Question: A physician on our medical staff, who has a history of disruptive behavior, just filed a complaint against our Chief of Staff. According to the complaint, the Chief of Staff was “demeaning, condescending, and degrading” during a meeting that was supposed to be a collegial intervention. He claims the Chief of Staff violated our Code of Conduct Policy and we need to take action, pronto. It was just the two of them at the meeting, so it’s a classic “he said, she said.” What do we do?
Answer: There are a couple of important lessons here. Let’s start with the lesson that the collegial intervention should never be one-on-one when you are dealing with a physician who has a history of behavioral problems. It was predictable that the physician would try to deflect attention away from himself and onto someone or something else. Do yourself a favor, always have at least one other person present when you have a collegial intervention with a physician who has a history of engaging in “behavior that undermines a culture of safety” or, as my colleague likes to say, “behavior that an adolescent does.” The opportunity to make up what happened, including accusations about inappropriate conduct on the part of the Chief of Staff, is greatly reduced when there is a witness.
The second lesson is that complaints or concerns raised by the physician cannot be ignored even if you think there is no substance to them. Ignoring concerns will come back to bite you and it may be in the form of a whistleblower lawsuit. (And we are seeing more and more whistleblower actions.) At the heart of these actions is always an allegation that the physician raised concerns about quality or safety, that the physician was ignored and that the physician was subsequently disciplined for raising the concerns.
So even if you are confident the Chief of Staff would never act inappropriately, follow your Code of Conduct Policy in reviewing the complaint. This means you should meet with the complaining physician and get as many details as possible and then meet with the Chief of Staff. If there was an inappropriate interaction, address it. If the complaint was fabricated, that should be considered a violation of the Code of Conduct.
And the final lesson is to make sure you document the collegial intervention. Concurrent documentation that tells what you did, how you did it, and why you did it will go a long way if there is either an internal challenge or a legal challenge. The documentation is your opportunity to tell your side of the story in a thoughtful, detailed, organized way. It is amazing how often this piece of the puzzle is missing or deficient in court cases.
Join us for The Complete Course for Medical Staff Leaders for a more in-depth review of collegial intervention and tips on how to deal with physicians who engage in disruptive behavior.