As humans, we’re primed by evolutionary forces to fear the loss of something much more than we value an equivalent gain.
That’s why many medical group leaders are concerned that market and other pressures will have a significantly negative impact on their group. From competition from hospital-aligned physicians, to the failure of the hospital, to increasing pressure from far better capitalized, venture backed practices, these and other concerns actually do keep you up at night.
But while medical group leaders are keenly focused on the dangers from the outside, there are dangers lurking inside groups, as well, just as dangerous, or maybe even more so.
You recruit Dr. Stacy because of the sterling CV and other credentials. College in Cambridge, medical school in Cambridge (the other one), and trained at an even more famous place at the elbow of a Nobel laureate.
And then six months later, you learn that Stacy might just be a pathological a-hole. Stacy badmouths your group to the hospital CEO. Stacy questions your leadership abilities in the cafeteria, but never in a conference room with you present. Stacy works with your competitor to undermine your group. Stacy screams at nurses. Stacy might even throw scalpels, not as a hobby at children’s birthday parties, but in the actual operating room. Yes, these are all real-life examples of real-life Stacy, an amalgam of Stacies, of course.
It’s important to distinguish your Stacy, the poster child for disruptive physicians, from a simple nonconformist. Nonconformists aren’t trying to take your group down. Nonconformists aren’t conspiring against your leadership or the group’s future. As they say, they simply march to the beat of a different drummer – they didn’t pop out of the same mold as the rest of the group. Nonconformists can easily be contained and even harnessed to the group’s benefit.
But there’s no pH strip or imaging procedure that definitively diagnoses the difference. (Some from former Eastern Bloc countries have hinted that there may be a highly invasive procedure, but that’s another story.)
Fortunately, disruptive physicians leave snail-like trails. Before jumping to the conclusion that your Stacy is a disruptor, pause and question motives at the same time that you’re examining evidence. Is it truly disruptive action that should lead to, perhaps, one warning and then termination, or is it, instead, nonconformity that can be made to be beneficial to your group’s success?
Because wrongful termination claims are far more common than thrown scalpels, it also pays to get legal advice in connection with the determination and, certainly, before any actual termination.
The worst thing you can do is to do nothing. Lopping off a gangrenous toe, after an attempt to resolve it less drastically, is better than letting the patient (or your medical group) die.
