Day 14: 

We have thus far been able to sail into the first of two straight holiday months having survived two main catastrophes.

The first was on Halloween. With one click my boss accidentally reset the entire month’s schedule, undoing 12 hours of work in the process. She had to spend 6 hours on the phone with IT while I calmed everyone in the scribe team down. I missed handing out the candy to the neighborhood kids. I probably put on the scariest display ever, shouting at so many over the phone while still in my costume. In the end, the situation was remedied within 2 days of the error and in the process we only had 1 scribe quit. Too bad that it had to be one of our most veteran scribes but at least the majority of the team stood by.

The second catastrophe happened during the week of the site visit of the AM. Much still had to be done in the days surrounding the visit and the staff meetings. Our meeting with the lead physicians was very productive in that we got a lot of constructive feedback on how to improve and remedy certain faults within our processes. The AM, however, was not taking in the feedback as well as expected. Instead of pointing out what could be done better, she let down her guard and simply said, “That did not go well.” I was about to snap something back which, left unchecked, might have incited anger. Those words would have gone something like, “Well, we can only see so much in Quality Assurance Audits.” or “What do you expect from a team which has constant turnover and inconsistent training?” Instead I said nothing, which might have been saying a million words.

There will be a two-hour conference call with the AM tomorrow, in which several things will need addressed. Honestly, there has been no steady state found. Former SC’s are telling me that I need to stand up more for myself. I suppose I can start small with the following.

An open letter to my boss…

Dear AM,

I understand that your intentions toward those in my position have been aimed in an attempt of mentorship. However, it is baffling to think of the double standards which you so sternly set for the team and myself. You tell us to be mentors instead “hover-ers” when training and passing on our wisdom with each other, and yet you ask me to hover over the most inane details like posted shifts. That is, you say you want me to encourage self-reliance in my team members while simultaneously asking me to hover over their inability to follow up. Hovering is not and does not encourage self-reliance. Hovering encourages, rather, a singular dependence on me as the leader, and if you say I am capped to working 30 hours per week including shift work, hovering of any kind cannot happen. If, therefore, our scribes don’t abide by our policy, how is hovering my responsibility when I do not have time allotted to hover as well as your word against that action? Hovering makes me like a lawn-mower parent, not a mentor, which completely defeats the purpose of my coordinating position.

I also fail to see how your monitoring my emails before sending a reply to our contractor ensures the accuracy of my response. The contractor demanded a response requiring the facts, which was going to be provided with or without your approval. In fact, I was already working on a reply when you asked me if I was writing one. A little patience on your part, I think, would have greatly helped here. I was trained administratively in a legal consulting practice for nearly a year prior to starting my current position. Believe me, I know how to write formal communications when called to do so. I also know how to write them in timely fashion and do not need reminded by you to check my email more than every five minutes during the work day. Quite frankly, emails need to be checked less often. It is my observation that you intermittently use them as a form of text messaging rather than a formal means of communication.

Additionally, I despise and do not comprehend the need to defer to you as letter of the law for every issue, when in the time it takes you to incorrectly recall policy from memory, you could have looked up the exact policy consistent with the company and provided the citation. Medicine and the documentation thereof is an exacting procedure and cannot tolerate many such memory lapses. This is in no way meant to be a contention for its own sake; this is for the sake of the scribes who are smarter than what you give them credit for and who have already called out your errors of memory on more than one occasion, and who do not trust you much. I know that you need coordinators and scribes to work with you, but you need to understand that without us, you would not have a job. We were hired to work for the physicians in our contract, and for the company that you work for, not just for you alone. Our loyalties likewise proceed in that order. We are not yours to mindlessly twist until you bend us past what we are willing to commit to. And as students, there are still bigger commitments we need to respond to, commitments in which we have a higher financial investment than in this part time job which barely pays over minimum wage. Be less volatile with us; we’ll be less volatile toward you.

And another thing: “All other duties as assigned” constitutes 6.25% of my weekly time, or at maximum 52 minutes. This would need to include our weekly calls or any other extra task given. If your needed task takes more than 5 minutes a week, I cannot do it.

Lastly: do not expect an immediate answer from me after 5 pm on the weekdays or 10 am on Sundays while I’m in church. You want 24/7 coverage from 1 person, which is way above my pay grade, the grade that you established.

Best wishes,

SC