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  • Workplace disputes

    Conflicts and disputes in the workplace can have a significant impact on your professional and personal lives.

    Workplace Disputes

    Workplace disputes can take many forms. It may be that you are not getting on with your supervisor. You may be in a dispute about the terms of your engagement, such as your working hours. You may be facing performance management or the suspension of your employment for alleged misconduct. Regardless of the cause of the conflict, it can make it difficult to concentrate at work and inevitably results in you bringing your anxieties about work home with you. This can lead to sleepless nights and increasing anxiety, and can have a significant impact on patient care.

    In recent years, Avant has seen an increase in claims involving workplace disputes which means that more of our members are finding themselves involved in employment disputes and in need of advice and assistance.

    Some of the common situations leading to workplace disputes are confusion about the terms and conditions of the engagement; disputes over pay; disputes over the doctor running behind time; disputes over the expectation on the doctor to work the after hours shifts and to do the ‘on call’ roster on a perceived unequal basis; issues concerning clinical supervision; dissatisfaction with the level of mentoring; disputes over whether a lawful and reasonable direction has been given; and disputes over allocation of annual leave and sick leave.

    Dispute resolution

    It’s best to try to resolve disputes early and as informally as possible, however sometimes a more formal dispute resolution process needs to be followed. If there is a dispute resolution process in your Award, Enterprise Agreement or Contract, this process should be followed.

    Dispute resolution mechanisms are called by a number of names, including “grievance procedure” or “complaint process”.

    In general, private and public hospitals have dispute resolution mechanisms in a doctor’s:

    • Contract of Employment or Contractor Agreement
    • Award or Enterprise Agreement
    • Employment Policy

    Doctors should familiarise themselves with the dispute resolution mechanisms.

    Dispute resolution mechanisms generally contain a number of different procedures that a doctor may opt to use, for example:

    • Informal resolution – discussing the issue directly with the person concerned in order to resolve the conflict
    • Formal resolution – this may include a range of things such as:
      • Escalating the dispute to a higher level of management
      • Participating in mediation
      • Instituting an investigation into a complaint
       
    • External resolution – making a complaint to an external body such as the Fair Work Ombudsman or the Fair Work Commission (for private hospital doctors), a State Industrial Relations Commission (for public sector employees), a discrimination tribunal etc

    Doctors may wish to seek advice about the best way to resolve a particular dispute.

    There are a range of people that doctors can seek advice from including:

    • Avant
    • AMA
    • Unions
    • Hospital contact or grievance officers
    • Hospital human resources department

    The procedures often explain what doctors should not do. For example, many procedures say:

    • A doctor cannot be victimised for making a complaint
    • A doctor cannot make a frivolous or vexatious complaint
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    Tools and Resources

    Doctors may wish to seek advice from many places for the best way to resolve a dispute:

    Your employer’s Employee Assistance Program

    Key support services

    Avant Medico-legal Advisory Service

    Doctors' Health Advisory Services around the country

    The AMA in your state or territory

    Your Union

    Your organisation’s human resources department

    Cautionary Tale

    Tips

     

    Breach of hospital Code of Conduct

    In the hospital context, in Avant’s experience, alleged breaches of a hospital’s code of conduct are a common cause of employment disputes.

    For example, a hospital may allege that a doctor has failed to comply with infection control measures and has spoken inappropriately to a nurse who questions the doctor about this.

    Avant’s claims experience shows that poor communication, not competence, is a significant factor in many employment disputes.

    Abiding by an organisation’s Code of Conduct is a contractual obligation for employees and contractors. Penalties for breaches of a Code of Conduct can include a reprimand, suspension of clinical privileges or even termination of employment.

    Codes of Conduct breaches handled by Avant have involved alleged ‘poor clinical care’, ‘negative work environment’, ‘inadequate availability’ and ‘fitness to practice’.

    Examples of alleged ‘poor clinical care’ have included leaving patients unattended, poor patient monitoring, and maintaining inadequate medical records. ‘Negative work environment’ allegations have included being uncooperative or argumentative. Allegations of bullying or intimidation of staff have also increased markedly over the past 5 years. Matters concerning inadequate availability included being absent without adequate cover, and being difficult to contact. Alleged ‘fitness to practise’ breaches included working while ill or fatigued.

    Reducing your risk of workplace disputes

    Maintaining good relationships with the medical team and ensuring clear communication between health professionals is vital to reducing your risk of a breach (perceived or otherwise) of a Code of Conduct. Clear communication includes:

    Clinical care

    • Clearly documenting instructions to staff
    • Ensuring appropriate handover to recovery staff
    • Ensuring staff responsible for patient follow-up understand what to look for and when you need to be called
    • Maintaining appropriate documentation: is the anaesthetic chart sufficient, or should you also maintain your own records?
    • Participating in the open disclosure process should an adverse event occur

    Work environment

    • Developing an awareness of how you are perceived by others, including asking for feedback from a mentor or senior colleague
    • Ensuring your communication is appropriate at all times

    Availability

    • Ensuring the team knows how to contact you and under what circumstances
    • Being open to contact from the team should the need arise

    Fitness to practise

    • Advising colleagues if you become affected by fatigue or illness. If you notice a change in your general health, fatigue or stress levels, make an appointment with your GP. You could also call one of Avant’s medico-legal advisers for a confidential discussion

    Cautionary Tale

    Tips

     

    Tips for preventing workplace disputes

    • Before taking a position, be clear on what’s expected of you
    • Be familiar with the terms and conditions of your engagement
    • Only sign a contract if you are happy to accept its terms
    • Be familiar with the policies and procedures at your workplace, and follow them
    • Be aware of how you are perceived by others – ask for feedback from a mentor or senior colleague
    • Maintain good relationships with your colleagues and ensure clear communication
    • Don’t let workplace conflict fester – deal with conflict early
    • Seek advice early if you are concerned