Doctor must confront problem employee

A:This is a fairly common problem. When an employee is valued highly by a solo physician, he or she may believe it gives them a license to ignore the office manager and coworkers. Often the problem behavior shows itself in the form of failing to observe practice policies and procedures. For example, the employee may refuse to be re-assigned or redeployed on other work when the "guardian angel" physician isn't around, or may come in late or leave early when that doctor isn't there. Usually, these are technical or patient-care workers who are valued highly by the doctor because they are smart, trained, and skilled at dealing with patients or technical issues.

The problem in these cases often lies with the physician, who doesn't see or just doesn't care about the fallout that the "sacred cow" treatment causes. The physician must conduct the performance or incident review with the problem employee. The practice manager should also sit in on this meeting. The message should be something like this: "You're a great employee and I sometimes wonder what I'd do without you. But when you [list problem behavior] it creates [list negative results] and that's not acceptable here. I would hate to have this come between you and me, and I hate having this kind of incident review. That's why [practice manager] has my complete support on this and I expect you to work cooperatively to ensure that we never have to discuss this again."

Answers to our readers' questions were provided by Judy Bee, Practice Performance Group, La Jolla, California. She is also an editorial consultant to Medical Economics.