Dear Director, I’m finishing residency and starting my first job. I’m pretty good but want to make a good impression and not screw up. What advice can you offer about getting started on the right foot?

director-90Dear Director,

My chairman tells me I need to see more patients. I’ve been doing this for a long time, and, believe me, I really am working as fast as I can. Now, I’m being told that if I don’t speed up, I could lose my job. Are there any tricks to being faster?

Dear Director, I keep hearing that the federal government is getting into the Patient Satisfaction business through something called ED-CAHPS. Is this like Press Ganey? I just want to focus on clinical excellence and patient safety - satisfaction seems to be all about fluffing pillows. Is ED CAHPS real and if so, how can we prepare?

Dear Director, I want all of my docs to sit on some hospital committees, but I hesitate with some, not knowing if I can trust them. What makes a physician good at representing the department? Is it a quality that I can teach?

Dear Director, I’m an experienced physician who is thinking of switching to a fixed overnight schedule.  I’m wondering your thoughts on the benefits to this and any potential risks to my career.

Dear Director,

I recently got sued for a missed appy case. Although my expert witness was supportive of my care (which did not include a CT), my attorney tells me we’ll need to settle.  Now I feel like I need to CT everyone with abdominal pain. What should I do?

Dear Director,
I’m hiring a new physician and I really like a certain senior resident but their residency director told me they failed their in-service exam. Everything else about this candidate seems perfect. Am I setting myself up for trouble if I bring someone on who may be academically challenged?

Dear Director,
My hospital is making me undergo mandatory EMR training and I think I should get paid for my time. I also think I should get paid for attending our monthly staff meeting and a committee meeting. Don’t nurses get paid for these kinds of things?
-Frustrated Hourly Worker

Dear Director,
I received a complaint from an ED triage nurse that one of our emergency physicians yelled at her for getting an ECG on a patient that he didn’t think needed one. She told me she’s now afraid to order ECGs on anyone but a straight forward chest pain patient. How can I improve the communication in my department between the physicians and the nurses?

altDear Director,
I was just asked to take over as medical director of another ED in our hospital’s system. While I want to be a chairman one day, my kids are young and the timing just doesn’t seem good right now. Am I shooting myself in the foot for other jobs down the line if I say no now?

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