Question

Dr. D is the director of surgery at Union Medical Center. He has long been recognized for his disruptive behavior and outbursts of anger in the OR. Carol, the VP of nursing, makes an appointment to speak with you (Daniel, the new CEO) about the abusive disposition and mood swings of Dr. D in the OR.

“Daniel, Dr. D has a history of name-calling and berating Roberta, the OR manager, in the presence of her staff. He fails to follow hospital policy and threatens that he is going to get her fired. Roberta has repeatedly spoken to Dr. D several times for his failure to follow presurgical hand-washing technique. His postsurgical infection rate is the highest in the OR. We have spoken to the Infection Control Committee several times about this. They keep telling me that they will talk to him and yet nothing seems to change. Sometimes I think they are afraid of him. The staff is fearful of Dr. D and they have been reluctant to come forward with their concerns. I am new to the hospital and had hoped that we could resolve this without your intervention. However, we do need your help. Dr. D is recalcitrant, mean-spirited, and will not change. Roberta is a hard-working and conscientious supervisor. Today, Dr. D. again told Roberta that he was going to get her fired before the week was out. You know, she is an extremely conscientious nurse with patients being her first priority and is well liked by her coworkers. I went in Roberta’s office earlier today and found her crying. She said she has put up with Dr. D for 5 years and just cannot take his abusive outbursts any longer and has decided to resign her position and leave.”

Daniel responds, “Carol, we are both new to this hospital, and such abusiveness by any physician to any staff member will not be tolerated. I plan to speak to Roberta myself and follow up with the surgeon, and if necessary, the medical board.”

1. If you were Daniel, how would you address this problem?
2. What procedures should be in place to handle disciplinary issues of this nature?

Answer 1

If I am Daniel, I talked to Roberta and reassure her that I will take her complaint and investigate it seriously. I will investigate Dr.D abusive behavior and take necessary measures to prevent the reoccurrence of these kinds of activity in the future. I will take a written complaint and incident report from Roberta to proceed with the problem legally. Next, I will talk with Dr.D directly and discuss his disruptive behavior. I will try to explain the outburst of his behavior and how it affects the relationship with other staff members in the team. Make him aware that he is responsible for his misconduct and the outcomes. This will help to change his offensive conduct.

I will approach the executive committee regarding his disrespect of hospital policies and his misbehave with the coworkers.  Arrange for a meeting whereby the authorized persons can talk with Dr.D. List out the complaints on him and his behavior against hospital policies and procedures. Argue in detail about the adverse effects of his misconduct and the sequence of events. Give enough opportunity to explain his concerns. Identify the issues with Dr.D like depression, pressure, and resolve the problem. Give him a written retaliation policy that has to be followed by him in the surgical unit. Develop a performance improvement plan to assess his behavior in the future. Monitor his behavior for a specific time period to identify the issues and prevent further problems.