Involving human resources directly to implement a formal performance review policy across the organization would be critical (regardless of how well or poorly any provider is performing). Then a more formal and individualized performance improvement plan can be implemented for each provider. I think engaging the formality of the process may lessen some of the emotional impact.
Tough situation. It seems that each team functions quite independently without much collaboration or alignment of operations/processes. Perhaps a good place to start to to synchronize processes across the teams that the basic workflow is similar even though the type of surgery is a little different. I also agree with aligning financial incentives.
I have worked in both environments as a private practice physician and an “employed” physician. The biggest barrier to trust for the physicians is usually money (sad but true). The physicians only see the the money or wRVUs that directly impact their income and not what the health system finances looks like. From their perspective the health system is always trying to make more money at the expense of the physicians doing more work and seeing less return with declining reimbursement. Personally, I think complete financial transparency is the starting point of improving physician trust in our current fee-for-service environment. While physicians often loathe EMR integration, I have never had a conversation with my physician colleagues about that being a factor of trust with the health system.
I agree with Bidur. A professional or executive coach could be of great value, and she may actually be greatly appreciative of the opportunity especially if they do not feel threatened by someone inside the organization trying to “change their behavior”. It seems that the highly technical skills this person brings are unique and valued and because of that skill set they have likely not had good coaching or mentoring to develop their communication skill set.
This seems to be a common issue in today’s Health Systems with regional campuses. Clear articulation of the system strategies across the service line is a starting point with common practice models (physician payment, service line offerings like testing practices and policies, and similar leadership structure), but then having some regional “culture” that fits the needs of that community and local interests of the physicians. I often think of a “wheel and spoke” approach.