Managing The Difficult Colleague Jeff Morris MD, MBA, FACS: Physician Coach & National Speaker Studer Group

Transcription

1 Managing The Difficult Colleague Jeff Morris MD, MBA, FACS: Physician Coach & National Speaker Studer Group

2 Setting Expectations of Behavioral Standards What is the greatest predictor of future behavior and performance?

3 Setting Expectations of Behavioral Standards So what are the best organizational recruitment predictors? CULTURE

4 Sustaining the culture you desire.. what will determine your success? Success is neither magical or mysterious. Success is the natural consequence of consistently applying the basic fundamentals. Jim Rohn

5 Physicians are More Receptive to Behavioral Standards When They write the Code There is an understood need to be more consistent Standards are a manifestation of a well understood Vision Behavior standards are an expectation -framework for physician training and are included in orientation

6 Creating Behavioral Standards Specificity - determine whether your document will be Physician specific Applies to everyone Compact Assemble aligned leaders and physicians to draft

7 Creating Behavioral Standards Clarity of foundational building blocks & anticipated outcome Consensus on content is mandatory prior to roll out

8 Creating Behavioral Standards Get input during draft process Better to list the things to do rather than what not to do Sometimes less is more Read back and gut response should be: Yes, we should do this and I know what to do

9 Is Everyone On Board? Physicians and the Bus: Some will... Jump on Board Stand at the door Stand10 feet away Who takes up most of your time? Who should get more assistance? Let the air out of the tires

10 Do You Have Any...? CAVE people Consistently Against Virtually Everything ROAD warriors Retired On Active Duty

11 Definitions Difficult: hard to deal with or get on with; hard to please or satisfy; hard to persuade or induce Disruptive: tending to cause disorder or turmoil; tending to destroy the normal continuance or unity Inappropriate: not suitable or fitting for a particular purpose, person or occasion

12 What is Considered Disruptive /Inappropriate? The Obvious Profane or disrespectful language Demeaning or intimidating behavior Sexual comments or innuendo Inappropriate touching, sexual or otherwise Comments that undermine patients trust in physician or hospital Racial or ethnic jokes Outbursts of rage or violent behavior Throwing Inappropriate criticizing colleagues in front of pts. or staff Boundary violations w/ staff, pts, surrogates or key third parties Federation of State Medical Boards, 1998

13 What is Considered Disruptive / Inappropriate? The Obvious

14 What is Considered Disruptive / Inappropriate? The Somewhat More Subtle Inappropriate comments Inappropriate chart notes Unethical or dishonest behavior Difficulty working collaboratively with others Repeated failure to respond to calls Inappropriate arguments with patients, family, staff, or other physicians Resistance to recommended corrective action Poor hygiene, slovenliness Federation of State Medical Boards, 1998

15 Dealing with Unprofessional Behavior - Guided Interventions Improvement & Eval Plan + Accountability Aggregated Data Presented by Peer or Authority Informal Intervention Cup of Coffee Conversation Failure to Respond Restriction or Termination Reporting No Change Pattern Persists Apparent Pattern Single Incident Unprofessional Level 3: Disciplinary Intervention Vast Majority : No Issues Level 2: Authority Intervention Level 1: Awareness Intervention Mandated Issues Boundary, sub abuse, impairment Hickson GB et al. Acad Med 82(11);2007: Slide 15

16 Managing Behavioral Standards Define the expectations that they are to perform and achieve. 16

17 Taking Conversations from Difficult to Doable: 3 Models to Master Tough Conversations Say what needs saying successfully. This book explains why we shy away from critical conversations and provides the tools and tactics to navigate them confidently and effectively. What You Will Find Inside: How to structure and execute a conversation with a peer, direct report, boss, or physician How to implement each of the three powerful conversation models detailed in the book so that the outcome is a winwin How to respond when a person s behavior doesn t change after a difficult conversation To take a look inside this new book, visit the Fire Starter Publishing bookstore.

18 Stub Your Toe Conversation

19 Stub Your Toe Conversation An informal conversation during which you bring your observation / experience of troublesome behavior to awareness

20 Stub Your Toe Conversation Key steps With whom? When appropriate When inappropriate Follow-up Documentation

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22 Impact Conversations Beth Keane

23 Impact Conversations

24 Impact Conversations Describe the behavior Describe the impact Indicate the desired change Get an explicit commitment

25 Impact Conversations Key steps With whom? When appropriate When inappropriate Follow-up Documentation

26 Ultimate Commitment...

27 It always seems impossible until it is done. Nelson Mandela

28 EVALUATION REMINDER: We want your feedback to get better. Please remember to take the session evaluation. Thank you! Insert Your Photo Here Jeff Morris MD, MBA, FACS: Physician Coach & National Speaker Studer Group

29 Next Presentation: Physician Goal Setting & Feedback Jeff Morris MD, MBA, FACS: Physician Coach & National Speaker Studer Group