Discussions

Criticizing Your Employer’s CoVid Response

Posted by Matthew Rehrl @matthewrehrl, Sat, Mar 28 2:34am

Here’s a recent article about an ER physician in Bellingham, WA getting fired, presumably for criticizing via Facebook his contracted employer’s approach to CoVid.
https://www.seattletimes.com/seattle-news/health/er-doctor-who-criticized-bellingham-hospitals-coronavirus-protections-has-been-fired/
For frontline clinicians these are going to be highly emotional times, and I can appreciate their desire to speak out online using social media.

However, generally speaking, most physicians have signed a contract or agreed to a social media policy which is heavily weighted towards the healthcare organization, and generally direct public criticism could well be in breech of the contract, possibly resulting in the termination of a very valuable staff member.

So, what to do? First I think the physicians and staff posting need to recognize that during an intensively emotional time, it’s probably not the right time to be posting public information on social media. In fact, the more passionate one is, the more important it may be to give it a day, before hitting the post button, Rephrased, ask yourself this: How will my attorney (and the hospital’s attorney feel about this post? (And truthfully, if you have to ask that question, you probably shouldn’t be posting it.). Anyway, an email reminder not just of the policy, but why it is the policy, may be helpful if it isn’t heavy handed.

Equally important, however, the CEO of the organization needs to recognize that if frontline workers are posting negative stuff about the organization online, then the normal channels of feedback may be dysfunctional, and that is clearly the CEOs responsibility.

I would recommend if there is a significant frontline safety issue which isn’t being addressed, then the CEO would like to hear from them directly. (And why would the CEOs agree to this? Because most of them would rather spend a few minutes on a phone, hearing from the frontline, rather than seeing their org on CNN or MSNBC in a negative light. )

Anyway, keep in mind that social media in the time of CoVid probably has equal potential to help and hurt, and marketing may be best positioned to help frontline staff not make a career ending mistake, but also make it clear to senior administration that there is a reason for types of negative posts, which probably could be nipped in the bud.

(Also, throughout all of this, keep in mind that several of these frontline staff may well die from CoVid in the next 3 months)

"he CEO of the organization needs to recognize that if frontline workers are posting negative stuff about the organization online, then the normal channels of feedback may be dysfunctional, and that is clearly the CEOs responsibility."
That is the key.

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Undoubtedly what healthcare administrations don’t want is photos of nurses wearing garbage bags posted to Facebook at the same time many of these administrators are probably trying to do their best. (see attached), but there is also the question of what healthcare providers should do in the context of Possibly inadequate PPE.

My advice to the providers is to work through the system using current reporting methods, and OSHA when necessary. IN fact, if providers are seeing things which even may be unsafe, it’s likely they have an ethical duty to point it out; However, I would stay off of social media.

And for administrators? 3 months, 6 months, or a year or two from now there will likely be a lot of legal pieces to pick up from this, which likely will include Worker injury claims, disability, wrongful termination, etc. Although I suspect state legislators which eventually get involved, it’s probably going to be a big mess for some orgs, but the orgs which have radical transparency with their staff now will probably fair much better, and if there are indeed PPE shortages its best to work with your staff rather than against them. I am not sure what this will entail – perhaps daily emails from your safety officer giving real updates, perhaps coordinating social media efforts with your staff, highlighting what you are trying to do……

But, regardless, I think most administrators need to take a good look at the attached photo and ask themselves now how to prevent this, rather than figure out how to react to these type me of photos. (Hint: threatening staff with discipline/termination without providing them a real avenue of participation/communication will probably not help).

04F12D9F-6064-423F-A84F-BC8929E99BFE

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Thanks Matthew – problem is where the government or organization narrative bumps up against reality on the frontline. Good short podcast interview about that here https://podcasts.apple.com/nz/podcast/nejm-journal-watch-podcasts-clinical-conversations/id292018914?i=1000469480291

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Can I ask you – is freedom of opinion an issue? Can you not post something without having a fear of punishment? I think getting rid of a doctor in times where each doctor is needed is real crime.

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People have the right to express any opinion they choose, but as an employee they also agree to obeying certain policies, such as not speaking to the press, and not posting negative content about ones employer. For example, even when I was part owner of a fairly large clinic, I was contractually restricted from saying certain things about my organization online, and if I did, I would have certainly expected repercussions.

I think there are some things which companies, including healthcare organizations, may do which are so egregious that going straight to the public is both ethically warranted and necessary, However, in this particular case the issue seemed to be over a lack of adequate testing-which isn't just an institutional problem but a statewide problem-and a policy decision on the best place to test.

Regard the former, it's unlikely the institution has any control over the number of tests, and regarding the latter, the location of CoVid testing might need to be based on other issues, for example, would screening outside delay the care for other, more urgent patients, such as MIs and strokes, and trauma?

Now, for me personally, if I disagreed with an administrative policy-, likely one which the org medical director had likely already approved -I probably would first try to change it from within the org, and if that was ineffective, and I felt strongly enough about it, I could in theory, bring it up directly to the State Department of Health or OSHA, where I likely would have significant whistleblower protection, and likely would be in compliance with the contract I signed. Or, alternatively, and more likely-if I felt that my employer and I had significantly different approaches to care, I would simply move on.

But I just think for the most part, negative social media commentary is not the appropriate way to effect change against ones own employer, and likely will backfire, as it looked like it did here. Anyway, I am speculating here, It in this physician's case, it's possible he was putting his contracting employer into a breach of contract with the hospital, and after a warning, and a request to remove his posts was declined, his employer, the contracting org to the hospital, likely had no choice but to let him go.

So, the key point I am making is that although we have rights as citizens, we also have legal responsibilities when we choose to sign an employment contract, and we should only choose to break our contractual obligations in the rarest of circumstances, and when we do, we should expect repercussions. Often, I think we would find there are a lot of other options besides posting to Facebook.

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@matthewrehrl

People have the right to express any opinion they choose, but as an employee they also agree to obeying certain policies, such as not speaking to the press, and not posting negative content about ones employer. For example, even when I was part owner of a fairly large clinic, I was contractually restricted from saying certain things about my organization online, and if I did, I would have certainly expected repercussions.

I think there are some things which companies, including healthcare organizations, may do which are so egregious that going straight to the public is both ethically warranted and necessary, However, in this particular case the issue seemed to be over a lack of adequate testing-which isn't just an institutional problem but a statewide problem-and a policy decision on the best place to test.

Regard the former, it's unlikely the institution has any control over the number of tests, and regarding the latter, the location of CoVid testing might need to be based on other issues, for example, would screening outside delay the care for other, more urgent patients, such as MIs and strokes, and trauma?

Now, for me personally, if I disagreed with an administrative policy-, likely one which the org medical director had likely already approved -I probably would first try to change it from within the org, and if that was ineffective, and I felt strongly enough about it, I could in theory, bring it up directly to the State Department of Health or OSHA, where I likely would have significant whistleblower protection, and likely would be in compliance with the contract I signed. Or, alternatively, and more likely-if I felt that my employer and I had significantly different approaches to care, I would simply move on.

But I just think for the most part, negative social media commentary is not the appropriate way to effect change against ones own employer, and likely will backfire, as it looked like it did here. Anyway, I am speculating here, It in this physician's case, it's possible he was putting his contracting employer into a breach of contract with the hospital, and after a warning, and a request to remove his posts was declined, his employer, the contracting org to the hospital, likely had no choice but to let him go.

So, the key point I am making is that although we have rights as citizens, we also have legal responsibilities when we choose to sign an employment contract, and we should only choose to break our contractual obligations in the rarest of circumstances, and when we do, we should expect repercussions. Often, I think we would find there are a lot of other options besides posting to Facebook.

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I think an employer should invest more money in having good doctors than chasing privat accounts on FB.

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