When A Physician Lashes Out Part 4: The Confrontation

The story so far: In episode one, renowned surgeon Dr. Cliff D.’s angry outburst at a nurse and a physician colleague during a procedure prompted HR director Joelle K. to investigate. In episode two, she found nurse Janice L. and attending Dr. Gita K. were “walking on eggshells” in the presence of the volatile surgeon, [...]

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When A Physician Lashes Out Part 3: The Dilemma

In episodes one and two of the story, Dr. Cliff D. was overheard shouting at two colleagues during surgery. When HR director Joelle K. carried out interviews and found Dr. D. had ordered nurse Janice L. to remove a retractor and Janice questioned the procedure, prompting Dr. D.’s outburst. After attending physician Dr. Gita [...]

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How to Cultivate Healthy Care Teams and Eliminate Risk

With more and more medical care being delivered by teams made up of physicians, nurses and other professionals, intrateam cooperation and communication are becoming as crucial as diagnostic and treatment skills in giving quality care, maximizing the patient experience and saving lives. One study shows more than 70 percent of [...]

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When A Physician Lashes Out Part 2: The Fallout on the Clinical Team

In the first episode of the story, Dr. Cliff D. was overheard directing loud, hard words to two colleagues during surgery. Someone—we’re not sure who—complained to HR director Joelle K., and she interviewed the participants. What emerged was that Dr. D. had ordered nurse Janice L. to remove a retractor, and Janice was [...]

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A Promising Future: The Millennial Impact on the World of Medicine

There’s been a good deal of attention recently on the graying of the medical workforce, but at the other chronological end, millennials (by some influential definitions, adults born after 1982) are also having a major impact on medicine, constituting as they do, anything from a quarter to a half of physicians in certain [...]

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When A Physician Lashes Out Part 1: The Incident

The nurses in the corridor outside O.R. 6 could hear it, and when they heard it they cringed: the voice of Dr. Cliff D. in full explosion. “You take out the retractor because I tell you to!” Indistinct reply. Dr. D. again, louder: “Oh, for God’s sake!” Another reply, also indistinct. Dr. D.: “Gita, I run this show ‘til we’re [...]

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Can I have a drink when the day is over?

There’s nothing wrong with one or two drinks after work. Or is there? As I write about substance abuse concerns for us physicians, I could have easily started with worst-case scenarios, or cautionary tales. Some of the risks of alcohol use have been known for decades, if not centuries. But what about moderate use? When does [...]

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Appropriate, Inappropriate and Disruptive Behavior by Physicians: Some Official Definitions

When it comes to the behavior of physicians, the lines between what’s appropriate, what’s merely inappropriate and what is genuinely disruptive are not always easy to draw. Here’s how the Model Medical Staff Code of Conduct, developed by the Organized Medical Staff Section (OMSS) of the American Medical Association, explains [...]

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What Does a “Prevention Plan” for Disruptive Behavior Look Like?

Discussing the need to deal with disruptive behavior on the part of physicians, one of the most prominent researchers in the field, H. Alan Rosenstein, MD, writes: "The greatest potential for success in the intervention process is to intervene before a disruptive event actually occurs. Once an event occurs the damage is [...]

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