Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

4 complaints of physician employees and 1 solution to fix them

Dike Drummond, MD
Physician
June 30, 2013
Share
Tweet
Share

Medscape published an article titled, 4 Top Complaints of Employed Doctors, and it was a very interesting read. Turns out the things employed physicians complain about are basically that they are employees.

Let me lay out these employed physicians gripes for you with a little detail so you will see what I mean. I will finish this article with a solid way to address all of them. These gripes are basically a cry for effective physician leadership.

Although the numbers are not exact, these days about half of doctors are employed physicians, either by a hospital, a medical group or a larger healthcare system. That number is rising pretty rapidly as the industry consolidates to grab the bonus pools soon available to groups large enough to qualify as ACOs.

This move to become employed physicians is so popular, I have even seen articles lamenting the death of private practice and killing Marcus Welby.

Here is what Medscape identified as the four things employed doctors dislike the most and my suggestion of the best way to avoid these in your organization.

1. Being bossed around by less educated administrators.  As an employee, you no longer have the final say in the decisions affecting the logistics of your practice. The person actually in charge is often not a physician. They work for the institution, not you. They report to the heads of the administration, not you. They can literally tell you what will and will not be done. You are treated just like any other employee.

The article uses the term “loss of autonomy” over and over again.

You do retain most of your autonomy over clinical decisions in the exam room (notice I said “most”) and lose the decision making power over the way the office/hospital is run.

2. Not being able to make decisions about staff and personnel. That is because you are no longer their boss. You are not the leader/manager/person responsible for any of these decisions in the org chart.  If you had an office manager in your private practice, you probably lost them in the transition. Your medical assistant and receptionists are hired and fired by a middle manager, sometimes without your input, consent or awareness.

3. Having less authority over billing and charge coding. In many cases your employer has a remote and centralized billing office that takes over billing on day one. They may not have much experience with your specialty or outpatient medicine in general. They will require documentation in enough detail to survive an audit. You may not have been as thorough in your private practice as you are required to be now. It can sometimes feel like you have to learn documentation and coding all over again.

4. Being forced to use new equipment and technology. Your employer has their own equipment, EMR, supply chains and procedures. You will now comply with their systems, just like any other employee – systems you did not choose, request or approve along the way.

If a copier breaks down in your office you will have to go through the bureaucracy and policies and procedures to get a new one. That is much more difficult than handing your office manager the credit card and sending them down to the local office supply store to pick up a new one.

In some cases there are reports of groups “telling employed surgeons which kinds of joint implants to use, and according to a New York Times article, even whether to implant defibrillators in Medicaid patients.”

ADVERTISEMENT

What don’t employed doctors complain about?

Turns out Medscape’s answer is practice guidelines. The reason is simple. Most groups don’t enforce them, yet. Many organizations have established guidelines, they can even be built into the meat of the EMR, however few are strictly enforcing them at this time. As ACOs grow and shoot for quality bonuses, you can certainly expect that to change.

Physician leadership is the answer to these concerns

Leaders have influence and power, Employees do not. So how can physicians get these features of autonomy back as employees? The key is a strong physician leadership structure on the clinical side of the business.

Doctors must step up and play a leadership role within the organization. Don’t fight and object and resist. Dive in and lead. Without strong physician leadership in your organization, you have little or no influence on the administration and in the board room.

It is equally important that you allow your physician leaders to lead. You must allow them to represent you and provide solid input from our clinical side of the house to all the decision making committees in the organization.

Without physician leadership, the gripes will continue and the feeling of powerlessness will not change.

There is a famous quote, “Lead, follow or get out of the way.” My encouragement is that these gripes be addressed by a wave of effective physician leadership that accompanies your move to become an employee. Just because you are not in private practice, does not mean leadership stops. It is perhaps even more important when you are inside MegaHealthCorp than when  you were in private practice.

The two biggest challenges to employed physicians taking this leadership role are:

1. Bandwidth. Where do you find the time for the committee work to represent the doctor’s interests in your busy practice?  Does your organization respect these leadership activities enough to compensate you fairly for them?

2. Learning how to lead inside a large and established bureaucracy. The rules of influence here are very different than in your smaller, physician lead private practice.  It is a whole different ballgame.

The bottom line is some group of physicians in the organization must step powerfully into this new style of leadership. It is the only way the doctors as a group can hope to maintain any influence or autonomy as members of a large group of employed physicians in a much larger organization.

There is an alternative that might become viable in the near future. I will only mention it here. That option is for physicians to unionize.

Dike Drummond is a Mayo-trained family practice physician, burnout survivor, executive coach, consultant, and founder of TheHappyMD.com. He teaches simple methods to help individual physicians and organizations recognize and prevent physician burnout. These tools were discovered and tested through Dr. Drummond’s 3,000+ hours of physician coaching experience. Since 2010, he has also delivered physician wellness training to over 40,000 doctors on behalf of 175 corporate and association clients on four continents. His current work is focused on the 7 Habits of Physician Wellbeing. Dr. Drummond has also trained 250 Physician Wellness Champions, and his Quadruple Aim Blueprint Corporate Physician Wellness Strategy is designed to launch all five components in a single onsite day. He can also be reached on Facebook, X @dikedrummond, and on his podcast, Physicians on Purpose.

Prev

Medical conversations are happening on Twitter, not Facebook

June 30, 2013 Kevin 2
…
Next

The patient is the center of the medical home

June 30, 2013 Kevin 9
…

Tagged as: Hospital-Based Medicine, Primary Care, Public Health & Policy

Post navigation

< Previous Post
Medical conversations are happening on Twitter, not Facebook
Next Post >
The patient is the center of the medical home

ADVERTISEMENT

More by Dike Drummond, MD

  • Stop physician burnout: the hidden danger of AI note-writing software

    Dike Drummond, MD
  • Why resilience training alone won’t fix physician burnout

    Dike Drummond, MD
  • Ensure your physicians always have crisis support: 5-step awareness program

    Dike Drummond, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • The J-1 work exemption: a flawed solution to the physician shortage

    Gregory Tan
  • When physician pay packages become hospital kickbacks

    Jordan Rau
  • Don’t judge when trainees use dating apps in the hospital

    Austin Perlmutter, MD
  • Healing the damaged nurse-physician dynamic

    Angel J. Mena, MD and Ali Morin, MSN, RN
  • How a physician keynote can highlight your conference

    Kevin Pho, MD

More in Physician

  • Civil discourse as a leadership competency: the case for curiosity in medicine

    All Levels Leadership
  • When a medical office sublease turns into a legal nightmare

    Ralph Messo, DO
  • Why the heart of medicine is more than science

    Ryan Nadelson, MD
  • How Ukrainian doctors kept diabetes care alive during the war

    Dr. Daryna Bahriy
  • How women physicians can go from burnout to thriving

    Diane W. Shannon, MD, MPH
  • Why more doctors are choosing direct care over traditional health care

    Grace Torres-Hodges, DPM, MBA
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Dear July intern: It’s normal to feel clueless—here’s what matters

      Tomi Mitchell, MD | Education
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Dear July intern: It’s normal to feel clueless—here’s what matters

      Tomi Mitchell, MD | Education
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

4 complaints of physician employees and 1 solution to fix them
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...