Curbside Consult with Dr. Jayne 4/6/20

I was awakened this morning by a call from my clinical employer. Usually those early morning calls are along the lines of someone being sick and asking if I can cover a shift, or it’s one of my partners asking follow-up questions on a patient visit from the night before.

This morning’s call was absolutely surreal. They were notifying me that they’re taking me off the schedule for the rest of the month.

It would have been one thing had they just laid it out cleanly and said it was a low census issue. Instead, the person calling (who probably hadn’t discussed the word track with HR) went on and on about needing to have physicians “give up their shifts” because of other providers who have student loans to pay or whose spouses have been laid off from their jobs. I suppose they assume that physicians of a certain age don’t have student loans or other critical deb, and whatever other assumptions they made about my finances made me less needy of work than others.

I was frankly shocked that they would approach it in the way that they did. It is certainly not something I would handle with an early morning phone call.

A quick check of the “under revision” schedule shows that the majority of shifts being moved around were indeed those belonging to physicians, while keeping the physician assistants and nurse practitioners working. As it is in so many things, it appears to be about the money, because it certainly doesn’t look like it’s about having the most experienced clinicians available to treat patients who might have complex presentations. And it’s definitely not about presenting such a drastic change in a way that might be palatable to those affected.

They went on to babble about needing me to provide coverage “when the surge comes, whenever that is” as if we’re supposed to just pick up extra shifts at their beck and call. Mind you, this is an organization that declined my offer to help them stand up a telehealth program at the beginning of the COVID crisis. Where other similar clinics are using technology to deliver care and allay patient concerns in a way that makes patients (and staff) feel safe, we’ve entrenched and have watched the world pass us by.

I’m certainly not alone, as plenty of hospitals and practices have furloughed physicians in various subspecialties due to lack of demand. My ophthalmologist friends have been largely benched since they spent the majority of their time performing surgeries that are now classified as elective.

As someone who is used to manning the front door of the healthcare system, I didn’t think it would be me. It certainly doesn’t scream job security to know that when the going gets tough, decisions aren’t going to be made on quality of care, patient satisfaction scores, or the ability to treat patients quickly and thoroughly (since I’m an A+ performer in those areas).

Needless to say, I’ll be doubling down on the informatics work and telehealth visits for a while. Frankly, I wish they would have just pink-slipped me, because I’ve definitely lost that loving feeling.

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