Physicians and Professional Behavior Management Strategies: A Leadership Roadmap and Guide with Case Studies
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One of the most difficult tasks physician leaders regularly face is managing and mitigating unprofessional physician conduct complaints from patients, colleagues, nurses, and staff. Navigating the process well is usually a trial-by-fire exercise for most. Newly appointed physician leaders, especially, are nervous and uncomfortable confronting these issues with their colleagues.
Physicians and Professional Behavior Management Strategies aims to assuage those concerns and instill confidence by providing practical advice and guidance on managing disruptive behavior with real-world case examples and in-depth discussion on the process.
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Case examples include:
Sexual harassment
Physical aggression
Substance abuse
How to have difficult conversations and conduct meetings with proactive follow up
Complementing the case discussions are strategies to reduce and mitigate disruptive behavior.
Physician leaders often lack formal training on how to “manage” physicians engaged in unprofessional behavior. There are professional, personal, and legal pitfalls, and everyone engaged in the process is uncomfortable. Through Dr. Matthew Mazurek’s leadership positions, he has had the opportunity to conduct dozens of investigations of unprofessional and disruptive conduct from the mundane to the serious. He offers practical advice and guidance on managing disruptive behavior, description and analysis of personal traits and disorders of disruptive physicians, and strategies to reduce the incidence of these behaviors.
The Joint Commission, recognizing the need for hospitals and medical staffs to intervene, released a statement on how disruptive behavior harmed patients and lead to medical errors.
Physicians and Professional Behavior Management Strategies, through a variety of case examples, gives readers a roadmap on how to recognize and manage chronic disruptive behavior instead of looking the other way.
About the author
Matthew J. Mazurek, MD, MHA, CPE, FACHE, FASA, was born and raised in Fresno, California, and earned his Bachelor of Arts in English, magna cum laude, at California State University, Fresno. He attended medical school and completed anesthesia residency at the University of California, San Francisco.
He was a partner in private practice for 12 years with Southern Arizona Anesthesia Services, P.C., and served as both chair of anesthesia and chief-of-staff at St. Mary’s Hospital in Tucson, Arizona. He also held the position as medical director for Envision Physician Services and Sanford Health in Bemidji, Minnesota, and served on the board of directors for the Minnesota Chapter for the American College of Healthcare Executives.
His interest in leadership led him to pursue completion of his Master’s in Healthcare Administration as a distinguished scholar at Colorado State University-Global as well as CPE and FACHE certification through the American Association for Physician Leadership and the American College of Healthcare Executives. More recently, he was designated Fellow of the American Society of Anesthesiologists (FASA). He has held numerous positions as adjunct assistant professor providing clerkships and rotations for medical students, residents, and CRNA students. Currently, he is assistant professor in the Department of Anesthesiology at the Yale School of Medicine, dedicating his time to teaching, writing, and research.
Contents
- Introduction
- The Joint Commission Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety
- Behaviors that undermine a culture of safety
- Root causes and contributing factors
- Existing Joint Commission requirements
- Other Joint Commission suggested actions
- Chapter 1: History of Disruptive Behavior
- Chapter 2: Definition of Disruptive Behavior
- Types of Physician Disruptive Behaviors
- Passive Disruptive Behaviors
- Passive-Aggressive Behaviors
- Aggressive Behaviors
- Consequences of Disruptive Behavior
- High Turnover and Low Morale
- Patient Safety
- Economic Impact
- Non-Action Risks
- Chapter 3: Codes of Conduct, Bylaws, and Committees
- Chapter 4: Know Yourself: Your Emotional Intelligence Quotient (EIQ) and Behavior
- Chapter 5: Determining Your Leadership Style
- Defining Leadership
- Democratic Leadership
- Autocratic Leadership
- Laissez-Faire Leadership
- Strategic Leadership
- Transformational Leadership
- Transactional Leadership
- Coach-Style Leadership
- Bureaucratic Leadership
- Servant Leadership
- Chapter 6: The Process of Investigating a Professional Behavior Complaint
- Be Curious
- Talk with Parties Involved and Witnesses
- Gather Evidence
- Discuss and Plan
- Conduct a Professional Behavior Meeting
- Disposition and Action Plan
- Chapter 7: Case Examples
- Sexual Harassment Behavior
- Case 1: A Love Letter
- Case 2: The Off-Handed Comment
- Case 3: Working After Hours
- Title VII
- The #MeToo Movement and One Medical System’s Response
- Inappropriate and Abusive Physician-Patient Relationships
- Passive-Aggressive Behavior
- Case 1: I’m Late. So What?
- Case 2: Bad Jokes at a Bad Time — All the Time
- Case 3. I Hate My Job and St. Anywhere Sucks
- Case 4: He Will Not Answer His Pager
- Physical Aggression and Assault
- Case 1: Should I Call the Police?
- Case 2: Operating Room Rage
- Violence in the Healthcare Setting
- Drug Diversion and Impairment
- Case 1: Missing Drugs
- Case 2: The Impaired Physician
- Passive Behavior
- Case 1: A Mountain of Unfinished Charts
- Patient Complaint
- Case 1: The Doctor Told Me I Am Fat
- Physician Denigrating Another Physician
- Case 1: Dr. S Is Incompetent
- Case 2: Consequences of Doing Nothing
- Social Media Pitfalls
- Disruptive Physician Leaders
- Chapter 8: Avoiding Pitfalls: The Legal Minefield
- Due Process and Fair Hearings
- Legal Counsel’s Role and When to Seek Counsel
- Human Resource’s Management and Role
- State Medical Boards and the National Practitioner Databank
- Hospital Administration’s Role
- CEO’s Role
- Chief Medical Officer’s Role
- Medical Executive Committee’s Role
- Board of Directors’ Role
- Chapter 9: Personality Types and Personality Disorders: Behavioral Impact and Management
- Personality Traits and Profiles of Disruptive Physicians
- Personality Disorders and the Disruptive Physician
- Chapter 10: Rehabilitation of the Impaired Physician
- Drug and Alcohol Use Disorders
- Deciding Whether to Refer a Colleague to a Physician Health Program
- Physician Health Programs
- Chapter 11: Preventing Physician Disruptive Behavior
- Effective Communication
- Managing and Minimizing Drama in the Workplace
- Environmental Factors and Stress
- Physician Specialties and Disruptive Behavior
- 360 Feedback and Performance Evaluations
- Conflict Management
- Case Example
- Preventing Sexual Harassment
- Creating a Just Culture
- High-Reliability Organizations and Disruptive Behavior
- Chapter 12: Physician Burnout: Impact on Behavior
- Chapter 13: Moving Forward: Leadership Investment Strategies
- Chapter 14: Conclusion
- Appendix
- Sample Report and Disposition Form
- Anywhere Hospital Professional Conduct Report and Disposition Form
- Professional Conduct Policy Examples
- Employed Physician Example
- Mixed Medical Staff Conduct Policy Example
