I offer on-site consultations and education to medical practices, hospitals, and health care systems that are challenged by physician behaviors that interfere with a culture of safety. These individuals are sometimes said to be having “professionalism problems” or "anger management problems" or are called “disruptive physicians" or "impaired physicians.”
Physicians with these types of problems exist in almost every healthcare setting and are extremely costly in terms of the time required to deal with them. They can take up time from the chief medical officer, department chairperson, human resources department, legal department, and peer review committees. In addition, they often have low productivity, low patient retention, and low patient satisfaction. In the end, they require special time and attention from the rest of the healthcare team in order to manage them.
I offer expert consultation to the organization to understand the underlying causes of the behaviors and can make an independent evaluation, report, and plan for action to help find an appropriate path forward for the individual and the organization.
I am available to personally work on-site as needed or to conduct the consultation in my office. I generally interview several of the stakeholders, including administration representatives and coworkers. I provide detailed written reports and follow-up as needed. Since I serve as a consultant to the organization, all information is shared with the organization.
Using an independent consultant is vastly different from curbside consultation with one of the members of the medical staff, such as a staff psychiatrist. I have been working with physicians and consulting to organizations for 20 years. I have consulted on physicians with professionalism and behavioral problems, anger management problems, personality disorders, psychiatric issues, and addiction. I have the skills to work with a division or department to manage the consequences of unprofessional behavior on the productivity and the culture of the department.
Since 2008, JCAHO has required that healthcare systems create policies to detect and deal with physician behaviors that interfere with a culture of safety.
I specialize in assisting health care systems to:
- develop processes to detect behaviors that interfere with a culture of safety
- devise interventions and education to help change the culture of departments and divisions struggling to manage challenging staff behavior.
Nationally, about 10% of physicians exhibit problematic behavior and it is likely that every organization or practice has doctors with problematic behaviors.
When surveyed, the vast majority of physicians report that they have witnessed unprofessional or unsafe behavior in at least one colleague, in the last 30 days. Often, one unprofessional doctor, if not dealt with immediately, can signal to others around him or her that such behavior is acceptable in the department and gradually, others may be at greater risk for unprofessional behavior.
Unprofessional behavior has obvious consequences for clinical care and patient satisfaction. In addition, unprofessional behavior with patients has been shown both to make patients more inclined to initiate litigation, and to decrease morale and performance in the rest of the team along with an actual increase in the risk of complications from medical care.
Although behaviors that interfere with a culture of safety can be highly challenging for a department and medical staff, the majority of physicians with these behaviors, depending on the severity, can be remediated and safely return to practice as before. It has been proven time and again that it is of the utmost importance to retain an experienced, independent consultant when the organization values the physician and wishes to remediate and retain them.
David Steinman, MD