What if a doctor wanted to speak up to promote better patient care?
It can be difficult under the new Joint Commission guidelines, which casts a wide definition of what a “disruptive physician” means, giving examples like “reluctance or refusal to answer questions, return phone calls or pages; condescending language or voice intonation; and impatience with questions.”
Like any profession, some doctors are indeed jerks. But Doug Farrago wonders if they’ve gone too far, and have intimidated some doctors against blowing the whistle when they observe events adverse to patient care.
Related posts:
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- Whistle-blowing = bad outcomes
- When a disruptive physician isn’t
- Doctors dealing with difficult patients, is it the fault of young physicians?
- The disruptive family
- Billed for a 19-hour ED wait
- What makes doctors doctors
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Do they think there is such a thing as a “disruptive hospital administrator”? Probably not.
Two things: I have a solemn duty to advocate for my patients; and I will never surrender my right to think.
The term “disruptive physician” is intentionally vague. It could be anything that anyone chooses–as in “reluctance” to answer pages (in whose opinion, and how exactly does one define “reluctance”?) Likewise, a “disapproving look”, an expression of exasperation, absolute garbage concepts like “body language” are being given recognition on the same level as real language; something that is utterly subjective and as impossible to prove as it is to defend: “I opine, therefore you are.”
What this is becoming is a very pernicious form of control devised through JCAHO and hospital nursing staffs and administrators to use the power of credentialing, and the dark side of that power, de-credentialing and subsequent reporting to the NPDB of anyone who can be termed “disruptive” which, with these amorphous and endlessly expandable definitions can mean anyone at all.
If the AMA wants to salvage itself in the eyes of what remains of this profession, if we expect to even remain a profession at all, it will fight this in every way possible. The very idea of calling something a “disruptive” is inherently subjective and invites abuse when it becomes the channel for retribution. This is a monster. It really is something that should be killed.
Surely you’ve seen this newspaper series from five years ago:
http://www.post-gazette.com/pg/03299/234499-84.stm
This is curiosity about a theoretical case.
If litigation could take out the JCAHO by a ruinous verdict, would doctors like that or not like that?
JCAHO has found a way to set the health care providers against one another, rather than against the true threat to good patient care.
This is just a way of creating a scapegoat for the disgruntled.
I’d love it. Dream on, I suppose….
Thing is, I don’t see any regulation requiring JCAHO accreditation in the first place. Maybe I’m missing something.
The hospital can just as easily be accdredited by the American Osteopathic Association or the State Health Department as I understand it. We are sick and tired of JCAHO. The hospitals themselves at least say they don’t like JCAHO either.
I don’t understand why they don’t just take their business elsewhere.
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