Constant Rollover

The article in the American Medical News starts out with this headline:

Many hospitals recruiting doctors continually

Experts say physicians may want to contact health care institutions even if there is not a job listing that’s an obvious fit.

Basically, hospitals are always recruiting.  Is that a surprise?  “Physicians are in high demand, which means the response rate to their inquiries could be overwhelming.”  They go on to say that a physician posting his or her resume can receive 200 to 500 solicitations within 24 to 48 hours!

I am not convinced that the marriage of doctors to hospitals is a good one.   Been there.  Done that.  Twice.   But until we break free, that is almost all we have.  But buyer beware.  Hospitals make it so easy to buy the car but many times it turns out to be a lemon.  My advice to any docs looking to join a system is to contact some doctors who have left.  Find a way.   What hospitals don’t understand is that they spend a lot of money recruiting doctors but do very little to keep good doctors.  It’s moronic.  It reminds me of this line from Seinfeld:

“You know how to take a reservation but you just don’t know how to hold the reservation. And that’s really the most important part of the reservation – the HOLDING. Anybody can just take ’em”

My spin:

“Hospitals know how to recruit the doctor but they just don’t know how to keep the doctor.  And that’s really the most important part of hiring a physician – the KEEPING.  Anyone can just recruit’em”.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Constant Rollover

  1. big picture doc
    September 23, 2012 at 2:30 pm

    I ran into this a long time ago when I worked for an HMO. The idea was simple: You get a doc to sign on and promise them the moon including benefits. You treat them quite well initially, but then slowly start increasing patient loads. You especially give the most difficult and time-consuming patients to the female docs because they “listen better”. When the doc cries “Uncle!”, you just tell them that they are not a team player and laugh as they leave to find the next job to that will screw them into the ground. In my day there were plenty of new primary care docs coming out of school with huge loans who would gladly replace the doc who was bolting. Now, they just rely on nurse practitioners because they can practice without the supervision of a physician. This all began back in the 1970s when business schools became king on college campuses, and the bottom line became the holy grail. Have you noticed that private industry now funds and owns research on most college and medical school campuses? Now I am going to say this for the umpteenth time and I hope all you conservatives are paying attention: It was the private sector that screwed me the most. Should I say it again? Still not listening? OK, It was the private sector that screwed me the most. Still not listening? Oh well, enjoy your suffering.

  2. msdelta
    September 19, 2012 at 9:54 pm

    I also recently left one of our area’s large hospital-based groups because of administrative bullying. Thankfully I had the common sense and good fortune to get in with a private clinic in the same town. Just as large but privately owned, not affiliated with either hospital in town and very well run. While I agree that physicians make lousy administrators, I also think that non-physicians who try to run physician groups also make lousy administrators. While I was at this hospital-based group, I also NEVER heard one proposal on increasing PHYSICIAN satisfaction. NEVER, NOT ONE. We had monthly meetings were the monthly “productivity” list came out, listed top to bottom from “most productive” to “least productive”. We were all berated every time, once a month, like clockwork, for not being “productive enough”, or not meeting some arbitrary MGMA “standard”. They also spent thousands of dollars on a consulting firm that advised them (administrators) to provide “patient satisfaction cards”, upon which patients could “grade” us on a scale of 1-10. They then used these cards to “track” how well we were doing. At the said monthly meetings they would provide this additional “data” (N= anywhere from 2-5) and point out that Dr. so-and-so was doing 97.6% better than the other Dr. so-and so. They would implement policies over which we had NO say, but of course which impacted us tremendously. The day I left that place was one of the happiest days of my life. Shortly after I left, many of the other doctors also started leaving. In the 3 years since I left, 8 other doctors have also left that practice.

    I completely agree with the idea/fact that happy physicians will provide better care just cannot seem to take root. About 2 years after I left, I got a phone call from the NEW “Retention Committee”, asking me why I had left. I was blunt and honest and the doctor who called me (actually on my side), informed me that the hospital administrator was convinced that all those doctors leaving were leaving because of things written in the contract, i.e., the usual BS about not-compete, etc. He just found it incredulous that all of these doctors were simply MISERABLE.

    Thankfully I am happier where I am now but of course what is looming on the horizon is nauseating, the BS P4P and meaningLESS use, etc. I thought this place would be my last job but I’m not so sure anymore. This year they (owners) tried to sneak into our contracts a new clause in which 10% of our earnings are withheld and NOT paid back UNLESS we meet some ill-defined benchmarks. When I demanded to know the specifics of those benchmarks before I would sign the contract, I was told “well we dont really know, but its all coming and we need to all be prepared.” Not sure if I will survive all of these changes mentally, but I will have to find a way, because I pretty much have to work until I’m dead to pay off my medical school loans. Very disturbing to feel this way after dedicating so much of my life to prepare for a job which I love (love, that is, without all this BS that we all know too well).

    A bright spot is that I have learned some people HAVE made it work. If you’re interested in a great article on this, read “The Doctor Will See You Now”, in the Sept/Oct issue of the magazine “The Intelligent Optimist”. Its inspiring and planted a seed in my head that hopefully will be able to take root.

    • Doug Farrago
      September 19, 2012 at 10:03 pm

      Great stuff. Thank you!

  3. Ken
    September 16, 2012 at 12:29 pm

    I recently left one of our area’s large groups because of administrative bullying and moved to another, which is nearly as bad. Physicians just make lousy administrators–I have literally never heard one proposal on increasing PHYSICIAN satisfaction. The idea that happy physicians will provide better care just cannot seem to take root. Instead we get eternal demands to make patients happy (the “no patient leaves without an orgasm” policy). We have to see patients when they want, not turn away late arrivals (though they screw up waiting times of other patients), not keep patients waiting, answer phone messages and patient e-mails rapidly (but not get paid for doing so), and always have a smile on our face. Oh, and never make a mistake. I am the fourth generation physician in my family, I can only hope that my children choose not to follow in my footsteps.

  4. September 16, 2012 at 8:08 am

    Doug- I have tried to sign up for Authentic Medicine
    Gazette muliple times, but have not received it. I have been a devoted fan of Placebo Journal, and was sorry to have it expire.

    Eric Fisher MD

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