Like others, I think behavior training should begin much earlier. But as we are in the middle of this it does not provide a solution for now. Clearly setting the culture of the organization is a start, however, there must be a system to hold physicians accountable for behavior that by others would be deemed inappropriate. Typically, these physicians know their behavior is not acceptable but there is not a system to make consequences. An idea is to bring physicians together and ask them to develop a code of conduct policy that includes discipline measures as well as team goals for doing well.
Tough situation! The big issue here is the union. If this was a problem within the organization there are many things you could do. Therefore I see it as working with the union versus removing them from the equation. For many centers removing the union is not an option. So with regards to working with the union you may need to meet with their leaders in order to address the issue. Negotiating with them may not be ideal but you may be able to find a solution that makes you both happy.
This is not an easy situation. However, I think you have the good fortune of having the whole department in your consideration. If Team D is structured and aligned with how you would like the future of the department, I suggest working on incentives and education to help other teams follow this structure.
Additionally, it sounds like the department as a whole has low resources. This may be a time to lobby for the department to as a whole to get more resources for all teams.
I agree! As a surgeon myself, if the hospital came to me and asked me to switch my day I would say no. But if they presented the whole case and provided some concessions on the things I want I would be more likely to help them find a solution together.
This is a challenging problem that occurs in many organizations. In fact, I think 5% is very good! That said – the organizations that I have seen manage this best have a culture of excellence. This happens from the top, the middle and the bottom of the organization. And when someone who doesn’t fit this cultures is inadvertently hired they don’t last long because they stick out and nobody (their co-workers and bosses) want them as part of the organization.