RESIDENT PHYSICIAN GRIEVANCE PROCEDURE

GOAL
To establish a uniform mechanism for grievance procedures for all Residents in the Graduate Medical Education program.  Each residency program is to have their own individual procedures within their particular departments with the final decision, if necessary, remaining standard among all three residency program.

POLICY

Initiation of any corrective action is at the discretion of the program director(s) of reach residency.  The course of the corrective action and any resulting grievance procedure actions by the Resident shall be specific to each residency (Internal Medicine, Surgery, Radiology).  The final step in any appeal of a corrective action by a Resident in any of the three residencies is to the Medical Executive Committee of Santa Barbara Cottage Hospital.  Whenever a Resident is prematurely terminated or referred to the Medical Executive Committee for problem resolution, collaboration with the Vice President of Human Resources will occur prior to the final disposition.

PROCEDURE

RADIOLOGY PROGRAM

In the event that a Resident exhibits unprofessional behavior or a level of professional performance unacceptable to the program director, the program director will bring the matter before the full-time Radiology teaching staff.  Following deliberation of the teaching staff, and consultation with Human Resources, one of the following recommendations may be made:

1. Continue in the program;
2. Continue in the program on probation;
3. Be placed on administrative leave with pay;
4. Be terminated from the program.

The Resident will be informed in writing of any adverse decision.

Under compelling circumstances, the program director may place the Resident on administrative leave with pay pending a meeting of the teaching facility.

Should the Resident not accept the recommendation of the Radiology teaching staff, he/she may request and will be granted a hearing by the full-time Radiology teaching staff.

Should the Resident continue to disagree with the decision of the staff, he/she may apply to the Medical Executive Committee for a hearing.  The decision of the Medical Executive Committee will be final.  Human Resources will be consulted prior to any decision resulting in suspension, loss of pay, or termination.

SURGERY PROGRAM

In the event that a Resident exhibits unprofessional behavior or a level of professional performance which is unacceptable to the program director, the program director will bring the matter before the Surgical Education Advisory Committee (SEAC).  The Resident may be invited to appear before the SEAC at which time a full discussion of the Resident’s performance can be aired and proper counseling given.  Following this deliberation, and in consultation with Human Resources, the SEAC may make one of the following recommendations:

1. Continue in the program;
2. Continue in the program on a probationary status;
3. Be placed on administrative leave with pay;
4. Be terminated from the program.

The Resident will be informed in writing of any adverse decision of the SEAC.

Should the Resident not accept the recommendation of the SEAC, a request may be made in writing to the Chairman of the Department of Surgery for review.  Following review by the Department of Surgery, the Resident may be given the opportunity to appear before the Department of Surgery to state his/her case.  Following his/her hearing the recommendation made previously by the SEAC will be upheld, rejected, or modified by the majority vote of the Department of Surgery.  In the event this decision is not acceptable to the Resident, appeal may be made to the Medical Executive Committee of Santa Barbara Cottage Hospital.  The decision of the Medical Executive Committee will be final.  Human Resources will be consulted prior to any decision resulting in suspension, loss of pay, or termination.

INTERNAL MEDICINE PROGRAM

In the event that a Resident exhibits unprofessional behavior or a level of professional performance which is unacceptable to the program directors, the program directors may place that Resident on administrative leave with pay pending a discussion of the situation at the next MEAC meeting.  At that meeting, the events that precipitated this intervention by the program directors will be presented, along with a discussion of any previous efforts at correct measures relating to the performance or behavior of concern.  The MEAC in conjunction with the program directors, in consultation with Human Resources, may recommend one of the three following actions:

• Return of the Resident to his/her previous position with appropriate counseling about the behavior or work problem which led to this intervention, special monitoring to insure correction of the behavior or work problem, and/or other individualized corrective actions as deemed necessary by the committee and program directors;
• Continue administrative leave with pay pending a discussion of the alleged problem among the members of the MEAC and the Resident involved;
• Recommend premature termination of the Resident’s contract or temporary suspension of the Resident’s contract.  If the Resident disagrees with this decision, the Resident will continue on administrative leave pending resolution of the issue.  The Resident will continue on administrative leave with pay pending action by the Medical Executive Committee.

The Resident will be notified in writing of the recommendations of the MEAC, the matter will be considered resolved pending successful implementation and conclusion of these recommendations.  If the Resident disagrees with the recommendations of the MEAC, the Resident can request a hearing with the MEAC to discuss the recommendations.  Following this meeting with the Resident and representatives of the MEAC, the MEAC will develop its own recommendations.  The recommendations, which result, may take the following forms:

• Uphold the prior recommendations and refer the matter to the Medical Executive Committee for resolution if so requested by the involved Resident; or
• Modify the prior recommendations of the MEAC such that both the MEAC and the Resident find the modified recommendations satisfactory.

If the grievance is taken to the Medical Executive Committee, then the decision of the Medical Executive Committee will be final.  Human Resources will be consulted prior to any decision resulting in suspension, loss of pay, or termination.

ALL PROGRAMS

The non-renewal of an agreement of appointment by any program requires a written notice of intent a) no later than 4 months prior to the end of the Resident’s current agreement; or b) when the primary reason(s) for non-renewal occurs within those 4 months, as much notice as is feasible.

The grievance procedure describes herein is available for implementation by any Resident receiving a written notice of intent to non-renew.

This grievance procedure may be implemented unilaterally by any Resident wishing adjudication of Resident complaints or grievances related to the work environment or other issues related to the program or facility.

March 2008