Disruptive Physician Behavior the Objective Thesis

(Singh, 2007)

E. Conflict Resolution

Conflict resolution is inclusive of several specific steps which are stated to include:

(1) Fact finding: Identify all individuals who are affected by the behavior and get complete history about the patterns of physician's behavior, preferably in writing (assuring the complainant about confidentiality). Identify probable risk to all affected individuals including patients and the organization itself. Make sure and document this step.

(2) Meetings: meeting comes when manager has got the most complete knowledge about the issue and its consequences. It is advised to plan for the meeting beforehand. Set the agenda for the meeting, communicate about the issues and how it is affecting staff and the workflow, and what is expected or desired. listen, listen, listen to the physician (sometimes just listening itself resolves the issue or gives you an idea about what to do). Stay focused on the issue, don't send mixed messages and don't bluff. Tell them about the consequences of non-compliance and make sure to follow up on it. Again, make sure this is documented.

(3) Resolution: the result of the meeting is either resolution or call for action. Both the parties may understand each others perspectives and deficiencies during the meeting and make a commitment to make necessary changes. Document this step just as in the first and second step.

(4) Follow up: is important to ensure adherence. Formulate a process or system to ensure adherence to the agreed resolutions and behavior monitoring of the physician. It is also the most important step to start the next one -- Formal Investigation. This should also be documented.

F. Methods of Conflict Resolution

Methods of conflict resolution are stated to include the following steps:

(1) Coaching: One of the most effective ways. In this method you establish a rapport with them and get their attention. Then you need to communicate to them about the issues and expectation in the way they understand and make an effort to make them feel like both the parties are concerned about each other and they are partners in change. It should seem like a collaborative process in which management is acting out of care and concern but at the same time make sure that you tell the hard truth. If possible give them a plan for change or necessary steps of change and help them through the process;

(2) Mediating: is one of the other most often used techniques. The mediator is the third party, frequently medical director of the organization. In this scenario both parties agree voluntarily to come to a mutually acceptable solution or agreement and are dedicated to follow up or deliver on that;

(3) Referring: to the person higher up in hierarchy or board or the PHP. You can also refer to counselors or executive coaches to acquire inter-personal skills; and (4) Disciplining: This is the last resort undertaken when everything else fails or if it is a very serious unpardonable incident.V. Analysis

The disruptive physician is just as any other individual a human being with their own set of problems and life stressors. The disruptive physician results in costs to the hospital both in terms of revenue and workers which there incidentally are a shortage of presently. Rather than lose patients and nurses it is noted in the literature reviewed in this study that there are actions that may be taken to resolve the conflict created by the disruptive physician.

VI. Conflict Resolution Recommendation

Arising from this study is a recommendation that hospitals develop a conflict resolution action plan and toward this end the conflict resolution action plan described in the work of Singh (2007) and reviewed in this work is the plan recommended to address the problem of the disruptive physician in the hospital setting.

VII. Reflection

Healthcare workers are under a great deal of stress due to the demands of the healthcare field and when a disruptive physician is added to their heavy workload it is often just too much for these healthcare workers to effectively cope with and is more than they should be expected to cope with during the course of their working hours. It is critically important that today's hospitals have a conflict resolution action plan for dealing with such problems and the disruptive physician.

Bibliography

Bartholomew K. Ending Nurse-to-nurse Hostility. Marblehead, MA: HealthPro, 2006.

Brown D. At med schools, a new degree of diversity. Washington Post; June 1, 2007:A1.

Early P, Soon C, Soon a. Cultural Intelligence: Individual Interactions Across Cultures. Stanford University Press, 2003.

Ford, John (2010) Contextualizing Disruptive Behavior in Health Care as a Conflict Management Challenge (nd) Conflict Management Practice Notes. Online available at: http://johnford.blogs.com/jfa/2009/03/contextualizing-disruptive-behavior-in-health-care-as-a-conflict-management-challenge.html

Glick T, Rizzo M, Stern B, Feinberg D. Neurologists for patient safety: where we stand, time to deliver. Neurology 2006;67:2119 -- 2123.

Gray J. Men and Venus in the Workplace. New York: HarperCollins Publishers; 2004.

Kohls LR, Knight JM. A Cross-Cultural training Handbook. 2nd Edition. Boston Intercultural Press, 1994.

Lanacaster L, Stillman D. When Generations Collide. New York: Harper Collins Publishers, 2002

Lehmann, Christine (2003) Disruptive Physicians Get Makeover in Hospital Therapy Program. Psychiatric News 20 Jun 2003. Online available at: http://pn.psychiatryonline.org/content/38/12/12.2.full

O'Daniel, Michelle (2008) Professionalism, Managing Disruptive Physician Behavior. Neurology 2008;70:1564-1570. Online available at: http://www.neurology.org/cgi/content/full/70/17/1564?cookietest=yes

Peterson B. Cultural Intelligence: A Guide to Working with People from Other Cultures. Boston: Intercultural Press, 2004.

Rosenstein a. The impact of nurse-physician relationships on nurse satisfaction and retention. Am J. Nurs 2002;102:26 -- 34

Singh, Vikas (2007) Disruptive Physician -- Special Report, Department of Health Policy and Administration, University of Arkansas for Medical Science. Online available at: http://works.bepress.com/cgi/viewcontent.cgi?article=1016&context=vikas_singh

Taylor SL, Lurie N. The role of culturally competent communication in reducing ethnic and….....