Pros
The other doctors in the group were very nice. The patient population is kind
Cons
One concern that left a very poor impression was the lack of equity in scheduling. In a democratic group, I would expect leadership to share in working off shifts, including nights, weekends, and holidays, even if at a reduced administrative FTE. It is difficult to maintain morale and buy in when the group is held to one standard, but the medical director appears exempt from the most undesirable shifts. This is especially concerning because scheduling fairness is central to the culture of an emergency medicine group. I do not know many successful democratic groups where administrative leadership does not occasionally roll up their sleeves and work some nights, weekends, or holidays alongside the rest of the team. When that does not happen, it can come across as disconnected from the realities of the group and undermines trust in the schedule. In addition, the schedules themselves often feel inexperienced and inefficient. Rather than reflecting a thoughtful understanding of emergency department staffing, circadian burden, fairness, and operational needs, the schedules can appear reactive and poorly optimized. This adds to the perception that scheduling is not being approached with the level of expertise, transparency, or care that a democratic group should expect.
