Cohesive Group Group Culture

Disruptive Physician – You Know Who! (He/She Works for You)

September 9, 2013

I hated taking out the trash.

When I was a kid, my parents’ garbage cans were in a little yard next to the garage. Mondays were “trash day” and that meant that on Sunday night, when I was already dreading going back to school the next morning, I also had to dread taking out the trash. I mean it really stunk. Like old fish. And old chicken. And dog stuff, too.

But I had to take it out.

When you think of a medical group failing, you often think that a competitor crushed them. That’s sometimes what happened. But often the rot started from within — a disruptive or megalomaniacal or bad-mouthing group member.

Benjamin Franklin is said to have quipped that house guests and fish smell after three days. Crappy group members stink a lot faster than that.

Sure, it’s all PC to “counsel” these guys. To tell them how much you love them if only they will toe the line and be good boys or girls and get along with everyone while singing Kumbaya.

Go ahead, try it once. But after that, realize that these people just can’t help themselves. In your group they are a rot that will spread. In some other setting they may be perfectly happy, highly productive good citizens. Do them a favor and get them started on their journey to find their perfect spot: it is somewhere else. Fire them.

The corollary is that you must make certain that your group’s contracts, your employment agreement, partnership agreement or other applicable agreements, create the ability to save your group from this rot.

It’s Sunday night for your group. Time to take out the trash.

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