Sweatshop for Doctors - Primary Care MD Kaiser Permanente Employee Review

2.0
6 Aug 2011
Recommend
CEO approval
Business outlook

Pros

- Excellent retirement package if you stay 10+ years working 100% full time - Flexible scheduling for time off, coverage by other colleagues - Compensation is very good and competitive - Sturdy EMR and easy consultation structure. - Incredible growth and marketshare thanks to an ever apparent corporat-ization of American health care so that literally it is run like a business. (which I am not arguing should be the case but no one ever expects a clinic to be run like General Motors.)

Cons

- Literally a sweatshop if you are a primary care MD doing majority primary care patient time. - You are pushed into a situation of every 15/20 min appointments with a mixture of either patients who are really sick and need 40 mins of time or "worried well" healthy patient who are psychologically imbalanced and obsessed with inane and irrelevant issues who also take 30-40 of your time. As a results you are always behind. (I am an extremely efficient person so time management problems are usually not a problem for me) - Kaiser's business model is to enroll and take over the marketshare for healthy young patients, show them how "cool" Kaiser is with instant e-mails and fast consults so that they never want to leave, keep them healthy and phase out the sick folks. - As a result tons of new and healthy young patients without problems except it self selects for young patients who are a tiny bit insane who come in with a list of complaints and demands that are not medically significant, but they want care at that moment, and they demand an MRI, CT, blood tests, without any regard to your medical opinion or expertise. Then it is your job as a physician to explain to them why they should not be ordered etc, they get mad, you lose, and so you order the tests, then a few months later you get a report of your superiors detailing the unnecessary tests you ordered, if significant enough your bonus is withheld and you are punished. - contrary to common belief there is a punitive system of punishing doctors for unecessary testing. It is not done at the front end (which is good) so there is some autonomy, no preapproval nonsense) but after awhile you are forced to change the way you practice because you can be sent for remediation education, and financial withholding of your bonus checks. You are warned of this by middle management (at least they whisper this to you) - Doctors who have been there for awhile and with political ambitions are promoted to higher positions of power, awarded with less patient time, and higher salaries and therefore are sorely out of touch with the frontline doctors trying to keep their head above water to take care of the droves of patients coming through their doors. - Leadership is not composed of primary care MD's (the heart and majority of the KP workforce), Leader CEO Robbie Pearl, a non practicing plastic surgeon, is credited with saving Kaiser(and he did) but he is no longer a doctor, literally he is the Jack Welsh (General Electric) of Kaiser. Legendary in status but now completely out of touch with his workers and spitting out initiatives that are ineffective to making primary care more bearable but still making tons of money for the company. Therefore no problem is perceived when a company still makes a profit. - You are constantly monitored. Because Kaiser's IT is so advanced every aspect of your practice from the second you "open" a chart to when you "close" a chart, how much time you spend with a patient, how many labs you order, how many clicks you click, how fast or slow you return patient e-mails is logged and reviewed by higher management and interpreted without the scientific standards we learned in medical school. Instead it is analyzed by MBAs or executive MD's pretending that they have an MBA.

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5.0
3 Jun 2026
Recommend
CEO approval
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Pros

Learned a lot, coworkers nice

Cons

N/a no cons in my experience

4.0
9 Sept 2015
Recommend
CEO approval
Business outlook

Pros

Kaiser is a great place to work and build a career over time. In my experience salaries are above market for most positions, and the benefits are so good that many people become "lifers". The health coverage is extremely generous, and time off starts off adequate and gets better over time (18 days when you start, moving up to 33 after 15+ years - this does not include sick time). Employees truly believe in the mission of KP (at least, I do) and it's clear that this is a place where employees' contributions are valued. Although my role is not part of any of the unions, the fact that our workforce is predominantly unionized also places a positive role in KP's reputation as a good place for workers (although having unionized staff also presents many challenges). Overall, I enjoy working at KP and would recommend it to others, but understand that you are entering a big bureaucracy. A friendly, mission-driven bureaucracy, but still.

Cons

Cons: having lots of "lifers" means that innovative ideas and workflows are not always adopted without a fight. People have their roles deeply embedded here, and any threat to the status quo is seen as negative, even though we need to make some pretty radical changes given the new health care environment post-ACA. There's a lot of "not my job" attitudes here. It's hard to navigate the layers of bureaucracy, both in terms of personnel/HR/benefits, and in getting work done (there are often 4-5 departments at the regional and national KP levels working on similar areas, and no guidance on who does what.) Be aware that KP is not immune to reorganizations and layoffs -- they do make a good attempt to ensure workers are hired elsewhere in the organization, but there are no guarantees, and there can be a lot of turnover in certain departments. Benefits are currently generous but are always subject to downgrades in the future, so just be aware of that. Some changes to the pension and retiree medical benefits are about to hit, and with them a wave of Baby Boomers will be taking retirement, which should hopefully open up many new management opportunities for Millennials. Oh, and the biggest con of all: we still - STILL - use Lotus Notes for email. Shocking, I know, but true.

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