How to Deal with a Problem Partner
Many physician groups suffer because of a member's deficiencies. The 'problem partner' may have an explosive temper driving patients and referrers away. Or he/she may have become an underperformer, either in terms of clinical quality or work volume. Once in a while the problem partner becomes a threat to the group's very existence as his or her presence kills new-doctor recruiting and generally disrupts the other members' group loyalty.
Yet partners rarely face up to the issue. I recall consulting assignments in which a member's pattern uniformly recognized by his colleagues as undesirable was allowed to continue without even a reprimand. The partners in each case simply refused to confront the errant member.
Confront the Problem
Don't let the problem fester. Unacceptable behavior patterns become perceived as satisfactory beyond question if they are observed and not challenged. This is just as true for a senior physician as it is for a ten-year old child.
One or all the other members must confront the errant partner as early as possible. Keep early confrontation informal and private out of regular group meetings. Your managing or senior member should accept the responsibility to sit down with the errant partner and candidly discuss the situation and everyone's concern including an offer to help. While obviously not threatening expulsion, the leader must make it clear that he speaks for the entire group and that he will put the concern on the group's agenda if things do not change.
Keep a written record of the meeting just as if any other employee were being evaluated. And keep the other partners informed, informally or in the problem member's absence, so the counseling and warning has the "clout" of being supported by the members. I have seen problem partners go on the attack after confrontation, becoming emboldened when they perceive lack of support for the leader's efforts.
If individual, low-key confrontations fail to change things, it's time to take a stronger step. In small groups, this means putting the problem on the agenda for the next partners' meeting. In larger groups, the board of directors or executive committee should slate it for an upcoming meeting. Inform the partner specifically that he/she is on the agenda and that he/she is expected to attend.
Handle the meeting carefully. Either the managing doctor or a designated person should describe the group's specific concerns. These remarks must be well prepared, fair, accurate and respectful- keep tight control over this part of the agenda so all sides remain civil. The confrontation’s purpose is to make the problem partner aware of group concern and desire to help, as well as to warn that the pattern must stop. As with the private evaluations, have the group's secretary keep a written record of the matters discussed.
The Last Resort
As a practical matter, people seldom change their basic personality traits. Some problem partners, struck by their peers' pressure, can and will correct their bad habits; the suggested process will then have succeeded. And some "behaviorally handicapped" partners can be "cured" by remedial treatment. Others, though, will either disregard the warnings or else revert to old traits after a period of effort.
If the partner continues to be a "problem" even after the warning process, take the problem back to the group. Unless the partners are unwilling to carry the issue further something the group's leader should informally have discovered early on reschedule the issue for an upcoming partners' meeting. But this time propose more specific sanctions.
One sanction would be a monetary penalty, such as no bonus or a pay cut, if warranted by your legal contracts. Another, which really should be used more often, is an out-and-out vote to expel the member. Remember this advice: "Sometimes you grow by subtraction!"
Don't Ignore It
Is it worth the bother? Absolutely! If a partner's performance or conduct jeopardizes your group's continuing success, you simply cannot ignore the issue. Recognize early on that dealing with it may lead to a confrontation including a possible traumatic departure which you and your partners must be prepared to accept.
Having been through the issue with a number of groups, I've learned that you are far better off to endure the trauma of confrontation and possible departure than simply to carry on. When your partners almost unanimously privately concede that they would be happier without the member as a partner, that really tells you something critically important. Proceeding in a careful and constructive but decisive manner is then even more useful at the partner level than it is with other layers of personnel management. Get in touch so we can discuss your problem.
Have questions? I’m here to help.