Kaiser Permanente reviews

Very bureaucratic and intensely political environment. All promotions are based largely on seniority. Managerial hires must often be approved by union leadership. The union leadership often paralyzes the organization. SCPMG has legions of administrators, both physician and non-physician, who sit around, criticize, pontificate and add no value to the organization. Physicians have little to no autonomy in shaping their own work processes and no control over the unionized support staff. The unionized support staff are often thuggish and are not held accountable for their actions I was stuck in a department that was perceived to be of little import to the hospital and medical group. Thus, I did not get the support that I needed. The physician chief of service did not care for either myself or my colleague, perceiving us as a means for him to escape into administrative functions. The non-physician department administrator was weak, ineffectual and unsupportive. The salary structure is based SOLELY on seniority. There are no rewards given for productivity or revenue brought in. Thus, SCPMG retains older, less productive physicians who find ways to spend their time performing administrative functions. Inappropriate usage of patient satisfaction surveys often discouraged integrity in the arenas of disability management and opioid prescriptions. While I would not cater to malingerers or drug seekers, I saw colleagues who did both, to preserve their patient satisfaction ratings.

Primary care physicians spend a lot of time on tasks below our licenses. You do many hours of extra patient emails, prescription renewals, and phone calls. The support staff is largely medical assistants. Kaiser doesn't like to invest a lot in mid-level providers like RNs who could make our job easier. Why? because the physicians are salaried--it's cheaper for MD's to do this in the evening and weekends on their own time than provide professional-level support. You have to close charts, answer calls and emails within one day. You also have to work evening clinics and weekend clinics. They are slow to replace MDs who leave and this adds to the burden of coverage. As a result the work-life balance is poor. You can feel like an overpaid data-entry clerk and customer service representative. You will be given talks about "providing excellent customer service." It's hard to feel like a physician. I have several ethical concerns regarding how the company inserts itself in the doctor-patient interaction. The patients rate you and these ratings are partly used to decide whether you can stay in the Medical Group. [My ratings are actually on par with my group so this isn't just sour grapes]. Making sure the patients are "satisfied" promotes overprescription of antibiotics, narcotics and sedatives. Doctors need to be able to say "no" and have difficult conversations that aren't "satisfying". And, because Kaiser is an insurance company, patients occasionally worry we are "trying to save money" on their care. An example, if you make more specialist referrals than your colleagues, you will get "dinged." Specialists more likely to give a quick phone opinion and are less inclined to "own" patients and follow them for their chronic problem than in private practice. There is a corporate culture of "Kaiser Kool-Aid" about how great the system is. Smart doctors with ideas for improvement and contrary opinions are ignored because they don't reflect the unrealistically rosy view of management about the Kaiser system and our work lives. There are a lot of physician jobs. If you don't like following commands from management about how and when you work and don't embrace corporate medicine, then you will find a better fit elsewhere.