Handling Challenges with a Difficult Doctor

 
Working with a Dr with
Difficulties
 
TIMELINE
 
PRINCIPLES
 
Be fair to both sides as it is likely there are facts you do not know:
Follow Trust guidance, use HR expertise
 
Avoid constructive dismissal
What do you want your endpoint to be?
 
What is best for patients, dept & that person
 
Confidentiality
 
But ensure those who need to know do in order to avoid undermining
the interventions you are using
 
Drs specifics- who is available for advice?
 
HR
 
Responsible Officer – GMC
 
What tools do you have?
 
MSF – person to choose who asked. Can be used to disprove a
general problem, too
 
ES / CS – College Tutor & TPD now available if trainee
 
PSU - if trainee
 
Occ Health – self-referral vs management referral
 
TO Consider
 
Risks to patients
  
Underperforming Drs
  
Not fitting in with system & processes
  
Interpersonal skills
  
Burden on colleagues
If you need time off sick, you need time off sick. Cover can be arranged
 
Risks to Dr
 
Continued deterioration
 
Insight or guilt – eg asking to stay late, may not be in best
interests
 
Should not be doing extra or later shifts at risk to normal shifts
 
 
Risks to Others
 
Driving
 
Colleagues left with unexpected rota gaps
 
1. Importance of having everything in writing
 
Cannot act on hearsay & rumour, or unless something happens
 
Must have proof
 
Accumulation of concerns may start small
 
Not witch-hunt / bullying. Have to keep that person at the centre
 
Leadership
 
2.Importance of clear plan
 
eg Lateness  - report to senior
 
Everyone understands acting together – no mixed messages /not
being undermined.
 
Not punitive
 
3. DOCUMENTATION
 
Minimises comeback. Can demonstrate being fair
 
Same format & reason as clinical notes
Especially if lack of insight
 
4. Often multiple areas of concern
 
Clinical , reliability / teamworking
 
ePortfolio
 
5. Is this a Dr with difficulties / Dr in difficulty
 
SUMMARY
 
Principles applicable to many other situations
 
Curriculum
Prioritisation of patient safety
  
CC7
  
NTS
Team working & patient safety
  
CC8
Communication & co-operation with colleagues  CC15
Personal Behaviour
   
CC24
Medical Ethics & confidentiality
  
CC17
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In dealing with a doctor facing various difficulties and behavioral issues, it is crucial to follow principles of fairness, confidentiality, and effective communication. Utilize available resources such as HR guidance, MSF feedback, and support from colleagues. Consider risks to both the doctor, patients, and colleagues, and maintain a clear, documented plan to address concerns and ensure the well-being of all involved parties.

  • Doctor Challenges
  • HR Guidance
  • Communication
  • Risk Assessment
  • Conflict Resolution

Uploaded on Sep 14, 2024 | 0 Views


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  1. Working with a Dr with Difficulties

  2. TIMELINE FEB Didn t turn up for regional event hosted by own Consultant said was there when challenged. Didn t work the night shift Time owed to dept paid back MAR Late When challenged about being on time, said working elsewhere Reporting to senior when arrives APR Multiple concerns raised by nurses Distracted behaviour, disappearing concerns re mental health raised Not seeing patients asked to. Failing to self-care Sent home sick several times by senio Informal meeting Occ Health referral Time off JUN DNA Occ Health review letter written but received by dept 3/52 later Further instances of lateness. Provable that reason was not true Formal letter from Consultant colleague raising concerns, times & dates provided Formal meeting with HR present AUG Changeover. Dr pursued alternative career

  3. PRINCIPLES Be fair to both sides as it is likely there are facts you do not know: Follow Trust guidance, use HR expertise Avoid constructive dismissal What do you want your endpoint to be? What is best for patients, dept & that person Confidentiality But ensure those who need to know do in order to avoid undermining the interventions you are using

  4. Drs specifics- who is available for advice? HR Responsible Officer GMC What tools do you have? MSF person to choose who asked. Can be used to disprove a general problem, too ES / CS College Tutor & TPD now available if trainee PSU - if trainee Occ Health self-referral vs management referral

  5. TO Consider Risks to patients Underperforming Drs Not fitting in with system & processes Interpersonal skills Burden on colleagues If you need time off sick, you need time off sick. Cover can be arranged

  6. Risks to Dr Continued deterioration Insight or guilt eg asking to stay late, may not be in best interests Should not be doing extra or later shifts at risk to normal shifts Risks to Others Driving Colleagues left with unexpected rota gaps

  7. 1. Importance of having everything in writing Cannot act on hearsay & rumour, or unless something happens Must have proof Accumulation of concerns may start small Not witch-hunt / bullying. Have to keep that person at the centre Leadership 2.Importance of clear plan eg Lateness - report to senior Everyone understands acting together no mixed messages /not being undermined. Not punitive

  8. 3. DOCUMENTATION Minimises comeback. Can demonstrate being fair Same format & reason as clinical notes Especially if lack of insight 4. Often multiple areas of concern Clinical , reliability / teamworking ePortfolio 5. Is this a Dr with difficulties / Dr in difficulty

  9. SUMMARY Principles applicable to many other situations Curriculum Prioritisation of patient safety Team working & patient safety Communication & co-operation with colleagues CC15 Personal Behaviour Medical Ethics & confidentiality CC7 CC8 NTS CC24 CC17

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