• E-mail
• Print
• RSS

Ask the expert: In the case of a disruptive or impaired physician, how many people should be involved in an intervention?

Medical Staff Leader Connection, December 9, 2009

Want to receive articles like this one in your inbox? Subscribe to Medical Staff Leader Connection!

The first intervention is collegial and only one person should carry it out. However, if the physician displaying disruptive behavior is particularly combative or litigious or if the medical staff leader anticipates significant resistance, it may be wise to have two people present.

Subsequent interventions are less collegial, so it is wise to have a second person present, whether it is for a show of strength or merely to have a witness. Any more than two people can create a hostile environment and detract from the success of the intervention. Only at a final warning, with a potential appearance in front of the medical executive committee, would be it appropriate to have more than two people.

Generally, the department chair should conduct the first and second interventions unless there is a potential conflict of interest or unless he or she is not a strong leader. When the disruptive physician is recalcitrant, is a high admitter, or has significant influence within the medical staff, it may be more appropriate for the chief of staff to perform the intervention, usually in conjunction with the vice president of medical affairs. The board chair may also participate in the delivery of a final warning when the disruptive physician is especially difficult.

This week’s question and answer are adapted from Medical Staff Leaders’ Practical Guide, Sixth Edition, by William K. Cors, MD, MMM, FACPE, CMSL; Mary J. Hoppa, MD, MBA, CMSL; and Richard A. Sheff, MD, CMSL.

Want to receive articles like this one in your inbox? Subscribe to Medical Staff Leader Connection!

• E-mail to a Colleague
• Print
• RSS
• Archive