Unfair Work Distribution

Question:

I work in a very small department in a hospital. I work primarily with two female doctors and their private secretaries. I have two co-workers who hold the same title/job as I do. My two coworkers and I see patients for many other doctors, but these two doctors provide a very large portion of the patients we see.

For the most part, they appreciate our workups and even fight over how many of our available work slots they get. The three of us have all passed a board certifying exam and theoretically are equally qualified.

It has become very apparent recently that both doctors have told their secretaries to book with co-worker A first and then us. Co-worker B also is given patients I am apparently not allowed to see.

Our performance development reviews are always good. I have never had either doctor come to me to ask me to do something different in my work-ups. They certainly request things occasionally, but I honestly cannot see a difference between co-worker A’s assessment and my own.

I can’t believe I have gone to university for four years, then did a two year professional post grad program in hopes of getting a good job just to be stuck in a situation like this. Hospital jobs in our profession are hard to come by. Seven people applied the year I graduated, so I was very lucky to get this job.

Please understand, I love seeing patients and doing my work. What I don’t like is that everyone seems to have control of us. Even though we have a schedule we are suppose to adhere to, we have to wait for the secretary to check the patient in and put up the chart before we can take the patient in. The patient can be here for 10 minutes before they check them in and our appointment slot is half over by the time we get the patient into the room.

The other day I waited 12 minutes for a chart and just as I finally got it, Doc A stopped me to ask me to do something for her that would take about 5 minutes. I’m sure she could tell I looked harassed, but I’ve learned not to say no. No one backs me up if I do. It’s not that I would get in trouble; in fact my coordinator would back me up and say my job is to see patients not do that task; but she had changed her attitude and I want to meet her half way.

Also, if I am between patients and am waiting, I don’t mind doing a little extra. Problem is, they don’t see it as us doing extra things for them. They see it as if this is part of our job. We had a meeting recently and the secretary was very nice to all of us until the meeting started and then it was like a bear came out and growled at all of us. I couldn’t believe that the doctor allowed her to talk to us like that or even that our coordinator let her. But everyone backs down around her. She was upset about us asking for time off because she has to then move patients. We try to do things as far in advance as possible, but frankly, it is part of her job to move patients.

So, no one listens to me. I have tried in the past and been unable to make the doctors listen to me. The secretaries are in control. Co-worker A is not ever going to stand up for us and frankly on one level enjoys that status of being the most wanted. Even the third co-worker who was very upset and going to talk to the coordinator has decided she isn’t sure she wants to be the one to rock the boat. Today co-worker three had two patients booked in. Co-worker A had almost a full day and I had no patients booked in. We are not unionized, I don’t believe we are in danger of losing a position, but even thought I am the middle one with seniority, I know I would be the one both doctors would want gone if they had to choose.

Normally I would have taken some of the patients, but I don’t feel like I can now. They truly want Co-worker A to see them, and this upset her. She asked me if I was going to speak to our coordinator and I said no, I wasn’t going to be the one to speak up again.

I have never been given a bad review and I don’t want the doctors to be pushed into putting something down on paper because they are in defensive mode. I am quite prepared if anything is said to ask my coordinator to sit in with during an exam to evaluate me, I know I am good at my job. Perhaps co-worker A is better, she’s been at it a decade longer than me, but why does it have to be a constant comparison? Why can’t we all be good? Why can’t we all be happy and do our jobs without this constant threat of you aren’t good enough……. I’m not sure what I can do to change this situation. There are literally no other jobs for me in this area. I feel like I have been unfairly judged and cannot undo people’s opinions of me. I can either fight for fairness and my reputation or I can back off and simply accept that life isn’t always fair. I have a good job and should I be pressing these doctors about why they want co-worker A over me? Should I not leave well enough alone and be grateful to be employed. Most days we are all fully booked so it doesn’t matter. It is just days like today that aren’t fully booked for all of us that it is noticeable.

Signed,

Frustrated and Feeling Shut Out


Answer:

Dear Frustrated and Feeling Shut Out:

I can tell how frustrated you are, although it might be that your lack of work on the day you wrote added to it. I edited a considerable part of your message to avoid having it identifiable. I kept the essence of it, which is that you feel patients are being scheduled unfairly and you receive less that your share. You also are concerned about a misperception of your role by the physicians. You are treated almost like an assistant to them instead of a professional who is officed with them. The attitude of a secretary to one of the doctors is also a source of frustration and irritation, as is some aspects of how scheduled time slots are managed.

The question is, what can you do about all of this?

From what you have described it seems that Professional A (as you named her) has done the assistant role that the doctors want. She gets the most patients from those three doctors. Sometimes, as happened on the day you wrote, she was booked all day while you had no one.

Professional B has done a few things to assist the doctors, but not as much as A. She has more patients than you but less than A.

You have not shown a willingness to do things that are not part of your actual role in the office, focusing instead on your patients. You only get the left-over patients, not nearly as many as A and B.

There’s a clear pattern there! If the doctors are allowed to refer as they wish, they have the right to do what they are doing. If there is some guideline about how work is scheduled, perhaps your coordinator can bring it to their attention and request a more fair allocation of work.

Perhaps you can write a letter expressing the concerns of all of you and have everyone sign, so it will be seen as being from all of you.

You can decide to do what A does and be seen by the doctors as worthy of the reward of getting more patients.

Instead of talking to the doctors about fairness, perhaps you would want to talk to them about your need to have more patients to fill your work days and ask for their assistance in doing that.

Another option would be to talk to your coordinator or some other person you respect and ask if there is something they can suggest, since they know the system and the culture.

Those are the only options that seem likely. I know you know them already but maybe staring at them will lead you to a reality-based solution. The reality may be that you can’t make them book patients differently. So, either you accept it, talk to them or purposely solicit things you can do to help the doctors in exchange for them giving you more patients.

You said that no one listens to you. What that may mean is that they listen but don’t agree and don’t intend to make a change or follow your suggestions. If that is the case you will need to decide how much you want the job and want to stay there.

However, it sounds as though everything in your work situation is made more difficult because of lack of openness about concerns. You say you have meetings, but it sounds as though they are unpleasant. But, you don’t mention any productive efforts to improve things.

For example, if the secretary is being rude and harsh, you could let her have her say then respond with, “Helen, I want to work with you, but the way you just talked to me is unprofessional and inappropriate. I’ve never talked to you that way.” Then you could look at the doctors or others present and say, “Could we agree that we will only talk in respectful tones in these meetings and we will try to work with each other instead of attacking each other?” Few people would disagree with that, so everyone will be sensitized to what is said and how it is said, including the secretary.

The patient time scheduling is another issue that should be communicated about. I feel sorry for the patients, dealing with a medical facility that doesn’t put their best interests first! Perhaps your coordinator would be able to help with this as well.

One thing I think you will need to keep as a perspsective: You may be a company of one on these things. If something bothers you, you will need to decide if it’s important enough to deal with it on your own, because you probably won’t get any help from A and B. Maybe you will, but I wouldn’t bet on it.

None of this is a solution because I don’t know that there is one. Things may have gone too far down the road for the physicians to change now. You may not want to make any changes at all either. But perhaps just reading about it will let you see the options that are avaialble and generate even more–maybe a mixture of all of these–that will work.

Best wishes to you in your career. I wish I could wave a wand and make it better. But, I can respond and let you know that your concerns are understandable and valid. If you have the time and wish to do so, let us know what happens.

Tina Lewis Rowe