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Disruptive Physician Attacks Weaponized Against Doctors

Comic image of a disruptive physician
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Disruptive Physician Scenario - A Trap for the Unwary

The disruptive physician attack is a weapon used against doctors.  Classically, a disruptive physician scenario involves a doctor whose behavior negatively impacts the workplace environment, patient care, or the ability of other healthcare professionals to perform their duties effectively. Here’s a detailed look at such a scenario:  However, sometimes the most innocent matter can be used against the doctor.  Here is a nightmare scenario based upon cases we have handled for doctors.  Note our choice of picture for this blog.  In our experience "disruptive physician" claims are usually as over the top and absurd as the photo.  However, this does not mean that the cases just go away.  The unfortunate victim of the disruptive physician attack is turned into a cartoon version of their real self and the stakes can escalate.  Consider the following:

Scenario Description

Initial Incident:

  • A nurse reports that a doctor ignored him in the hallway when he tried to ask a question. The doctor explains to the Chief of Staff that he didn’t realize the nurse was speaking to him and was rushing to his office for a scheduled call.

  • The Chief of Staff suggests the doctor write a note of apology to the nurse, which he does, and the matter seems resolved.

Escalation:

  • Several months later, the doctor is called before an informal group of medical staff members and the Chief of Staff. He is informed that several nurses have felt offended by his dismissive conduct.

  • The doctor offers to apologize again, but the medical staff recommends he take a course in social skills in the workplace.

  • The doctor decides to resign his privileges and leave the hospital, feeling that enough is enough.

Reporting to the Medical Board

Legal Implications:

  • Any restriction taken against the physician due to disruptive behavior for “medical disciplinary cause or reason” is reportable to the Medical Board of California. It is also reportable to the National Practitioner Data Bank.

  • California courts have stated that disciplinary action based on disruptive behavior must not be “substantively irrational or otherwise unreasonably susceptible to arbitrary or discriminatory application”. Physicians may only be disciplined for disruptive behavior if there is a sufficient nexus to patient care.

Key Considerations:

  • The connection between the alleged conduct and patient care is crucial in determining whether a report should be filed.

  • Once a report is made, the physician is subject to the medical board's review, with limited rights to sue due to peer review protections.

Some Case Law

Is disruptive conduct reportable to the Medical Board?:

It is unquestionable that any restriction taken against the physician due to disruptive behavior, which is taken for “medical disciplinary cause or reason,” is reportable to the Medical Board of California (See: Sahlolbei v. Providence Healthcare, 112 Cal.App.4th 1137 (2003)), and it is reportable to the National Practitioner Data Bank (See: Leal v. DHHS, 623 Fed.Sup 1280 (11th Circuit 2010)).

Legal Considerations: On the other hand, California courts have made clear that disciplinary action predicated upon disruptive behavior may not be “substantively irrational or otherwise unreasonably susceptible to arbitrary or discriminatory application” (Miller v. Eisenhower Medical Center, 27 Cal.3d 614 (1980)). For that reason, the California Supreme Court noted in Miller that physicians may only be disciplined for disruptive or inappropriate behavior “if there is a sufficient nexus to patient care” (Id at 622). In a dispute about whether a report should be filed, the connection between the alleged conduct and patient care will be the core issue. Once the report is made, the physician is at the mercy of the medical board and without significant rights to sue as peer review conduct is generally protected.

Expert Legal Guidance:

  • Disruptive Physician attacks are increasingly common. They are subjective and difficult to defend against. The Horowitz physician lawyers have extensive experience defending against false claims of disruption.  Call us if you need assistance.