A Better Strategy for Dealing with Bad Physicians

Lena J. Weiner, for HealthLeaders Media , April 7, 2014

While HR handles most personnel issues in hospitals, the use of professionalism committees is on the rise. Staffed by physicians, they confront peers who are exhibiting disruptive behavior and they provide counseling.

As a human resources professional, have you ever felt like there's a cultural gap between your team and the clinicians employed by your organization? Perhaps you've felt you're not the right person to speak directly with a physician known for being nasty or with the too-casual resident who fails to respond to pages?

If so, you're not alone. The sentiment that the cultural chasm between HR and physicians might be a bit too hard to cross is becoming increasingly recognized and understood by both parties.

"There are some things human resources are good at, but, regarding professionalism, I think a peer-to-peer, physician-to-physician conversation is what's needed. It's complicated to talk to a physician about unprofessional behavior," says Daniel Wolfson, Executive Vice President and Chief Operating Officer of the American Board of Internal Medicine Foundation, an organization with a dedicated mission to spread professionalism among medical staff. 

While HR handles most personnel issues in hospitals, a small-yet-growing number of organizations have been developing professionalism committees. These are groups outside of human resources that confront physicians who are exhibiting disruptive behavior, provide counseling, and follow up on the issue to ensure things have been remedied. Members of these committees are often physicians.

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3 comments on "A Better Strategy for Dealing with Bad Physicians"

Deb Waugh, LCSW (4/10/2014 at 1:36 PM)
With an end-goal of enhanced patient care by physicians and other healthcare team members, a two-pronged approach that combines the policies of HR with the communication and coaching from a medical director is optimum. If tis is not possible, then objective monitors from outside organizations can provide both parties (hospital and physician employee) with a neutral assessment and coaching program to address the issues.

J. Wells, RN, MSN, MBA (4/8/2014 at 12:41 PM)
This obviously is written by a physician for physicians. If they are employees of the medical facility, physicians should should be "handled" like an employee. To do anything else encourages the very culture of tolerance of all behaviors that needs to be eradicated.

alan (4/7/2014 at 5:13 PM)
Good overview. Having spent a lot of time researching, writing, lecturing, and facilitating change on the topic of disruptive behaviors (see most recent article: Rosenstein, A. "Bad Medicine: Managing the Risks of Disruptive Behaviors in Health Care Settings" Risk Management Vol.60 No.10 December 2013 p.38-42) I am all for resolution. There is no one solution group. I agree that it's probably not HR, at least on its own, but it does have to be an organization driven effort requiring a multidisciplinary approach that includes education and training and appropriate intervention by skilled individuals. This process may include raising levels of awareness, providing education and training on ways to improve relationships and communication efficiency, coaching, counseling, and in some cases more comprehensive behavioral therapy. Many organizations are using their own staff or wellness committees to address, but many are going outside utilizing either a physician EAP or dedicated coaching/ counselor resources. The crucial points are two. First, particularly in today's stressful health care market, we need to look at physicians and other team members as crucial resources and work with them in a pro-active supportive manner to try to get them to better adjust to the pressures of today's health care market. Second is the importance of early intervention. Working with individuals who appear stressed, angry, agitated, or more before a disruptive event occurs has a much better outcome than interventions post outburst. Physicians are busy and are just trying to do their jobs. They won't come to you for help so we have to reach out to them in a respectful, convenient, confidential, and non- confrontational manner.




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