Residency: A Day in the Life

I feel my eyelids begin to fall again as I struggle helplessly to keep them open. We are 2 hours into a 4-hour meeting. My pocketful of mints I brought has long disappeared, as well as the contents of my 40 oz water bottle. I glance down at my arm, now bright red and adorned with fingernail marks. Although effective short term, pinching was not an ideal solution for staying awake. I decide to try something new. I raise my legs under the table and think “how smart am I” to find an impromptu way to exercise and stay awake at the same time. As my feet fully extended in my enthusiasm, the toe of my shoes strike something hard. My boss sitting across from me grimaces in pain and reacts in his seat. I immediately shift my gaze to the left and become interested in what is happening on the wall behind him.

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Fortunately, the fear that comes from kicking my boss and worrying about my job security give me the adrenaline I need to stay awake for the rest of the meeting.

This is a (rare) example and small insight into what I do at my job.

I am an administrative resident part of a healthcare system in North Texas. When I tell people of my role as a resident at a hospital, they falsely conclude I care for patients in a setting similar to Grey’s Anatomy. When I correct them, they usually respond like the cop who had seen my badge, wrinkled his nose, and then proceeded to write a ticket for my traffic violation, rather than the warning I was expecting. Uninteresting. To be fair, hospital administrators ARE found on Grey’s Anatomy – usually as the bland, unattractive, background cardboard characters seated around a board table. Representation.

I have many friends who have done, or are doing their own administrative residencies. We frequently compare experiences and have healthcare discussions that would make us the social pariahs at any normal party. I therefore wanted to educate the public about what occurs during a day in the life of an administrative resident (at least my own) and dispel the perception that hospital administrators are just a bunch of boring suits. . . . although we do wear suits.

5:15 AM – Wake up and eat Oatmeal pancakes made with almond milk. Real milk gives me indigestion.

6:47 AM – Arrive at the gym at the hospital. Was supposed to arrive at 6:15, but went back to sleep after eating pancakes.

7:56 AM – Walk into the boardroom for a meeting. I’m sweating profusely because today was cardio day and it always takes me half an hour to cool down after showering but since I slept in, I’m now low-key fanning myself under the desk with a manila folder to no avail. This meeting has to do with the hospital’s kidney transplant program. I am helping to create a business case that shows where we are and where we want to take it. I work with the director of the transplant program to put it together before we present it to the corporate leaders next week.

9:20 AM – I have the opportunity to meet weekly with the President of the hospital, who acts as my preceptor. During this visit, we walk throughout the hospital visiting different departments and eating popcorn bought from the volunteer stand. It’s a nice moment.

10:03 AM – Rotations through all the departments in the hospital are part of the residency. In some areas, it gives me the excuse to get out of dress shoes and into tennis shoes. Today I’m spending time in the operating room, specifically watching a robotic surgical hysterectomy. Upon the completion of the surgery, the surgeon hands me the freshly removed, and still warm organ and tells me to go put it in a container that will go to the lab. My journal entry that night read:

“I held my first uterus today…”

Hopefully last as well. I have no reason to hold any more.

12:11 PM – What may be my favorite area in the hospital, the cafeteria is a spectacle to behold. The food is good, the food is inexpensive, and the options are many. With 11 different lines, you can get options such as freshly-rolled sushi, comfort food, grilled food, salad bar and Mediterranean food. What is most amazing is that my hospital is perhaps one of the only hospitals to have a BBQ line that smokes its own meats! Only in Texas.

12:49 PM – What no one tells you about work is how much time is spent answering emails. Yes, Powerpoint, Excel, and analytical skills are good, but a great employee is someone who can efficiently manage their email folder.

1:23 PM – Talk with the administrative assistant to the president. Everyone thinks it’s the hospital president and their team who run the hospital. But really, it’s the administrative assistants. They are the gatekeepers who determine who enters and who shall not pass. They know exactly who to call to get a job done. And they will tell you that if you ever want to make a good impression, never wear that tie again.

2:07 PM – Work on my Powerpoint presentation for the Women’s Services renovation project. I now know way more than I probably should about breast pumps and lactation specialists. Also, do you know how much it costs for new furniture and the cost of power-washing an entry way. It’s an absurd amount. Even buying a deluxe armchair at Ashley Furniture would be less expensive than an uncomfortable armchair put in a hospital room. The real problem is every construction project adds additional contracting fees, general fees, and just-for-fun fees that shoot up the price. Heck, rather than paying $60,000 for power-washing, if the hospital provided pizza, I could get a bunch of guys from church to show up and do it for free.

3:23 PM – I drive to the corporate office to attend one of those meetings mentioned in the beginning. Luckily this one is only 3 1/2 hours. Occasionally, these type of meetings can go on for 8 hours. The purpose of this meeting is to determine which hospitals are allowed capital funds that are being requested. One after another, different presentations are shown and capital is approved. I feel like I’m on the Oprah show: “You get a million dollars! You get a million dollars! Everyone gets a million dollars!” However, these approvals come with a much lower level of enthusiasm than Oprah.

6:51 PM – As I drive home and get caught in DFW traffic, I listen to How to Win Friends and Influence People on audio book, hoping to learn the skills necessary to increase my chances of landing a job after my residency. Chapter 6: How to get people to like you.

7:30 PM – Begin cooking some delicious Dijon Crusted Cod with roasted broccoli. Cooking is my way of unwinding after a long day. Besides the gym, none of the activities I did today were physically demanding, but I am exhausted.

9:57 PM – Ya, I’m 27 and try to go to bed before 10. Call me old.

Wake. Work. Sleep. Repeat.

The administrative hospital residency is an invaluable experience that I would encourage to anyone looking to get into healthcare administration. What could be better than a year of paid learning? If you have any questions about the process or additional experiences, feel free to reach out.

Beyond Salary: What Makes a Company a Great Place to Work For?

I began working at the early age of 8.  I delivered Thursday’s newspaper beginning at 4 A.M. with the assistance of my dad (who I now appreciate even more).  I brought in a sizable $30 a month – significant at that age.  From that point on, I usually held some form of work: mowing lawns, scout camp counselor, grocery store stocker (the kind that puts the food on the shelves, not follows people around), restaurants, life guard, custodial work, call centers, acting (I was a Jew in a feature film called Yankles – $3.99 on Google Play), voice work, valet parking, and currently a plans representative at an Insurance company (not to be confused as a salesman).  Needless to say, I’ve held quite a few positions and have worked for a number of companies.

As I’ve gotten older, I have taken notice at what makes a great company to work at.  A decent salary is always appreciated, but how about insurance, fitness facilities, appreciation, and just a good fit within the company?  Although you may be demanding a higher salary, do you feel appreciated and fulfilled within your role?  This has been my limited experience as an employee and how I plan to incorporate this knowledge as a future employer.

I currently work at SelectHealth, a not-for-profit insurance company (how does that work??).  My position is a Personal Plans Representative – no that is not a fancy phrase for insurance salesman.  I help people who have questions about insurance plans and help them navigate through the ACA (Affordable Care Act (for those who view it favorably, Obamacare for those who do not)) as it pertains to them.  I took the job for a number of reasons:

  • I needed a job
  • I needed to pay off student loans before I accumulated more loans
  • Furnish my lavish lifestyle – eating large quantities of Costco churros is expensive
  • Commuting to work signified I was actually an adult and not a useless millennial

The main reason was that the position would educate me on the provisions of the Affordable Care Act as it is critical to my future as a healthcare administrator.

During orientation, I learned that SelectHealth was voted as one of the best places to work in Utah, and had received that honor for the past 8 years.  “What is so great about working at an insurance company?” I thought to myself.  During the past 3 months I have been employed, I have come to realize that no matter the industry, a company can make its employees feel valued and special.

Before I continue, I’d like to talk briefly about a former company I worked for.  I won’t use their name, but will only say that they are known for their aggressive sales tactics and were given an F by the Better Business Bureau.  During their orientation, they boasted a company culture similar to Google: free lunches, gyms (critical at this company), parties, volleyball courts, and free swag giveaways.  In theory, this sounded great and should have been a great place to work for me; out of all those things, I love free lunch the most.  So why was it that in the three months I worked there, my anxiety and dread towards going to work prevented me from enjoying my food and just made me sick to my stomach?

This company’s culture works for many of its employees.  Perhaps I am just an anomaly (along with my two friends who joined me when we all quit together).  We took calls on the phone from both customers and representatives.  Many calls were from angry customers.  These calls would often relate to unfulfilled promises, damaged homes, and the occasional disbelief that a rep was attempting to sell to someone’s parent who has Alzheimer’s.  Anything for the sale, right guys?

What was frustrating was that there was such a lack of communication between departments which created so much confusion and inefficiency.  Even more upsetting was that we were unable to tell off these representatives for their blatant errors and dishonesty because they are “the lifeblood of the company.”  I never felt valued or appreciated for the work I was doing and quit as soon as I had another job lined up.

At SelectHealth, I work with agents and brokers (representatives) who are less concerned with how swoll they can look and more concerned with the wellbeing of those they help (nevermind the fact that most are middle-aged family men).  We still deal with the occasional angry member, but more often than not it is due to uncontrollable circumstances (having to get insurance and the price of premiums, #ThanksObama).  We are trained to be completely open with people and if our plans aren’t a good fit for them, we will refer them to other carriers.  It is common to be thanked sincerely at the end of a call, which offers a sense of satisfaction not found from the previous job.

Aside from job responsibilities, SelectHealth goes to great lengths to ensure its employees are satisfied and happy coming to work.  A full gym is provided to employees at a cost of $2.50 per paycheck, however, they provide additional benefits for staying fit such as $50 per quarter.  Even more convenient is that the gym is nearly empty now since most people have given up on their resolutions to be fit (please see Realistic New Year’s Resolutions).

What has impressed me the most is the executive team at SelectHealth.  They realize that each employee makes a difference and contributes to the success of the company.  During my orientation, an executive member came down to speak with us new hires and joined us for lunch.  From her busy schedule, she took 2 hours to come have an enjoyable conversation with new employees.

A few weeks after I began, I received a letter in the mail.  It was directly from the CEO and President of SelectHealth welcoming me to the team. Yes, it was a printed letter that is likely a template for everyone.  But it was addressed to me and personally hand-signed at the bottom.

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A few weeks later around Christmas time, I received another letter in the mail.  This time it was a Christmas letter signed by all the executives of SelectHealth.  As you can see, it isn’t a very personal letter, but I won’t hold it against them since they did this for over 1,400 employees!  How much simpler would it have been to forward a “best wishes” email out to every employee instead?  This attention to detail makes me appreciate the time (and likely cramps) that went in to these letters and appreciation for every employee.

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At the end of the year, everyone received an email explaining that due to the excellent performance of Intermountain Healthcare/SelectHealth throughout the year, each employee would be receiving an end-of-year bonus dependent upon the number of hours worked.  In a world full of executives receiving millions of dollars in bonuses and inflated salaries, how many companies can boast that their CEO receives the same bonus they do?

All of these small examples signify to me how much the company values its employees and the lengths it will go to in order to prove so.  Obviously, each person will determine a great workplace based off of different variables.  Maybe salary is the only factor or perhaps it is job security.  For me, a great workplace comes from receiving praise and appreciation for the work you are doing and knowing that the company appreciates each and every employee; not just those at the top.

PS – I am writing this post during a redeye flight on Southwest Airlines.  I had never flown with them before, but heard how enjoyable and different the experience was from other airlines.  Some things worth mentioning:

  • I tried trading in my pretzels for one more bag of peanuts, what I got was the stewardess dumping a handful of peanut bags on my tray and enthusiastically say “Have four more!”
  • Their safety announcements:
    • “In the case of an emergency and the oxygen masks drop down, please place the “I can’t believe it’s not butter” cup over your mouth first and then any children with you. If you have multiple children, choose your favorite child.
  • Due to unassigned seats, being able to go clear to the back and stretching out on the empty seats beside me

It takes a great company culture to be able to pass the positivity on to its employees.