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Toxic Docs Require Management Finesse

Joe Cantlupe, for HealthLeaders Media, August 8, 2013

It's important for hospitals and physician groups to address disruptive behavior when it first appears, by not making excuses for "high performers and politically protected employees who harm others," says William "Marty" Martin, PsD, MS, MPH, PsyD, CHES, director and associate professor at DePaul University in Chicago and a former member of the American College of Physician Executives faculty.

Healthcare organizations must deal with the issues incrementally, from the first "cup of coffee," trying to understand the issue when discussing it with a physician, Martin says. If the issue recurs, a peer review may be needed, and possibly followed by disciplinary action.

"You have to make it a bit more formal. You have to put on your risk management hat because you don't want to railroad that particular physician, but you do want to balance what's good for the organization and what's good for the individual. "That includes, of course, discussions with someone who may have filed a complaint.

Hospitals must strike the balance of "managing disruptive behavior" and "caring for and protecting the victims," he says. At Florida Hospital, physicians who engage in disruptive behavior have a chance to retain their positions, depending on the circumstances.

Over the last decade, the hospital has intervened with at least 1,000 physicians and their family members. At least 100 physicians who may have lost their positions were able to keep their jobs because of the hospital's intervention services, Paolini says.  

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1 comments on "Toxic Docs Require Management Finesse"


Robert Fielder, MA (8/8/2013 at 4:46 PM)
The consequences of a disruptive physician's behavior can be among the most destructive to the effective delivery of medical services! Whatever the environment, behavior of this sort falls under the heading of workplace conflict and as other employers in other industries have repeatedly demonstrated, there's considerable benefit to be gained from implementing the full range of Dispute Resolution Techniques. Taken together, the various strategies and resources that can be deployed, in additional to those cited by Florida Hospital and DePaul University, constitute a Dispute Resolution System (DRS). A DRS can be locally designed and customized (usually by a multidisciplinary committee) at each hospital or practice. They are specifically designed to accommodate progressive discipline and incorporate coaching of and counseling with the offending individual. But [INVALID]ing the behavior is just the first step in the process. Effectively demonstrating to the offended individuals that such a change of heart has been accomplished requires that the offended individuals be involved in the search for effective resolution, as well. The participation of these fellow physicians or nurses, with the aid of peer or professional coaches, facilitators or mediators is the key to rebuilding the fractured relationships and that's the final step in the successful restoration of a functional healthcare team.