Coordinating patient care improves quality of care, efficiency. Interview by Therese Droste.
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Medical leaders need to understand that attending to quality of professional life issues includes dealing with the insidious costs and stress associated with disruptive physician behavior. The disruptive physician or professional undermines practice morale, heightens turnover in the organization, steals from productive activities, increases the risks for ineffective or substandard practice, and causes distress among colleagues. Physician executives need to help reduce or prevent this behavior and develop accepted systems in which to manage, confront, and rehabilitate the person labeled "disruptive." Suggested strategies to consider in developing a system include: (1) Defining reasonable and competent interpersonal behavior; (2) educating in interpersonal skills; (3) evaluating interpersonal skills; (4) developing disruptive policy; and (5) assessing, confronting, and rehabilitating.
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This author finds it curious that for a long time, whenever I have tried to explain what an agent relationship is, everyone understands the concept with ease. "It's common sense," they usually respond. Nonetheless, it is curious to note to what point agent relationships are ignored by those persons having managerial responsibilities in the majority of businesses in any industrial or service field. We use this statement by the author to introduce the fundamental purpose of this article. Probably, once having read it, any professional would have a clearer idea about such important concepts (in order to realize how costs function and how they are generated inside a health organization) as uncertainty, agent relationships or asymmetrical information. Using a British Airways flight as a comparison, it will be difficult not to understand these terms in their practical applications to the health field.
You've watched them comfort colleagues, defuse tense situations, and take the heat from tough bosses. You've seen them step in to ease the pain during layoffs and change programs. Who are they? The authors call them toxic handlers--managers who voluntarily shoulder the sandness, frustration, bitterness, and anger of others so that high-quality work continues to get done. Toxic handlers are not new. They are probably as old as organizations themselves. But there has never been a systematic study of the role they play in business. In this article, the authors introduce the role of toxic handlers, explaining what they do and why. Managing the pain of others is hard work. Toxic handlers save organizations from self-destructing, but they often pay a high price--emotionally, professionally, and sometimes physically. Some toxic handlers experience burnout; others suffer far worse consequences, such as ulcers and heart attacks. The authors contend that these unsung corporate heroes have strategic importance in today's business environment. Effective pain management can--and does--contribute to the bottom line. No company can afford to let talented employees burn out. Nor can it afford to have a reputation as an unhappy place to work. The authors offer practical advice for managers and organizations about how to support toxic handlers--before a crisis strikes. The role of toxic handler needs to be given the attention it deserves for everyone's benefit, because the health of employees is a key element in the long-term competitiveness of companies and of society.
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Physician executives face low to mid-level intensity conflicts, day-to-day issues and problems associated with pressures and changes in the health care environment. Such conflicts can be sorted on the basis of relationship, duration, and intensity. The authors apply the five major modes of conflict management--competition, avoidance, compromise, accommodation, and collaboration--to specific scenarios taken from their work in health care and suggest guidelines for managing conflicts with peers, supervisees, and authority figures. Thorough preparation and a portfolio of skills build flexibility through the conflict management process. In part 1 of this article series, the authors presented the conflict management checklist, a diagnostic tool for assessing conflict in organizations.
Managing workplace conflict is one of the most important, stressful, and time-consuming tasks faced by today's physician leaders. In Part 1 of this article series, the authors describe how to assess an organization's interpersonal dynamics. True change comes from interventions that help an organization to become a positive interpersonal culture, one that fosters cooperation and collaboration. Part 2 offers seven steps to solving the disruptive physician problem: (1) provide protection to complainants; (2) listen, empathize, and avoid communication triangles; (3) confront offenders with data, authority, and compassion; (4) if needed, get outside help; (5) offer workplace training and experiences that foster positive relationships; (6) follow-up; and (7) practice what you preach. The self-assessment and intervention guidelines discussed in this series of articles can help physician executive move beyond struggling with episodes of conflict to shaping stress-resilient medical organizations.
Various methods of alternative dispute resolution have gained wide acceptance in general commercial disputes. With the ever-increasing commercialization of the healthcare industry, many participants are examining ADR as a means of resolving disputes in this area as well. This Commentary provides an overview of the two most prevalent forms of ADR (arbitration and mediation), and discusses ongoing legislative, judicial, and industry activities that will guide the application of ADR in the healthcare arena.
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