I would start by
1.Keeping a log for when he is called: date, time, patient, reason for the call.
2.Time call returned, response-try to remember what he said in as much detail as possible include foul language used by him.
3. It is HIS JOB to care for the patients in the facility. Hand a piece of paper and pen to the patient and/or family, to write a complaint to give to the Medical Board. Keep copies of all complaints.
4. Report him to the Medical Board, JCAHO, and the parent company who owns the facilty. You might also call/write the Facilities and Licensing Division in your state. They are the ones who license health care facilities. I am sure that they would be interested in his conduct.
5. I hate to be an "in your face, opinionated, New Yorker". But, obtain a copy of his job description and, "remind Mr. Abusive, that, " this is his job description, and that he is paid alot of money to be the medical director of the facility to do this job". What is his excuse for not wanting to do his job? What exactly does he think he is being paid for? WHO is HIS boss?
He is being paid to care for the residents, provide orders for pain medication is part of caring for them, and what he is doing is considered abuse. It is not important to their care what he believes patients should get for pain medication or how often they ask for it. Patients deserve adequate pain relief. Period. He is obligated to provide that to them.
I would also call DSHS, and the Elder Abuse Line and describe what is going on. What is is doing, IS ABUSE. Again, keep a log of times called, response time, his response to being asked for an order, or whatever, etc. If he believes that his license and job are in jeapordy, he will get a load of defense attorneys to circle the wagon around his detractors, to discredit you. Include complaints from patients and family members. Remind the patients and family members, that "MD" does not stand for, "mighty deity". He is legally responsible to care for the patients according to the laws of your state, and every and all, administrative agency regulations, like JCAHO.
If he doesn't like it, he is welcome to go back to where he came from.
Also remind him that YOU are a licensed medical professional, and you DEMAND respect for your job! Let him know in no uncertain terms, that you will not stand for it. If he gets out of hand, call the police.
If you have a cell phone
with a camera and a recorder, I would have it on and ready to record him, his complaints, refusals ,etc. I picture is worth a thousand words! He does not have to know you are doing it. Let it be a surprise.
Also, when you write your nurses notes, phrase it something like, " Dr. so and so called at 0200 about Mr Smith' pain, Call returned at 0700. Dr so and so informed about Mr. Smith's pain. Dr so and so responded, "all you American women are the same. You can't handle any pain and you make me sick". Dr so and so hung up the phone and did not give me any pain medication orders for Mr. Smith".
That is factual and to the point and objective. Make sure that you make copies of your notes, and his orders, because they WILL disappear, if and when the you know what hits the fan. Just don't tell anyone what you did.
You have a big hurdle to jump over, but your patients deserve it. You might want to call a lawyer, and get some feedback. You might also contact the law firm that defends the facilty. Speak to the senior partner.
JMHO and my NY $0.02.
Lindarn, RN, BSN,CCRN
Somewhere in the PACNW