Disruptive physicians: Is this an HR or MEC issue?

Disruptive physician behavior can be more than a headache for the medical team, it can greatly lower staff morale and compromise patient care. Addressing this behavior head-on is imperative, experts said, but knowing which route to take is not always clear.

Mark Peters

Physician leaders may wonder: When is this a human resources (HR) issue and when should the medical executive committee (MEC) step in?

The answer depends on the circumstances and the employment status of the physician in question, said Mark Peters, a labor and employment attorney based in Nashville, Tenn.

“There are a couple of different considerations when deciding how, or more accurately who, should address disruptive physician behavior in the workplace,” Mr. Peters said in an interview. “The first consideration is whether the physician is employed by the health care entity or is a contractor. Typically, absent an employment relationship with the physician, human resources is not involved directly with the physician and the issue is handled through the MEC.”

However, in some cases both HR and the MEC may become involved. For instance, if the complaint is made by an employee, HR would likely get involved – regardless of whether the disruptive physician is a contractor – because employers have a legal duty to ensure a “hostile-free environment,” Mr. Peters said.

The hospital may also ask that the MEC intervene to ensure the medical staff understands all of the facts and can weigh in on whether the doctor is being treated fairly by the hospital, he said.

Jeffrey Moseley

There are a range of advantages and disadvantages to each resolution path, said Jeffrey Moseley, a health law attorney based in Franklin, Tenn. The HR route usually means dealing with a single point person and typically the issue is resolved more swiftly. Going through the MEC, on the other hand, often takes months. The MEC path also means more people will be involved, and it’s possible the case may become more political, depending on the culture of the MEC.

“If you have to end up taking an action, the employment setting may be a quicker way to address the issue than going through the medical staff side,” Mr. Moseley said in an interview. “Most medical staffs, if they were to try to restrict or revoke privileges, they are going to have to go through a fair hearing and appeals, [which] can take 6 months easily. The downside to the employment side is you don’t get all the immunities that you get on the medical staff side.”