By Vinh Chung, MD, Dermatologist/Mohs Surgeon, Colorado Springs
The patient-doctor relationship has been ingrained through our long medical training and remains at the center of our decisions in daily practice. Based upon trust, this relationship demands that we make decisions that are always in the best interest of the patient. The coronavirus pandemic has brought to the forefront another type of critical relationship – the staff-doctor relationship. While antagonistic staff-doctor relationships are notoriously common and can drive physicians to burnout, they do not have to be this way. When healthy, the doctor’s relationship with staff can be an incredible source of pride and joy.
After executive orders suddenly limited medical services and procedures, the revenues of our medical practice dipped by 90 percent. This unsustainable situation had no end in sight. The cash reserves in our practice were bleeding out and would be depleted if changes were not made immediately. Even before any federal loans or financial assistance became available, our leadership team took action.
We committed to follow our motto that “leaders eat last.” Financial setbacks are scary for everyone, but we recognized that our hourly employees have it much worse. They need their paychecks to buy groceries and to pay rent, so we committed to protect them. Starting from the top down, our executive team took an 80-100 percent cut in our salaries. The rest of the medical providers also voluntarily took significant pay cuts. After we announced our decision, other staff members stepped up and followed suit. Our managers asked to “work more and get paid less.” Some staff members even volunteered to work for free. Across our medical practice, team members who earned the most sacrificed in order to protect those who earned the least.
Watching our team members care for each other is an incredibly beautiful moment that I’ll never forget. I’ve always been proud of our staff because of their excellent work. This time I’ve been humbled by their character. Generosity, selflessness, and the desire to protect one another flourished and became so much more contagious than fear or self-preservation.
Our practice has since received the Medicare stimulus payment and funding from the Paycheck Protection Program, which will buy us more time as we ride out the pandemic. While we had to accelerate departures for team members who were already transitioning out, we have not had to lay anyone off. Two-thirds of our tribe volunteered to furlough, cut pay or reduce hours. There are glimpses of light at the end of the tunnel, and we really do believe we can make it through this crisis with our entire team intact. When we make it to the other side, we plan to restore everyone’s pay and hours in the reverse order from bottom to top. The leaders will eat last.
Similar to the patient-doctor relationship, the physician’s relationship with staff is based upon trust that must be earned. When trust is absent, any relationship can become a thorn in our side or an obstacle we must work around. These unhealthy relationships with staff and administrators are often the root cause of physician burnout. They must be addressed if physicians want to have fulfilling careers.
There is no better way to earn trust than to walk with our staff through a crisis. When our staff know that we are willing to protect them, they will do the same for us. And I believe wholeheartedly that in the long run, our patients will be better cared for as a result.
Vinh Chung, MD, works for Vanguard Skin Specialists in Colorado Springs, Colo. He has a passion for instilling meaning and purpose into the workplace. He can be reached at [email protected].
The following poem is offered for inspiration during the COVID-19 pandemic.
Author: Monica Anita Gupta
The sun is rising with each shivering step I take.
It’s still dark out, but I see pink creeping into the blue:
spring pastels to match the canary yellow gowns inside.
Cotton candy dreams. A veneer of peace.
A flock of birds welcomes it in, nibbling,
eager for a taste of life,
thirsty for the warmth of sun.
Show me how you fly, you birds.
How, on little nibbles, you get by,
consuming little, yet soaring
long and wide and far and singing,
enthused about the dawn you’re bringing,
with faith in the power of the morning sun.
The poem below was shared with a PCMS physician whose friend, a critical care physician, has posted it in his intensive care unit. It is titled “When this is over.”
“When this is over, may we never again take for granted:
A handshake with a stranger, full shelves at the store, conversations with neighbours, a crowded theatre …
Friday night out, the taste of communion, a routine checkup, the school rush each morning …
Coffee with a friend, the stadium roaring, each deep breath …
A boring Tuesday, Life itself.
When this ends, may we find that we have become more like the people we wanted to be …
we were called to be …
we hoped to be and may we stay that way …
better for each other because of the worst.”
We are grateful to our colleagues who serve on the front lines of the global COVID-19 crisis or work in hospital settings. We value your personal sacrifices and want to do our part to support you and this community.
We commit to doing everything we can to keep patients out of the hospital and urgent care facilities:
- We remain open for urgent, acute, or highly symptomatic dermatology and plastic surgery conditions, e.g., skin cancers with high morbidity or metastatic potential, rapidly spreading rashes, and any conditions that may be urgently concerning to another medical provider.*
- We will serve as a resource to you for any dermatologic or plastic surgery consultations. Our physician team will be available 24x7 (personal emails and cell phone numbers below) for phone consultations.
- We provide telehealth consultations for all patients who need an evaluation, so that patients can remain at home.
- We are happy to assist if you are interested in setting up telehealth.
Most importantly, we want you to know that you are not alone. Please let us know if there is any other way we can serve you and your patients. Email [email protected] to be connected directly to me.
Vanguard Skin Specialists
What is all the fuss about? It is just a virus right? Wrong. No one really knows the extent of the damage the virus can have on our health. This unknown is what leads many of us to be worried, and this concern is not only appropriate, but is healthy. If it leads you to practicing social distancing as much as possible, and staying home unless you need to perform essential tasks, then we still have a chance to decrease our risk. We are behind the ball. This is well known. But so is the rest of the world. We could not prepare for such a virus but knew it was potentially possible (anything is). As a result, please don’t panic when you see daily numbers of the number of deaths in certain cities, counties, or countries. Just know that the risk is real and we have to do what we can to help. In a time where it seems like we are hopeless, we do have the power to stop the spread and hopefully limit future casualties.
But what if I am not feeling any symptoms?
This is where it can get scary. You can still be a carrier, which means you have the virus, but you don’t have symptoms. Is this supposed to scare you? Not necessarily. I just want you to know that the reason social distancing was implemented has to do with this fact.
Why are doctors’ offices closing down or limiting appointments?
This is to help ensure those who have symptoms that could be related to coronavirus can get in to see us, we want to keep them out of the hospital as much as possible if it’s safe to do so.
But there’s no cure, or treatment right?
Well more to follow on that. It is possible that by the time the virus runs its course, the medications will still be in production. Is all hope lost? No! Our social distancing, limiting handshakes, WASHING hands with soap and water can still help us. Sometimes, we have to go back to the basics.
Together as a county and city, we can get through this. We have amazing men and women throughout the city that are working to ensure you are as safe as possible. We are going through the same stress that you are going through and if you get a chance, thank them (but without a handshake please!)
Jacob Mathew, Jr. DO FACOI FACP CHSE FAWM
Faculty, Internal Medicine Residency, Parkview Medical Center
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