Dealing with an overdemanding doctor

Nurses Relations

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Long story short- doctor takes 2-4 hours with a single patient. He uses up all the interpreter's time for non-English speaking patients and he expects ridiculous things of the nurses. Recently he started demanding work during lunch and after hours. I am tired of having no breaks and no lunches because he's so insane. How can I deal with this? It's not an emergency but he acts like everything is life or death! He's afraid of being sued, he talks about it constantly. He wants crazy amounts of work done by the staff and no one wants to work with him because of it. He refuses to deal with patients he doesn't like or who ask for things he doesn't like and he does unnecessary testing and examinations as well. Help!!

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Specializes in Ortho, Case Management, blabla.

Do you work in a hospital? Is this a hospitalist? What size hospital? That'd be useful before I can make any suggestions

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You may be required by law to receive breaks or a lunch. I would consider talking to HR about it or a house supervisor.

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Specializes in ortho, hospice volunteer, psych,.

Is he young and right out of residency? He may be terrified that he'll miss something and the patient will die or that the patient or

her family will sue him.

Our old internist retired and our new one is almost Doogie Houser young. OK, so he isn't quite that young, but he is just out of residency. His dad and Grandpa are MDs and have scared him with their stories without meaning to. He is caring with his patients but is difficult with his staff. Almost obsessive. He's rude with them at best and obsessively careful at worst.

Our neighbor is his NP and she said because he's so good at diagnostics, she'll forgive him a lot and stay on, but if he weren't, she'd be out of there.

Sound like your doc?

If he's just nasty, I'd start looking.

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He's not that young. He just expects unreasonable things and doesn't think about or care about how much time it takes doing non-important things or things that are only important to him or how far behind you get doing important things while doing his crazy stuff. He has zero prioritization skills...

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Specializes in Emergency & Trauma/Adult ICU.

... duplicate post ...

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Specializes in Emergency & Trauma/Adult ICU.

What kind of setting is this? Office practice? If so, and he is the owner or part owner of the practice ... it's his gig, his rules.

Having said that ... you & other staff might consider asking to meet with him to discuss "ways to improve our efficiency" ... and go in prepared to list one or two or three of the biggest obstacles you face, and prepared to offer suggested changes/solutions and concrete examples of the process improvements you would expect to see as a result of those changes.

At that point it's up to him ... his gig, his income, his rules. You can always vote with your feet.

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He is not the owner of the practice or even part owner. Today he ordered 9000 dollars worth of testing on a patient because the patient said she was always tired...

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He is not the owner of the practice or even part owner. Today he ordered 9000 dollars worth of testing on a patient because the patient said she was always tired...

It is within his realm to do so. Otherwise, this patient would continue returning as not receiving answers to her complaint.

I think the point is that you all are not going to change this MD's personality nor how he chooses to practice. What you can do it figure out how the work that needs to be done can be more effectively. Ask for staff meetings. Delegate where you can so that each person is responsible or partly responsible for a task--and rotate so no one gets burnt out.

Maybe you need more than one interpreter. Maybe you need a couple of NP's to come on board if he is taking 3-4 hours with a patient. Maybe you just schedule 4 patients a day for him. Maybe the last patient of the day is scheduled at 2pm. Maybe you have a part time person per diem who comes in at 4 until the doc is done.

I am not sure what the answer is, but maybe some re-orginization can help. If it is beyond repair, then I would start putting feelers out for another position.

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Specializes in Emergency & Trauma/Adult ICU.

I don't doubt for a minute that this provider may be a pain in the bee-hind to work with. jadelpn's post above gives some great suggestions.

Consider too -- what's in the differential diagnosis for the vague complaint of "fatigue"? A huge amount of bad stuff: anemia, cancer, lung disease, heart disease, thyroid issues, depression ... Vague complaints often, appropriately, generate more diagnostics than a complaint of "it hurts right here".

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The practice needs quantity of patients to keep its doors open so I know that he's being looked at as someone who is costing us more money than he brings in. I have more than respect for his position and that he is a doctor and should order what he feels is right but he is doing serious overkill on some patients when they need an antibiotic and maybe a week off work, he sends people to the ER for sore throats all the time. The other providers are angry because he uses all of the resources and interpreter time. We spend hundreds of thousands a year on interpreters and cannot afford to hire any more than we already have. I think that it needs to be time for a serious staff meeting this week.

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I don't doubt for a minute that this provider may be a pain in the bee-hind to work with. jadelpn's post above gives some great suggestions.

Consider too -- what's in the differential diagnosis for the vague complaint of "fatigue"? A huge amount of bad stuff: anemia, cancer, lung disease, heart disease, thyroid issues, depression ... Vague complaints often, appropriately, generate more diagnostics than a complaint of "it hurts right here".

True but this patient came to us as a woman in her late 20's and had already had every scan/mri/ct/xray/blood test under the sun in the last year and they all came up with nothing. I am tired all time too but....

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