Probationary period

I say take the extra 4 weeks and ask them for specific expectations that they want you to meet in that time. Are you not seeing enough patients in a day? Are your notes not done fast enough? Them telling you only that your time management isn't where they'd like it to be isn't helpful. I would sit down with them and find out what exactly their concerns are and put a plan in place to address their concerns in the next 4 weeks. It is very overwhelming trying to learn a new system and if they are a good employer they should be willing to help you through that process.

Oh I'm seeing my share of patients , 20-22, my charting gets done in a timely manner, but the nurses complained because I'm not ordering immunizations before I go into see the pt, and because I ask them to call parents back with lab results, and because I did not hand referrals to the patient, a few fererrals I had to decide where they were going and they had to mail the referral letter out so they complained about my time management . The supervising md is furious , I'm scratching my head wondering really is this a time management issue or is ther more than what I'm being told

This sounds more personal to me. Pleasant, cooperative "team players" don't have conflicts of this nature. IME, the provider tells the staff how they want to approach tasks like this and the staff adjust to their new assignments. Staff do not tell the provider what and when they (the provider) will perform simple tasks such as inputing orders or hand patients pieces of paper. Now, if there is a good reason to do things a certain way, and a new team members just isn't aware of the rationale, perhaps someone could politely make a suggestion or two for the sake of harmony and efficiency. You and your team should ideally discuss the issues and come up with a plan that works in the best interests of the team.

I disagree with writing orders before you see the patient. They are dead wring to complain about that; no one should be doing that. You might tell them what you anticipate, but you can't order it in advance of seeing the patient for crying out loud. Any number of reasons could make it inappropriate to administer them, and then those immunizations they have drawn up are going to be wasted. Staff should not be calling abnormal lab results IMO, nor should they be giving results the patient doesn't understand in context/implications of, so I'm a little equivocal on that one. I do not understand the issue with mailing referrals at all. I call and mail them later all the time; I'm not going to have people hanging around for hours while we wait for PA #s and get times scheduled. What. the. blazes.!? We call them when it is approved and complete, give the the info over the phone and mail them confirmation. I'd say we do it that way more often than not. That is just a petty complaint.

So all in all, my summation is you and they have a communication problem and you need to sit down with the staff and talk through your expectations of one another. Leave the doc out of it. He probably only cares b/c they are bothering him with this petty nonsense and he doesn't want dramatic bull crap like this in his office. I don't blame him. Adults need to work this stuff through.

Good luck.

Thanks BLUE DEVIL( ah my high school mascot). But I see no reason for them not to call a parent for a low Hgb and tell the parent miss XYZ recommends a iron supplement and follow up in one month and repeat labs, of course something more serious a ANC of 2 or something like that I would call. I agree there is a communication issue, and I think before they go to admin they need to come to me , I have been told I'm approachable and easy going , but some times it's easier to go to admin than approach the provider . So the plan is we are sitting down and having a frank discussion and going from there ,