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toxic work culture
Does anyone work in a situation where the culture is toxic toward the radiologists?
Where the main interest of the administrators, who are the ones actually in charge, is the convenience and happiness of the non-physician personnel even at the expense of the radiologist and what the physicians may perceive to be best for patient care ?
Is this just the norm now?
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41 Replies
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Not the norm.
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Care to elaborate?
My work situation is bordering on toxic. Admin does not care about us. I have told them several times I do my best work before 3:30 and think my workday should end at 3:25 but they insist on making me work 9-5. I even said the words “patient care issue” which I’ve found usually wins any argument but they will not give in. -
Quote from Doby
Does anyone work in a situation where the culture is toxic toward the radiologists?
Where the main interest of the administrators, who are the ones actually in charge, is the convenience and happiness of the non-physician personnel even at the expense of the radiologist and what the physicians may perceive to be best for patient care ?
Is this just the norm now?
Think it would be hard to get away with “toxic” these days. Market is too wide open for radiologists to seek out greener pastures…With this said, certain HC systems/groups have cultures that can be sub-optimal (eg. current group has to deal with subpar tech work at times which has been exacerbated by their shortage). Most rads just accept this as it’s easier than fighting. Plus we get treated well by hospital administration when it comes to financials-
Can’t say too much without giving clues to where I am.
One example: changing the order for a CT or MRI study when not most appropriate imconveniences the tech who then has to call the referring so just do what the Rx says, for example, no contrast, then no contrast.
And pointing out tech mistakes on imaging not really welcome, for example cutting off important areas on imaging.
Is this kind of work culture common?
Best for pt care argument doesnt work here.
Market is even tighter for techs in some areas remember.-
Can you not report their performance to their supervisor ? If you dont do it and the patient suffers from that.you could be liable as well after reading a incomplete study.
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OP, Are you recently out of training?
Some things – like contacting doc to change orders for incorrect study – thats just part of life. In many places, rads get used to just doing what they ordered. CT foot to evaluate plantar fasciiitis? One rad will say, just scan it, Ill recommend MRI if they want it. Another rad will insist that the doc be called, order be changed to MRI, squeeze them into the outpatient MR schedule same day so that magnet is running behind schedule and playing catchup. That radiologist is usually the one who is recently out of training.
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Yes, mechanism in place for reporting issues (because it would look bad not to have one) but there is blowback, negative for the radiologist. Efficient workflow (not in itself a bad thing) and tech retention are paramount. What I mention are just a few of the issues. So then there are places where the radiologists still have control of the department? I am in PP and thought these issues were mostly confined to bureaucratized academia.
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Keep bringing it in the meetings that deal with quality of the studies. Or complain directly to their supervisor in writing.
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Um, that won’t work. This is all at the direction of the supervisors.
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Quote from Doby
Um, that won’t work. This is all at the direction of the supervisors.
Is this an independent private practice? If so bring this up to the partners. If not, accept this as a down-side of the job or move on-
I posted mainly to get a sense of how much out of the norm this is. There may be no point in seeking greener pastures. It is a hospital based independent private practice. I don’t think it is unusual these days more broadly in medicine for administrators to actually be dictating what physicians do.
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It happens because radiologists, by and large, are meek individuals unwilling or incapable of risking their job to make demands of administration. Put your foot down or shut up. You dont get to whine about it unless youre willing to make demands. Demands that have consequences if not fulfilled.
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Now is the time to get what you want in your radiology life. Uou may have to ruffle some feathers, but that is life.
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I am too low level and do not have much leverage, and I am too cowardly and pragmatic to be a hero or martyr. So i guess this situation is not normal and many would consider it an unacceptable working environment ? I do know that no place is ideal, but I guess there are places where there is a healthier relationship between the radiologists and administrators who control the department and non-physician hospital staff? I really don’t have much experience but remember during residency that the admins did try to push the radiologists around sometimes and that there was always some grumbling and grousing.
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I have been in PP for 15 years and never experience anything close to this. I’d say it sounds quite toxic. -
Agree.
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When you say “administrators” do you mean hospital admin or the administrators of your group? If its the former then yeah theres probably nothing you can do about it, either adjust to the culture or get a better job, now is the time.
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Hospital.
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Quote from Doby
Hospital.
Clearly I don’t know the details of your practice. Perhaps its located in a super-desirable location. With this said, seems like leadership in your group is sub-optimal (unless the group is getting crazy subsidization from the hospital as a trade-off)…The job market is really good right now (albeit there are lots of bad jobs out there). If you’re going to make a move, you should take advantage and start looking now. -
Where are people finding these great jobs right now? Everyone keeps mentioning the market is really good, but the ACR job board is full of PE jobs and I haven’t heard of something amazing yet through word of mouth.
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your patients deserve better than “cowardly”, no?
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I know it is a difficult situation. But do you really want a patient to be harmed because you were unable to speak up and do something about it? This patient could be your own family member.
Do what is uncomfortable but right.
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Tech feedback is important. But you need to do it in an instructive and diplomatic way.
Don’t be the guy fresh out of training that shows up at the small community hospital and expects the tech to perform at the same level as they did at your academic center from fellowship. You have to put in a lot of effort over a lot of time to change the culture. Buying breakfast or lunch for your support staff every now and then helps increase your political capitol with the support staff
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Thanks for all the well-meaning advice. Culture and practices are well-entrenched and can not be changed without major personnel change(s). So only option really is grin and bear it (I can imagine there are other workplaces far worse or not much better, for some reason or another). At least good to see that I am not crazy for thinking this kind of thing is not ok. Again, thankS to everyone for sharing your comments.
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you could always try to play the long game. Butter up your techs with the occasional box of donuts and boxed coffee. Establish some rapport with them over a few months. Find a way to get them under your spell. Then slowly assert your will, little by little, until you’ve molded them into decent human beings and decent techs.
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Most already are decent. As it is probably in most human settings, it is a few bad apples that are the problem, and in my situation loyalty matters more than competence and ethics.
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In my first job I had a co-worker who thought it was ok to put their hands around my neck and shake my throat. Another one, a married man, came into my reading room and tried to kiss me and when I pulled back and ignored him, he retaliated against me for years. Another co-worker snarled at me Get the hell out of here and also retaliated against me after I told him I wanted to rest in my reading room instead of going to lunch with him after I had worked an entire day, been on call overnight and had to come into work the following day (that day.) Horrible. The list of this kind of crap goes on and on. By the time I left, I had legal claims I could have both sued and arbitrated for, and instead I j didnt do any of thatI just left. I think when youre poor and unsupported, you may stay in a job longer than you should. Its hard to know whats normal especially if your are early in your career. Sorry to say, but David usually wins against Goliath in Hollywood only. If things seem bad or youre not comfortable, just leave. Let them deal with their own dysfunction and problems.
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You must be attractive. Speaking from experience, it can be tough being good looking…
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Nope.
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Just naive and gullible.
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There are many studies that actually show that less attractive people are treated worse at work.
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Sorry for your experience. I have never seen such stuff in my career but I am sure it happens a lot.
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Its funny. People on here are constantly complaining about PE, admin, abuse by the outside man etc.. and Im sure there are issues with these-I know there are, but the problems Ive had in my career have always been with other radiologists. Dont get me wrong, I know and have met radiologists who are friends and good people. I think maybe Ive just had bad luck and have had the misfortune of meeting a lot of the bad ones.
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Xx
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There is some truth to that. I think boomer pointed out earlier that radiologists are very bad managers of other radiologists. I have had bad managers ( who were radiologists ), but not bad rad colleagues. What you have gone through is terrible.
Quote from Picasso01
Its funny. People on here are constantly complaining about PE, admin, abuse by the outside man etc.. and Im sure there are issues with these-I know there are, but the problems Ive had in my career have always been with other radiologists. Dont get me wrong, I know and have met radiologists who are friends and good people. I think maybe Ive just had bad luck and have had the misfortune of meeting a lot of the bad ones.
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You may have to bring up the issue with senior group members?
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May not be toxic but a question about work consolidations. As hospitals everywhere are getting merged into larger academic networks, have any rads found that parts of their work are getting siphoned off to the higher prestige academics who look down on skills on the newly acquired practices? Ive heard mixed stories about private practices being forced into employee status, and others where the acquired department and hospital lose any sense of input or decision making.
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I am sorry you had to put up with that. Totally unacceptable.
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Quote from Doby
Can’t say too much without giving clues to where I am.
One example: changing the order for a CT or MRI study when not most appropriate imconveniences the tech who then has to call the referring so just do what the Rx says, for example, no contrast, then no contrast.
And pointing out tech mistakes on imaging not really welcome, for example cutting off important areas on imaging.
Is this kind of work culture common?
Best for pt care argument doesnt work here.
Market is even tighter for techs in some areas remember.
Who cares if it’s “not welcome”? You put what is right in your report and you do the best you can for the patient in areas that you have power and if they dont like it they can go fly a kite. Personally I would never work in an environment where rads didnt have control of the department.
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I hope that you….
Have the courage and strength to change the things you can,
The fortitude and patience to endure the things you can’t, and perhaps most importantly….
The wisdom to know what you can and cannot change.
Good luck.
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Quote from Doby
Does anyone work in a situation where the culture is toxic toward the radiologists?
Where the main interest of the administrators, who are the ones actually in charge, is the convenience and happiness of the non-physician personnel even at the expense of the radiologist and what the physicians may perceive to be best for patient care ?
Is this just the norm now?
I’ve worked in more than one VA system and experienced the above.
In day to day practice ease of ordering and throughput are more important than quality at some VAs.
I’ve experienced and witnessed radiologists labeled as complainers when they try to prevent unnecessary exams, or redirect and try to educate ‘providers’ who order incorrect studies, or offer corrections to techs for errors. Some VA cultures are extremely provider customer service driven. A radiologist with an opinion BEFORE the study is completed is frequently unwelcome.
OTOH providers rely heavily on radiologists and value the reports (well, at least the impression). In the VA system the radiologist is often the only physician involved in patient care. The other ‘providers’ are all midlevels (some good, some bad, many are really really bad).
