By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
I have never read a Jeff Foxworthy book, and I have never watched more than a minute or two of one of his comedy routines, so my apologies to him in advance.
However, I find his comedy routine about rednecks (or what I know of the little bit I have heard) to be a good vehicle for conveying what might be a joke to many, but should be taken very seriously, especially by one accused of being a disruptive physician.
In my decades of representing physicians, I have encountered cases where false complaints have been generated by the economic competitor of a physician with the medical staff of a hospital, in order to eliminate his competition. I have experienced cases where administrative personnel and nursing staff have conspired to generate complaints against a physician who was too demanding and unpopular with the nurses. I have seen unjustified complaints encouraged against physicians who have demanded only quality treatment for their patients. So it does not surprise me when I am consulted by a physician who claims he or she is the subject of trumped up and unjustified complaints, especially those as subjective as being "disruptive."
Unfortunately, identifying and eliminating the disruptive physician has become a recent goal of many hospitals. This has become a "hot button" among hospital administrators, medical staff leaders and credentials committees.
Being proven to be a "disruptive physician" may lead to adverse action against clinical privileges (resulting in a National Practitioner Data Bank (NPDB) report), action to drop the physician from insurance panels, adverse action by the state medical board, loss of specialty certification, and other consequences.
Types of Conduct That Might Make You a "Disruptive Physician."
According to reported cases and our experience in these matters, you might be labeled a disruptive physician if:
1. You use profanity in the work place.
2. You "yell at" or raise your voice to a nurse.
3. You threaten a hospital employee with having him or her fired.
4. You berate or "put down" a nurse or other staff.
5. You insinuate that a hospital employee is stupid.
6. You throw anything, anywhere in the presence of anybody, in the hospital.
7. You slam down anything (chart, coffee cup, lid to photocopier, etc.), anywhere in the presence of anybody, in the hospital.
8. You knock over anything (gumball machine, lamp, computer, etc.), anywhere in the presence of anybody, in the hospital.
9. You refer to anyone else as fat, stupid, lazy, "dumb blondes" or any other demeaning label.
10. You make sexually suggestive (or sexually explicit) comments and remarks in the presence of anybody else, anywhere in the hospital.
11. If you break anything (including the glass on the photocopier, the television in the doctors' lounge, etc.).
12. If you threaten a hospital employee with filing an incident report against him or her.
13. If you pull down the television set off of the wall in the waiting room and throw it down on the floor breaking it.
14. If you push a gurney into someone else in the hospital knocking her or him down.
15. If you "accidentally" drop a scalpel and it sticks into the foot of the scrub nurse in the operating room.
16. If you accidentally kick a bucket of bloody lap pads and it "accidentally" hits the nurse in the head and cuts her head open in the operating room.
17. If you are an on-call physician and you yell at the nurse on duty when he calls you at home and wakes you up at 4:00 a.m., and tell him not to call you again.
18. If you go to a nurse's supervisor and complain that the nurse is incompetent and should be removed.
19. You throw a surgical instrument "in the direction of" an operating room nurse because she handed you the wrong one.
20. You let it be known that you refuse to refer patients to another medical staff member because you consider him or her to be incompetent.
21. You tell sexually suggestive, racist, discriminatory or off-color jokes in the presence of anyone else, anywhere, at anytime in the hospital.
22. You refuse to work with nurses or technicians on the hospital staff because they are incompetent.
23. You refuse to follow established hospital protocols, policies or procedures, whether written or informal, because you don't have to.
24. When you are confronted with a mistake, a bad outcome, a complaint by staff against you or a request for input on a peer review of one of your patients, you blame the person making the complaint or report, and point out the shortcomings and lack of skill of others on the staff.
25. Physically threatening or merely intimidating others, including by insinuating that something bad might befall them.
26. Bullying or attempting to bully or intimidate others.
27. Passive aggressive conduct like refusing to attend mandatory department meetings, refusing to complete charts, refusing to respond to phone calls and pages, refusing to answer questions of others, refusing to complete forms and reports, advising that it is not your job or that you are not on call any longer.
28. Retaliate against any other physician or hospital staff member who has reported you for violation of the code of conduct or for investigation of an incident.
29. Making negative or derogatory comments about other physicians or hospital staff members in front of any other person, at anytime, anywhere in the hospital.
30. Telling nurses, other staff members or patients that you don't care or don't want to hear what they have to say.
For other examples and a policy statement regarding disruptive physicians, see this Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG).
Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.
The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Tag Words: physician, doctor, discipline, physician complaint, physician report, disruptive behavior, doctor complaint, disruptive physician
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