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EPtalk by Dr. Jayne 5/25/17

May 25, 2017 Dr. Jayne 2 Comments


I’d wager that 99 percent of people who have worked with me wouldn’t classify me as a delicate flower, a special snowflake, or someone who is easily offended. I’ve spent the majority of my academic and professional careers in male-dominated fields and have been on the receiving end of sexual and other harassment.

I take issue, however, with organizations that pay lip service to diversity and inclusiveness when their actions say otherwise. Not everyone has a thick hide, however, so when one of my consultants reported that a client was behaving badly, I wanted to gather some evidence.

I spent a good chunk of today listening to recordings of conference calls, which unfortunately demonstrated everything my consultant said was going on and more. Boorish and unprofessional are the mildest adjectives I could come up with as I prepare my letter terminating our professional relationship.

We had been hired to assist a small practice with their workplace dynamics and to help try to correct some issues they’ve had with staff turnover. Our first onsite assessment revealed countless sports and gambling analogies (in nearly every conversation) that had a tendency to alienate members of the staff who might not find stories about betting at the dog track to be amusing or in harmony with their religious beliefs. Based on our findings, we agreed that you can coach your way through a lot of that, and we persisted because they seemed willing to participate in making things better.

Many of their issues were process related, with staff being frustrated by lack of policy and procedure documents that would explain why they were constantly being told by one partner or another that what they were doing was wrong. My consultant worked on getting an employee handbook together and at standardizing their office workflows knowing that reduced variation would make things less stressful and perhaps increase retention. She did some stakeholder assessments that identified many of the issues being attributed to a couple of the physicians, with the rest of the providers being highly respected.

The two physicians who needed the most work have been abrasive to my team, but within the realm of what the team felt they could handle. Plus, they were treating both male and female consultants badly, so we chalked it up to boorishness rather than discrimination.

Over the past few weeks, though, the behavior has escalated. One consultant (who happens to be a man) never complains about anything, so I knew that there was more to the story when he described some of the behavior as “unseemly.” We discussed strategies for discussing it with the managing partners and office manager and that we’d monitor how things were progressing.

At this week’s management meeting, however, some comments were made about certain office responsibilities being “women’s work” and one of the managing physicians told a young female physician to stop bringing her complaints to office meetings and maybe bring some cookies or cupcakes instead. It may have been meant in jest, but I doubt he would have said the same to a junior male physician. In fact, after reviewing the recording of the meeting, he didn’t say anything of the sort to a male peer who was also complaining. He listened to the same types of concerns from one while chastising the other for hers.

It wasn’t just that. The meeting ranged all over the place, with outright mocking of the regional dialect of one staff member and some snarky commentary about various ethnic groups and international political conflicts. There was also some talk that could be graciously referred to as “locker room talk” that was pretty rough.

Listening to some of the banter, all I could picture in my mind was an episode of “The Three Stooges.” Some of the comments were so bad and so highly inappropriate that I felt like the physician in question was trying to sabotage himself. I don’t care who you are, or where you are, or what your beliefs are, some things are just not OK and there are lines that should not be crossed.

I transcribed some of the dialogue and scheduled a call with the head physician to address it. Although he was apologetic, he wasn’t willing to address his partner and essentially told me that since Dr. Lawsuit-Waiting-to-Happen was the top biller and we needed to stop making waves.

At that point, I let him know that I was unwilling to put my team in a hostile environment and that we were done since the entire point of the consulting engagement was to help them get to the root of (and hopefully fix) their office turnover issues. If he wasn’t able to assist with the process, there was little more for us to do. He seemed to take it in stride, said he understood why I was canceling our agreement, and asked me to send a formal written termination notice so he could release us from the rest of the engagement.

It was at that point that I realized the extent of his partner’s bullying. He knows he has a problem and he knows he’s not ready to take on his partner, so he is going to go along with it. I hope he comes to his senses before they get slapped with some kind of lawsuit, but I’m not holding my breath.

For practices struggling with the transition from fee-for-service to value-based care, or dealing with shifting payments and increasing patient responsibility, or all the other pressures, having a physician behave like this is the last thing they need. You need your office running as a finely-tuned machine. But until they’re willing to address it, or let someone else address it, they’re going to get what they get.

Like I said, I’m not easily shocked, but this guy took the cake (regardless of whether a man or a woman baked it). I didn’t have the opportunity to shadow him with patients, but I wonder how he is on the other side of the exam room door and why patients continue to flock to him. He has to have some redeeming value, but after this week I am challenged to figure out what it might be. It makes me more grateful to be in my current practice situation, where this sort of nonsense would never be tolerated.

Since most of us can’t fire our colleagues or co-workers when they act like this, how does your organization handle boorish behavior? Email me.

Email Dr. Jayne.

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Currently there are "2 comments" on this Article:

  1. And this is how it propagates all the way up to the Executive branch of our government — nobody says “no”. Nobody puts their foot down. Everybody puts money ahead of basic decency. People say they care, but they don’t care enough to take a little dent in their profits to do anything about it. The rest of us suffer for it, unfortunately (do you really think that doctor, who demonstrably believes women are inferior animals, treats his female patients with the same dignity and respect he treats his male patients?)

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