Reply for two posts and answer the questions:
First Post:
I have actually watched this happen in real life and it’s almost the same area. A physician was very unhappy with the clerks in the clinic. They didn’t have an issue with the Director of Nursing, but it is still basically the same situation. I would ask the physician what is going on and for him to give me a couple of examples of what the issue is. I believe that you can’t fix it if you don’t pinpoint what the exact issue is. Once he is able to tell me what is going on, I would assure him that I would look into the situation with the clerks to see if it is a training issue, personnel issue, process/procedure issue, or something else. In the article, “Tips for Working with Difficult Doctors”, it says to use the 3-D’s – diagnose, design & do. You diagnose the issue, design a process to fix it and then do it. Maybe putting it into those words would also help the physician calm down as well. It is always a good idea to remain calm too as sometimes, when you also get upset and raise your voice, it can make things worse.
Later in the week, I am the problem. I would tell the physician that I am investigating the issues and if the physician went to my boss, I would also explain to my boss the same. I would provide the information that I had found so far in the investigation and let him know what my next steps are. I know, sometimes, it is very frustrating when something is not being done right, but you also have to give time for it to be corrected as well.
Sometimes, having a physician mad at you can be intimidating.
What are some approaches you have that can keep the situation calm? I have never had one specifically upset with myself but I have had one upset with my staff before and had to determine what was going on.
Would you elevate the situation to someone in Administration to let them know that this physician is upset and has came to you twice in a week?
Second post:
As this case study gives minimal information first I question whether this short encounter with a disgruntled physician is occurring in the hallway or a public setting or in my office? If this is occurring in a public setting then I would strongly recommend that we have a follow-up discussion regarding his concerns in my office at a time that is scheduled to work best for both schedules. This will give the physician time to cool down if an event had just occurred in order for me to understand the root cause of his comments. It is best to let the physician know that you value his input and will look into the situation he discussed. Once I have properly met with this physician and given him time and a safe place to discuss his concerns then I would have a discussion with other physicians that work directly with this physician and the staff members in question. The reason why I am hesitant to completely be on the physician’s side is because there are always numerous sides to hear out. MGMA suggests to “confront the problem because ignoring complaints will lead to more bad behavior and potential legal liability” (Holmes, n.d., 2016). It is possible that the physician that came to you in the first place is the problem which you may discover when speaking with his colleagues and the two individuals he pointed out are not doing their jobs correctly. If collectively the staff is pin-pointing the problem on the physician that came to you then try being made more visible in the department to see behaviors for yourself. If the physician that spoke with you is in fact the problem then rather exchanging in a he said she said argument it would be better to discuss expected and acceptable behaviors and describe the situations and behaviors displayed by the physician. The idea of disruptive physicians can be linked to burnout. Dr. Hoyt Burdick was quoted in an article saying, “inappropriate or disruptive behavior by a physician, while more commonly attributed to underlying disposition, frustration, or fatigue, may also symptomatic of more serious problems associated with professional burnout, including depression or substance use,” (Berg, 2018). If I found out that the root cause of this physician’s behavior was because of burnout then I would recommend the physician take some paid time off to reset his behavior then upon return implement checking in and performing performance improvement plans regularly to help prevent burnout or other issues that could arise.
Questions:
If you were already short staffed would you make a physician that was experiencing high levels of burnout go on leave in this situation?
How would you try to repair any damage to the team that the disgruntled physician caused?