Friday, September 8, 2017
Sunday, September 3, 2017
I have worked with small groups that have gathered to undertake work that would be impossible for one person to do alone. These groups have generally focused on four areas: professional training using a seminar format, group psychotherapy, consultation groups, batterer’s intervention and didactic anger management classes. In most of these situations, I have been asked to act as facilitator or trainer. In the seminar groups, I am clearly the trainer. In the other formats, I am the facilitator who assists the group in gaining from the unique experience of learning and sharing in a group. In French, the word facile means "easy." It is the aim of facilitators to make the work of a group easy.” This involves coming up with a plan and process that will help participants accomplish their goals. In all of the groups in which I have participated, I have found it useful to provide participant workbooks with an outline and, when possible, ancillary videos and other visual learning material. Facilitation involves helping people co-operate and act collectively. When a group works together in this way, they experience many benefits, including:
Saturday, September 2, 2017
A look back at George Anderson’s recent appearance at the The Association of Nigerian Physicians Of The America’s, held in Las Vegas. George gave a titled “Emotional Intelligence, A Core in Healthcare Leadership”. There were 500 physicians, nurses and in attendance.
Effective January 1, 2009, The Joint Commission (JCAHO) issued new guidelines to respond to the negative behavior of physicians that often places patient care at risk while increasing medical errors. These new standards made it mandatory for Hospitals to establish written policies designed to address what is defined as "disruptive physician behavior." The following is one definition of what is considered "disruptive behavior":
Disruptive conduct can take many forms. Raised voice, profanity, name-calling, throwing things, abusive treatment of patients or employees, sexual harassment, disruption of meetings, repeated violations of policies or rules, or behavior that disparages or undermines confidence in the Hospital or its staff may be disruptive behavior, although this is not an exhaustive list. Unacceptable disruptive conduct can also include such behavior as:
I. Attacks (verbal or physical) leveled at others that are personal, irrelevant, or go beyond the bounds of fair professional comment.
2. Impertinent and inappropriate comments written or illustrations drawn in patient medical records, or other official documents, impugning the quality of care in the Hospital, or attacking particular practitioners, employees, or Hospital policy.
3. Non-constructive criticism, addressed to its recipient in such a way as to intimidate, undermine confidence, belittle, or to impute stupidity or incompetence.
4. Refusal to accept medical staff assignments, or to participate in committee or departmental affairs on anything but his or her own terms or to do so in a disruptive manner.
5. Imposing idiosyncratic requirements on the Hospital staff that have little impact on improved patient care but serve only to burden employees with "special" techniques and procedures.
In addition to written policy and promotion of these new policy guidelines, physicians who are determined by the appropriate hospital committee or disciplinary unit to be "disruptive" must be mandated to participate in an appropriate intervention to address these issues and acquire appropriate interpersonal skills along with self-control, empathy, self-awareness and other key emotional intelligence skills.
Rarely are these physicians psychiatrically impaired, substance abusers or sexual abusers. Therefore, none of these options are available as resources without specific justification and documentation.
The typical physician referral is a highly skilled surgeon who is accused of throwing an instrument, cursing a staff member, yelling at co-workers or was impatient or discourteous to a patient. Stress is almost always a significant factor in the physicians' behavior.
Resources For "Disruptive Physicians"
Physicians and Healthcare Organizations nationwide are under pressure to find coaching resources for "disruptive physicians." Mandating any physician to participate in an intervention for "disruptive behavior" is difficult for Physician Well-Being Committees, Medical Directors and Hospital Credential Committees as well as State Medical Licensing Boards.
Leaders responsible for managing physicians are willing to look the other way or do almost anything to avoid complying with this new Joint Commission requirement.
By delaying the decision to take action based on a distaste for adversarial tension, pressure begins to mount as the year comes to an end. Many organizations need to show evidence that they are following the Joint Commission Policy relative to mandating assistance for "disruptive physicians".
Two of the three major programs for "disruptive physician behavior" are already filled for 2017. These programs are the Distressed Physician Program at Vanderbilt University School of Medicine at Nashville and the PACE Program at the University of California School of Medicine at San Diego. Both the Vanderbilt Program and the PACE Program only accepts 8 physicians each quarter for its respective classes.
The largest provider of individual coaching for disruptive physicians is Los Angeles based Anderson & Anderson, APC. The uniqueness of the Anderson & Anderson curriculum is that it was specifically designed for "disruptive physicians." The Practice of Control, the client workbook and all of the DVDs, CDs and ancillary training material are carefully designed to improve assertive communication, increase self-awareness, self-perception, social awareness and relationship management and stress management.
Anderson & Anderson has a well trained Certified Coaching Faculty with the capacity to offer the internationally recognized EQ-i-2.0 Emotional Intelligence Assessment and intensive coaching On-site anywhere in the U.S. followed by six months of Aftercare and Post Tests. Emotional Intelligence Classes For The Prevention of "disruptive" Behavior at Work. In order to keep JCAHO accreditation, every hospital now must have a system in place for recognizing and effectively dealing with disruptive physicians — whether they’re on staff or simply have hospital admitting privileges.
In order to minimize the risk of adverse events and malpractice suits, medical groups must have the awareness and skill set to intervene effectively when a colleague or employee first begins behaving unprofessionally.
Organizations that identify and deal with disruptive behaviors and performance problems at the earliest stages can not only save a considerable amount of time and money — but also mitigate risk.
Since Emotional Intelligence is the core of most of the intervention programs for "disruptive behavior," it seems reasonable to offer general courses in emotional intelligence to physicians, nurses and other ancillary staff.
Such courses may focus on leadership, interpersonal relationships, self-control, social awareness, relationship management, stress management, decision -making or any of the many other emotional intelligence scales.
The American Medical Association as well as local medical associations are offering and/or promoting presentations on how to prevent or manage disruptive physician behavior. Kaiser Permanente of Southern California has taking the lead in being proactive in preventing the consequences of "disruptive physician behavior" in hospitals and healthcare organizations.
George Anderson, MSW, BCD, CAMF, CEAP
Monday, August 28, 2017
With the popularization of anger management in the media, many counselors, teachers and educators are flocking to Facilitator Certification Training in Anger Management. Many of these potential providers are attracted by the potential for providing anger management for profit.
As the major provider of anger management facilitator certification throughout the world, we are asked daily about the potential for establishing an anger management practice as a sole practice offering or as a separate area of specialization. Recently, we at Anderson & Anderson begin asking our active Certified Anger Management Facilitators (CAMF) for information regarding their current number of groups, executive coaching clients and related monthly income from private practice.
In January of 2017, a phone survey was made of the entire list of 45 Certified Anderson & Anderson Anger Management Facilitators in Los Angeles County. Of this group, 44 acknowledged earning what they considered to be an acceptable income from their anger management practice. Additional information was obtained from the one provider who was not profiting from his current practice. As it turned out, this provider offered only one group. This group was scheduled for Friday evenings from 7-9. The provider explained that this was the only time which he had available to schedule a class.
Those providers who were successful offered classes days, evenings, Saturdays and Sundays. It is reasonable to conclude that the one provider who was not successful may have sealed his own fate by the lack of flexibility in his schedule. I personally interviewed this provider and asked if he would attend a class o Friday evenings if there were other options, his answer was no. I suggested that most potential clients would give the same answer.
During our survey, we learned that most Certified Anger Management Facilitators are Licensed Mental Health Clinicians or Substance Abuse Counselors who work full-time and have a small practice on a part-time basis. These Clinicians are not sophisticated in advertising, marketing, or the use of the Internet and most other small business practices.
Therefore, the question relative to the viability of anger management as a specialty practice is not much different than that of a psychotherapy practice. Essentially, it depends on the investment both financial and otherwise made by the provider. However, most anger management providers are able to do well at this time based on the inverse number of trained anger management providers in contrast to the need worldwide.
The average income from the part time practice of anger management ranges from a high of $12,000 per month for one provider with 5 locations to $2,000 per month for one provider who has two groups that meet once per week on Saturdays.
George Anderson, MSW, BCD, CAMF.