Vignette 2: Partner Relationships

Answer to Question 2

This situation represents a two-part problem, where both parts need to be solved in order to resolve the problem. 

Answer A (tell the partner that this behavior will not be tolerated, and if it happens again, the partner will be placed on probation) is unlikely to have the desired effect, as this partner, and probably every other partner that deals with this office, will still have the irritant of the comparison exam coming late.

Answer B (tell the partner that you understand the difficulty, and ask the partner to be more understanding of the office staff in the future, as they are a good referral source) also does not solve the issue of late arrivals of the comparison exam and does not provide an adequate professional rationale as to why the partner needs to be more understanding. Without solving the comparison exam problem or having a plan to ensure the partner’s cooperation in behavior modification, neither aspect of this problem is addressed.

Answer C (ask the partner to work out a solution directly with the office staff of the referring physician so that it doesn't happen again and so that the partner gets some management experience) is not likely to work, as the partner clearly does not have a good working relationship with the referring office. It is likely to engender more discord without coming to a solution and also does not address the behavior problem of the partner.

Answer D (instruct this partner not to read any more imaging exams referred from this office) is most likely a step in the wrong direction. It does not solve either problem, and it allows the partner to “escape” the responsibility of reading these exams, with a greater work burden placed on the other radiologists, who will then have to read these exams while the original partner is given a “free pass.”

Therefore, the correct answer to Question 2 is E (call this referring physician’s office yourself to develop a routine of having the comparison exam sent to the radiology practice prior to interpretation of the imaging exam, and work with the partner to modify his/her behavior), which works to solve both parts of the problem.