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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A P R I L 2 0 1 5
Short-term thinking correctly calculates the pain that disciplinary
action will bring. In the long run, though, the cost of a disruptive sur-
geon can chase much more money out the door. Disruptive docs
impact working relationships, trigger inappropriate retaliatory action
and teach others that the facility either doesn't enforce its rules or
sanctions their poor behavior.
That's why it's important to keep an eye on everyone's professional-
ism, documenting instances of inappropriate behavior and all action
taken to correct it. If you conduct annual or other periodic employ-
ment reviews, make sure that those reviews are consistent with the
rest of your actions with respect to behavior.
When corrective action is necessary, carry it out immediately. In the
case of action pertaining to the medical staff bylaws, make sure it is in
complete compliance with their procedural requirements.
Time to terminate
The politically correct solution to disruptive physicians is a counsel-
ing intervention telling them how much you appreciate them and
imploring them to toe the line. You can try that, but the hard truth
may be that the disruptive doc just can't help himself and termination
is the only way to end the fallout on your business.
When it's time to terminate, adhere to the procedures laid out in
your medical staff bylaws, employment agreements or other contrac-
tual provisions. It's extremely important that you apply these policies
consistently among your surgeons and staff.
Document everything: the precipitating events, who said what when
and where, the counseling efforts. Be as detailed as possible. Make
sure you have a witness to your termination actions.
Condition any extra-contractual payment, such as severance pay
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