When joining a medical practice: The importance of autonomy

Not too long ago before I was unexpectedly dismissed by my organization, I had the audacity to complain and request change for the betterment of my patients.   Forgoing the traditional route of a solo practice, I wanted to join a large organization which supposedly provides a worry free investment that normally comes attached with starting an independent medical practice.  I agreed to the terms and conditions of any large organization and began my new found journey hopefully into “happiness.”

My patients were nevertheless pleasant and easy to deal with despite getting my practice on a rough start.  On my first day prior to seeing patients, I was reproached by the senior practice manager for parking in the “loading zone.” I had pieces of office equipment and necessary moving items all needing the convenience for quick access to unload.   From this moment onward, this person who claims 20 years of experience since the birth of the practice really couldn’t find any respect nor any sense to my position.  I figure my years of dedicating my heart and soul learning to become a physician with an amounting student debt was anything but.  I had to apologize and took immediate action moving my half emptied vehicle far away as possible.

I only ask that when an organization charges nearly 20 thousand dollars a month in overhead per clinician to be at least supportive and cooperative to the cause of the practice.  So it really doesn’t make any rational sense to waste dollars on multiple printing errors on business cards without first consulting the person on the card to verify.  Even a broken bathroom door knob without hesitation should be fixed.  Any favorable appeal for the administration declined as my practice began to pick up.  The terse and firm exchange with the practice manager on various issues non-pertinent to patient care was in no way promising for the better.

For most physicians joining a large organization, autonomy and control must be respected and granted.  I find these entities equally important as it enables us to provide ways to treat patients effectively and efficiently.  But when an organization fails to recognize and provide even the basic practice needs for their clinicians, it is led for long-term bitterness and resentment.

Some would contend that this is the norm and expectation for joining such a group.  But I like to differ.  Without any transparency and mutual agreement between administrators and physicians, a medical practice is only good to those who are given the authority to govern.  In this case for the former.  And unfortunately, employed physicians will always be at the mercy of their organization; always struggling to seek balance between their practice managers and patients.

In the end, it’s our patients that really matter the most.  I don’t think my organization cared one way or the other about patients when they decided to terminate my contract “without cause.”  I figured that my ranting on any unmet needs to the betterment of the practice was unfortunately a threat to their establishment than the opposite.

Phillip Kim is a physician.

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