You could be a disruptive doctor if you: avoid the disruptive doctor label

I’ve never read a Jeff Foxworthy book, and I’ve never seen more than a minute or two of one of his comedy routines, so I apologize in advance.

However, I find your comedy routine about rednecks (or what I know of what little I’ve heard) to be a good vehicle for conveying what might be a joke to many, but should be taken very seriously, especially by one accused of be a disruptive doctor.

Unjustified complaints?

In my decades of representing physicians, I have encountered cases where false claims have been made by a physician’s economic competitor against a hospital’s medical staff in order to eliminate their competition. I have experienced cases where administrative staff and nursing staff have colluded to generate complaints against a doctor who is too demanding and unpopular among nurses. I have seen unwarranted complaints encouraged against doctors who have demanded only quality treatment for their patients. Therefore, I am not surprised when I am consulted by a doctor who says that he is the subject of invented and unjustified complaints, especially those as subjective as “disturbing”.

Unfortunately, identifying and eliminating the disruptive physician has recently become a goal of many hospitals. This has become a “hot spot” among hospital administrators, medical staff leaders and credentialing committees.

Being proven a “disturbing doctor” can lead to adverse action against clinical privileges (resulting in a National Practitioner Data Bank (NPDB) report), action to remove the doctor from insurance panels, adverse action by state medical board, loss of specialty certification, and other consequences.

Types of behavior that can make you a “disruptive doctor.”

Based on reported cases and our experience in these matters, you could be labeled a disruptive physician if:

1. You use profanity in the workplace.

2. You “yell” or raise your voice at a nurse.

3. You threaten to fire a hospital employee.

4. Reprimands or “puts down” a nurse or other staff.

5. You imply that a hospital employee is stupid.

6. You throw anything, anywhere in the presence of someone, in the hospital.

7. You hit anything (chart, coffee cup, copy cover, etc.), anywhere in the presence of someone, in the hospital.

8. Knock over anything (gumball machine, lamp, computer, etc.), anywhere in the presence of someone, in the hospital.

9. You refer to any other person as fat, stupid, lazy, “dumb blonde” or any other demeaning label.

10. Makes sexually suggestive (or sexually explicit) comments and remarks in the presence of any other person, anywhere in the hospital.

11. If you break something (including copier glass, doctor’s room television, etc.).

12. If you threaten a hospital employee with filing an incident report against them.

13. If you rip the TV off the wall in the waiting room and throw it on the floor breaking it.

14. If you push a stretcher against another person in the hospital and knock them over.

15. If you “accidentally” drop a scalpel and it sticks in the scrub nurse’s foot in the OR.

16. If you accidentally kick over a bucket of bloody sanitary pads and “accidentally” hit the nurse in the head and split her head open in the operating room.

17. If you are a doctor on call and yell at the nurse on duty when she calls you at home and wakes you up at 4:00 am and tells her not to call you back.

18. If you go to a nurse’s supervisor and complain that the nurse is incompetent and should be removed.

19. You throw a surgical instrument “in the direction” of an OR nurse because she handed you the wrong one.

20. Makes it known that you refuse to refer patients to another member of the medical staff because you consider them to be incompetent.

21. Tells sexually suggestive, racist, discriminatory, or off-color jokes in the presence of any other person, anywhere, anytime in the hospital.

22. Refuses to work with hospital staff nurses or technicians because they are incompetent.

23. Refuses to follow established hospital protocols or procedures, whether written or informal policies, because you are not required to do so.

24. When faced with an error, a poor outcome, a staff complaint against you, or a request for information about a peer review from one of your patients, you blame the person making the complaint or report and point out the deficiencies. and lack of skill from others on staff.

25. Physical threats or outright intimidation of others, even implying that something bad could happen to them.

26. Bullying or attempting to bully or bully others.

27. Passive-aggressive behavior, such as refusing to attend required department meetings, refusing to complete charts, refusing to answer phone calls and pages, refusing to answer questions from others, refusing to complete forms and reports, advising that it is not their job or that you are no longer on call.

28. Retaliate against any other doctor or hospital staff member who has reported you for a code of conduct violation or investigation of an incident.

29. Making negative or derogatory comments about other doctors or members of the hospital staff in front of any other person, at any time and anywhere in the hospital.

30. Telling nurses, other staff, or patients that you don’t care or don’t want to hear what they have to say.

For other examples and a policy statement regarding disruptive physicians, see this American College of Obstetricians and Gynecologists (ACOG) Committee Opinion.

Consequences of disruptive medical behavior.

According to an article on the subject written by a medical leader, the consequences of a doctor’s disruptive behavior in a hospital are as follows:

Disruptive physicians undermine morale, decrease productivity and quality of patient care, and cause distress in the work environment, leading to higher employee turnover. A survey found that the majority of nurses believe that disruptive behavior by physicians causes stress, frustration, impaired concentration, reduced collaboration and communication, and potentially negative outcomes for patients. Another survey found that nurses see a direct link between disruptive physician behavior and satisfaction, retention, and quality of the nurse-physician relationship. Other consequences of disruptive medical behavior include disciplinary actions, dysfunctional activities of medical colleagues (eg, coverage, leadership, peer review, referral, etc.), and compromised communication within and efficiency of health care teams. (References omitted).

The doctor’s “disruptive behavior” will be linked to patient safety.

Hospitals and medical staff are being instilled with the idea that a doctor’s “disruptive behavior” undermines patient safety and is a risk to patient care. This will be the basis for supporting the action against the medical staff membership and clinical privileges of a physician in a medical staff privilege action. The state medical board will also rely on it if a complaint is filed against the doctor’s medical license. It will also be the basis for defending a legal challenge if the doctor challenges the medical staff’s action in court. Courts will generally defer to hospital medical staff in such matters and will not want to reverse their decision.

What to do and not to do.

Learn what is considered conduct that exemplifies a “disturbing doctor.” Avoid angry outbursts; they may make you feel better in the short term, but in the long run, you’re doing yourself a disservice. Hold your tongue. Avoid saying anything that might offend you. If you are so weak-willed that you cannot control yourself, you may have a problem.

No one lives in a glass house, but pretend you do. Always think that someone can overhear or monitor what you do or say in the hospital. Everyone is human; everyone has flaws, even you. If you are known as a disruptive doctor, everyone will look for anything you do wrong and find it.

If you receive complaints or reports that suggest you are being labeled a disruptive physician, whether it is informal advice from a colleague or a formal written warning, take immediate action to address the concerns. This may include, for example:

1. Find out about the subject with the articles that appear on the internet.

2. Seek professional advice; maybe you have too much stress or an anger management problem.

3. Seek the assistance of an experienced health attorney; you may be prepared for a later adverse clinical privilege action.

4. Avoid all kinds of behaviors listed above.

5. Respond to the complaint or counseling, but do so with your attorney. You should maintain an even, objective, neutral and non-accusatory tone in your response and not try to point fingers at others. Avoid the temptation to do so.

Disclaimer:Please note that this article represents our opinions based on our many years of practice and experience in this area of ​​health law. You may have a different opinion; you are welcome to it. This is mine. This article is for informational purposes only; it is not a legal notice.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, PA – The Health Law Firm, a Florida professional services corporation, since 1999.

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