Clinician Violation Potential

There is one major thing that most clinicians are unaware of, and it has the potential to jeopardize their careers.

While most clinicians may not be aware, the truth is every professional has a violation potential and needs to be proactive in protecting their patients and their license to practice. The best proactive action a clinician can take is to have a plan that specifically addresses risks to practice as well as their own personal vulnerabilities and risk factors as a professional. This was PBI Education’s goal when we pioneered the use of the Personalized Protection Plan© as a component of remedial courses more than 20 years ago.

Participants in PBI Education courses graduate with something much more valuable than a certificate of completion. They leave with a self-formulated Personalized Protection Plan, created with guidance from the course faculty, that serves as their roadmap of steps they will take going forward to safeguard the public and avoid future transgressions. Each Plan is as unique as the individual who creates it, reflecting what that person discovered during their PBI course about their own internal vulnerabilities and the risks they face in practice.

Course participants develop and present their Plan during the course for review and feedback from the faculty and other participants. Each Plan is developed to address reasons for course referral as well as concerns identified during the course, while still being realistic about what the participant can achieve. The final product outlines the steps the participant plans to take and the changes they intend to make in three domains: organizational (their work environment), professional (their own conduct at work), and personal (their lives outside of work).

The Personalized Protection Plan© is comprised of three domains:
– Organizational (work environment)
– Professional (conduct at work)
– Personal (life outside of work)

Personalized Protection Plans are living, breathing documents that need to be revisited to keep up with participants’ own life changes, such as a new baby or a parent’s decline, a promotion or retirement. Significant events prompt re-evaluation of one’s Personalized Protection Plan. It should not take a major change to prompt a re-evaluation though, as participants are urged to review their Plan regularly to make sure they are still adequately addressing their risk factors and vulnerabilities.

Developing a Personalized Protection Plan: Case Study

The following case study (a composite of PBI Education course graduates’ experiences) offers a look into the process PBI Education course participants go through to create and implement their Personalized Protection Plan.

Melissa, an internist in a small group practice, was referred to complete a course after repeatedly losing her temper and raising her voice with patients. During her PBI Education Elevating Civility and Communication course, Melissa shared about being angry at her husband, who she said constantly complained about how little time she spent with him and their two kids. She blamed her long hours at work on overly demanding senior partners and shared that she had a hard time dealing with patients who were often angry about having to wait so long past their scheduled appointment times. Part of the problem was that she too was feeling angry and frustrated. The same over-booking that enraged patients, she explained, left her with no downtime to complete other important office tasks in between appointments.

Overall, Melissa expressed feeling trapped by what others demanded of her, and angry about how little time she had to do what she wanted. She especially missed watching her kids play soccer and her weekly tennis matches with friends.

Reviewing the Three Domains of the Personalized Protection Plan: Organizational, Professional, and Personal

After group discussion and receiving feedback from her fellow course participants here is a portion of the plan Melissa developed:

Organizational: Melissa started out wanting to immediately demand shorter hours and end overbooking. After discussing it in the course, she realized this strategy would only solidify the pre-existing notions that had developed about her in-office temperament. Melissa decided to meet with her supervisor to share what she had learned about herself and explain her plans for improving her performance.

Also, she planned to explain why she felt it was important for the patients, her colleagues, and her own well-being that the practice resolve its scheduling difficulties. Additionally, she set out to offer suggestions that might help — hiring a PA or perhaps a scribe to relieve some of the strain. With these action items in place, her goal was to be patient as long as she felt progress was being made. If things did not go well, though, she promised herself to start looking for a new practice.

Professional: Melissa was concerned about her ability to manage these negotiations with her supervisor without losing her temper. She decided to ask one of the senior partners to be her mentor. This partner was known for her ability to defuse tense situations and remain calm. She understood the office culture and knew the other partners well. Additionally, she was nearing retirement, so might welcome the chance to share all that she had learned in her career.

Personal: Melissa realized that her anger at her husband was spilling over into her work. Having come to see his point of view, she planned to talk to him about what she had learned and offer to accept his suggestion that they begin couple’s therapy. She would also explain the steps she was taking at work to prioritize time with the family.

Melissa planned to share with her kids how she was making changes that would allow her to attend their soccer games. It would show them how much she wanted to be with them and, as a side benefit, help increase her sense of accountability.

The Role of Accountability

Increasing accountability is an important aspect of developing a Personalized Protection Plan. Melissa knew that her supervisor, mentor, husband, and kids would help hold her accountable to her Plan. However, she appreciated the type of candid feedback she received during her PBI course from the faculty and other participants, who understood what she was going through. This inspired her to participate in PBI Education’s Maintenance and Accountability Seminars course (MAS), a weekly teleconference group discussion where participants engage with their cohort and faculty facilitator on the implementation and updates to their Plan. Melissa registered for the MAS course to gain additional accountability as she began to implement her Personalized Protection Plan.

Melissa’s Personalized Protection Plan

Organizational– Meet with supervisor to explain what I’ve learned and how I plan to improve my performance
– Request bi-weekly meetings with supervisor to review my progress and discuss possible changes to scheduling that should benefit patients, colleagues, and help me work as well
– Work with mentor to prepare concrete suggestions to bring to bi-weekly meetings
If no progress after a few months, begin search for a new jobProfessional– Ask senior partner to work with me as my mentor, explain what I’ve learned, share my protection plan, and work with her on ways to communicate suggestions for resolving scheduling issues
– Enroll in MAS for 12-week cycle to maintain accountability as I implement plan
– Revise plan as neededPersonal– Discuss my plans with my husband to prioritize family time and agree to look for a new job in a few months if things don’t improve
– Offer to begin couple’s therapy

This is the part where you may expect to read something that says “Melissa and her family went on to live happily ever after she created her Personalized Protection Plan”. A Plan is only as effective as its implementation. While Melissa developed a strong plan for how to move forward in her situation, the execution and continued review of her Plan is paramount to her success. This is the most important takeaway for course participants: You must Live Your Plan. When a Plan is realistic, implemented, and reviewed often, it can safeguard against future lapses and violations. 

The source of this information is Professional Boundaries Incorporated (PBI). The original publication can be found here https://pbieducation.com/how-a-personalized-protection-plan-decreases-violation-potential/?utm_source=parblast&utm_medium=email&utm_campaign=febeb24

If you are interested in fortifying your legacy of success and creating your own personalized protection plan, Eric J Consulting may be able to help.