All physician members of the Greater Rochester Independent Practice Association, Inc. (GRIPA) are expected to provide the highest level of professional behavior, decorum, compassion and ethics. In accordance with this charge, the GRIPA Code of Conduct is designed to clarify common expectations and facilitate unity among the physician members of GRIPA. It is also an instrument of compliance with regulatory guidance and enhances the quality of care provided by the physician members of GRIPA and our patients’ perception of that care.
The guidelines set forth in this Code of Conduct govern all interactions with patients, their families, other colleagues, team members, students, residents, government agencies and their representatives and the public at large. This Code of Conduct also uses the behavioral definitions and conduct boundaries set forth by the American Medical Association and expects all Physician members of GRIPA to abide by them. Physician members of GRIPA who do not abide by this Code of Conduct will place themselves in jeopardy of disciplinary and/or corrective action. Disciplinary and/or corrective actions may be initiated and/or implemented by the Chief Medical Officer, Credentialing Committee, Clinical Integration Committee, Quality Assurance Council, or the President/CEO of GRIPA, as defined in the GRIPA Bylaws.
A. All physician members of GRIPA will abide by the Bylaws of GRIPA, New York State Health Law 6530, principles of medical ethics (primacy of patient welfare, patient autonomy, and social justice), and the policies and procedures of GRIPA.
B. Physician members of GRIPA will interact and communicate with all individuals in a courteous, respectful and dignified manner.
C. Effective communication is considered a vital component of quality health care and physicians have the primary responsibility for direct communication. At crucial times in the delivery of healthcare, patients and their families are entitled to immediate and clear communication from the treating doctor or the delegated physician member of GRIPA (on call coverage or midlevel provider).
Physician members of GRIPA agree to:
- Seek out assistance in conflict resolution when managing disagreements with others.
- Address dissatisfaction with policies, administrative or supervisory actions through the proper leadership channels
- Communicate quality and patient safety concerns to GRIPA leadership as appropriate.
- Regard families and visitors with respect and consideration
Physician members of GRIPA will not engage in or condone the following behaviors
- Sexual harassment and sexual innuendos
- Abusive language, including repetitive sarcasm
- Make direct or indirect threats of violence, retribution, litigation or financial harm
- Make racial or ethnic slurs
- Foul language, shouting or rudeness
- Criticize or embarrass staff in the presence of others
- Slander or physically threaten others
- Treat patients, coworkers or others in a discriminatory way, including but not limited to; race, age, gender, religion, national origin, medical condition, physical or mental disability, ancestry, marital status, sexual orientation, citizenship, legal status, language skills, or hearing ability.
- Provide patient care while impaired by alcohol, drugs or illness
D. Physician members of GRIPA will provide their patients with a standard of care and recognized level of quality as measured by desirable patient outcomes, efficient resource utilization and other tools as they are developed (i.e. Joint Commission, National Patient Safety Standards and Goals, etc.).
E. Optimal health care depends on the harmonious interaction, communication and combined efforts of a multidisciplinary team that includes but is not limited to; physicians, dentists, affiliated healthcare providers, students, residents, social workers, patients, families and others. As physician members of GRIPA strive to provide the highest level of care they will engage in the following behaviors:
- Respond promptly and professionally when called upon for consultative and clinical services
- Respond to patient and staff requests for information promptly and appropriately
- Respect patient confidentiality and privacy at all times
- Follow approved procedures for release of information
- Practice and promote infection control standards including handwashing protocols.
- Seek and obtain appropriate consultations when appropriate.
- Arrange for appropriate coverage when not available
- Prepare and maintain medical records
- Disclose potential conflicts of interest and resolve conflicts to the best interest of the patient.
- When terminating or transferring care of a patient, provide a prompt handoff that has pertinent and appropriate medical information to ensure continuation of care, medication reconciliation, and adequate follow-up
- Be collaborative with and respectful of all team members and individuals involved in the care of the patient.
F. Physician members of GRIPA are strongly urged to contribute meaningfully to the GRIPA community by:
- Serving on GRIPA committees when requested and available
- Notifying the Chief Medical Officer of any physician member of GRIPA who may be impaired, disruptive or repeatedly violates the Code of Conduct.
- Maintaining professional skills and knowledge through continuing medical/dental educational activities
- Following and obeying the law at all times
- Accurately presenting all data derived from research.
- Holding in strictest confidence all information pertaining to peer review, and quality review and improvement.
- Protecting the confidentiality of log-ons and passwords that access any healthcare data as well as protecting patient identifiable information or other confidential hospital information from loss or theft
- Report all medical errors and/or patient harm that he/she is aware of to the Chief Medical Officer.
- Reporting medical error and/or harm to patients and their families is also necessary and ethically correct
G. The medical record is a vital legal document that records all aspects of a patient’s health care. This document should include but is not limited to all information regarding patient histories and physicals, diagnostic evaluations, treatment plans and outcomes. All entries in the medical record must be dated. Additionally they should accurately reflect the professional recommendations and actions taken by all healthcare providers. Medical record entries should reflect the same level of respect that is expected of interpersonal and verbal communications previously set forth in this Code of Conduct. It is inappropriate to include in the medical record descriptions of interpersonal conflicts, judgmental statements of others or unprofessional attitudes.
H. Future Changes to this Code of Conduct will be addressed by the GRIPA committee structure.
The GRIPA Code of Conduct includes the American Medical Associations behavioral definitions and conduct boundaries. These are printed below:
I. APPLICABLE DEFINITIONS:
“Appropriate behavior” means any reasonable conduct to advocate for patients, to recommend improvements in patient care, to participate in the operations, leadership or activities of GRIPA.
“Disruptive behavior” means any abusive conduct including sexual or other forms of harassment, or other forms of verbal or non-verbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.
“Harassment” means conduct toward others based on their race, religion, gender, gender identity, sexual orientation, nationality or ethnicity, which has the purpose or direct effect of unreasonably interfering with a person’s work performance or which creates an offensive, intimidating or otherwise hostile work environment.
“Inappropriate behavior” means conduct that is unwarranted and is reasonably interpreted to be demeaning or offensive. Persistent, repeated inappropriate behavior can become a form of harassment and thereby become disruptive, and subject to treatment as “disruptive behavior.”
“Sexual harassment” means unwelcome sexual advances, requests for sexual favors, or verbal or physical activity through which submission to sexual advances is made an explicit or implicit condition of employment or future employment-related decisions; unwelcome conduct of a sexual nature which has the purpose or effect of unreasonably interfering with a person’s work performance or which creates an offensive intimidating or otherwise hostile work environment.
II. TYPES OF CONDUCT
A. APPROPRIATE BEHAVIOR
Physician members of GRIPA cannot be subject to discipline for appropriate behavior. Examples of appropriate behavior include, but are not limited to, the following:
- Criticism communicated in a reasonable manner and offered in good faith with the aim of improving patient care and safety;
- Encouraging clear communication;
- Expressions of concern about a patient’s care and safety ;
- Expressions of dissatisfaction with policies through appropriate grievance channels or other civil non-personal means of communication;
- Use of cooperative approach to problem resolution;
- Constructive criticism conveyed in a respectful and professional manner, without blame or shame for adverse outcomes;
- Professional comments to any professional, managerial, supervisory, or administrative staff, or members of the Board of Directors about patient care or safety provided by others;
- Active participation in GRIPA committee meetings (i.e., comments made during or resulting from such meetings cannot be used as the basis for a complaint under this Code of Conduct, economic sanctions, or the filing of an action before a state or federal agency);
- Membership on other medical staffs; and
- Seeking legal advice or the initiation of legal action for cause.
B. INAPPROPRIATE BEHAVIOR
Inappropriate behavior by physician members of GRIPA is discouraged. Persistent inappropriate behavior can become a form of harassment and thereby become disruptive, and subject to treatment as “disruptive behavior.” Examples of inappropriate behavior include, but are not limited to, the following:
- Belittling or berating statements;
- Name calling;
- Use of profanity or disrespectful language;
- Inappropriate comments written in a medical record;
- Blatant failure to respond to patient care needs or ancillary staff requests;
- Personal sarcasm or cynicism;
- Deliberate lack of cooperation without good cause;
- Deliberate refusal to return phone calls, pages, or other messages concerning patient care or safety;
- Intentionally condescending language; and
- Intentionally degrading or demeaning comments regarding patients and their families, nurses, Physicians, dentists, or any other ancillary staff.
C. DISRUPTIVE BEHAVIOR
Disruptive behavior by physician members of GRIPA is prohibited. Examples of disruptive behavior include, but are not limited to, the following:
- Physically threatening language directed at anyone in a patient care setting including physicians, dentists, nurses, staff members, or any GRIPA employee, administrator or member of the Board of Directors;
- Physical contact with another individual that is threatening or intimidating;
- Throwing instruments, charts or other things;
- Threats of violence or retribution;
- Sexual harassment; and,
- Other forms of harassment including, but not limited to, persistent inappropriate behavior and repeated threats of litigation.