QUESTION:        We are finally reviewing our conduct policy after a number of years, and in the policy we define unprofessional conduct with a few broad categories, such as abusive or threatening language, throwing an object, or inappropriate physical contact.  Is this what you recommend?

ANSWER:            First, it is fine to have broad categories, but we recommend that those categories include specific examples.  For instance, “abusive or threatening language” is fine, but it should be further reinforced with examples, such as “abusive or threatening language, e.g., belittling, berating, and/or non-constructive criticism that intimidates, undermines confidence, or implies stupidity or incompetence.”  It could also be language that is “degrading, demeaning, or condescending.”  This makes it clear that “abusive or threatening language” is more than just yelling/screaming, etc.

For example, unprofessional behavior also means:

• refusal or failure to answer questions regarding patients, return phone calls, or respond when on call for the Emergency Department in a timely manner;
• intentional misrepresentation to Hospital administration, Medical Staff leaders, or others in an attempt to avoid responsibility for an action taken;
• retaliating against any individual who may have reported a quality and/or behavior concern regarding a practitioner;
• repeatedly failing to renew legally-required credentials prior to expiration;
• inappropriate medical record entries impugning the quality of care being provided by the Hospital, another practitioner, or any other individual;
• inappropriate access, use, disclosure, or release of confidential patient information.

The point is to make the list as specific and exhaustive as possible (but even so, still include language stating “including but not limited to” before the list).  This will help Medical Staff leaders tremendously because those leaders can point to a specific category/example without having to resort to interpretation of the language and trying to convince others that this category does really include that behavior.

Finally, we recommend that these polices be called “professionalism” policies, not “conduct” policies to reinforce that all practitioners conduct themselves in a professional and cooperative manner.

For more on this topic, please sign up for the upcoming
Grand Rounds audio conference
“Professionalism Policy — Key Elements”
on April 2, 2019 from 1:00 pm to 2:00 pm (Eastern time)
presented by: Lauren Massucci and Phil Zarone