When the Difficult Physician Is You: Let Your Lawyer Do Her Job

Physicians are often advised on how to handle issues with patients and other physicians who are causing problems in their medical practice. This week I want to talk about when you, the physician, are the one creating the problem.

Over the past month I have had three different physician encounters create frustration for me. In the first instance, a practice has received visits from a federal agency. Although this agency has every right to visit the practice, repeated visits have interrupted operations. Additionally, the investigators have been unprofessional in their conduct with the staff. A letter was sent to the government and we were contacted by counsel who indicated there was an allegation/complaint against the practice and they would like to interview employees. She apologized for the overzealous activities of the agency’s staff, which were outside the norm of acceptable conduct, especially for this agency. The lawyer was professional in her conduct and has the authority to make such requests.

In relaying this conversation to my physician client, she was at first entirely cooperative. However, this was soon followed by numerous calls lasting over an hour each and not less than 20 e-mails a day where the doctor repeatedly questioned the advice I provided, the government lawyer’s integrity, and whether I understood the basic facts. She would not agree to the interviews and was outraged by any accusation of wrongdoing. This is a typical case of a physician who feels she knows better than everyone, who wants to control the activities of counsel and who believes her intelligence and understanding are superior. This same physician fails to appreciate her counsel’s expertise or the advice that cooperation is the best way to resolve allegations quickly. How does this physician handle herself with colleagues and peers? Is she controlling? Is this physician emotional and dominating with patients, staff, and partners?

Another matter in which I am involved requires legal pleadings which are detailed and extensive. No less than four times a day do I receive calls from my client wanting to spend hours meeting and talking about the case. Additionally, I am the lucky recipient of hundreds of pages of researched case law and drafted arguments which are useless to me, yet must absorb hours of the client’s (rare) free time. This client’s conduct takes away from my time on his case and with other clients and creates great frustration for me. This physician is unable to respect my role in the process and is assured his superior knowledge and intellect is needed to achieve success, even when the fault in his logic or arguments are made clear to him. This behavior may soon end our attorney-client relationship. What is this physician like in his practice? Does he waste time redoing the work of others because he knows better? Does he believe his intellect is superior to others even if their experience and training is greater? How can this type of personality succeed in a group practice?

Lest you think that all physicians I work with are overbearing, consider the case of a client who runs a busy practice and is being investigated for billing issues. Getting this physician to return my calls or e-mail me requested materials is nearly impossible. A caring and dedicated physician, he simply does not (or is unwilling to) grasp the seriousness of the claims against him. His lack of cooperation speaks to his confidence in me, but also hinders my ability to be responsive to government demands. This focus on patients has also led to a severe lack of compliance with billing, record keeping, and other legal requirements. This passive physician is the type who believes that as long as he practices “good medicine,” it will all work out; however, he cannot understand that being a good doctor is not enough in this health care environment and his apathy could be his demise.

I love working with physicians but they don’t always make it easy for those who work with them, whether it’s other physicians, lawyers, or consultants. Consider whether you share the character traits of these clients and, if so, how you might be negatively impacting your practice, your colleagues or your own legal defense.

Find out more about Ericka L. Adler and our other Practice Notes bloggers.