Bohuntr Posted March 26, 2013 Share Posted March 26, 2013 Our company has a new policy, treat patients like we are working at McDonalds. Give them whatever they order. Basically, if they want a z-pak, give them one. If they complain, the complaint will be sustained. If you deny to give a steroid shot because the patient has not taken an antihistamine/decongestant and used flonase or a sinus rinse, and the patient complains to the corporate office.... The corporate office will have a provider from another clinic go to yours and meet the patient to give them the steroid shot. If a patient is on the phone while you are trying to examine them, and you tell them that they are free to wait up front and continue their phone call while "patients that really need to be seen" can take their place, you are rude... I work in retail medicine in Austin, and all that stuff you though you had left forever when you quit McDonalds at 16, it's back!! No matter how stupid the patient... (er, customer now sir), they are right and you will do whatever they need so they don't put how bad their service was in writing. As the provider, you have no recourse. We hear this continually from the people that manage our company in Houston (none of them have ever seen a patient, seen a patient with our existing EMR, or provided care for patients who know what they have when they come in the door and just need your prescription pad, they can take care of themselves! It's amusing to see people leaving retail medicine in droves because doing the right thing for the customer is not as important as getting a good write up by the customer. Is this a sad trend we have to face? Is there a place to work where they just want quality care without providing narcotics and benzo's for the block? I hate being encouraged to write narcotics because it's got to hurt him... I have a friend who just signed and handed out three blank prescriptions, Vicodin 10/325 #400, sure this will take care of your knee pain no problem. Better luck walking the puppy next time... What a waste. Do this or corporate gets a complaint against you. I feel like my life is over 3 years after PA school... There are no more medical jobs worth a ****. I'v come to learn that the president of the united states is a hemorrhoid on the rectum of society....Aim him well and we can tamp down the next bled. Link to comment Share on other sites More sharing options...
Bohuntr Posted March 26, 2013 Author Share Posted March 26, 2013 Our company has a new policy, treat patients like we are working at McDonalds. Give them whatever they order. Basically, if they want a z-pak, give them one. If they complain, the complaint will be sustained. If you deny to give a steroid shot because the patient has not taken an antihistamine/decongestant and used flonase or a sinus rinse, and the patient complains to the corporate office.... The corporate office will have a provider from another clinic go to yours and meet the patient to give them the steroid shot. If a patient is on the phone while you are trying to examine them, and you tell them that they are free to wait up front and continue their phone call while "patients that really need to be seen" can take their place, you are rude... I work in retail medicine in Austin, and all that stuff you though you had left forever when you quit McDonalds at 16, it's back!! No matter how stupid the patient... (er, customer now sir), they are right and you will do whatever they need so they don't put how bad their service was in writing. As the provider, you have no recourse. We hear this continually from the people that manage our company in Houston (none of them have ever seen a patient, seen a patient with our existing EMR, or provided care for patients who know what they have when they come in the door and just need your prescription pad, they can take care of themselves! It's amusing to see people leaving retail medicine in droves because doing the right thing for the customer is not as important as getting a good write up by the customer. Is this a sad trend we have to face? Is there a place to work where they just want quality care without providing narcotics and benzo's for the block? I hate being encouraged to write narcotics because it's got to hurt him... I have a friend who just signed and handed out three blank prescriptions, Vicodin 10/325 #400, sure this will take care of your knee pain no problem. Better luck walking the puppy next time... What a waste. Do this or corporate gets a complaint against you. I feel like my life is over 3 years after PA school... There are no more medical jobs worth a ****. I'v come to learn that the president of the united states is a hemorrhoid on the rectum of society....Aim him well and we can tamp down the next bled. Link to comment Share on other sites More sharing options...
Acebecker Posted March 26, 2013 Share Posted March 26, 2013 I'm no fan of Obamacare, but you can't attribute this behavior and this method of medical "practice" to his plan for our medical system. The problem is not insurance companies, or necessaril even your corporate office - the problem is people. We, as a culture, have an instant gratification problem. This is worsened by peoples' access to "medical" information. They google a set of symptoms - nasal congestion, occasional bloody discharge, headache progressive over 7 days and they get the answer: cancer. Then they come see us, thinking they already have the answer. It is further worsened by their distrust for anyone with a stethoscope around his or her neck and our fear of lawsuits *if* they get worse -- and therein lies another problem. These doc-in-a-box clinics have zero relationship with their patients; they have no ability to follow-up, to re-evaluate, to begin on antibiotics if things worsen. Instead we just jump to the ABx in order to treat what *might* be going on or what *might* develop. I'm guilty of this in some cases, but I have a relationship with my Pts and will prescribe parachute ABx in order to save them another copay. Concierge clinics don't have that ability; they don't know if the Pts are reliable or not and will wait the recommended amount of time before begnning on the parachute. The answer: get out. Get out fast. I work in UC and would never be treated like you're discussing... Not ever. If my Pts complain about me, it's not for this because they know they will get nowhere. Not with me or any of my colleagues. It's poor practice of medicine... You're right for feeling the way you do. And you didn't go to PA school or give up all of the things that you sacrificed for that. My $0.02. Andrew Link to comment Share on other sites More sharing options...
Acebecker Posted March 26, 2013 Share Posted March 26, 2013 I'm no fan of Obamacare, but you can't attribute this behavior and this method of medical "practice" to his plan for our medical system. The problem is not insurance companies, or necessaril even your corporate office - the problem is people. We, as a culture, have an instant gratification problem. This is worsened by peoples' access to "medical" information. They google a set of symptoms - nasal congestion, occasional bloody discharge, headache progressive over 7 days and they get the answer: cancer. Then they come see us, thinking they already have the answer. It is further worsened by their distrust for anyone with a stethoscope around his or her neck and our fear of lawsuits *if* they get worse -- and therein lies another problem. These doc-in-a-box clinics have zero relationship with their patients; they have no ability to follow-up, to re-evaluate, to begin on antibiotics if things worsen. Instead we just jump to the ABx in order to treat what *might* be going on or what *might* develop. I'm guilty of this in some cases, but I have a relationship with my Pts and will prescribe parachute ABx in order to save them another copay. Concierge clinics don't have that ability; they don't know if the Pts are reliable or not and will wait the recommended amount of time before begnning on the parachute. The answer: get out. Get out fast. I work in UC and would never be treated like you're discussing... Not ever. If my Pts complain about me, it's not for this because they know they will get nowhere. Not with me or any of my colleagues. It's poor practice of medicine... You're right for feeling the way you do. And you didn't go to PA school or give up all of the things that you sacrificed for that. My $0.02. Andrew Link to comment Share on other sites More sharing options...
rcdavis Posted March 26, 2013 Share Posted March 26, 2013 ^^^^^agree. Find a new job ASAP. Send a letter of concern regarding these ( I cannot believe they would be stupid enough to put these philosophies in writing.. But if they have, send it also) working parameters to both the DEA / DHEC and the state board of medicine. Quit as soon as possible... As soon as you have any other job lined up.. The handwriting is on the wall.. Quit, comply, or be fired. What a terrible situation.. (and one which will get worse now that CMS will be coupling patient satisfaction and reimbursement rates... Watch how hospital administration will start responding to complaints... ) Link to comment Share on other sites More sharing options...
rcdavis Posted March 26, 2013 Share Posted March 26, 2013 ^^^^^agree. Find a new job ASAP. Send a letter of concern regarding these ( I cannot believe they would be stupid enough to put these philosophies in writing.. But if they have, send it also) working parameters to both the DEA / DHEC and the state board of medicine. Quit as soon as possible... As soon as you have any other job lined up.. The handwriting is on the wall.. Quit, comply, or be fired. What a terrible situation.. (and one which will get worse now that CMS will be coupling patient satisfaction and reimbursement rates... Watch how hospital administration will start responding to complaints... ) Link to comment Share on other sites More sharing options...
TWR Posted March 26, 2013 Share Posted March 26, 2013 Bohuntr, Thanks for voicing and articulating this McDonald type of medical practice. After 26 years of practice, I was "let go" from a private practice because I did not practice "MickeyD" medicine. I agonized over that for months and you have succintly put this issue in a perspective that will allow me to move on and hold my head high. PS my 2.5 years in a previous position in retail medicine (RediClinic) was not the same as yours. Although they did their "patient satisfaction surveys monthly", they did take a lot of the "negative" comments with a grain of salt. Link to comment Share on other sites More sharing options...
TWR Posted March 26, 2013 Share Posted March 26, 2013 Bohuntr, Thanks for voicing and articulating this McDonald type of medical practice. After 26 years of practice, I was "let go" from a private practice because I did not practice "MickeyD" medicine. I agonized over that for months and you have succintly put this issue in a perspective that will allow me to move on and hold my head high. PS my 2.5 years in a previous position in retail medicine (RediClinic) was not the same as yours. Although they did their "patient satisfaction surveys monthly", they did take a lot of the "negative" comments with a grain of salt. Link to comment Share on other sites More sharing options...
Teasip Posted March 26, 2013 Share Posted March 26, 2013 Bohuntr, I'm there with you. I recently left a position early while awaiting another upcoming one and left for many of the same reasons. Administration said "HE should be doing 60 wellness examinations/day" and give "door prizes" to all (antibiotics primarily since we didn't prescribe controlled substances, thank goodness). Many I saw didn't want to listen, or even read the posted recommended therapies by specialty organization ("Don't blame me, I'm just regurgitating what the experts tell me, and others like me, to do with folks such as yourself", i.e.-rhinosinusitis, bronchitis....you know the drill). I joked with medical staff co-workers that we should just have a gum ball machine in the lobby and ask them to put their coins in to get what they think they need. All kidding aside, what administration in your facility is apparently not taking into account is the low, but still real, risk of an adverse outcome based on treatment alone. Those unnecessary antibiotics, or other classes of medications, over time will eventually catch up with someone and there will be an adverse result, including a potentially lethal one. Guess who gets to do the explaining? Everyone (patients) wants to be better yesterday but the fact of the matter is that most of the stuff that is seen in doc-in-the-box locations doesn't require treatment to begin with. It's all supportive therapy until the illness resolves on its' own. This is why customer satisfaction scores are so high with regard to the population's willingness to see mid-levels in such a setting at a cheaper cost than their own provider because it doesn't matter what we do because they get better regardless (as long as we don't hurt them)! After 30 years I'm at least getting closer to that bright light at the end which will allow me to walk away from this nonsensical approach. Link to comment Share on other sites More sharing options...
Teasip Posted March 26, 2013 Share Posted March 26, 2013 Bohuntr, I'm there with you. I recently left a position early while awaiting another upcoming one and left for many of the same reasons. Administration said "HE should be doing 60 wellness examinations/day" and give "door prizes" to all (antibiotics primarily since we didn't prescribe controlled substances, thank goodness). Many I saw didn't want to listen, or even read the posted recommended therapies by specialty organization ("Don't blame me, I'm just regurgitating what the experts tell me, and others like me, to do with folks such as yourself", i.e.-rhinosinusitis, bronchitis....you know the drill). I joked with medical staff co-workers that we should just have a gum ball machine in the lobby and ask them to put their coins in to get what they think they need. All kidding aside, what administration in your facility is apparently not taking into account is the low, but still real, risk of an adverse outcome based on treatment alone. Those unnecessary antibiotics, or other classes of medications, over time will eventually catch up with someone and there will be an adverse result, including a potentially lethal one. Guess who gets to do the explaining? Everyone (patients) wants to be better yesterday but the fact of the matter is that most of the stuff that is seen in doc-in-the-box locations doesn't require treatment to begin with. It's all supportive therapy until the illness resolves on its' own. This is why customer satisfaction scores are so high with regard to the population's willingness to see mid-levels in such a setting at a cheaper cost than their own provider because it doesn't matter what we do because they get better regardless (as long as we don't hurt them)! After 30 years I'm at least getting closer to that bright light at the end which will allow me to walk away from this nonsensical approach. Link to comment Share on other sites More sharing options...
Guest Paula Posted March 26, 2013 Share Posted March 26, 2013 Do not loosen your standards and start practicing medicine in this manner. The day you hand over a Z-Pack and your patient goes into Vtach and dies, you will be responsible, especially with the new warnings out about some Abxs that prolong the Qtc interval in those with heart disease,etc. Your corporation is just a business, they do not care about you or patient care. But the Board of Medicine and the DEA care and your license could be compromise for giving non-standard care. Look for a new job. Link to comment Share on other sites More sharing options...
Guest Paula Posted March 26, 2013 Share Posted March 26, 2013 Do not loosen your standards and start practicing medicine in this manner. The day you hand over a Z-Pack and your patient goes into Vtach and dies, you will be responsible, especially with the new warnings out about some Abxs that prolong the Qtc interval in those with heart disease,etc. Your corporation is just a business, they do not care about you or patient care. But the Board of Medicine and the DEA care and your license could be compromise for giving non-standard care. Look for a new job. Link to comment Share on other sites More sharing options...
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