Question to Ask the Workplace Doctors about dysfunctional structure:
I work for a medical organization. By law, my medical work must be supervised by a physician. However, the “organizational structure” of the practice has a non-physician (peer) as my immediate supervisor. This person reports to a non-physician administrator (MBA – no health care experience). The immediate supervisor handles scheduling issues, performance evaluations, and tracks time & attendance, etc. I think this organizational structure is dysfunctional, in that our “supervisor” has no lawful authority to supervise our medical work, which constitutes 99.99% of our work. Any thoughts or suggestions regarding this?
Signed, Concerned about Supervisor
Dear Concerned about Supervisor:
Your question makes me think you are not happy with your supervisor in general, rather than only being concerned about the appropriateness of having a non-medical person do your scheduling, time and attendance and so forth. I can understand that it might be frustrating to be supervised by someone you feel is not as knowledgeable as you about your work. But, the key is what supervision is done and how much medical input is involved. As you noted, there are laws in all states that regulate medical supervision. However, there are no such regulations for administrative supervision, and it is often the case that non-medical (thus less expensive) staff are used for that.A non-medical person can look at a check-list and see if appropriate procedures were followed, but they cannot decide to depart from normal protocols based on their opinions about it. A non-medical person could schedule medical staff, review compliance with rules, ensure that scheduled work was done to a written standard and so forth, but could not prescribe treatment or medication. A non-medical person can schedule vacations, handle payroll and so forth–which are not tasks for which medical experience and education is needed.If you feel something has occurred where having a non-medical supervisor caused harm to a patient or prevented appropriate medical care, you have something substantial to take to a medical board or to a regulatory agency that deals with organizations such as yours.Or, if you feel some aspect of the supervision you receive is inappropriate, perhaps this could be discussed with your HR section, or at a higher level in the organization.If you are a member of an association of health care workers, you may be able to get assistance from them about this matter.
Even if you are not a member, an association would likely be glad to give you information about a situation such as yours. By contacting someone in your state you can get more specific help than we could give you. All of this brings me back to my original statement that it sounds as though you, and perhaps others, are primarily unhappy with the current supervisor for reasons other than other medical credentials. If that is the case, you will want to be very careful to not seem to be going out after your supervisor for no solid reason. If she is still there when it’s all over, your relationship with her will be even worse! Focus on your own good work and the care that is being provided to your patients and clients. If they are receiving good care, you may find there is no dysfunction after all, just an organizational structure you don’t like. If there is harm to patients, then you certainly have a duty to do something to improve it, and you can justify your actions clearly. Best wishes as you consider this situation and how you want to deal with it.
Tina Lewis Rowe