Reporting Protocols
If an otolaryngologist has obtained accusatory information from a patient, they may first want to contact the otolaryngologist in question to make neutral inquiries about their diagnosis, findings, examination, evaluation, and treatment. “This works best if there’s an established relationship. It can be effective to hear the other otolaryngologist’s rationale and compare it with the initial information,” said Dr. Holt. If the otolaryngologist in question is curious about why their colleague might be asking these questions, it’s best to come clean without being accusatory.
Explore This Issue
May 2020Dr. Setzen concurred that a peer-to-peer discussion is a good first step to broach the subject with a colleague who had shown unethical or incompetent behavior. For example, if a colleague were performing surgical procedures that didn’t align with best practices, clinical consensus statements, and/or clinical practice guidelines, you could ask the physician why they are practicing that way and suggest that it would be more prudent to practice in alignment with these documents.
When approaching an accused physician, you could start the conversation by saying something like, “I don’t know if this is true or not, but I’ve heard some concerns about you. I think you’ll want to hear about them,” Dr. Shapiro said. “If the concerns are valid, then you could speak with the doctor about ways to respond or change behaviors.”
The earlier someone receives feedback, the better. “If it’s a minor problem, they can correct it going forward,” added Dr. Shapiro, who was the founding director of the Center for Professionalism and Peer Support at Brigham and Women’s Hospital in Boston. “In our culture, we often wait until things are really bad to say something. But being silent allows more harm to occur and deprives the colleague of a chance to remediate.”
According to data collected by the center, most physicians who exhibited inappropriate behaviors changed them after receiving feedback intervention from Dr. Shapiro and their supervisory physician.
If confronting a physician isn’t successful, then Dr. Shapiro recommended reporting the physician to an organization’s professionalism committee or peer review board before reporting them to the state medical board, which should be reserved for egregious behaviors such as criminal activity or sexual harassment, said Dr. Shapiro.
More Serious Behaviors
If a situation is delicate or egregious, reporting the suspected violations through the established channels right away may be the most appropriate course of action, Dr. Holt agreed. If you suspect criminal behavior, then it may be appropriate to report the physician to the police.