These hospital administrators are forcing me to fundraise for their so-called “nonprofit” hospital.  They’re even tying it to my bonus!


These administrators make me work with Nurse Practitioners!!


These administrators keep intruding into my practice of good medicine!!!


REALITY CHECK:  You are not in private practice.  You are not the boss.  You are working for a hospital owned practice.  They OWN your practice.  You do what they say or they fire you.  It is as simple as that.  

“Why aren’t you referring to our surgical group? Why did you send a complex neurosurgery case to that big competitor hospital?  Our neurosurgeon is pretty darn okay!  Why aren’t you a team player?”

Practices are being acquired by hospital systems at a remarkable pace.  The reasons a practice decides to sell  are many:  Financial trouble, property issues, senior partners retiring and wanting an expensive buy-out, managed care complexities, etc.

Yes!! Working as an employed physician takes away a lot of the hassle.  You don’t have to fret over a lot of regulations.  When you have issues with your office building, you don’t have to act like a construction contractor.  You don’t have to handle Human Resource issues.  You don’t have to even read complex managed care contracts.  You don’t have to choose a malpractice plan.  You don’t have to even think about OSHA.  You delegate that to your employer.

Life is easy.  All you have to think about is “CARING FOR PATIENTS!”  What could be better?

Meanwhile, the hospital bought you for one reason:  CONTROL.

Yes, you lost autonomy.  If your boss says: “You have to offer fries with their burger,” you better darn well comply.  Sorry.  We have choices and this was your choice.  We’re not the only profession to face these issues.  If you were an employed attorney and your boss said: “You have to lead the case to defend that sleazy politician serial rapist,” you don’t get to say: “Ewww!  No!”  As long as the demands do not cross clear ethical or legal guidelines, you have little choice.

Know what you are getting into.  There are trade-offs.  If the hospital demands you help with fundraising, you may want to support the team.  You are an employee.  You are replaceable.  You are not special.  It’s in your contract!

Do you know what else is in that contract?  Did you sign a brutal restrictive covenant?  Looks like you may need to leave town for a while….It’s not easy taking charge and being your own boss.

But… it is also way more satisfying!

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