1. Unlimited PTO (not really unlimited and not friendly to working parents with last minute time-off needs). 2. Management is vertically linear, which was restructured from a previously horizontal, team-based system. NPs report to one NP manager who is spread really thin with little middle management (<1yr) and clinical experience (3 yrs) as of May 2023. She does not have a voice. 3. NPs also do not have a voice even though they are the backbone and face of the entire operation. There is a front of support and appreciation, but the reality is not so. Medical director, HR, People officer all unresponsive when outreached for support. 4. Physicians are afforded flexible hours (4 days per week schedules), NPs are not and expected to carry the full patient care load. If you ask for help or request a break without notice, you may be given a written warning. Physicians do very little clinical work and do not have the same work expectations. 5. BH is not actually available for support and they see very few patients. Not clear their role. 6. Panel size is ever-increasing as the anticipated patient growth is 500,000+. May 2023 max was 900-1000 and growing. Much of patient care is managed by a chat app, plus 6 visits/day. Very difficult to finish your work in an 8hr shift and feel you are giving good attention and care to your patients. No overtime pay. Even though virtual, this makes work-life balance challenging, especially as a parent to young children. Sometimes feels like you are expected to "be on" all the time. 7. No comp for 1 week on-call duties 8. Little room for professional growth; seemingly few promotions available/intended. Unclear the credentials and background needed for promotion eligibility other than personal connections.
8. Still pretty disorganized "front desk" operations, which make NP work more challenging and inefficient.
