Trouble in Paradise: If someone was looking to disrupt my enjoyment of my new job, they succeeded. [View all]

Since coming back on board my old community health organization after thirteen years of overwork with their crosstown rival, I've been working in the urgent care department, and also as a float, going to whichever clinic needs help on any particular day. I'm hoping to secure my primary care position in the next few months.

Urgent care stays pretty busy, and we have a good-sized team of providers, all of whom are wonderful colleagues to have, and with whom I really enjoy working. Sometimes, however, the unpredictable schedule in urgent care can lead to days that are slower than others, resulting in a decrease in billable patient encounters.

The organization's bean-counters think they have found a wonderful way to increase the number of billable encounters. Any time any of we urgent care providers are "not doing anything", they want us to surf the electronic in-boxes of certain specific medical providers who are not in urgent care, and sift through the items looking for opportunities to create billable encounters. If we find a notation that might lead to a follow-up visit for a medication refill or a lab result review, we're supposed to forward it to scheduling. This, according to those who dreamed up this cockamamie scheme, is because the primary care providers are too busy with their own encounters to work their electronic in-boxes.

If this sounds sketchy to any of you, it certainly does to the rest of us in urgent care. Why the hell should we be responsible for another provider's in-box? Isn't it that provider's responsibility? Claiming to be "too busy" to do one's paperwork is the height of unprofessionalism, as is expecting someone else to do it.

For thirteen years, I spent every single day keeping tabs on my e-inbox. Because I was always facing a tall stack of papers on my desk in the mornings, and needed office time to tackle that, I had to make sure my electronic in-box was cleared out so I didn't have to waste office time on it. Every single day, days off, weekends, sick days, vacations, holidays, I was always in there taking care of the work. When every category of item was cleared out, it was never more than an hour or two before it would start to fill back up again. I never allowed the work to get to an overwhelming level.

Now, I'm being told I have to do someone else's work. I pointed out to the architects of this scheme that it was ill-advised, and unfair to those of us who are doing our own work. They just about came unglued. The words "unprofessional", "insubordinate", and "a bad PA", names I was never, ever called before in my old job, were hurled at me all in the space of about fifteen seconds. After getting ambushed with this, I got up to leave, and one of them barked "WE'RE NOT DONE YET!"

It's been a pretty rough couple of weeks since that disastrous meeting. Mrs. Aristus is urging me to quit, even though we have the chance to soon be working in the same clinic. My confidence in myself and my work has taken a huge hit, and the Medical Director, and the Director of Operations, both of whom I have known and respected for nearly twenty years, are hearing from people who don't know me or my work that I'm unprofessional and insubordinate.

It's enough to make a man drink. (Which I intend to, soon. )

One of my colleagues in the float pool, whom I assume suffered her own ambush after objecting to that crazy scheme, has e-mailed the rest of us, requesting a meeting amongst ourselves before going to upper management. As in everything else, it's nice to know one has allies. The MD at the head of the float pool was scandalized when I told her how I had been treated, and I think I can count on her support, too. We'll see what happens.

But it's been a nasty knock, since I came here to get away from the toxic atmosphere of my old job. Right now, I'm holding out for my primary care position, when I will no longer be required to do some other provider's work for them.

If you've gotten this far, thank you for listening.

You are all very dear friends, and I love you all.