After one particularly egregious incident with an end-stage COPD patient (someone whom I had also treated over time), I respectfully told our medical director that I no longer would accept this physician as my collaborating MD. The medical director verbalized understanding and himself became my collaborating MD. Some time after this, I was informed that my position was “being eliminated,” and the clinic went on to hire three new physicians. I had been the first, and last, NP to work in this clinic. This physician’s behavior has been common knowledge throughout our large health care system for nine years.
You can imagine the amazement we all have about how this situation has persisted. There seems to have been no one who could deal as Dr. Onieal did with the physician in her editorial: calling him on his behavior. It is widely known that the highest-ranked administrators in the health care system are fully apprised of the situation. So why does it continue? My husband ruefully jokes that this MD must have incriminating pictures of these administrators! Apparently, not even the prospect of running afoul of the Joint Commission has any impact.
It pains me deeply to think of the many emails like mine you are no doubt receiving. We will continue to lose talented, experienced, and compassionate nurse practitioners, and other professionals, because of unchecked “conduct unbecoming” on the part of our abusive coworkers. It seems as though all we can do at this point is to refuse to enable the process, and resign our positions. But this deprives our patients as well as ourselves. There are clearly many ethical as well as practical problems stemming from workplace abuse and how it is, or is not, handled.
Thank you for showcasing this prevalent yet underreported situation in health care. The longer it continues, the more we all lose.
Marla Bass, DNP, APRN, Woodbury, MN
In my 31 years of hospital nursing (10 as an APN), I have witnessed many episodes of unbecoming conduct by physicians toward patients and staff. To summarize: I was recently targeted and verbally threatened on several days by a physician known to act inappropriately in front of “scared staff” and patients. I documented his disruption of our daily business and his verbally hostile bullying and “called” for witnesses to the situation. I reported this to my director.
After his behavior continued—and believing that my credibility and integrity superseded my fears of reporting him and possible retaliation—I reported the physician to human resources. He has been reported several times before, and other staff members came forward after I stood up to him.
I took a work-related medical leave of absence due to the situation. An investigation was completed. I returned to work with a stipulation to have my position or schedule changed so that I would not have to have any contact with this physician. I was informed that he had been given a behavior modification “contract.” There is an ongoing investigation secondary to his continued inappropriate behavior.
However, I am tired of watching physicians get away with this sort of behavior for years before any serious action is taken. If any employee of the organization behaved the way this particular physician does for one minute, they would be fired. I think moving toward hospital-employed physicians or practice mergers will help, as then they will be held to the same standards that all employees are, and organizations will no longer have to allow physicians to get away with this time and time again before they have enough data to suspend, expel, or not credential a physician.
Sara Neyers, MS, APN, C, Mays Landing, NJ