altDelivering a top quality patient experience is “a mountain without a top.”
Is it time for your EM group to take the first step up?

Being an ED chairman requires a skill set that you may never appreciate until you step into the role. Clinically, there are few surprises; it’s the little things that make being the boss a unique challenge, like dealing with a troubled provider, learning how leaders get treated differently, and feeling the responsible of running a 24/7 business.

Part II: Democratic groups must define their core values, clarify the owner’s obligations to the group, and put in place a system of accountability.

Dear Director,
I’m Facebook friends with a bunch of the nurses I work with and when this came up in a conversation with my chairman, he told me that I’m setting myself up for disaster and that I shouldn’t be social network “friends” with the people I work with. Is he right?

Dear Director,
I have a new CEO who has decided he wants to replace our group, even though we’ve been here forever and have been very successful. Can he do this? Could we have prevented this?

altDear Director,
We recently changed our coverage pattern from three 12-hour shifts per day to five eight-hour shifts. While this increases our daily coverage, we’re all working more shifts, despite hiring more docs. And now it seems like some of us get stuck doing more of the nights and weekends than others. What’s the appropriate length of shift? How do we divide them up evenly?

Dear Director,
I’m 62 years old, and have been with my group for 20 years. Although we evenly split the overnight shifts, I’m having a hard time doing them, both physically and mentally. Don’t you think there’s an age cut off where we shouldn’t have to do overnight shifts anymore?

Dear Director,
I received a complaint from a patient who was sent by their physician for an ED evaluation and possible admission. I saw the patient, did an appropriate workup, and discharged them with a treatment plan. But the patient complained that I was supposed to have arranged for their PMD to see them in the ED. How am I supposed to respond?

Dear Director,
I’ve worked for a group for several years as an hourly employee but they now want me to get paid on a productivity based incentive plan and I have a lot of concerns. Can they do this and should I be concerned?

Dear Director,
I’ve been thinking that I want to cut back clinically and maybe get started doing administrative work for our department. I’m pretty good at picking out some things that need improving in our department. How do I know if I’m ready to take that next step up?

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