Dr. Johnson said that sometimes dramatic action, such as pulling clinical privileges, must be taken quickly when a physician is being abusive or incompetent. “My experience has been that overwhelmingly these individuals say there’s nothing wrong. And they want to just move straight forward. So you have to stop them,” he said.
Explore This IssueApril 2019
Dr. Healy said it was important to remember that revoking clinical privileges is a “large, consequential event,” likely involving notification of state regulators and the specialty’s certifying board.
But more modest steps can sometimes be appropriate. Amelia Drake, MD, professor of otolaryngology-head and neck surgery at the University of North Carolina-Chapel Hill, pointed to Vanderbilt University’s Patient Advocacy Reporting System (PARS) and Co-worker Observation Reporting System (CORS) as a program that uses a softer approach when possible. “The first intervention’s usually a cup of coffee; you send in one of your peers to talk [to the colleague],” she said.
“Listening is the important thing, not so much talking,” Dr. Shapshay said. “I think you could probably get the diagnosis just as you would by taking a medical history. The differential diagnosis in this case would include impairment from substance abuse as well as organic causes such as dementia and brain tumor.”
Thomas R. Collins is a freelance medical writer based in Florida.