‘Take This Job and Shove It’

As I was finishing my residency, I envisioned working in a small group, where I could develop strong doctor-patient relationships, a very important aspect of my practice style. So I was excited when I was hired by a solo physician. He had been alone for more than 20 years, but now wanted to add a female physician to enhance his appeal to potential patients.

During the first six months or so, our relationship was cordial and I did everything asked of me and more, including taking extra call without compensation. Our personalities were quite different, but I was convinced that if I immersed myself in taking care of my patients, everything else would work itself out.

I was in demand. My boss seemed to feel rather threatened by my habit of hugging my patients, and he complained to me that I spent too much time listening to my patients. He was expecting me to change my personality, which was something I could not and did not want to do.

One particular patient interaction tipped the balance for me. A postmenopausal, new patient had come to see me with a chief complaint of vaginal bleeding. Upon inspection, I did visualize blood at the cervical os. I performed an endometrial biopsy at that visit, instead of having her return at a later date for the procedure, as I had been previously instructed to do. I sent the specimen stat to the hospital, and received a call the next morning from the pathologist that confirmed my suspicion of cancer.

This was the first time I had to inform a private patient she had cancer, and I believed it best to relay the news in person. I called her and asked her to come in to discuss test results. She and her husband arrived, and I spent an entire hour talking with them and explaining the diagnosis and treatment. They chose to go to a gynecologic oncologist, so I provided some names and phone numbers and gave them a copy of the pathology report that had been faxed to me. I offered to help make the appointment.

Later that afternoon, I saw my boss and relayed the details of the situation to him. His response was, “Did you bill her for the consult?” My jaw dropped and I responded, “No, it never even crossed my mind to do so.” Walking away, he said, “Make sure you bill her, and I would have just told her over the phone.” At that moment, I knew I did not like him at all.

He began pressuring me to sign a new contract that he himself, and said was nonnegotiable. The contract was very restrictive and completely unacceptable, but even if the offer had been perfect I knew I could not stay because of our differences in practice philosophy. I told him I would not stay, and he became angry and raised his voice to me. He demanded I remain an additional 90 days at the same pay, to allow him time to find a replacement, to which I did not respond. Over the next few weeks, he was increasingly suspicious of me. A receptionist informed me that he listened at closed exam room doors to hear if I was saying anything he did not like to my patients. He repeatedly told me that he owned the practice and all of the patients were “his patients.” He disabled my computer access and the copier, to prevent me from copying patient records.

One day, close to the end of my contract, he was particularly obnoxious and rude to me. I finished seeing “his” patients for the day, walked into his office, put my pager and keys on his desk, and said “I quit!” He raised his voice to me and said, “You can’t do that. What about your patients?” I replied, “You said I don’t have any patients!” and walked out the door for the final time.

I did not have another job, but I felt such relief at that point that I didn’t care, and was hired by another practice within a month.

My former boss, however, began seeking revenge. He told patients that I had been fired because I was incompetent and had left town. He even sued me in an unsuccessful attempt to have me removed from the hospital staff. He did everything he could think of to discredit me.

Some of the patients I had previously seen had ties to the hospital, and word of my whereabouts spread. Patients came to see me at my new facility, and informed me of the untrue stories they had been told. Many urged me to sue him for defamation of character. I brushed the stories off and did not speak negatively of my former boss to them. I wanted my reputation to speak for itself, and just wanted to continue to take care of my patients. Those who believed the stories would not seek me, and that was fine with me. Many were incredulous of his behavior, and were loyal to me. Appointments filled quickly, and I worked through lunch most days.

I learned that in treating people with respect, dignity, and compassion, the reward comes back to you tenfold or more. I refused to play the game of accusations and revenge. If I had to go through the same experience again, I would respond in exactly the same way.

Robin Carter, DO, is a retired OB/GYN in New Jersey, now enjoying reading, writing, and cooking.

This article originally appeared in the September 2009 issue of Physicians Practice.