DEVILISH DILEMMA FRANK J. LEXA, MD, MBA, DAVID FESSELL, MD
Danger on Social Media
One of your key radiologists posted a racial epithet on a social media site that is public and can be identiﬁed back to that radiologist and therefore to your institution. One of your younger colleagues at the hospital brings this to your attention and demands that you do something about this “or else.” What do you do next?
Cheri Canon, MD, University of Alabama, Birmingham The greatest chance for a misstep is to make assumptions and react too quickly. Step back and review the situation in its entirety, with an empathetic viewpoint, even if the faculty member seems way out of line. You cannot solve the problem in a silo. Immediate communication with organizational leadership will mitigate legal and reputation risks. Openly admitting the wrongdoing with a sincere apology is difﬁcult, but often the best course of action and better done with legal counsel. Signiﬁcantly more challenging is dealing with the faculty member. Learn the rationale behind the actions rather than adopting an accusatory approach. At a minimum, cultural sensitivity training should be prescribed. That being said, racial bias or prejudice of any sort cannot be tolerated. Successful leaders must be courageous, determine the best course of action, and make the right
decision, even in the face of something so challenging.
Rich Duszak Jr, MD, Emory University Social media does not create new problems as much as it catalyzes, accelerates, and ampliﬁes ones that have always challenged leaders. Thoughtless, hurtful, and sometimes outright illegal comments have always occurred in the workplace. But the ease with which these can now be impulsively and instantaneously broadly disseminated and forever digitally memorialized raises the stakes dramatically. Given that the fundamental issues are largely the same, so too are the solutions. Responsible and forward thinking organizations have all created policies and procedures for disruptive behavior. These should be consulted, and closely followed, to chart a course of action that has the best chance of being viewed as objective and fair to the offender and offended alike—and one that will most likely survive legal challenge. If institutional policies do not speciﬁcally address digital media, the time to update them is now, before such a potentially explosive situation arises. M. Elizabeth Oates, MD, University of Kentucky I would ﬁrst ask the faculty member if he or she did indeed
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post the alleged item; if true, I would ask for an explanation. Facts in hand, I would then confer with the dean’s ofﬁce, probably the associate dean of faculty affairs and/or the associate dean for diversity, to inform and obtain guidance as to next steps and an action plan. I suspect that the faculty member would receive a formal reprimand and be required to attend sensitivity training. Of course, the outcome would hinge on whether this was a ﬁrst-time or repeat offense; the latter could potentially result in steps toward termination (for violation of behavioral standards).
Alan Kaye, MD, Advanced Radiology, Bridgeport, Connecticut Physician discipline is the most difﬁcult job of a practice leader and department chair, complicated by today’s complex legal and “political” environment. One must do the right thing in the contexts of patient care, citizenship, the prestige and wellbeing of the practice and hospital, and fairness to the physician in question; consider the vulnerabilities of radiology practices in hospitals; and realize that the people with whom we directly work and supervise are not our employees and that the need to work in an environment of mutual respect is more difﬁcult to establish and maintain.
The ﬁrst step would be to remove the post. Then, consult legal counsel who is expert in employment law, with the hospital contract, physician contract,
operating agreement, and disruptive physician policy in hand. The attorney and the practice’s executive committee should expeditiously choose a course of action, at
which time a discussion should take place with the “offending” physician, and appropriate action and remediation should commence.
Frank J. Lexa, MD, MBA, is from the Global Consulting Practicum and the Department of Marketing, The Wharton School, Philadelphia, Pennsylvania; and the Radiology Leadership Institute and Commission on Leadership and Practice Development, American College of Radiology, Reston, Virginia. David Fessell, MD, is from the University of Michigan Medical School, Ann Arbor, Michigan. The authors have no conﬂicts of interest related to the material discussed in this article. Frank J. Lexa, MD: The Wharton School, The University of Pennsylvania, 306 Gypsy Lane, Wynnewood, PA 19096; e-mail: [email protected]
Journal of the American College of Radiology Volume 14 n Number 1 n January 2017