Can You Speak Out Without Getting Fired or Being Labeled a Troublemaker?

Harris Meyer

Disclosures

April 17, 2013

In This Article

Introduction

Physicians often see problems at their workplaces relating to patient quality of care, financial practices, mistreatment of staff, and other issues. But as more doctors take jobs as employees of hospitals, medical groups, and other large organizations, they increasingly face the same dilemmas as millions of other working stiffs. When they come across actions or policies that they don't think are right, they have to decide whether it's worth it to speak out and get labeled as a troublemaker -- or perhaps even get fired.

Across the country, a growing number of physicians are indeed losing their jobs -- and often their hospital staff privileges -- after protesting employment conditions. Such complaints may involve patient quality-of-care problems, short staffing, misallocation of funds, improper financial incentives, fraud and abuse, discrimination, overuse or withholding of medical services, or other misconduct, say organized medical groups, employment attorneys, and physician recruiters.

Or the issues they contest may be less extreme but still of personal concern. They may include differences of opinion over clinical protocols recommended by medical staff leaders; particular equipment being used in the hospital; the physician call schedule; or compensation issues, such as profit sharing.

"Most physicians don't fight back," says Barbara McAneny, MD, an Albuquerque oncologist who serves on the American Medical Association (AMA) Board of Trustees, expressing her personal view. "Most of them just say, 'I'll go someplace else.' I wish they would stand up more. But they don't want to spend years on that battle and give up patient care."

Physicians should communicate their concerns to their employers as professionally and objectively as possible through official channels, such as their medical staff organization or medical group, experts say. But physicians sometimes don't take the ideal approach and risk getting labeled as disruptive personalities or troublemakers.

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