Something unfortunate happened
to a group practice in Edmonton last month: they had to
fire one of their doctors. That was bad enough, now it
looks as though she may sue. The ex-employee has a variety
of grounds from which to choose, suggests the practice
lawyer. She's originally from Indonesia and though she
completed degree requirements in Canada, she could argue
discrimination on racial grounds. Or argue sexism because
she's female. Even sexual harassment can't be entirely
ruled out. The fact that she was incompetent may be hard
to prove, says the legal eagle.
Bringing a new physician into an
established group is never an easy task. There's the
question of how they're going to get along with the
other doctors, the staff and, not least, the patients.
Will the new doctor turn out to be a hard worker? Will
he or she be argumentative and/or set in their ways?
Will they be willing to work nights and weekends as
required? How do they react in emergencies? Do they
have the skills required? Are they pleasant to have
around?
CVs and interviews can tell you
a lot about a person. References can be useful and should
be checked � but sometimes the other party simply won't
tell you the truth � especially if it's negative.
Walking a candidate through the
office, introducing them to staff and arranging for
a meeting with all members of the group helps. In the
end, though, it's difficult to really judge a prospect's
potential until they're on the job. They may be a gift
from heaven. Then again they may not. That's why it's
important to establish a probationary period � three
months is normal � and to rate the physician's effectiveness
over that run-in time.
The Edmonton group did the former
but failed miserably with the latter. Even though every
single member of the group had reservations about the
new doctor, no one said anything. The end of the probation
came and went without a word either from the group or
the doctor. Not until six months after the hire did
it become clear to all members that the new physician
wasn't working out.
The situation could have been easily
avoided had the practice taken care to establish a clear
paper trail on how the new physician was getting along.
Practice consultants suggest that interviews with a
new group member be conducted once a month for the first
three months and quarterly for the first year. These
sessions need not be lengthy but they must be systematic
and written notes or an evaluation sheet is essential.
Here are some of the items you
should cover in such interviews. One suggestion is that
you list the items and rate them on a scale of one to
10. You may come up with a rating system of your own:
A, B, C, D, for example; or the traditional excellent,
very good, good, poor, unsatisfactory.
• Clinical: How are
their diagnostic skills? Treatment skills? Are their
records completed when they should be? Are they filled
in according to practice standards?
• Work ethic: Do they
come in on time? Flexible about on-call hours? Willing
to do what has to be done to get a good outcome? How
do they perform in emergencies?
• Interpersonal: How
are they with patients, staff, other MDs at the hospital
and referring docs? Do they have a pleasant telephone
manner? Do they get along with other group members?
Are they a team player?
• Other: Do they seem
to be in tune with the long-range goals of the practice?
Do they fit into the group culture?
Are they likely to become good and trusted colleagues?
Keep the meetings cordial. Record
your evaluation and any comments you may have. Go over
points where you'd like to see improvement, then file
it away in case you ever need it. In most cases, you'll
never have to look at it again.
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