Encourage reporting of problem physician behavior

The importance of creating a reporting system that respects and protects staff members who disclose improper conduct can not be overstated. Hospital staff may be reluctant to report physician misconduct out of fear of retaliation by powerful physicians, and a physician's colleagues may be concerned about a potential harm to a colleague's career. These colleagues are often unaware that the conduct is part of a pattern of disruptive behavior, and failure to report it may deprive the physician of an opportunity to be helped by medical staff leadership.

Staff may be concerned that their efforts to bring attention to inappropriate behavior will create uncomfortable tension in daily working relationships. To avoid this, some hospitals allow anonymous reporting through complaint forms and incident reports. But keep in mind that although this approach may protect workers, it also creates the potential for abuse of the reporting system.

A viable alternative is to adopt a clear nonretaliation policy. Such a policy puts all parties on notice that reporting improper conduct is an affirmative duty of all staff, and it articulates the disciplinary consequences of any effort to punish an employee for carrying out this duty. It is critical that hospital leadership enforce the policy-otherwise, their assurances to staff will lack credibility.