Surprise mtg w/ chief of service and admin. Should I have lawyer present?

[OSman]

So I get this ominous email this AM from the chief of service of my department. Usually very limited interaction otherwise. Email is requesting to set up a meeting with the chief and an administrator, just the 3 of us. I ask about the nature of the meeting and am told it will be in regards to an interpersonal interaction but is otherwise very vague. I can't for the life of me think of what the scenario is... unless I am digging back from months and months ago... nevertheless, it seems strange that they are seemingly being intentionally vague about what exactly it is they want to talk to me about. Makes me nervous some and wanted to gather some thoughts as to if having counsel at my side would be needed.

For full disclosure: I have had one of these meetings before. Long story short it was a 30 minute session titled "We don't care about the details, just admit you were wrong and promise you won't do it again". That too was related to an incident maybe 4-5 months preceding the meeting.

[Random1]

I would not bring a lawyer, but I also would not say much other than I dont recall

[CordMcNally]

No lawyer needed now but I would lean towards you needing one after. Don't admit anything or sign anything.

[FIREshrink]

You need to ask yourself why you've now had two of these situations in your career, and stop letting them happen.

[OSman]

You need to ask yourself why you've now had two of these situations in your career, and stop letting them happen.

This is a reasonable thing to ask me to consider. And believe me, I am always looking inwardly and take as much responsibility as I can. However, the practice of medicine in the hospital setting now is not compatible with a provider who demands care for patients equivalent to that which they'd like to receive themselves. At least that's the case where I work. When those demands for excellent care are perceived as creating "hostile" working environments and no attempt is made by administration to accommodate the providers... all in the name of "Just Culture", not much else one can do other than have these meetings every so often. Obviously an exit is in the works but I need to protect my name/interests while still employed.

[Kamban]

You need to ask yourself why you've now had two of these situations in your career, and stop letting them happen.

I agree. There must be something there for the first meeting to have occurred and now a second one. Unless the chief is a vindictive person, there must have been something there to have triggered these meetings. The most important thing is to be honest to yourself and if needed, seek help. You really need to get all details, don't admit to anything and if needed, seek the help of a psychiatrist if there are issues in that area.

[Sundance]

You need to ask yourself why you've now had two of these situations in your career, and stop letting them happen.

can’t stand these types of posts.

Easy to say for an outpatient psychiatrist who works in a zero stress environment- other physicians aren’t so lucky... and anyone working in a hospital environment especially with docs pulled a million directions with inpatient/outpatient work/critical care/surgery than your potential interactions with random staff are 1000x more frequent and 1000x more likely to be misinterpreted

I’ll always error on the side of giving the doc the benefit of the doubt in today’s ridiculous environment

[Anne]

It sounds like your chief only reaches out when something bad is happening. I think this is crappy leadership on several levels. He/she only sees you at your worst, and doesn’t really have positive interactions with you. The first reaction to a complaint about interpersonal interaction is to jump right to administrator involvement rather than getting your side of the story. Obviously we don’t know the whole story but sounds like a potentially toxic work environment. Toxic work environments where you feel unsupported will lead to people reacting in ways they might not if they were provided adequate support. So I wouldn’t jump to blaming OP to being in this position.

[Marko-ER]

^^^ This ^^^

Not so much about other docs who are in less stressful practice environments, but I wouldn't judge OP without facts.

More to the point for the OP: don't say anything, don't get thrown by any accusations, especially if it is heresay and not in writing. Take notes, or if your state allows one-party consent for recording, consider that if you can be discreet. One thing you also have to remember, they cannot overtly lie or mislead you. Express regret about the situation, but don't admit fault. And yeah, a little reflection wouldn't be a bad thing... maybe you are a bit too inflexible about your practice paradigm, or could be more overtly pleasant (even if that feels fake to you) to mid-levels or junior staff. If you are lucky enough to be in position to work in a small private practice or even work for yourself (ad hoc, as a contractor 1099), maybe that's a better solution. However, beware, that's a double-edged sword too.

[MaxPower]

You need to ask yourself why you've now had two of these situations in your career, and stop letting them happen.

I think there’s a big difference between being sexually suggestive/inappropriate and getting after someone (rightfully) for being a** at their job. There isn’t enough info in the OP, and probably for good reason, to determine which is the case here. If it’s the latter, I don’t find it out of line to demand from others the same effort or expertise one demands from themself, and to let them know when they’ve not met expectations.

[CordMcNally]

can’t stand these types of posts.

Easy to say for an outpatient psychiatrist who works in a zero stress environment- other physicians aren’t so lucky... and anyone working in a hospital environment especially with docs pulled a million directions with inpatient/outpatient work/critical care/surgery than your potential interactions with random staff are 1000x more frequent and 1000x more likely to be misinterpreted

I’ll always error on the side of giving the doc the benefit of the doubt in today’s ridiculous environment

On the flip side to this, the OP said this is because of interpersonal issues and not because of performance issues. In my n=1, the interpersonal interactions that cause sit down meetings like this are typically more frequent than assumed and there's usually something there. We'll never know both sides of the story no matter how much information OP gives. OP looking for other opportunities is smart because I can guarantee the hospital is already planning the exit.

[FIREshrink]

can’t stand these types of posts.

Easy to say for an outpatient psychiatrist who works in a zero stress environment- other physicians aren’t so lucky... and anyone working in a hospital environment especially with docs pulled a million directions with inpatient/outpatient work/critical care/surgery than your potential interactions with random staff are 1000x more frequent and 1000x more likely to be misinterpreted

I’ll always error on the side of giving the doc the benefit of the doubt in today’s ridiculous environment

I assume you meant some other psychiatrist. More than half of my clinical work is as an inpatient and CL psychiatrist. We have the only involuntary psych unit for a four country primary service area, and a contract with the state to take their sickest long term psych patients. We also do ED consults as well as an active, busy CL service to the med/surg/L&D floors. My clinical expertise is in severe and persistent mental illness, addiction, and the neurology-psychiatry interface, meaning I work closely with hospitalists, neurologists, neurosurgeons, and all the ancillary services a hospital provides. We do ECT and esketamine treatments so we interact routinely with PACU staff. And I’ve served in medical staff leadership for over 15 years, meaning I frequently address staff complaints about problem physicians and also unreasonable and unfair staff accusations as a matter of course.

Don’t be defensive. I simply encouraged the OP to ask him/herself a question.

[K82]

I'm the chair of my dept and I would find it very unusual if one of my medical staff brought a lawyer in to a meeting I requested to just discuss a dept concern. Look at it as an informational meeting, you don't have to commit to anything. If they are asking for some sort of concession ask for some time to think it over. Bringing a lawyer would be viewed as an inappropriate and aggressive move.

[fatlittlepig]

this is what i have done my entire career: treat everyone you come across from custodians, physical therapists, discharge planners, nurses, random people moving supplies in the hallway as an equal, and with respect and kindness. bad behavior can't be justified by (i was demanding excellent care for my patients: we all are but we have to behave respectfully and professionally).

[OSman]

I really appreciate everyone's input. I certainly appreciate those who recognize the constraints administration puts on providers regularly and I also appreciate those asking me to look inwards. Someone above mentioned that it is impossible to get all the details out there and that is true. There are probably some details that I am not even aware of, ones that I am sure I will find out soon enough.

Given that it is impossible to get out all the details, I am trying not to bore the group with the story. I guess all I can do is hope this group of colleagues assume the best of me. I am fairly actively involved in the WCI community which I think demonstrates a certain commitment to financial responsibility. As such, I recognize that cavalier and arrogant behavior, "surgeon" like machismo and the like is not something that is tolerated and is more of a financial risk than is necessary. So if you can assume that about me, what would your advice be? There have been some great answers so far and I really appreciate them. Yes I promise to look inwardly and fix what I can but we all know what's going on here big picture and I am sure many are unsurprised by this behavior of hospital leadership.