Physician viewpoint - Anonymous employee SOC Telemed Employee Review

If you are a physician who enjoys quality improvement work, teaching, system-level changes, service research, this is not the place for you. Also, if you want relationships with nurses and other allies health professionals, this is not the place for you. Your role in the company is purely that of a cog putting in hours and generating revenue. Think of Modern Times by Charlie Chaplin. Any concerns you might have will be empathically acknowledged and then nothing will happen with the hope you forget. Many of the docs have developed learned helplessness and people believe that’s it is pointless to complain. We just endure with mild annoyance that is offset by the benefit of working from home. Quality care is considered anything that meets the bare minimum standard of care. The company leadership cares that its doctors don’t provide poor care, but there really is nobody in leadership who can tell the difference between barely mediocre and really good care. There are a few “highly efficient” doctors who generate significant eye rolling in most other docs who care more about patients. Most company communication is provided in corporate speak where a lot of words are used to obfuscate as much as possible. Hard to trust. This really is a MBA-run operation and there really are few people who understand what taking care of patients is all about. Although there is a ton of lip service paid to patient care. I do believe management cares about the company and patients, but their training, experience, goals, perspective is alien to clinical medicine. There is token physician leadership in the form a full time chief medical officer who is board certified and well-respected, but not in any of the three clinical lines: neurology, critical care, and psych. There are other nominal physician leaders but they have minimal real influence and are mostly seeing full caseloads like anyone else. There is really no ability for a physician’s individual strengths or interests to be incorporated into the work responsibilities. There is one process for hiring, licensing, credentialing, scheduling, training and it’s the same for everyone. This company is definitely married to a fee for service model. Company is paid by consult. There is no system in place for it or its doctors to be meaningfully involved in accountable care organizations, value based care, or whole patient centered care. There is no ability to really obtain information from any other clinicians. The company has no problem contracting with hospitals where the rest of the care is low quality. There is no mechanism for doctors to get redress if we worry that we are consulting into a system that is providing substandard patient care. Hard to know if recommendations are followed. For example, hard to know if when taps or MRs are recommended, if there is follow through. There is never any effort made by hospitals to obtain information from outpatient neurologists. Unclear if any hospital records are forwarded to outpatient docs who will continue care. Focus of upper management is likely to generate a technological product and then sell to a larger company at some point in the future. Creating a high quality physician practice or creating a culture of quality and safe care is likely not the ultimate priority or goal. Doing the bare minimum for doctors and patients is probably seen as a necessary costly step to ultimately sell the company for many $$$. Again, I do not believe senior management is evil or greedy, just have a different world view with different ethical principles. Lastly, the IT department is OK at best. They do not see themselves as integral members of a health delivery system. They are a very good corporate IT department, but not good enough given the whole function of the company is to connect doctors to patients. The members of the IT department do not see themselves as possibly responsible for life/death. I think IT and CCC staff should feel more like EMTs or 911 dispatchers than corporate call center workers.