Whose Fault Is It?

Whose Fault Is It?

When I am consulted for an issue with a “bad physician,” my first question to the person in charge is:

“Are you prepared to fire this doc?”

Firing used to take many forms, mostly working through the difficult process of medical staff bylaws and rules, appeals and making the case usually to the medical executive committee that actions needed to be taken (if it did).

We would look at the sentinel event, and the history of the physician, the attitude and mindset, remediation attempts, and develop a plan from there. That’s one of the things we do now in the Lifeguard® Program.

Now it is much easier, because they just fire the doc (who’s usually employed and whose severance agreement, if there is one, is usually, “in accordance with the laws of the Commonwealth” with perhaps a statement about a notice period).

The new age of mostly employed physicians has made things much easier.

A primary care friend of mine just got “let go” from a health system after 30 years or so working for them. He just had a medical event, returned to work, and was escorted out a few days later without notice or warning.

When I spoke to him, he said his partner had been let go a few weeks earlier. A colleague of mine had been fired from this same health system a while ago. All escorted out of the building by security in front of patients and staff.

Now the cynical side of me says “there must have been cause” because no one lets a primary care physician go in today’s world without cause, but I’m not sure. I know this doc, he works hard, is honest to my knowledge, and isn’t a bad egg. Yet, the CEO of this system was quoted as calling residents a name (which I won’t repeat) to a public forum, with a mixed audience of physicians, staff and nurses.

So are all the residents that bad? Finally, a surgical colleague took a friend into the office on a weekend and performed a minor procedure as a favor without charge. He got summarily fired as well.

Did all of these physicians perhaps break a rule? Maybe. But what was it? As a medical staff member, there is due process, rules and appeals and a series of procedures which must be followed, unless there is some truly aggravating, serious event that is generally well known.

But in these cases?

Was the offense they committed, if any, deserving of firing – never mind of the personal and professional embarrassment of being escorted out by security or police in front of a waiting room full of patients?

Was it deserving of being fired without notice or warning after years of working for that employer? Who decided that? Did they make the mistake of being employed by the wrong system?

Do you want to work for that system? Should we talk publicly about these events? Hear the system’s side of the story? Are we deserving of that much transparency amongst ourselves? Do you have a similar story?

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