Tuesday, September 16, 2014

Privileged parking

I don't want to appear to be nitpicking, but sometimes the decisions that are made by health care people are indicative of underlying problems--or just obliviousness.  Here, for example, I find it hard to understand why the doctors who work in this multi-specialty clinic--which includes orthopaedics and urgent care--should have reserved parking places that are closest to the entrance of the building.

Even if this non-patient-centric result doesn't bother you, consider the fact that only the doctors, among all the clinicians and ancillary health care professionals, get this privileged treatment.  Is the time of doctors more valuable than that of the nurses, the NPs, the PAs, and the techs?

I know, it's just a matter of a short distance to the other parking places in the lot, so it's not a big deal.  But why set up artificial class distinctions?  It would also not be a big deal for the MDs to walk that extra distance.


M Kashif Sheikh said...

From Facebook:

Aside from egalitarian principle, seems like it would make sense for the physicians to set a healthy example by walking a little extra too.

Jeanne said...

As usual, I agree with you on all fronts. I happen to work in said clinic and was struck by both the antiquated view that the doctors are more valued and thus deserve specialty parking as well as the actual location of these dedicated spaces.

Matt Leo said...

Apparently because nobody in this clinic has read Robert Townsend's classic "Up the Organization". Folks who want a parking place near the door should get to work early.

In a related note I once worked at an environmental non-profit that had a tiny parking lot that was always overcrowded. So I proposed this solution: Everybody who could commute by T in less than fixed time (including me) would pay for every day we used the parking lot instead of transit. The proceeds would then be used to subsidize T passes. I thought it was a pretty neat idea, but from the reaction you'd have thought I was proposing a mandatory-fur dress code.

R said...

I'm happy to see convenient parking for on-call physicians. Some specialists cover multiple facilities and actually do need to be in and out. I've got friends on home call that need to come in suddenly to supervise residents in procedures, attend births, or deal with complex admissions too. There are places that have on call anesthesia, radiology, or cath lab support staff that may have to make an urgent appearance but aren't physicians that are just as deserving of accessible parking. It makes sense to offer them easy access, the rest can figure out a way to arrive to their shift/clinic on time like all the other hospital staff.

Paul Levy said...

There are no births here. There is no cath lab. There are no complex admissions. The MDs who work here have regular shifts.

nonlocal MD said...

Why don't you ask several physicians who work there?

Anonymous said...

It is a perk that is given to the drivers of the system. Just as the administrators justify their 7 figure salaries as just, remember that the whole megillah stars with a physicians order. That's right, physician. Paul, you and the other wannabes can't admit a patient, write an order, or truly produce any revenue. After all, isn't that why health care is all about?

Several columns down we speak of morale issues with physicians. Clearly, lip service in act and deed. Would you allow the SEIU workers to hang in the administrative suites? Not egalitarian enough for the Boston libs?
Leave the doctors alone.

Paul Levy said...

I should have known that such an important topic, parking, would generate as much commentary as anything to date! Check over on Facebook to see a longer thread.

Nonlocal, ask them what? And how? Note that they were not present when the picture was taken, a 2+-hour interval in the middle part of the day.

Anon 7:53. I can't believe you are equating this issue with the issues of suicide and other morale issues of doctors discussed below. That topic, you recall, was about the how doctors treat doctors.

I don't ever recall being a "wannabe" with regard to being an MD. All I did was help save a hospital from going bankrupt after it was led that way by phsyician-administrators. You're certainly right that I couldn't admit a patient, though.

BTW, your terminology of MDs as the drivers of the system indicates a lack of understanding of the essential role of other professionals.

And finally, I never had a reserved parking spot. I parked several blocks away from the hospital so as not to take up a place that might be used by a patient.

nonlocal MD said...

Ah, Paul, you never fail to keep me engaged.
The fact they were not there in the middle of the day actually supports my case that they run back and forth and therefore need an empty parking space. Remember, the entire system doesn't 'go' until the doctor arrives. If s/he is late, it affects the system just as surely as one of your Lean assembly line glitches.

Ask them what? Ask them about whether they think they need special parking spaces and if so, why. Ask them would they be willing to give up those spaces if they were dedicated to poorly ambulatory patients instead. Ask them in a phone call to the ones you know, starting with your own physician, whom I presume was the reason you were there. Don't be helpless or jump to conclusions - go to gemba.

Paul Levy said...

Actually, my visit did not require an MD, just a very pregnant tech! Who knows, maybe she enjoys the extra walk twice a day.

The MDs don't run back and forth. They have assigned block schedules, something I learned at gemba. Many arrange their clinic time so that they arrive early and then leave to go to the hospital.

But this idea that the entire system doesn't go until the doctor arrives is just so, so wrong. Many of the functions in this clinic do not involve doctors.

Toni Brayer, MD said...

Paul, you are correct If this were California the first 25 spaces closest to the door would be marked handicapped. The employees, including regular shift, non emergency physicians should park further away and walk. The only reason to have assigned spaces would be if they were paying rent for office space with parking as part of the lease.

e-Patient Dave said...

So, where is this?