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Take a direct approach with disruptive physicians

Credentialing Resource Center Connection , June 27, 2003

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Dear Credentialing Colleague:

What action should a physician leader take when a medical staff member shows disdain for reasonable medical staff and hospital rules and thinks nothing of violating them?

The answer is painfully simple. First, the hospital's chief executive officer (CEO) should sit down with the physician leader and the physician in question to review the rules. There should be no discussion; no listening to excuses. The physician leader and CEO should explain the rules and inform the physician that future violations will result in specific corrective action.

If the physician continues to ignore the rules, physician leaders should make their warning more official. They should confirm the rules in a letter to the offending physician, state the consequences of the next confirmed infraction, and provide positive reinforcement if possible.

After delivering this letter, any single confirmed infraction of reasonable rules should result in automatic action.

The bottom line: When faced with this kind of situation, physician leaders shouldn't procrastinate. Medical staff services professionals (MSSPs) can do their part by reporting to leaders--in a constructive, professional manner--medical staff members' rule infractions and other unacceptable behavior.

Don't hope the behavior will change, and don't leave the issue to the next person who will fill your role. Seize the day, take a deep breath, and wade right in. MSSPs should encourage physician leaders to take the direct approach. They may be surprised by how effective it turns out to be.

That's all for this week,

All the best,

Hugh Greeley

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