Posts by Leslie Flores

Augh! I Just Got Laid Off! What Now?

Wait a minute. Isn’t there an ongoing national shortage of hospitalists? Don’t most hospital medicine groups have trouble recruiting enough providers? You wouldn’t think hospitalists would be at much risk for being laid off. But believe it or not, it does happen. Management companies lose contracts. Hospitals get acquired or lose a big book of business. Some administrator decides NP/PAs are more cost-effective than doctors. And – if our work with hospitalist groups around the country is any indicator – large integrated delivery systems are increasingly expecting top-quartile productivity from their physicians across all specialties, which means more work with fewer resources. I worked with a hospitalist program recently that has laid off several NP/PAs in an effort to improve productivity and financial performance; they haven’t yet laid off any doctors, but it could still happen. While it’s still rare, I expect that hospitalists will become more vulnerable to layoffs…

Making the Implicit Explicit

Last month, I wrote about some interesting workplace trends, in particular about how the implied compact between U.S. workers and their employers is evolving rapidly. Few of us in the workforce today can conceive of an employment relationship in which we are guaranteed lifelong employment and a generous benefits package including full healthcare and retirement in exchange for hard work and loyalty to a single employer. Since then, I’ve had several conversations about the term “compact” as I used it in that post. At its most fundamental, a compact is an agreement between two or more parties. In my recent post, I used the term to refer to the generally accepted but rarely articulated set of expectations that workers and their employers have of each other. There is an implied compact between physicians and the hospitals where they practice as well. Historically that compact assumed that doctors would refer lots…

What We Expect and What We Get from Work

Are American workers becoming happier with less? An interesting article in last Friday’s Wall Street Journal reported on the findings of a recent survey of U.S. workers by the Conference Board, a research organization. Although the survey wasn’t specific to healthcare, much less hospitalists, I see some parallels that might cause many of us to stop and think more carefully about what we expect from our work. The Conference Board’s findings highlight how American workers’ employment relationships are evolving and how that is impacting what Americans think of as a “good” job. The biggest shift has come in the nature of the implied compact between workers and their employers; unlike a generation or two ago, U.S. workers no longer expect to receive a generous benefits and lifelong employment in exchange for hard work and loyalty. In fact, I suspect many younger workers today would face the prospect of lifelong employment…

Many Paths to a Richer Job

No, I’m not talking about a job that will make you richer – at least financially. But as I think about strategies for making “hospitalist” a sustainable job that one can do for a career, pursuing job enrichment seems high on the list. The concept of job enrichment was first articulated by psychologist Frederick Herzberg. In his 1968 Harvard Business Review article “One More Time: How Do You Motivate Employees?” Herzberg suggested that what really motivates employees isn’t an attractive schedule or working conditions, or even high compensation, but instead things like achievement, recognition, interesting work, responsibility, advancement, and personal growth. Job enrichment involves redesigning jobs to provide more of these motivating factors, reducing the amount of repetitive and low-value work, and thus making the work more challenging and rewarding. Hospitalist work is plenty challenging already. But too many hospitalists don’t rave about their feelings of achievement and recognition, or…

Building a Practice that People Want to be Part Of

As those of you who have followed my posts on this blog know, I’ve been spending a lot of time mulling over issues related to hospitalist job satisfaction and career sustainability. I’ve written about concrete things like re-thinking hospitalist work schedules and minimizing low-value interruptions, as well as more abstract concepts like assessing your group’s “gross happiness index.” My fascination with these issues and my concern about their potential impact on the specialty of hospital medicine eventually led John and me, as course directors, to the theme of this year’s practice management pre-course at HM17 – Practice Management Success Strategies: Building a Practice That People Want to Be Part Of. Perhaps, like me, you are interested in digging deeper into matters of career satisfaction and sustainability. Or perhaps you are simply focused on the more mundane struggle just to recruit and retain enough qualified providers for your group. In either…