Write From Karen

It’s widely understood, if not openly admitted, that I have one of the most stressful, non-clinical, jobs in the clinic. My job is so misleading it’s almost funny … if I were only in the mood to laugh.

In fact, since we’re on the hunt for a new scheduler to fill the shoes of the girl who “voluntarily decided to pursue other job opportunities outside of the hospital” (which translates into “we actually fired her and don’t want to freak you girls out so that you’ll end up quitting and leaving us high and dry”) they listed the job as an internal job opening only. The job “description”, boy, do I use that term loosely, was unbelievably understated and flat out wrong. In fact, about 80% of the “description” were duties we don’t even do.

Let’s put it this way – we are on an active mission to redefine our job description with the hospital. Because honestly? We do a combination of about three different jobs, jobs that have their own departments and staff devoted to the task, at the hospital. But somehow, the scheduler’s job at my clinic has been a dumping ground of duties that no one else wants to tackle. “Oh. We need the toilets scrubbed?? No problem! We’ll just “ask” the schedulers to do it.”

And no, I’m not exaggerating and no, I’m not bitter – that’s just the way it’s been over the years. And because the girls before me didn’t have the … courage (?) to stand up and say “STOP WITH THE ADDED DUTIES”, management has just sort of continued to dump duties onto the schedulers because well … they would do it. And once someone has been designated to do something, it takes nothing short of an act of God to UNDO the damage.

So we’ve been trying to get the hospital’s attention on everything that we do so that one of two things will happen (or ideally, both – but beggars won’t be choosers at this point): 1. Reallocate duties to someone else thereby taking pressure off of us and/or 2. give us a SIGNIFICANT pay raise because you’re paying for one person to do three jobs.

Um. No.

We, the schedulers (there are now three of us), put our heads together and we all agreed on our job duties. I typed it up and submitted two and a half pages to our boss so that she could submit it to the hospital administration.

The job description they published? Had five, FIVE, bullet points of very vague, and very different, duties.

I think this is beyond disturbing because one – IT’S TOTALLY WRONG. And two, how is this fair to the incoming scheduler? He/she is being mislead and lead right into the hornet’s nest.

Is it any wonder that they’ve had two girls go to lunch only to never return over the years? People have actually walked out on this job and yesterday?? I could totally understand why.

There are many aspects of this job that stress me out – from the moment I clock in to the moment I clock out, I feel like I’m running. Everything, everything, I do has a deadline. I must answer nurse’s flags, and voicemails, within 24-hours of receiving them. I must stop what I’m doing to help a patient that walks to my window. Then I must resume what I was doing, assuming I can remember where I left off, the moment they leave.

I must drop what I’m doing to answer pages from the hospital, which are usually questions about the orders I sent or to double check to make sure I have an insurance pre-certification number on the order, otherwise, the patient’s insurance company will not pay any, or all. of the test that is being performed and the hospital has to eat the cost.

And that makes the hospital very, very cranky.

Then I resume whatever it was before I was paged, assuming, of course, I can remember where I left off and assuming I don’t get interrupted again – which I will because there are so many aveneues to pursue in my job that it’s not a question of “if” but of “when.”

Then I have to make phone calls to other hospitals to set up appointments for referrals – and this is assuming they WILL schedule before receiving records from me. And if they need records, then I must stop what I’m doing and fax them records AND THEN follow up to make sure the patient was scheduled so I can make a note in their chart and to satisfy the nurse whenever she has time to go back and make sure I’m doing my job.

If there isn’t a note, I get a flag – which must be answered within 24-hours.

And then I have to go through my faxes to see if the tests I’ve submitted for approval, either through the military or VA, have been approved. And if so, call the patient and schedule them. If not, why not? (Note to self – make time to research and make more calls … and this is only on ONE patient).

And then there are the voicemails – even though I have requested people not call me multiple times because it really does slow back my call back process (because I’m having to listen to ten messages from the same person), people leave me multiple messages because OH MY GOSH, I CALLED YOU TWO HOURS AGO AND HAVEN’T HEARD BACK FROM YOU AND I’M IN PAIN AND I CAN’T TAKE IT ANYMORE AND …

Yeah. You and everyone else in the clinic, ma’am.

Look. I don’t mean to sound insensitive, but people, it’s not all about you. *GASP* I know people that come in to see us are in pain, otherwise, they wouldn’t be coming in to see us, but we juggle eight, EIGHT, doctors and have on average, ON AVERAGE, 80 to 90 patients EVERY DAY … we have only been blessed with two hands … be patient, for the love of God.

And then we have patients who simply walk in and expect to be scheduled to see their doctor. That used to absolutely PISS me off to no end – thank God we complained enough to our boss that that doesn’t happen anymore. We’re not a walk-in clinic. We simply can not stop what we’re doing in order to take care of a person who walks in off the street and let the patient who has been in the clinic for several hours and is desperately wanting to finish his/her business and go home to collapse into a painful heap wait – how is that fair?? It’s not. And thank God we were able to convince our boss of that. So – if people walk in and request an appointment, they now get a card with our names and numbers on them and are sent on their happy way leaving us to research that patient and to ask the nurse if it’s even okay for our doctors to see him/her. Because our doctors are SURGEONS – if people are not SURGICAL then our doctors can’t help them. They must go back to their primary care physician for other options.

Reality.

And that’s only the watered-version of what I do. You must put all of that into a noisy, hectic, fast-paced atmosphere, and constant interruptions, and imagine me keeping my shit together long enough to focus on whatever the hell I’m doing. My job is exhausting because there is NEVER any down time and I’m NEVER caught up – ever. E.V.E.R.

But even after all of that, I’m okay with my job. I do, after all, thrive on it. I LOVE the fast pace, the multi-tasking and the sheer challenge of it all. And when I get overwhelmed, I simply put up my “Next Window Please” sign and screw everyone else – I have to ground myself or the top of my head will simply blow off.

No. The reason I nearly walked out on my job yesterday was because I was on the phone, ALL DAY, with insurance companies. I had a full day of pre-certifications. I reserve Fridays for pre-certifications because they take so much damn time!! (We don’t usually have doctors in the clinic on Fridays – we love Fridays). I take one step forward and two steps back with every patient that I have to pre-cert a test for (like an MRI or a CT). The insurance companies want to make sure that the test is medically necessary before they will agree to pay for their portion of it.

And yes – OF COURSE I get that. But I have to give them clinical information – what the test is, what are the patients symptoms, what is the doctor trying to rule out, has the patient tried any conservative treatment? And most of the time – I have no idea what the hell I’m talking about.

Google is my best friend. I’m not even kidding.

It’s a crap shoot – sometimes, I can breeze through the process – other times, it’s like pulling teeth and I start sweating because I know, I KNOW, it’s going to go to review, which means they either want me to fax supporting documentation or I have to turn it over to the nurse and the PA has to call the insurance company to give them more in-depth information.

That is the aspect of my job that I hate the most. Because if they don’t approve the test, and the patient is set to have the test before we get that approval, I have to call the patient to reschedule the test and then have to listen to them bitch at me.

It sucks. IT ROYALLY SUCKS.

And an entire day of that? Is nearly more than I can handle and I can handle A LOT.

But to be fair, yesterday was my fault. My stress was sort of self-imposed. Because I hate pre-certifications soooo much, I tend to put them off until the last minute and if they go to review, well, I make more work for myself. So, starting Monday, I’m on a mission to make sure I’m one week ahead on these stupid pre-certs. That way, if they go to review, I have a little wiggle room before the patient is scheduled to have the test.

I’m also on a mission to campaign for the hospital to either hire someone specifically for pre-certifications, because honestly, it’s a full-time job now, especially now with ObamaCare hovering on the horizon and freaking insurance companies out so much they have changed their policies and made them so approval-phobic. If we could just farm that responsibility off on someone else, then my job would be less stressful.

But I don’t look for anything like that to actually happen because why??? Why should they hire someone when the schedulers have been doing it all this time and they are paying them peanuts to do it?

It’s time for me to get serious about looking for another job. I can feel how stressed out I am – it’s like my heart never slows down anymore and I don’t want to die young … especially for this job.

It’s just not worth it.