Intervening with disruptive physicians: Who, when, where?

The following is an excerpt from HCPro's new book, Managing Problem Practitioners: A Leadership Guide to Dealing With Impaired, Disruptive, Aging, and Burned-Out Clinicians. Here, author Todd Sagin, MD, JD, discusses choosing the right leader to speak with a disruptive physician.

Let’s use a couple examples to illustrate the selection of an individual to speak with a disruptive physician.

1. Dr. Amiable has a stressful night on call and the next day rudely refuses the request of a nurse to come see a patient. This is an isolated incident, is uncharacteristic behavior for this clinician, and could easily be addressed by the department chair sympathetically reminding Dr. Amiable that a bad night on call does not justify improper behavior the next day. This interaction has a high probability of going smoothly regardless of the department chair’s expertise with disruptive colleagues
2. A senior surgeon is repeatedly throwing tantrums in the operating room. A newly elected medical staff officer may be a poor choice to speak with this individual if he is 20 years younger than the surgeon, relatively new to the community, and in a primary care specialty. This is not to suggest that such a leader could not perform a successful intervention. But the surgeon in this example might more readily respond to a colleague closer to his own generation and whom he believes has an understanding of the stresses of surgery. Alternatives to the medical staff president might be the current or a past chief of surgery, a respected VPMA, or even a senior member of the surgeon’s own group practice.
3. What about a physician who is a high-revenue earner for the hospital and believes this makes him immune from any consequences for his poor behavior? In such a case, an intervention that includes the hospital CEO or a board member might be most effective in convincing him the institution is serious about the enforcement of its conduct policies and won’t be intimidated by threats to its revenue stream.

The point in all these cases is to maximize the success of an intervention by consciously thinking about who should perform it and is likely to achieve the best result.

For more information on this book, click here.