For those of you who have recently subscribed to the blog, welcome. Let me catch you up on my recent journey. February of this year (2017) I pulled the plug on working and I retired.
Because I enjoy practicing a little (very little) urgent care medicine I decided to continue working a few shifts on occasion. Some are in-office shifts and most are telemedicine shifts.
In August I moved to Barcelona and have been working on various projects which interest me. I haven’t had any issues with telemedicine companies knowing I was in Barcelona except for one – here is the story.
“IMMEDIATELY!!”
In the US each state has its own telemedicine laws but as long as the healthcare provider is licensed in the state where the patient is a permanent resident, it’s all legit.
I was seeing patients for one of the telemedicine companies while in Barcelona. I’ve been doing so for 3 different companies. 2 of them found out and were okay with it. This 3rd medical group had an e-breakdown.
I get this short and nasty email from the account manager informing me that I will be taken off of their platform immediately!!! … and that I was violating HIPAA by seeing patients from Spain. No explanation, no follow-up.
Few actually understand what HIPAA is which is why it’s thrown out in so many clinical conversations. It doesn’t apply to this case, but that’s beside the point.
I have had a great relationship with this company for over a year. But what frustrated me is how rude his email was, how accusatory, how incorrect, and how unsubstantiated. It reminded me of the experiences I have had with workplace bullying.
Workplace Bullying
I’ve interacted with this individual on email before and once on the phone. He is quite mild-mannered but tends to be a bit dismissive when it comes to follow-up.
Healthcare is in such high demand that there are plenty of jobs, plenty of patients, plenty of money, and plenty to replace those who cause friction.
Even though healthcare jobs for primary care doctors are as abundant as HPV, our administrators and bosses still treat us like shit and get away with doing so.
I posted a while back about having had my fair share of bullying experiences at work. It’s not a pleasant experience and it slowly wears you down.
If I relied on the income from this telemedicine company then this email could have caused me a lot of grief.
Dealing With The Negativity
I’ll share something with you guys, the universe does not want you to stop working. So for anyone who is prepared to call it quits early, be ready for that push-back. Though a big part of me wants to kiss medicine goodbye permanently, it’s incredibly tough to walk away from it.
I no longer work because I need the income. I work because I don’t want to lose my clinical skills and because I am still too much of a chickenshit to tap into my investments in order to live off of them.
With every negative interaction such as this one, with every harassing patient visit, and with every 10 pages of paperwork I need to fill out to remain a doctor, I am losing my passion for medicine. I’m sure it will take me some more time to finally man up to the fact.
In the past, I would have gone to great lengths to diffuse such a situation. I would have kissed ass and repented. However, I replied to this individual immediately and explained to him why his explanation didn’t make sense and if there is a policy of not working from another country then I’d like to see it.
As soon as I sent the email I chuckled. I never send heated emails, I always calm myself down before replying. I wasn’t rude but I certainly wasn’t the warm & fuzzy Dr. Mo. Needless to say, I didn’t get a reply.
We Relinquish Power To Jobs
Just a couple of years ago I was heavily dependent on my income from my job. I was as good of an employee as you could imagine. I did everything possible to make sure my bosses were happy with me.
No matter how good you think you are, your employer has the right to let you go with a 30-second notice. There is a myth out there that jobs cannot fire you without a legitimate reason – that’s false.
Your job can let you go because they no longer want you as an employee. Simple. As long as it wasn’t retaliatory or discriminatory, there is absolutely nothing you can do about it.
Still, in order to prevent employees from retaliating legally, employers often go through the process of making sure that they have a “good” reason to let you go.
The Universe Hearts Me
As soon as I sent off that email I closed my laptop because I was irritated that this dude was so rude. I think I got some wounds to lick from a few negative work experiences in the past.
I flipped my computer back on because I wanted to find a new cafe to go read at and I see a new lovely email from another telemedicine company reporting that I had just successfully completed the credentialing process and that I could start immediately seeing patients.
Preventing Workplace Bullying
When I was at SCPMG Kaiser I saw a lot of bullying, really blatant. It was always directed towards the nicer doctors, those who wouldn’t fight back.
3 individuals, in particular, experienced the most of the workplace bullying in the primary care department. One of those individuals committed suicide. Maybe it’s unrelated but I don’t think workplace bullying helped.
- Work for more than 1 employer
- Diversify your sources of income
- Keep your dependence on your income low
- Confront workplace bullying immediately
- Disidentify from your career as much as possible
- Don’t think yourself inferior to other employees just because you have a different skillset
- Leave a negative work environment, don’t doubt your intuition
Recognizing Workplace Bullying
As healthcare professionals, you are so high up the food chain that few care about your feelings about work. If you mention the idea that you might be bullied at work, you’ll likely be ridiculed.
“Doctors get paid so much money, what do they have to complain about?”
When you experience stress at work or have negative interactions with colleagues, staff, or patients, it’s considered part of the job. After all, you became a doctor by putting up with stress.
As an affiliate clinician, you are always bullied. I have never, ever worked in a medical setting where NP’s or PA’s aren’t bullied. And no, your high salary doesn’t make it okay for you to suffer workplace bullying.
Here are some indicators that you might be bullied at work. There is no clear-cut signs but trust your intuition:
- your work responsibility changes and you are expected to perform at the same level as before without extra support
- you get yelled at in front of others without a way for you retaliate safely
- your negative performance is publicized intentionally or unintentionally
- you always feel something bad is waiting to happen to you at work
- you are constantly criticized for the way you do your work
- you feel as though you have a bullseye on your back even though you make a genuine effort to improve your performance
- others agree that the bully is in fact a jerk