The Doctor’s Lawyer: The bright side

I recently had the privilege of attending the grand opening of a client’s new clinic. It was a heart-warming display of the light at the end of the tunnel for a physician who had previously been the subject of a hospital’s ire. What happened? My client had previously been in the leave of absence trap (see my article: The ‘voluntary leave of absence’ trap). But he played his cards right and is now out from under the hospital’s thumb. He has since opened up a brand-new clinic on his own. With the hospital in his past, he’s moving on—stronger and more clear-headed than before.What does this mean? If you find yourself in the throes of a battle with hospital leadership determined to turf you, you can create a fresh start for yourself, but not without first laying the groundwork. So, how did he do it? First, he fortified his community. Over the years, not only did he establish his medical practice in his community, but he selflessly devoted his time, effort and love to the community outside of regular office hours. Whether it was community events, fundraising, sporting games—he was there. He did so purely out of the goodness of his own heart and his genuine belief in fortifying the place that he called home. At the time, he was unknowingly and unintentionally laying the groundwork for his fresh start today. Read: The doctor’s lawyer: the power of a chief of staffAs a result of his devotion to his community over the years, he had an outpouring of support from colleagues, nurses, political figures, and of course, patients. Specifically, the relationships he had built with other physicians in the community over the years was the most important cog in the wheel of getting him back on track. The countless, and I truly mean countless, thank you notes from patients, literally covering every square inch of his office walls, were also a constant reminder that he had an entire community behind him. He was with them through their good times and bad and they showed up to support him in return.Second, he always treated the nurses like colleagues and not subordinates. This was an exceptional case in which the physician had an overwhelming amount of support from every single nurse that he had ever encountered throughout his career at the hospital. I had never seen anything like it.Throughout his hospital career, he never hesitated, not for a second, to show up for the nurses no matter what time he was called—and regardless of whether he was actually the physician on call on any given night. He did so not for credit, but because he genuinely loves the practice of medicine. In turn, when he was down, the nurses showed up for him in droves. This kind of support cannot be bought. It was something he built over time and years because he is the kind of physician who views the delivery of patient care as a team effort. And the nurses felt it too.Third, he has great office staff. When we were in the thick of his case, his clinic staff diligently prepared the documents and records that I would routinely need to be gathered from his office to prepare his case on his behalf. One of the most common obstacles I face with clients is getting busy and overworked physicians to send me necessary documents—on time! In this case, he never delayed in getting me the documents I needed and, as a result, I could keep his case moving ahead. And because his staff were so helpful, he was able to focus on maintaining his office practice—something he desperately needed to hang on to when the hospital was gunning for his privileges. Before he moved, I had given my client and his staff advice on how the clinic should operate and what it should look like—everything from how the staff organized the reception, to record keeping, to maintaining and organizing medical supplies and equipment, and even the paint colour on the walls. I was blunt—to put it mildly. Rather than being offended, my client and his staff took my advice in stride and followed it! His new clinic is impressive and now he’s “cooking with gas.” Even the paint colour is exactly what I would have picked! Fourth, and crucial to his success, was the fact that he put his pride aside. When it became undeniable that this particular hospital was looking to push him out, he did not let his pride get in the way of doing what was best for him and for his family. He took a hard look at the odds, and the deck stacked against him with hospital administration, and said to himself: “I’m out’a here.” He decided to leave on his own terms, not theirs! Because of the recent CPSO bylaw change (see my previous article) he could rightfully get out without a blemish on his profile. Of course, leaving the hospital required making significant changes not only to his practice but to his overall life. But he was smart enough not to let the hospital’s vendetta be the hill that he died on. In the end, losing him was the hospital’s loss, not his, in my opinion! Now, he can rebuild without the toxicity. Finally, he had faith. He never let the hospital get under his skin, or make him doubt himself. He always remembered the doctor and the person that he really is. When things got tough, he leaned in: to his family, his friends, his community and his faith.The bottom line Admittedly, cutting ties with your hospital may not be the right decision for everyone, for a variety of reasons. In some cases, you’re better off to challenge hospital administration at the Medical Advisory Committee (MAC). Coming from a defence lawyer, if physicians never challenge their leadership before the MAC the balance of hospital power will remain unchecked. But the decision isn’t about a lawyer’s desire to duke it out at the MAC. It’s about what’s best for the physician. In this particular case, there were many factors at play that enabled my client to leave and not look back.However, the key take-away for any physician is this: keep some distance between you and your hospital. Maintain good relationships with other colleagues, clinics and facilities in your community so that you are not beholden (and tied professionally) to only one place. If you are a physician who needs hospital or independent health facility (IHF) resources in order to practice, monogamy is not the way to go! Remember—the hospital isn’t going steady with you either! As another physician said to me at the grand opening: the landscape of a toxic hospital administration won’t change “until physicians start taking back some of their power.” This case was a happy example of what happens when they do. Brooke Shekter is an associate with TTL Health Law.

The Doctor’s Lawyer: The bright side

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