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On April 11, 2019, MP commented on Psychiatry Staffing :

agree this indeed appears to be a widespread issue.

We have seen to some extent similar issues.

Have you tried exploring telepsychiatry? There are national or regional companies offering such services.

One suggestion is to consider creating a center of excellence with outreach programs. We have some form of this model that appears to be working.

On April 11, 2019, MP commented on PA/NP Engagement :

Appears to me that you have some that haven’t adopted the culture of your organization. Clearly there is a dichotomy in cultures where you have some that are willing to chip in at all costs while others are in it for themselves.

I suggest first try to understand what is holding some not to be part of the culture that exists in your organization? Have the expectations not been clearly defined? Is this not a good fit for them? Is this a system issue (recall one of the cases we discussed in class)?

Second, make sure the midlevels are engaged in the governance of the organization. In our institution, midlevels have a seat on the medical executive committee and are to a great extent viewed as a valuable part of the team.

Lastly, transparency in compensation should be apparent.

And if all else fails, maybe your organization’s culture is not meant for them.

On April 11, 2019, Mandip Panesar commented on Convincing your administration to change Physician compensation plan :

Although an RVU system of compensation has its own merits and tries to quantify and measure a person’s productivity , it can fall short with regards to compensation as the value attributed to an RVU is somewhat variability and not necessarily uniform. It has been my observations that some organizations do not treat the RVU value equally when it comes to RVUs earned and RVUs paid, meaning that a person is held to a different standard when expected to earn the RVUs and paid on a different RVU value if they exceed the expected RVU goal.

On April 11, 2019, Mandip Panesar commented on Primary care engagement :

time to bring back a physician lounge, which in some institutions has disappeared, as a focal meeting point where colleagues can engage in discussions, take a break, and socialize.

from the employer side, transparency in compensation and expectations need to be clearly delineated, once there is uncertainty or confusion in these dissatisfaction arises.

from the physicians’ standpoint realistic expectations must be sought.