How to deal with challenging Doctors

Snuggs105 · October 2018

Hello all -

What are some tips on how to educate/have doctors respond to your queries? My hospital is a teaching hospital, we nurses can't even call an attending, in most cases we have to go through the residents training with them (and pray they respond to your page). Everyone is stressed and some what aggressive. We also have a few challenging Medicine doctors who come in from their private practices and act like they still don't know how to put orders in electronically. It can be difficult to get just a medication order, I am wondering how I am going to speak to them about answering queries.

How do you build relationships with your doctors? Do you have some tried and true tips?

larchibald · October 2018

Hi @Snuggs105, I'm sure some ACDIS members will be able to shed some light on this issue as well, but I wanted to pass along some recent CDI Journal articles that you might find helpful on the topic of physician engagement:

Documentation training for residents: https://acdis.org/articles/buck-stops-here-cdi-escalation-policies
Creative methods for physician engagement: https://acdis.org/articles/breaking-through-noise-successful-physician-engagement-takes-creativity and https://acdis.org/articles/more-chocolate-sweet-provider-education-tips
Scripting for difficult physician conversations: https://acdis.org/articles/helpful-hints-communication-problems-follow-script
CDI escalation policies for unanswered queries: https://acdis.org/articles/buck-stops-here-cdi-escalation-policies

@lprescott1, @sbrodie@hcpro.com, @afrady@blr.com any tips for @Snuggs105?

Snuggs105 · October 2018

Thank you so much! @larchibald

lprescott1 · October 2018

This is a difficult task in a teaching hospital- as the residents only see the priorities handed to them by the attendings and if you cannot speak to the attendings you cannot stress the importance.

i would suggest that you push to be part of new resident orientation/education on boarding. So that you can describe your purpose to them and how you assist with quality scores, mortality measures etc. also when they rotate to a new service perhaps some contact to touch on the important documentation needs related to the specific specialty.

I would not give up on communication with the attending providers. Medical staff meetings, service line meeting etc. should allow you some time to discuss what you do and how it will help them.and of course administrative support form the c suite is important and a well educated physician advisor who can reinforce your messaging is helpful.

Lastly- the attendings should be bench marked against each other- (these can be blinded or open) what are their query rates? response rates? case mix? mortality rates? complication rates? denial rates etc. Create a sense of competition.

rachelondrasmith@gmail.com · October 2018

I am finishing up the cdi apprenticeship....certification through acdis and am having difficulty finding a job that will accommodate my qualifications. I currently hold a LPN license and have 20 years of healthcare experience....does anyone know of an apprenticeship program that will bridge some experience so I can sit for CCDS exam?

How to deal with challenging Doctors

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