Conference Coverage

Firm policies help address staff who behave badly




CHICAGO – Strong policies and open communication within a physician practice are key to resolving office conflicts and curtailing bad behavior by staff.

"Clear communication is essential," said Dr. Joseph S. Eastern, who practices dermatology and dermatologic surgery in Belleville, N.J. "Destructive political situations are often rooted in communication failure. Policies are also essential. Predictable conflicts can be prevented if policies have been agreed upon in advance; crises often result when there is no policy in place to address the issue in question."

Alicia Gallegos/Frontline Medical News

Dr. Joseph Eastern discusses how to resolve office politics at the August American Academy of Dermatology summer meeting.

Dr. Eastern and other presenters discussed common challenges that arise in staff environments during the recent American Academy of Dermatology summer meeting. Frequent challenges include employees who chronically leave early, staff members who abuse sick policies, and inappropriate interoffice relationships. Texting and Internet overuse are also growing burdens facing medical practices.

Firm policies that outline acceptable behavior by staff, and potential discipline for policy violations help tackle such difficult situations before they grow out of hand, presenters said.

"Every office should have a formal policy [that limits personal cell phone and Internet use during office hours]," Dr. Eastern said in an interview. "Mine is fairly straightforward: Using office time for personal texting and Web surfing is theft – pure and simple – theft of my time. I make this crystal clear. It is never permissible to steal any office property, least of all our most marketable commodity – office time."

In some circumstances, new rules may need to be drafted or old policies revised. For instance, in the case of employees who start dating. Smaller offices may not have specific policy language that addresses such relationships, said Dr. Seemal R. Desai of the University of Texas Southwestern Medical Center in Dallas and a dermatologist in private practice in Plano. Another challenge that may not be automatically outlined is staff members who constantly seek curbside consults with physicians to ask for personal medical advice. Both issues may lend themselves to consideration and institution of new standards.

Alicia Gallegos/Frontline Medical News

Dr. Seemal Desai

Discuss problems or complaints early with employees in a nonconfrontational way, added Dr. Desai. This could mean a one-on-one chat with a staff member or a conversation with two employees who are in conflict.

"Approach the conversation with a really open attitude to try to hear the concerns," Dr. Desai said in an interview. "Not every situation that at first seems like a negative one, really ends up being that way."

Make sure staff are aware of policies and stick to them, Dr. Eastern notes. The worst way physicians can react to an issue is to ignore it. Ongoing office politics not only can cause tension among employees but also can reduce productivity and affect patient care.

"Sentiments and feelings and themes in an office-based setting can really translate a lot into how you practice," Dr. Desai said "and how successful you are on a daily basis."

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