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Reflecting On My Administration Role

My Impression Of My Time Doing Administrative Work For My Medical Group

This post is about my experience doing administrative work for my medical group. Many doctors in larger medical groups are familiar with administrative roles. My position is referred to as Physician In Charge, also referred to as medical director. My direct supervisor was the chief of the department, overseeing about 50 providers in total.

I was in charge of 2 clinics, that’s how it started. Then I took over the role of being the pediatric liaison as we transitioned off of having pediatricians in the urgent care. In time I took over the monthly department meetings and I was also supervising 2 PA’s, interviewing new physicians and sending out updates on urgent care changes.

Because of my friendship with the chief it rarely felt like work, in the beginning. After some time I will admit that I had to put in a few hours every day in order to do a good job.

This role paid 5 hours of administration time per week along with nearly $800/mo of stipends. With my hourly wage at a tad above $100/hr it came to ~$3k/mo or $36k of gross wages annually – just to do some admin work.

Realistically I was putting in about 2 hours daily and my free time was routinely interrupted by phone calls, emails and texts from various individuals. When at work I would continue doing this kind of work so my regular shift was no longer just seeing 2-3 patients per hour but it was also doing the tasks I just mentioned.

The parts I really enjoyed was helping those providers who really cared to improve. Also, my medical group overall is a really good one so they are making changes in the right direction, I was happy to be part of that. Interacting with management and clinicians was enjoyable.

The parts I didn’t enjoy was putting in work without being financially rewarded for it. Dealing with unions has become one of the worst experiences I’ve had in my professional life. As far as admin, there was no point in making a to-do list, there was always something to do, someone to get back to, speakers to arrange, patient complaints to address or meetings to go to.

The things I was good at was communicating in a very straight forward manner with those in leadership. If a manager came to me with a problem that needed my input I had no problem making a decision and going with it, if that decision was wrong then I always picked up the slack. I didn’t show anger or frustration and was fair overall. I had no problem taking on something that nobody else wanted to tackle. Any big insurmountable task is just a series of smaller easy tasks that need to be completed.

I wasn’t very good at communication with difficult providers. I think more so in the beginning I came across a little too excited or dismissive. I couldn’t emotionally disengage from the leadership role, allowing results and bad outcomes affecting me a bit personally. I had a tough time dealing with so many different personality types, holy shit, there are so many of them.

As far as the experience, it was totally worth it. I learned great leadership skills, I added that to my resume and checked it off my list of things to accomplish.

Financially it wasn’t a worthwhile endeavor. There are ways of doing the work with the bare minimum of effort or perhaps by having impeccable time management skills but I was in neither category so for me it was probably like making $50/hr for the physical time put in – $20/hr for the physical+mental time spent.

Stress wise it wasn’t bad at all. There was a lot of busy work but I had plenty of support. I worked with incredible managers and as I mentioned before, the chief of the department was/is someone who I’m friends with and so we see eye to eye on a lot. That said, I think his leadership style is too nice/fluffy, I would like to see him lay down some stricter rules… but perhaps that’s why he is effective as a chief and my method might have failed terribly had I been chief.

Before trying to giving up this position I was offered an assistant chief role followed by taking over as the chief in a little under 3 years. I’m humbled by this offer and I’m mentioning it not only to impress you by how awesome I am but also to show that if you put in even half-way decent work a good medical group will recognize this and offer more leadership if that’s something you desire.

As the assistant chief I would have done five 10-hour urgent care shifts in a 2 week period along with getting paid 15 hours a week of admin time, 30 hours for the 2 week pay period. The responsibilities would have gone up but not proportionally since I was already doing a lot of that work already.

The reason I am leaving admin is because it isn’t my cup of tea. There are way too many personalities to deal with and getting rid of bad apples who are part of a union is hard. Not hard because of the laws and regulations, it’s more that unionized persons protect other union workers.

Another reason is that I am not sure whether I will end up in NorCal or stay here in Portland. It looks like my days in PDX are numbered in which case I would rather find a really good candidate who can do the assistant chief role because I’m not gonna take on the role just to do a half-assed job and collect a higher paycheck.

This is a form of passive income in my opinion. You are already involved in the clinic, doing clinical work and by putting in a little more work you can easily increase your salary by a much higher proportion. I realize that I just finished saying that I felt that I was underpaid but that’s because I’m a narcissistic little shit who believes he deserves the golden goose egg.

If in fact you are good with people and good with time management then administrative roles can help you learn a lot about the medical group. You will also realize how complex it is to run a medial group while trying to deal with unions, trying to please the patients and to keep doctors from leaving and to try to recruit enough providers to replace those who will leave for other reasons.

There is no being 2-faced once you’re in this role. As a clinician working the floor you can get away with being nice to a colleague and talking shit behind them later. As someone in leadership you are under the colposcope – whatever you say or do will reach everyone’s ear. You need to be fair and providers and staff need to feel like they can trust you.

Should you in your geriatric age decide to do less clinical work and pursue the role of a medical director it will be quite easy if you have some experience doing so in your own medical group. So think ahead but realize you will need to put in some effort.

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