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Urgent Care Doctor: I Quit
I quit my job last week. I was working another Urgent Care shift and I finally reached my limit. We have been slammed with the third wave of Covid. Volume is up to over 100 patients a day. This compares to normal times when 40 patients is considered a busy day. That’s 100 patients. 12 hours. One provider. One nurse. One X-ray tech. One front desk person.
Since the last surge, we have been begging our management to do something to relieve the pressure. For a brief two-week period, they paid time-and-half if people would pick up extra shifts. They had some shifts double staffed with providers. They even shut down registration when things got out of hand. But these were temporary, intermittent, and not consistent. By and large, we were just told to “deal with it.”
A particularly galling policy was that we’re obligated to see anyone who walked in right up to 8 p.m. we literally had patients walk in with less than a minute to go. This frequently resulted in our having to stay till 8:30, 9, or even on a few occasions 10 p.m. We’re told it was “Corporate Policy” as if this made it Holy Writ. We begged them to at least stop registering patients at 7:45 so we could have some hope of leaving at a reasonable time.
And so, December 30.
When we walked in, we were faced with over 30 patients in the online “save your spot” queue. Opened the doors and 10 more patients immediately rushed in. We got to work and were grinding through the patients. Covid positive. Covid negative. Influenza. Covid test for travel. Ankle injury. Etc., etc. At 1 p.m., I notice we are at 50 with the patients seen, the number in the waiting room, and those currently in rooms. Still almost 30 in the online queue.
At 2:30, I see we have 35 in the waiting room. I ask the nurse to tell management they have to shut down registrations so we can catch up. I’m told, “you’re going fine. You are seeing more than 8 an hour, and you should be able to see them and get out around 8 p.m.” We grind our way through the patients and by the time I take a break for dinner at 5:30 we are down to 12 in the waiting room and four more in the web check-in.
I come back in for the final push at 6 and try to clean things out. At 7, I notice we are down to about 10 patients, but suddenly two more pop up in registration. And two more are in line when I go to the registration desk. When asking the desk person, I’m told we are “just registering injuries and stuff like that.” And that’s when I snapped.
I get on the phone and call the clinic manager, and point out we are now 45 minutes from closing, still have eight patients to see and you have opened us up for more patients, pushing the total we are going to have to see to well over 100 patients for the day. Not for the first time, I pointed out that this was abusive of the staff, and frankly dangerous. And I told her I was resigning my position. I finished up my patients, thanked the staff for their hard work, emptied my locker, and walked out the door.
I’ve been in medicine since the 1970s. Starting as an orderly in the local ER, progressing through Med School, graduating in ’82, and working through a 40-year career, military Flight Surgeon, Residency Staff, EMS Medical Director, Hyperbaric Medicine, International Medicine, and most of all ER Physician. I’ve been able to see and do amazing things. It’s been a great ride.
Published in Healthcare
The goal of socialists is not to enact policies that improve our lives. Their goal is to control our lives. The better things work, the less they are in control. ObamaCare and all of the little laws enacted since Hillary was first lady are all intended to entice people like you to quit, and stop you from working outside of their control.
Enjoy your retirement. But don’t leave ricochet. Always enjoyed your posts and comments. Hoping you have smooth sailing from here on.
And then, after four and a half months of a successful practice, a nameless corporation comes along and buys Him out and We’re back where We started.
Great Balls of fire!- can you not post about your conspiracy theories on every occasion?
Behind a paywall, but similar sentiments from the WSJ (of all places):
https://www.wsj.com/articles/doctors-office-becomes-an-assembly-line-family-private-physician-hospital-medicare-reimbursement-ehr-medical-drug-price-cost-11640791761?mod=article_inline
God bless you for your years of hard work, Kozak. Wishing you a wonderful retirement from the situation you describe and great fulfillment in whatever you do next.
I wonder if 40 years is just enough. I was a university professor for 38 years when I quit. I will acknowledge that I never had to make a life critical decision or diagnosis like a doctor does, but I wonder if there might be a number of years when you just run out of gas, especially when you are in an environment where the management is not helpful.
For the first three decades the satisfaction of doing a good job was enough to keep me going. Then the admin overburden and the increasing snowflake factor in the students started making every subsequent semester less interesting and more of a forced march. Eventually, I just pulled the plug.
Thanks for all your hard work Kozak. You probably saved some lives. Toughest profession on the planet. Nephew an ER doc in Illinois who thought 3 months ago would be over the Covid panic soon. Didn’t work out and he is pretty stressed. Hope he comes through. Re: last comment: am into 51 plus years as a lawyer and probably on my last tank of gas. Hoping to make it to year end. But I don’t have to save anyone’s life. Just about money.
No disrespect to doctors but, um, no.
I can’t even imagine seeing 100 patients in a day. What’s that like 5 min. a patient? Impossible.
Good luck and God speed in you new life.
a)I was told in medical school that the half life of medical knowledge was 8 years.
b)In pharmacology you effectively have no drug after 4.5 half lives.
c)If medical knowledge is like an initial bolus of a drug then after 36 years you have no remaining medical knowledge from residency.
d)Therefore, you should retire at/ before 36 years after or residency.
of course this assumes you do not accumulate more (or replace) knowledge after training-if that is the case than one should definitely retire…..[in fact the 1st years in practice are critical to the formation of a young physician and good MDs constantly add to their knowledge base].
I have always tried to keep the 8 year rule in mind…..
Enjoy your retirement- almost every MD I know was nervous about retirement, but after a few months were happy they pulled the trigger.
Even if their goal is to improve our lives, their main goal is going to become looking out for their own, and that is going to come in conflict with whatever good motives they have. And yes, they will end up controlling us, because they will have the power to do so, and because their positions on the socio-economic heap will be threatened if they don’t.
OK; maybe Navy Seals is a tougher gig. Anyone else? Maybe miners. Can’t think of too many more.
Glad you did it and hope millions more follow your lead. This system is not sustainable and lessons need to be learned.
IDK- one of my sons is a mining engineer (works at one of the deeper mines in the USA)- thought the medicine lifestyle sucked so didn’t go into medicine….altho I wouldn’t trade places…
That number was one thing that helped me make the decision to retire last year.
I’m sorry you’ve ended your career on a down note. I just saw my doc for my annual physical yesterday and she said her year wasn’t too bad, although she’s just doing primary care and has picked up some hours at the hospital to help out. Maybe open a concierge practice?
My doc and I are completely simpatico on the COVID/vaccine stuff. She has a very libertarian bent and would just like to be able to talk openly about it, even citing Rand Paul taking on Fauci and asking perfectly valid questions. But, we agreed, people have been made crazy on both ends of the spectrum with all the speculation and sketchy information flying about. Sorry you’ve taken the brunt of it (both here and at work).
Yeah my parting “gift” from my last shift was getting Covid. Seriously. I then gave it to my wife.
I think we could name quite a few (Coast guard helicopter pilots, PJ’s, Bearing Sea fishermen, cops, wildland firefighter) who’d gladly trade professions (and paychecks) with an ER doctor.
It’s hell on both sides of the stethoscope these days. The only thing worse than corporate medicine is the government medicine they want to replace it with.
Nothing special there. The shelf-life of an engineer is 5 to 6 years, especially if he is involved in software. The answer is to keep learning.
A lot of people think the grass is greener on the other side. Occasionally they are even right.
Sometimes the greener grass is due to septic tank issues.
I think some people have some rather odd ideas of what tough jobs are like. I worked in an asphalt shingle factory and that was really bad, but I can think of dozens that are a whole lot worse. What makes a job worse is the lack of “glory” or admiration of peers or society, lack of interest by employers to keep the place safe or fair treatment, degrading conditions, and low pay. Most of the jobs covered by Mike Rowe on “Dirty Jobs” comes to mind.
There is probably a good post there. Listing the worst jobs one has worked in his life. I have a few temporary jobs that ranged from sandblasting metal railings on a hot, humid Kentucky day to hanging on a bell tower in a cold March breeze with a wire brush in my hand scraping pigeon crap off the bell. The height was at the worst: High enough to kill you if you fell and to let you have time to think about the impact when you hit the ground. Loading trap wasn’t a cake-walk either.
Anyone who thinks their profession is hard should throw around bags of concrete for just a few hours and report back.
I’m really getting tired of all you folks flaunting your “white priviledge”.
So I was an electrical engineer before going for the PhD. My post-college working career spanned 50 years total.
Frankly, I could have used more accumulation in the 403 accounts (especially now with Bidenflation) but I was really just done.
I’ve done that. Well, not for a few hours straight, but we’d unload bags of cement for a job off a truck by hand. It happened frequently enough. Then there was pushing the wheelbarrows full of wet concrete mix and delivering them along a narrow walkway and pouring them just so near the guys with the screed. Then troweling the floor by hand, which was a different kind of hard. Sometimes that went late into the evening. My boss was always reluctant to fire up his gas powered trowel.
The hardest work I ever did was as an elementary school teacher.
For heaven’s sake. There are different ways professions are “hard.” You take responsibility for people’s lives and health for a day. Watch people — children! — suffer and die! After you’ve done everything you know to do to save them. Sure the pay is better and people (most, but clearly not everyone here) respect you for your work. But, it’s still a hard job for which not many are equipped.
I’m kind of anal in my engineering job because I don’t want the (metaphorical) bridge to collapse on my watch. But, it’s not the same as having to give the bad news to a patient or his family. Doctoring is definitely a hard job.