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Ask the expert: What does zero tolerance mean?

Medical Staff Leader Connection, July 23, 2008

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When addressing disruptive physician behavior, organizations must understand an often confusing phrase: zero tolerance. Many medical staffs are adopting a zero-tolerance policy with regard to disruptive behavior, but some hospitals are confused about what exactly zero tolerance entails. This confusion is understandable because this phrase has been defined in two ways: strict and less strict.

The strict definition of zero tolerance implies that a single incident of disruptive behavior will lead to corrective action and the physician will automatically lose membership and privileges. The less strict definition of zero tolerance states that disruptive behavior is never justified, and the organization’s first step is to provide feedback to that physician and remind him or her of the expectations set forth in the behavior policy.

If your organization adopts a zero-tolerance policy regarding disruptive physician behavior, be sure to clarify how the term should be applied. This clarification is not only fair to your physicians, but it will likely improve compliance with the policy.

This week’s question and answer are adapted from A Practical Guide to Preventing and Solving Disruptive Physician Behavior by Richard A. Sheff, MD, CMSL and Todd Sagin, MD, JD.

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