Stay and fight or cut your losses? - physicians in medical organizations - In The Trenches - Column

Physician Executive, March, 1996 by Marilyn Moats Kennedy

IN THE TRENCHES

You are so unhappy about the direction the health care provider has chosen you talk about it incessantly. Your family and friends leave the room when you mention your woes. The organization's flagrant mismanagement fills your dreams. You've presented your arguments, reasons, statistics, and suggestions for a different course of action and you've been turned down flat. Should you give up?

Maybe the problem is a personal issue: You are being treated so badly--sexual harassment, overwork, or sheer abuse--that you wonder whether you should fight the boss, the system, and top management or get another job and cut your losses. All of us, at some time, have felt so strongly about a workplace issue that it became an obsession. When that happen. Before you call a lawyer, consider this: Organizations dispense justice poorly if at all. Fighting it out requires strength of character and the hide of a rhino. Is it worth it? Talk to people who've done it and then answer the questions in this column.

Why do you want to right? Does the issue matter to you personally? Here's an example. A woman MD working in the most backward, benighted division of a Fortune 500 pharmaceutical company was approached regularly by other women who wanted her to make a stand for women in the organization. She'd been there 20 years and was the highest ranking woman in the organization. Her husband had recently begun a new career, and they needed her, salary. While her colleagues were quick to call on her for help, what were they putting at risk? She was risking her family's livelihood, and they weren't risking anything. Unless it matters to you personally, let the others fight the war. Had she felt that her situation was intolerable, she should have taken up the cudgel, but not for people who might decide that, after all, they were quite happy with their jobs.

Is your ego on the line? They don't want you, but you'll get no severance if you quit. You've done nothing wrong. In fact, you're highly productive. The medical director and the CEO don't like you. Why not stay and make their lives miserable? It doesn't work that way. Anyone who's tried this strategy will tell you that they'll get you before you get them. There's only so much ostracization you can stand before you begin to wonder if you are indeed the problem. Once you've confirmed that you can't get a severance package or outplacement help, get a new job and move on.

Is it a personal vendetta? This is the worst. You cannot or will not rest until the perpetrator is humiliated, fired, escorted from the premises, etc. You want revenge, and nothing less will satisfy. Money, a new job, relocation, a better boss, winning the lottery wouldn't make you feel better. Revenge is never as great in reality as it is in fantasy.

Most people imagine a scenario in which their enemies are not merely vanquished, but humbled. It rarely works that way. Even the worst boss, organization, or co-worker has some redeeming qualities, Thus, pure revenge is never pure. If you're obsessed with the idea of humbling a boss or co-worker, seek psychological counseling. It won't happen. If it does, he or she will believe it was distemper on the part of the gods. There's no way to win!

Are you strong enough to take a stand? Is your personality strong enough? Do you have a good support system? What else is going on in your life? If you're in a strange town, away from family and friends and going through a divorce or break up, don't add a lawsuit to your troubles. We've seen otherwise normal people reduced to a breakdown by just one more emotional burden, and a lawsuit complete with a hostile boss and cold shouldering by other physicians is at least two more.

Jack took a new job as department chair of oncology with high expectations. He'd been there less than two months when he could document serious verbal abuse and sexual harassment from the vice president for patient care. He talked to an attorney who told him he had a case that he could take to the Equal Employment Opportunity Commission. (The attorney also briefed him on the length of time it would take EEOC to resolve his case and warned of possible career damage if he sued the hospital. Because Jack lived and worked in a small town, a lengthy investigation would be lonely if co-workers shunned him. If he left town to take a new job, how much time could he take off to work on his case?

Summary of Previous Scenario

Dr. Verde has been head of the department of medicine at Altrusa Hospital for more than 10 years. Over that period he has gained valuable experience in running a department and has been actively involved in the committee work of the medical staff. He firmly believes that his next step in career development is to a full-time medical director position, preferably at Altrusa. The problem at Altrusa is the opposition of the president of the medical staff, Dr. Fosse. Jim Lento, the hospital administrator has indicated that he favors the establishment of a medical director position and the filling of that position by Dr. Verde, but Dr. Fosse has successfully fought all attempts to do so. Dr. Fosse considers the proposal an unwelcome intrusion into his affairs and clearly is unwilling to share power. While Dr. Verde has been patient, he now wonders if his approach is wise. He's in his mid-40s, and he is convinced that he needs to make a move. He dislikes the idea of leaving behind all he has built at Altrusa, but he suspects his skills are portable. Should he wait a few more years, he wonders, and risk disappointment if the position does not appear? Or should be strike out and achieve his management goals elsewhere?