that afternoon, and go do it. No need to count that as vacation or sick days as long as the department understands it's cool - this type of thing is more likely to work with an wRVU heavy pay setup.

Can you expand on the better to not be under the radar?

 

[Sushirolls]

Can you expand on the better to not be under the radar?

My experience is that Psych is usually relegated to the old scat buildings or worse parts of buildings. If a separate building, this helps to add a true logistical barrier to being kept in the fold.

But how to enhance flying under the radar, I don't know. I've only experienced it in its natural state. Never really thought about how to induce it before.

 

[nexus73]

My experience is that Psych is usually relegated to the old scat buildings or worse parts of buildings. If a separate building, this helps to add a true logistical barrier to being kept in the fold.

But how to enhance flying under the radar, I don't know. I've only experienced it in its natural state. Never really thought about how to induce it before.

I’m sorry are you saying it’s better to fly under the radar or not?

 

[AD04]

Why can't you just say no? It doesn't mean you have to find a new job.

 

[robellis]

I’m sorry are you saying it’s better to fly under the radar or not?

Better to be under the radar so they don’t try to make you do what the other fields are doing because it’s often untenable

 

[SmallBird]

If you aren't the medical director in a Big Box shop, don't try to change anything. I was a slow, slow learner on this lesson.

I’ve had the same experience. Frustrating as admins won’t tell you directly that this is the reality but you end up hitting brick walls.

 

[hebel]

Good topic. Yeah, so when there's a department meeting with the upper admin in attendence (your chair's bosses), and they are asking for feedback should you hold back on being respectfully honest with concerns or ideas for improvement you have?

Should communication stay between you and the chair, who can then escalate things so you aren't seen as a complainer or a "difficult" employee?

 

[psychacad]

Can you clarify what is it that you'd like help with? I think the advice depends on what your aim is.

In general, I think as a first step it's always good to "diagnose" before you "treat".. i.e, figure out what the large goals/interests of the admin are. In some cases, it's to score high on quality metrics so that they could claim "#1 in US News", for others it's how to squeeze out the most of their providers.

Also, what are your goals? Be done with your day with the least amount of headache vs climb the political ladder?

Good topic. Yeah, so when there's a department meeting with the upper admin in attendence (your chair's bosses), and they are asking for feedback should you hold back on being respectfully honest with concerns or ideas for improvement you have?

Should communication stay between you and the chair, who can then escalate things so you aren't seen as a complainer or a "difficult" employee?

I think the attitude should be results-oriented. So, for example, if you know where the interests of the admin lie and think they are unlikely to respond to feedback (even if they formally ask) because it runs counter their interests, I wouldn't even bother.