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

[MPMD]

It is very hard to make an intelligent comment here since no except the OP knows what we are really talking about. I was a department chief at my hospital for a few years. A less formal watch out meeting would involve just me and the doc. A behavioural issue could be discussed or a clinical concern could be expressed. If the meeting involved me and an administrator in the "principal's office" then something was egregious or repetitive. My advice is to not bring a lawyer to this initial meeting. I would not record it either. I would try to remain calm. Do not become hostile. Find out what the problem is. Fact find. If false claims are being made then defend yourself with facts. Depending on what you find out you may need a lawyer. It is possible this is not as bad as you think. There are physicians and administrators who seem to enjoy using their powers over employed physicians. Please report back about the meeting.

second plug not to record the meeting.

even in a one party consent state i think that would be a little nuts.

also keep in mind that secretly recording* a meeting like this (especially since we think there is at least a possibility that the OP lacks insight into what caused the problem) could very much be a double-edged sword. imagine if your boss calmly spells out an action plan to you based on carefully documented patterns of behavior and you agree and then don't follow it. being able to whip out that recording isn't going to help you later on down the road, and concealing the recording (while unlikely to ever be found out) would be illegal in a lawsuit.



* fwiw i have never recorded any meeting, ever, under any circumstances secretly or otherwise and have a hard time thinking of when i would recommend that someone did so

[MPMD]

The offer is my current salary. I've just been negotiating buy in terms to the practice which is now down to 6 months. So really my intent was to make this move regardless. At this point all I care about is maintaining a positive relationship at the hospital so I can still operate there and making sure I don't end up having to report things for board and licensure renewal. Do remediation plans require this?

if you are definitely leaving the job then don't sweat the meeting except as a learning opportunity. definitely do not bring an attorney or ask other people (you mentioned an NP) to get dragged into this.

[Tim]

WBD is not perfect, but he consistently gives advice that follows a basic premise in problem solving.
Cause/action -> result -> desired outcome

Never does he criticize directly an individual/organization. The focus is always on the action or behavior, not the individual.

Whether paid by the hospital or in private practice with privileges there, the interactions have created issues. His suggestion is wise, it is not placing fault on either party or the administrator. All great people! Because you personally have some role in this friction, what personal style might change to get the desired outcome?
Wildass guess is to take a look at how you address correcting things. Focus on the action or lack thereof, not there person. You don’t have to be negative or positive about them personally.

• Order wasn’t followed -> complication->another surgery

Johanna’s situation can be avoided. How the nurse was subsequently handled might give her emotional satisfaction, but the goal is that the physician addressed the issue.
For the physician, nurse and future patients no additional surgery is required.
Friction in relations significantly limit the ability of team members to communicate. You want more communication and to be approachable.

The introspective comment by WBD will payoff regardless of this meeting. Note, it was not about you personally, it was about your specific actions. Ways you can achieve desired results.

[billy]

* fwiw i have never recorded any meeting, ever, under any circumstances secretly or otherwise and have a hard time thinking of when i would recommend that someone did so

You've luckily never met my former boss. History of cursing, lying, demeaning people and threatening lawsuits left and right for anyone leaving. I knew this beforehand (having been lied to and demeaned over the phone before my decision to resign) , and live in a one party state, so I recorded my final meeting with her. Not only was there unprovoked foul mouth intimidation, threats of making my last 60 days there miserable (actual quote), and threats of lawsuits, but also she blatantly violated FMLA in her ramblings. I for sure let the other senior partners know that I taped that meeting. Years later when they finally tried to kick her out as CEO and everyone sued each other, they asked me for the tape of the meeting to review- I said no unless you subpeona me. The partners knew she was doing this for years, and allowed it to happen. But I am certain the knowledge that I taped a meeting with the boss not only sounding horrible but also admitting to violating federal laws saved me from having to fight a frivilous lawsuit or having her potentially scaring off my future job prospects. Thankfully her reputation had permeated to other groups so they all dismissed anything she would say anyway, but I did not know that at that time.

For the record, i do not think OP is in the same boat as I was, so no, I wouldnt record this meeting.

[SerrateAndDominate]

You've luckily never met my former boss. History of cursing, lying, demeaning people and threatening lawsuits left and right for anyone leaving. I knew this beforehand (having been lied to and demeaned over the phone before my decision to resign) , and live in a one party state, so I recorded my final meeting with her. Not only was there unprovoked foul mouth intimidation, threats of making my last 60 days there miserable (actual quote), and threats of lawsuits, but also she blatantly violated FMLA in her ramblings. I for sure let the other senior partners know that I taped that meeting. Years later when they finally tried to kick her out as CEO and everyone sued each other, they asked me for the tape of the meeting to review- I said no unless you subpeona me. The partners knew she was doing this for years, and allowed it to happen. But I am certain the knowledge that I taped a meeting with the boss not only sounding horrible but also admitting to violating federal laws saved me from having to fight a frivilous lawsuit or having her potentially scaring off my future job prospects. Thankfully her reputation had permeated to other groups so they all dismissed anything she would say anyway, but I did not know that at that time.

For the record, i do not think OP is in the same boat as I was, so no, I wouldnt record this meeting.

Based on the understandably limited information provided, that drove my suggestion. I'd be very hesitant based on bylaws and, of course, the state laws. I guess my viewpoint is coming from trying to resolve a tenant situation and discuss obvious damages caused by the tenant. The co-signing father had every excuse in the book, and he admitted several lease violations over the phone. While my intent was to resolve things quickly and fairly without getting into a lawsuit, I knew it would have been for my protection to record that conversation and did. Now, it will be used in a lawsuit. Clearly different circumstances, but I feel it's worth OP considering if allowed. There seems to already be a level of distrust between OP and the admin. I'd go the recording route over a lawyer route.

Either way, hope this all ends up well for OP and appropriate insight is done by all parties

[OSman]

Since I know I am leaving... any reason NOT to submit my 60 day notice right before the meeting? A few details still to be worked out with the place I am going to but they are all minor issues and things I can stop negotiating and just accept as is if need be.

[VentAlarm]

Since I know I am leaving... any reason NOT to submit my 60 day notice right before the meeting? A few details still to be worked out with the place I am going to but they are all minor issues and things I can stop negotiating and just accept as is if need be.

I think it may leave a bad taste in their mouth. What if it’s a relatively minor misunderstanding? Then something at the new job doesn’t work out. Don’t burn bridges.

Also, under no circumstances should you interact with the nurse (I assume nurse) in question outside of the minimal cordial interaction required to do your job. Any sideways look to a person prone to file complaints will be seen as hostile and retaliation even if the intent and tone are 100% respectful.

[Zaphod]

Since I know I am leaving... any reason NOT to submit my 60 day notice right before the meeting? A few details still to be worked out with the place I am going to but they are all minor issues and things I can stop negotiating and just accept as is if need be.

Yes if you leave under investigation of any size, it is reportable on licensing etc....forever.

Lots of good advice on this and discussions on the reality of employees. Especially at big institutions they take some things very seriously, usually if it involves residents or junior staff, being a terrible person but in admin as well? nbd. In these situations even a misunderstanding by someone due to their plain ignorance can get you in hot water.

Its just as MPMD outlined, whether or not its how it should be, that is how it is and failure to recognize it is a problem for you. And as Hatton mentioned, you too often have scenarios where admin enjoy disciplining doctors, this is even more so in the setting of personality clashes.

[DrSam]

Since I know I am leaving... any reason NOT to submit my 60 day notice right before the meeting? A few details still to be worked out with the place I am going to but they are all minor issues and things I can stop negotiating and just accept as is if need be.

I'm a little torn on this one. If in your shoes, I very well might attend the meeting with a signed letter of resignation on me. If things start going south in the meeting, you find yourself on the receiving end of unreasonable disrespect, etc., you could smile and keep your cool and simply hand them the letter at that point. Might serve as a popoff valve of sorts to prevent you saying something you regret, etc.

[Marko-ER]

I'm a little torn on this one. If in your shoes, I very well might attend the meeting with a signed letter of resignation on me. If things start going south in the meeting, you find yourself on the receiving end of unreasonable disrespect, etc., you could smile and keep your cool and simply hand them the letter at that point. Might serve as a popoff valve of sorts to prevent you saying something you regret, etc.

I might be more tempted to do that if pandemic wasn't an issue and could travel or take my sweet time with transition into a new job over 6 months. Right now, with how things are as long as the OP is not miserable, stick it out and if anything be ultra-pleasant leave everyone with a solid last impression.

[ChicSkiier]

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 had a good colleague who is considered one of the nicest and hard-working and goes extra mile get reprimanded from chief of hospital because he was doing emergency procedure in ER (line placement etc for ICU pt there) and then when biohazard and sharps container was full, threw stuff away in the next patient room (curtained room I think) and it was in a VIP pt and he complained.. My friend got a lot of heat for that. Fair?

[Dusn]

This thread should be retitled, “reasons to reach FI”

[MaxPower]

I think it’s interesting, in reading this thread and in a couple of personal experiences where I have been “called to the principal’s office,” how far the pendulum has swung in blaming physicians before even finding out what went on. In olden days, it seems like doctors could do whatever they wanted and no discipline was meted out. Neither are good, we just happen to be practicing in a time where blame is assigned and then we figure out stuff on the back end.

The head of anesthesia at one of the hospitals I work at called me out to administration once for doing an “inappropriate case” on Easter. The email got sent to the nurse manager of the OR and the medical director of the OR, as well as my supervisor, before I even heard about it. The case was a BKA in a diabetic vasculopath who had come in septic a couple of days prior. My partner had done an emergency through ankle amp to stabilize him, and basically dressed the tibia hanging out the end of his leg with damp kerlix and Ioban. So the guy was sitting on the floor with his tibia hanging out of his leg, and when the swelling and erythema finally settled down I booked him for a BKA. The fact that it happened to be on Easter was inconsequential in my mind. Could it have waited until Monday? Probably. Was it better for the patient to have surgery when he did. I absolutely think so.

The second time was when I got called at the end of a case to evaluate a nec fasc patient. I was supposed to do a hip fracture next but was between the ER and ICU evaluating and getting the patient ready for surgery, so I had my PA go tell the hip fracture they were getting bumped. Some pre op nurse thought it was inappropriate to have the PA do that (having no idea what I was doing at the time), so she reported me to the nurse manager of the OR (same one) and the medical director of the OR (different MD), as well as the CEO of the hospital! So as I’m getting ready to do this nec fasc case, my boss/head of my group calls me to find out what is going on, so I tell her the story. She was beside herself that it had gotten this far, but no one had even bothered to find out what was actually going on and just assigned blame with minimal details.

Yet we are just supposed to sit idly by and take it, or let people disregard orders to the harm of patients? Not all of us practice in Mayberry or Lake Wobegone...

[StarTrekDoc]

I think it’s interesting, in reading this thread and in a couple of personal experiences where I have been “called to the principal’s office,” how far the pendulum has swung in blaming physicians before even finding out what went on. In olden days, it seems like doctors could do whatever they wanted and no discipline was meted out. Neither are good, we just happen to be practicing in a time where blame is assigned and then we figure out stuff on the back end.

These types of cases of looking back on efficiencies of holiday staffing costs drive me nuts.

When it comes down to someone's life/limb literally and being reported for perceived lack of urgency or cost effectiveness; I politely rebuttal that I stand by my medical decision and if you'd like to be notified at time of decision to review and override, I'd be happy to contact you on the holiday and document answer (or more likely than not answer as inability to reach for comment) in the chart with name and recording.

[VentAlarm]

I think it’s interesting, in reading this thread and in a couple of personal experiences where I have been “called to the principal’s office,” how far the pendulum has swung in blaming physicians before even finding out what went on. In olden days, it seems like doctors could do whatever they wanted and no discipline was meted out. Neither are good, we just happen to be practicing in a time where blame is assigned and then we figure out stuff on the back end.

The head of anesthesia at one of the hospitals I work at called me out to administration once for doing an “inappropriate case” on Easter. The email got sent to the nurse manager of the OR and the medical director of the OR, as well as my supervisor, before I even heard about it. The case was a BKA in a diabetic vasculopath who had come in septic a couple of days prior. My partner had done an emergency through ankle amp to stabilize him, and basically dressed the tibia hanging out the end of his leg with damp kerlix and Ioban. So the guy was sitting on the floor with his tibia hanging out of his leg, and when the swelling and erythema finally settled down I booked him for a BKA. The fact that it happened to be on Easter was inconsequential in my mind. Could it have waited until Monday? Probably. Was it better for the patient to have surgery when he did. I absolutely think so.

The second time was when I got called at the end of a case to evaluate a nec fasc patient. I was supposed to do a hip fracture next but was between the ER and ICU evaluating and getting the patient ready for surgery, so I had my PA go tell the hip fracture they were getting bumped. Some pre op nurse thought it was inappropriate to have the PA do that (having no idea what I was doing at the time), so she reported me to the nurse manager of the OR (same one) and the medical director of the OR (different MD), as well as the CEO of the hospital! So as I’m getting ready to do this nec fasc case, my boss/head of my group calls me to find out what is going on, so I tell her the story. She was beside herself that it had gotten this far, but no one had even bothered to find out what was actually going on and just assigned blame with minimal details.

Yet we are just supposed to sit idly by and take it, or let people disregard orders to the harm of patients? Not all of us practice in Mayberry or Lake Wobegone...

Yes, this culture of shoot first and ask questions later makes me nuts. Filing a complaint before a face to face conversation is inappropriate and should be take as seriously as the complaint itself.

“Nurse so and so, you think the doctor did this wrong. He or she has vastly more experience than you, but we’re happy to hear your side of the story first. Did you ask him or her about it? If not, do you really think this is important enough to waste all of our time because you are afraid of asking him or her about it??”