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Advanced meeting management: Dealing with disruptive physicians during meetings

Medical Staff Leader Connection, May 14, 2008

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Dear Medical Staff Leader,

Dealing with a disruptive physician is difficult enough when you have time to plan for an intervention and have others to help you. But, what can you do when you are confronted by a disruptive physician during a committee meeting?

First, we have to give up the idea that this issue is the chair’s problem. When a physician is disrupting a meeting by turning the agenda to his or her own purposes, the entire committee suffers. Rather than committee members waiting for the chair to fix the problem, it is necessary for members to support the chair’s efforts and work together to keep the unwanted behavior in check.

Typically, a physician becomes disruptive when the committee or its members advocate a position or action that does not fit the physician’s personal philosophies or goals. Many physicians have been able to get what they want through disorderly behavior, so they continue to display it. Individuals who are intimidated by the physician’s behavior and give in inadvertently reinforce it.

It is necessary to take the time to deal with the behavior in order to stop it. In all cases, it is important to speak in a calm voice, make eye contact, listen without interrupting, and keep emotions in check. It may be necessary to limit the time any one physician speaks to one or two minutes at a time. Here are some other steps committee chairs can try:

1. If the committee does not agree with the disruptive physician’s idea or position, point it out. Ask the disruptive physician if he or she believes everybody on the committee should go along with the idea or position even though they do not agree with it. If the physician says yes, ask if he or she would do the same if roles were reversed. 
2. If the committee has time, principle-based negotiation may be effective. This approach is most appropriate when two individuals in a long-term working relationship are in conflict. Ask each person to talk about his or her own principles and uses those principles to find a common ground.
3. Acknowledge the disruptive physician’s position, repeat it back, and ask if you have said it correctly. Continue to ask for clarification until you have repeated it back correctly. Then ask others how they feel about that position or idea and if they could live with it. If they do not agree with the idea, see the first tip.
4. Point out to the physician that others on the committee are not in agreement with his/her ideas and ask the physician for a suggestion as to how his/her position might be communicated to medical staff leaders.
5. If the physician is truly offensive (name calling or threatening behavior), tell the physician that the behavior is unacceptable, and if it continues, you will ask him or her to leave and you will file a formal complaint. If the physician continues to behave unprofessionally, follow through with these actions. In extreme cases, you may need to adjourn the committee and handle the behavioral issue through medical staff disciplinary channels.

When dealing with a disruptive physician, the primary role of the committee member is to speak up, validate the chair’s actions, and follow his or her lead. This can even be done through non-verbal nodding. Failing to support the chair in some way could give the disruptive physician the impression that committee members support him or her.

Committee members can speak up if they do not feel comfortable with the position or idea presented by the disruptive physician and discuss why in a non-emotional manner. They should, however, be sure to listen to the disruptive member’s point of view without interrupting. If the chair does not intervene, a committee member may need to take one or more of the actions above.

Best regards,
Barbara LeTourneau, MD, MBA
Consultant
The Greeley Company

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