THE DISRUPTIVE PHYSICIAN
BY
ALLAN TOBIAS, MD, JD
ISSUE
Some hospital staffs have at least one physician that is
"disruptive" in the smooth running of the hospital or medical staff.
What is meant by disruptive and how is the situation best handled? Due to space
constraints there will be no discussion of sexual harassment.
DIAGNOSIS
Who is "disruptive"? Is it the physician who advocates, even in a
loud manner, for better patient care? Is it the physician who advocates for the
"vocal minority" of the medical staff, the loyal opposition? Although
these physicians may cause consternation to the hospital administration, I do
not believe they fall under the heading of those the medical staff would want to
discipline.
The medical staff bylaws, as reviewed by an advocate retained by the medical
staff who has experience with the physician perspective in the medical staff
bylaws, should be the guide. The reason for the independent review is there is a
potential for a conflict of interest between the hospital and the medical staff,
especially as the medical staff represents the physician’s interests. The
bylaws, rules and regulations or policy should specify in its definitions what
is meant by "disruptive" and define the nexus to quality medical care.
This may be a statement that the physician applying for initial membership or
reappointment will be able to work with others as to not cause adverse patient
care. Vague phrases such as "cooperatively" should be avoided. In all
cases of initial appointment the burden of proof is on the physician to show
their ability to work well with others and not cause a problem with the quality
of medical care. On reappointment the burden would be on the charging party, the
medical executive committee.
Repeated acts of uncontrolled anger as manifested by yelling or other verbal
abuse towards patients, visitors, hospital personnel, other physicians or any
one act of physical abuse toward any person should never be tolerated. This type
of incident would be the underlying tenet of the disruptive physician, their
inability to get along with others as a cause for deteriorating patient care. If
a nurse is afraid to call a physician for fear of being verbally castigated and
a potential for harm to the patient results, this is a disruptive act or verbal
harassment. The main points above are the repeated verbal acts or one single
physical act and the causation element of decreased quality of care. Both must
be present.
If a physician rarely blows up and/or when investigated the incident is
potentially justified, there is no need to proceed further. If a physician sends
multiple letters to the Chief of Staff regarding what he/she perceives as poor
patient care or poor performance by any hospital employee or administrator or
medical staff officer, this is opinion and does not effect patient care either
directly or indirectly. Since this is done via formal channels and there is no
causation, no disciplinary action is required.
DIFFERENTIAL DIAGNOSIS
If a physician is acting unprofessionally as defined by repeated verbal
harassment causing problems with patient care, the medical staff should look to
the underlying reasons. This is especially true if this is a new behavior. There
may be physical as well as mental causes for the behavioral change. Many
physicians, especially in this age of managed care with more requirements and
less income, may have significant stress in their professional or personal
lives. This stress may lead to alcohol or drugs. The medical staff needs to be
aware of the legal aspects of the Americans with Disabilities Act and may need
to hire appropriate independent legal counsel. The new JCAHO requirements
starting in 2001 also address this issue (see www.jcaho.org).
TREATMENT
The Medical Executive Committee needs to establish a well thought out policy
for dealing with the disruptive physician or verbal harasser. The policy should
be disseminated to the entire medical staff for their approval via an insertion
into the medical staff bylaws or rules and regulations. It should also be
distributed to all hospital employees. This policy should include time lines for
investigation and the handling of the disruptive act. Once a policy is in place,
it must be followed. Do not back down if the physician threatens to sue for
antitrust, defamation or other actions.
In the past a senior member of the medical staff and a friend would
informally discuss the problem with the physician. This is probably still the
best first step in the diagnosis and treatment of the individual. A medical
staff wellness or assistance committee, where confidential discussions may take
place, may be the next appropriate referral. This may show the physician is
impaired and therapy may rehabilitate the physician, so the community may not
lose an otherwise good doctor. Even if the physician agrees voluntarily to
obtain help, vigilance and close follow-up must be performed. More formal action
is indicated if the disruptive acts continue. If a physician refuses to meet
with the wellness or other medical staff committee regarding the conduct,
immediate suspension of privileges would be appropriate until a meeting is held
if is believed by the Chief of staff that the potential for repeated disruptive
behavior poses a significant threat of patient harm. If the physician's
behavior does not pose an imminent risk to patient safety, a meeting should be
held by the MEC and a formal peer review should be initiated. To just wait
and potentially not re-appoint the physician at the next reappointment period
would not be adequate since it may be two years hence and would still require a
formal hearing.
Formal action would consist of a disciplinary hearing. The medical staff
needs to have clearly documented and persuasive evidence of repeated disruptive
behavioral acts that placed patient(s) at risk for an adverse outcome. This
evidence, however, should be relatively recent. Actions that happened longer ago
than the two prior reappointment periods may not be relevant to the current
action unless it was part of a continuous string of events.
One hospital consultant believes that if a hospital removes the physician
solely upon disruptive conduct, the physician need not be afforded a "fair
hearing" as defined by medical staff bylaws. Their sample policy goes on to
state that only a single appeal to the board will be permitted. If the board is
unclear whether the conduct was disruptive, they may seek the expert opinion of
an impartial individual experienced in such matters. This policy flies in the
face of the legal definition of due process where the same group is both the
trial court and the appeal board. Although the board is responsible for the
final decision as to who is on the medical staff, this type of unilateral
decision may lead to a significant political backlash by the medical staff and
possible legal action against the hospital.
The formal action against a Licensed Independent Practitioner for quality of
care issues by the medical staff and finally by the hospital board must follow
the rules of due process as outlined by the Health Care Quality Improvement Act
or the equivalent State law and the medical staff bylaws. This means there must
be a notice of all specific charges against the physician and an offer of a
formal fair hearing and appeal processes. Rarely, since disruptive behavior is
something that happens over time, is summary suspension appropriate.
If the physician’s medical staff membership and/or privileges are reduced
or revoked due to the disruptive influence on the healthcare team’s ability to
give good quality patient care and the physician sues, both federal and state
courts have usually sided with the hospital. Several New Jersey courts have
stated that all the hospital needs to establish is "prospective disharmony
will probably have an adverse impact on patient care." An Ohio court of
appeal decision allowed the hospital board to overrule the medical staff and
refuse reappointment on grounds other than professional competence to a
physician who made public comments critical of the hospital. As stated above
these decisions, as well as California and West Virginia decisions that favor
the physician link the questionable behavior to a decrease in quality of care.
If the disruptive physician is a contract physician their contract may be
cancelled or not renewed. There is a split of opinion as to whether these
physicians must be given a formal hearing. Some hospital consultants state that
since only the contract is lost and not privileges, a reportable event has not
occurred and no hearing is necessary. The counter argument as advanced by
attorneys representing the physicians state that since the definition of a
disruptive physician is conduct that adversely effects the quality of patient
care, it is a reportable offense and deserves a full hearing.
In summary, a disruptive physician is usually one who over time and by the
use of verbal harassment causes a disruption and potential for decreased quality
of patient care. These physicians may, depending on the circumstances, be dealt
with in a variety of ways from a friendly discussion to loss of staff membership
and privileges.
DISCLAIMER: Although this article is updated
periodically, it reflects the author's point of view at the time of publication.
Nothing in this article constitutes legal advice. Readers should consult with
their own legal counsel before acting on any of the information presented.
Allan Tobias MD JD is the principal in Allan Tobias MD, JD Healthcare
Consulting & Law, specializing in medical staff and individual physician
legal issues. He may be reached at (925) 935-5517 or altoby@aol.com.