We all have them, and yes they are our bosses, they are some of the most intelligent people on earth, but man, they can be a challenge at times! Welcome to the island of misfit doctors. You might not have realized it, but your journey has brought you to a magical place, a place maybe where squirt guns don’t shoot jelly, the Charlie-In-The-Box is absent, and your cowboys don’t ride ostriches, but a place that is specially misfit in its own ways.
Please do not get me wrong, I realize that if our doctor/owners were omniscient, we would not be currently employed as we are. I am thankful for every owner physician and employee physician that I have had the pleasure to work with / for and even though they can be a challenge, I have had my share of “unique” ones through the years. Maybe you can see some of your current or past employers in the characters that I am going to portray in this blog. If I omit some, I would challenge you to comment on some of your favorite ones that you have worked for. (As a disclaimer, no doctors that I currently or have worked with in the past have any of the characteristics that I am going to cover. I have just read about them in MGMA postings from other managers!)
First, I think we all have seen the tantrum thrower. Let us just hope that all this person throws is a tantrum. This doctor makes no bones about it that they are boss, they are in charge and if you don’t believe it, they will raise their voice, stomp their feet and fling things until you acknowledge their hierarchy. Nothing brings more recognition of someone’s importance than when they act as a spoiled child. Hopefully, this doctor is not a senior partner who has scared all of his contemporaries into submission. These ones are hard to deal with, but deal with them as you would a child who wants to get their way all of the time. Speak to them in soft tones, get them away from “public” places when they behave that way, and allow them time to vent and calm down. It is best to stay uninvolved during the tantrum and let your senior directors handle the situation(s) once you have documented the problem to the group. If you are in a practice where the owners will not address and take care of the provider who acts in this way, I would suggest that you seek other employment or seek a way to get this doctor off of your staff. If the behavior is extremely egregious, you might consider reporting the physician to the licensing board as an impaired physician. Some states have a way that you can report the physician anonymously. This physician will do nothing but poison morale, drive patients away and give you at a minimum an ulcer or high blood pressure.
Another physician type is the passive aggressive who would never say anything bad to anyone’s face, but seems to have an evil memo or email Tourettes syndrome as it may be; turning into a Mr. /Ms. Hyde at the keyboard when they find a wild hair or something crosses them wrongly. They play in the world of running with believed facts that seldom touch on the reality of a situation. This physician will smile to your face in meetings and be compliant and agreeable to change or to solutions given to problems. Then, once on their own, they communicate to the partners or to you by email or memo how outlandish a solution is or why the decisions made were unnecessary and unneeded. Look out from this lady/guy if they are working remotely or on call late and they come across something that sets them off. Their kind face-to-face demeanor will be stripped away by the power of the keyboard and they will ALL CAPS and quadruple exclamation mark you to death!!!! I have spoken to physicians in the presence of their peers or employees and had the most complimentary and compliant responses from these type physicians only to be floored by an email flurry of angst and fury over their true thoughts on subjects once they had time to ruminate. Handling this personality is not an easy task. I have done my share of email jousting back and forth, only to realize that it made me seem as ridiculously odd as the physician. Usually, this will just escalate the bantering and does no one any good either. Remember, never argue with an idiot – they will bring you down to their level and whip you with their experience! The email slinger is best handled by printing the offensive emails, not acknowledging that you ever received it, and compiling a few of them. Once you have a representative collection, present them to two or more of your shareholders/owners. Point out the lack of professionalism and unneeded written harassment, and you will find that your owners will assist you by ending this activity or at least making it subside for a few months.
Another great character is the “employee’s best friend.” This doctor is always getting involved in office gossip, believes everything that is told to them and always makes the employees feel as though they “have their back.” Their only perception of what goes on in the office is what their medical assistant or nurse wants them to believe. This doctor is really good for tearing apart the morale of an office and undermining the authority of a manager. They give employees false promise that they can make things change unilaterally and sometimes will undermine the very policies that you have established. I experienced a physician going to a group of four employees who worked in an area together, telling each of them that they were the smartest, nicest, and most talented in their position compared to their peers. He then told them since he considered them the “leader” in that work area that he expected them to report directly to him any wrongdoings by their co-workers in that department. Lucky for me, and unlucky for him, one of the employees relayed what was going on to me. Needless to say, this physician wore his trustworthiness very thin from his employees and partners over this stunt. This type of physician can be best handled by presenting their shortcomings to their partners in a meeting, behind closed doors. You as a manager cannot keep this from happening, but you can let the owners and employees know that this behavior is counterproductive to an orderly workplace.
We all have our misfit toys we have been blessed with and I do realize that no employer / owner / physician will be without fault. Even we managers can probably exhibit some of the things mentioned above. The key to handling the misfits well is to be keenly aware of them, understand the potential harm they can do to your practice, and address the abhorrent behavior before it gets completely out of hand. Turning your head to it can only feed the monster and make it stronger.