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.