Staff Problems

One of my employees is going to medical school. She is in her mid-40s and does a fantastic job. There is just one problem: she calls one of the younger doctors by his first name.

Outside of the office, a lot of us will socialize on occasion, and there are no formalities in terms of how people are addressed. But in the office, in front of staff and especially patients, the doctors don't go by their first names. It is Dr. ________. To do otherwise shows a lack of respect.

I've talked to the woman-in-question about this several times, and for a while she follows protocol. Then she will invariably slip, and the doctor-in-question will pull me aside to complain. I am quickly reaching a crossroads over this, as her behavior ultimately reflects on my leadership. I know it sounds crazy, but I am on the verge of firing her for not properly addressing a staff doctor. Has anyone else had a similar experience?

As if that wasn't enough, another employee who I paid an agency $4,000 in fees to hire has just given her notice after only working in our office for 5 months. I've heard of other offices who make a deal under-the-table with their potential employees to circumvent paying the agency fees. I refuse to do something so unethical, but I have to admit it's very tempting.

On a final note, I'd like to thank everyone who took the time to respond to my previous post about the doctor at my office with diabetes. I wrote it in a very emotional state, and by the next morning I realized it was something that just wasn't my business. Or rather, our relationship involves business, and that precludes me from commenting to him about something so personal.

Will Robot Nurses Require a Thermometer or a Dipstick?

(Before I start today's post, I wanted to thank everyone who responded to my last one about employers providing onsite medical care. I learned a lot from your comments, and wanted to say that even though I usually take a stance on something, I welcome everyone's opinion.)

This recent article in MedGadget suggests that robot nurses and doctors aren't far off in our future:

"The European Union is funding scientists to develop 'nurse bots', mechanised robots designed to perform basic tasks such as mopping up spillages, taking messages and guiding visitors to hospital beds...In the future more advanced nurse bots could even be used to distribute medicines and even monitor the temperature of patients remotely with laser thermometers or thermal cameras."

Apparently, the more sophisticated version of these "bots" would work in teams together. I didn't know this, but there are "robo-surgeons" already being employed (or perhaps "employ" is the wrong word).

The theory is these androids will optimize their services to eliminate waste and create a better, more organized method of patient care. This will supposedly give the human element a better chance to thrive, since a lot of the busywork will be handled by machines.

We've come a long way from the TV cartoon "The Jetson's" with their mechanized maid making short work of housecleaning. In some obvious ways, I am reminded of my uncle who lost his auto factory job in the 1980's to a machine. On the one hand, he hated that job and was glad to try something new, but on the other a lot of people lost their way of life.

Which isn't to say that I am automatically against these innovations in technology. For instance, when it comes to things like office computerization or insurance card scanners, I can see the direct benefits. I like the human element in medical care, but maybe that's a generational thing. Children not yet born may one day prefer a healthcare system where the only human face they see is their own.

Still, I am a practical person. Hospitals are complex environments, and once nurse-bots become commonplace, I foresee a long period of adjustment. In other words, patients shouldn't be surprised if the mechanical nurse who just took their temperature used a dipstick, and diagnosed them as a quart low.

Are Doctor's Offices Going the Way of Mom and Pop Stores?

I recently came across this very interesting article in the New York Times about how many companies are now creating on-site medical facilities for their employees. Once thought to be redundant and not cost-effective, corporations such as Toyota, Pepsi and Sprint Nextel are now offering their workers medical care such as "check-ups, allergy and flu shots, pregnancy tests or routine monitoring for chronic diseases like diabetes and asthma."

The employers insist that there is a "firewall" of confidentiality between clinic records and the company, but I am skeptical. While it is doubtless a sign of good management to keep your employees healthy, isn't there a temptation to control the bottom line and perhaps weed out people who aren't with the program?

In other words, doesn't it make sense to keep the company you work for and the doctor you see separate? Isn't your health a personal responsibility and not a business obligation?

I also wonder if the mentality that is used to operate these clinics has the best interests of the patient in mind. After all, they are directly beholden to the company which operates them. Can they maintain the rigor and objectivity of a private practice? Will the quality of care suffer because medicine isn't the main priority?

Still, it's hard to deny the lure of these onsite practices, especially since they are so convenient to the patient. It takes less time out of their work day, and many companies have fully stocked pharmacies, so it's like one-stop shopping.

Finding a physician, making and keeping doctor appointments, or just living a healthy lifestyle all require some degree of effort. Making those choices easier isn't necessarily a bad thing, but we must be careful about such things as the erosion of employer to employee regarding medical care. There may come a time when having a pre-existing condition or a bad personal habit will prevent you from getting employment, as well as the treatment you may need.