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quickly become a question of dollars vs. ethics. It's a tough spot, but
you can relieve the problem by having a firm, clear written policy on
how to handle these instances. This policy should have a step-by-step
procedure on how you treat disruptive surgeons and employees that
includes handing out warnings, mandatory counseling and, finally, ter-
mination or revocation of privileges.
Empower staff to speak up
You may have a misbehaving doc in your facility right now —
but if your staff isn't empowered to speak up, you may never know.
Make sure you and all facility leadership sets a tone that encourages
and welcomes employees to speak out if they feel someone is acting
inappropriately.
If an employee does come to you with a complaint about a physi-
cian, make sure you thoroughly investigate, hear both sides and don't
automatically chastise the staff member for "tattling" on a high-vol-
ume doc. You should instead instill a sense of ownership in your staff.
In the example above, if a staff member had seen and voiced con-
cerns about the insulting doctor before this case, the whole thing
could have been prevented.
Take a step back and cool off
In one of the recorded insults, the anesthesiologist talks about
how she's fed up with all of her "annoying" patients. How she handled
her feelings may have been completely wrong, but it does bring up a
good point about what can happen when providers feel burnt out or
frustrated.
Staff and surgeons deal with a large number of patients every day —
some of whom may be hard to please or frustrating to work with.
Stress to staff and surgeons that if they feel themselves losing their
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