Do not understand scheduling issue

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So, I've been at my practice a good 18 months and seem to be doing fine -- no comments or complaints from my boss or from patients out of the ordinary. A new doctor straight out of medical school started about six months later. She's good, but also very domineering and a few of the patients found her to be very condescending and from what nurses say, a few have said they'd rather not come back because of her. I feel she's ok and a decent provider myself.

I had built up a decent panel of patient myself, and for a while, it seemed I would see at least a third more to double the amount of patients that she would see on many days.

All of a sudden now, I found out that the front desk has been told to route patients to her schedule first, then fill mine. I'm not sure if this applies to the other mid level providers or not.

So now I sit, and when I'm with her, I see half the patients I normally do. On other days, I'm full, and when I'm working our call weekend shifts I'm full as always.

A couple patients have commented that they have been trying to see me for weeks, but they are being sent to her. One was upset to the point she wanted to leave the practice as it felt to her like they were shuffling her around.

When I approached our practice manager, she says that Dr. A needs to see patients "because she has bills from medical school and needs to pay them, " . I'm assuming that she wasn't happy or perhaps making her productivity bonuses or something.

Is this a thing? Or does it sound like they're trying to reduce my schedule for some reason? I feel paranoid they might be trying to get rid of me, although they keep scheduling me on and on for my regular days and asking me to take call, etc. I personally would often enjoy bonuses of my own due to high productivity, but with this happening, I guess I won't be seeing that extra bonus. As she gets more of the patients on her panel, mine just seems to be dwindling.

Don't even know what to think!! I have been thinking about leaving this practice for a while to be closer to home, but now I feel like leaving just to try to get to a place where I have potential to earn bonuses and will get to keep my patients!

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I don't have a whole lot of experience working as an NP, but from what I've experienced and what I know from colleagues, this behavior is not normal. You should not have to take a hit because she has student loan bills. Heck, we all do. And it sounds like this is affecting the business if patients are leaving because of it. I would probably state your frustrations once more and may be encourage your patients to state their frustrations to upper mgmt if possible to build a case. You also likely have student loans you need to repay and so need those bonuses too. They clearly are showing through actions that they don't value you as much as they do the doc, and that's unfortunte.

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I actually do not have student loans to re-pay, but that whole premise is just ridiculous anyway. If I've earned the trust and repeat visits of my patients, then deserve to keep them. It's all just very odd - the practice is odd in many ways, but I took the job to get experience. It's not a bad place overall, but this has me flummoxed. I guess I just need to go back to the manager and tell her how I feel. They are very cheap and I sometimes suspect they are also doing it to save money, but I'm not sure. I'm salaried but the doctor is not. However, I'm assuming she must earn productivity points as well.

I do remember that on days I'd be seeing more patients, she did seem frustrated and would complain that she was bored, "this is ridiculous ...I only have so and so number of patients today ...." etc, I just simply feel she is literally taking my patients from me. Now, on one hand, I'm glad she's taking some of them on, and I'm glad patients get to see a physician at times. But some of these folks I have worked hard with, and I have been following them and know them well now.

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Specializes in Nephrology, Cardiology, ER, ICU.

Patients usually want consistency. Do you not have your own panel of patients?

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It is unfortunate that your practice doesn't have enough work to keep you both quite busy. And obvious that she has a poor bedside manner and people would rather see you.

And it usually takes a couple of years to build a practice. So this could go on for quite awhile.

I would check out work closer to home.

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Specializes in Family Nurse Practitioner.

Physicians are more valuable and higher on the food chain than we are simple as that.

If you also work for RVUs you might consider changing jobs as this seems to be the writing on the wall. If in fact she has difficulty keeping patients I would wonder if she will ever fill up or you will be stuck with her sloppy seconds indefinitely?

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

Perhaps the service manager is trying to be tactful, and they are trying to determine whether this physician will work out. I agree with encouraging the patients who complain to you to take their concerns to upper management - including their desire to leave the practice if they continue to be routed to the new doctor instead of you. If I am wrong about the practice's motivation for scheduling patients the way that they do, it may be time to move on.

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Whether or not this is a thing, it is, in its purest form, favoritism. Nothing unusual about that. Based on what you have said, it might be best to be proactive about finding that position that is closer to home.

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Specializes in Pedi.

As a patient, I'd be mad if my provider's office did this to me and I'd call and ask to have the appointment changed to the NP. Perhaps your patients don't realize they can do this? I'd think if the patients put up a stink, the practice would re-evaluate this.

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As a patient, I'd be mad if my provider's office did this to me and I'd call and ask to have the appointment changed to the NP. Perhaps your patients don't realize they can do this? I'd think if the patients put up a stink, the practice would re-evaluate this.

Like in extended care home health, we usually tell clients if they want to bring about a change (that usually involves the nurse somehow), they need to get vocal with the agency as the agency will always listen to a client before it will listen to its nurses. Kind of a truism.

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Specializes in Nurse Anesthesiology.

If you want to continue practicing as an equal in this group you have to start thinking of yourself as one. Calling yourself a mid level provider already makes you sound like a 2nd class citizen in the group and someone who shouldn't be seeing their own clientele in the first place.

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Specializes in Family Nurse Practitioner.
If you want to continue practicing as an equal in this group you have to start thinking of yourself as one. Calling yourself a mid level provider already makes you sound like a 2nd class citizen in the group and someone who shouldn't be seeing their own clientele in the first place.

It probably isn't about how the OP is presenting and maybe its different for CRNAs? NPs can call themselves whatever they want including "doctor" if the facility allows but it will not put them on par with a physician. The hospital where I work calls us something else which I can't even remember what but it groups NPs and PAs together under physicians. I really don't care what they call me because I have no delusions that my education or knowledge is anywhere near the level of a physician.

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