Resolve Practitioner Turf Conflicts

Jack Cox, MD, MMM, one of the authors of Resolve Practitioner Turf Conflicts: Medical Staff, AHP, and Offsite Disputes, sat down with HCPro to share his personal experience with turf conflicts as both a physician and physician executive:

 

It seems like a small issue, but sometimes what appears on the surface as an inconsequential turf battle among well-meaning physicians trying to maintain market share can result in everyone loosing. Recently we had an issue that has not fully played out, but I can speculate on the outcomes if we don’t resolve it. In developing a comprehensive cancer program for melanoma, we have run into an issue of different specialties all claiming expertise in the field, especially in the area of surgical intervention. The health system is looking to invest heavily in this new comprehensive program. Success, which they have had in other areas like breast and GI cancer, would mean an increase in patient volumes for all the affiliated physicians. But back to the issue: the general surgeons, the plastic surgeons, the dermatologists and even an ENT physician all claim expertise with melanoma surgical excision. With that, add the fact we recently recruited a fellowship trained melanoma/sarcoma surgeon who is willing to help train others. The turf lines have been drawn.

 

The challenge is of course the short sided nature of everyone wanting to protect their “slice of the pie” when the focus should be on how to increase the size of the pie. This is not an uncommon scenario, especially in this time of major healthcare transformation when everything feels unstable and we regress back to protecting what we can see today. Strategic thinking is out. Now more than ever we need to anticipate potential turf conflicts, be willing to view solutions in a different way, and think of a more strategic outcome that will be better for all. Otherwise, we all suffer holding onto our preconceived notions of what is fair. Preparation and developing a process in advance as well as having the right people at the table goes a long way to avoid the above scenario.