On July 1, 2014, I retired after 35 years in practice. Or at least so it seemed. Before and after retirement, my cardiology group asked if I might be interested in part-time work. At first I said no. Due to my retirement, a physician’s poor health, and one partner’s departure due to chronic complaints of being overworked and under-appreciated, the group found itself without three doctors. As my retirement approached the four-month phase, I started to reconsider the offer. I knew if I did return, it would have to be far less than full-time and for only a finite period. Being located in Florida, the medical business here is somewhat seasonal. The busiest months are November to April.
Despite dropping off staff at two hospitals, the group still has trouble keeping up with rounds, consults, and procedures at five other institutions. I agreed to return to work for three months only: January to March 2015, and work solely at the most understaffed hospital. I would work 4 to 6 hours four days a week and be paid on an hourly basis. The only thing I needed was my medical malpractice policy renewed and paid.
What surprised me the most was that upon reapplying for privileges at this one hospital was the ensuing paper work. Remember I have only been off staff for less than six months. My office administrator emailed me six forms to sign.
The first was acknowledging that I had read and agreed to the terms of the bylaws. Having been on the bylaws committee at the hospital, I had no problem with this. The second form however was of more concern. It was titled the “Disruptive Physician Document.” Essentially by signing, I was agreeing to behave nicely to staff, patients, and employees and not bad mouth the hospital.
Moreover, it said, “The (medical) staff recognizes that acting professionally entails treating others with courtesy and respect, and refraining from the use of abusive language, profanity, threats of violence, retribution, or litigation, and actions that are reasonably felt by others to represent intimidation.”
So any sarcastic, snarky, or unpleasant look or comment could be interpreted that I was disruptive. (Note the overused legal adverb here: reasonably.)
It gets even more vague and subjective. Here’s one example in the document: “Imposing onerous requirements on the nursing staff or other hospital employees.”
Hmm. Does asking for daily weights to be charted again and again qualify?
Or how about this one: “Degrading or demeaning comments regarding patients, families, nurses, physicians, hospital personnel, or the hospital. ” And if I agree to this aren’t I waiving my first amendment constitutional rights?
Next was my agreement to practice good hand hygiene. I can’t object to that. Then there was a notarized form identifying myself as me. Did you guys forget who I was so soon? And last but not least, documentation of my flu vaccine, or a reason for why I didn’t get one.
What at first seemed so simple has turned into a bureaucratic morass. I could only imagine if I wanted to return to work at more than one hospital. I am grateful at least that I am not a new physician, facing this mountain of paperwork without a clerical staff. In trying to do my former group a favor, I am reminded of that phrase, “No good deed goes unpunished.”
David Mokotoff is a cardiologist who blogs at Cardio Author Doc. He is the author of The Moose’s Children: A Memoir of Betrayal, Death, and Survival.