Losing the Better of the Two

Taking a break from the tornadoes

People in health care tend to get comfortable in a routine working with one another. Physicians tend to have their nurses with whom they get along best. They understand each other. They know what the other one wants in certain situations. This all ultimately leads to better efficiency. Granted, in academic medicine, this largely falls apart, but anyway.

In ophthalmology, rather than nurses, we tend to have technicians with whom we become acquainted. Of course as residents, we would never be in a situation to have our own tech. But in the resident clinics, we for the most part have the same two technicians. They understand our clinics, our scheduling needs, and the flow of things. Because, let's face it, private retina clinics aside, more patients go through the resident clinic than any other at JEI.

One of these technicians has been uprooted from our possession to work as the primary technician for two new staff we are soon to have. Key word: soon. They're not even here yet. One is an oculoplastics specialist (hell yeah!!) who starts sometime in the next two months, and the other is a pediatric/strabismus specialist who starts in September or later (and of course she will primarily be at ACH, not JEI). And instead of having the leaving one train his replacement, the tech who is staying with us (the far slower of the two) has the job.

A consulting firm is telling JEI to either increase patient visits or trim the number of technicians for financial sustainability. And yet we've hired two new technicians/RN's long before new staff shows up, and we're about to lose a different staff member - that's only a net gain of one physician sometime in the fall. Not sure this was an economical decision. Increasing patient load is not feasible - for residents because we see more than anyone else already, and for several staff because they could never handle it, either because they are efficient but overbooked, or just plain slow.