A prescription for the rogue doctor: part II ready, aim, fire

As discussed in Part I of this series, rogue doctors have serious sociopathic behavioral deficiencies which may be the result of a defect of character or a flaw in ethics. Under these circumstances, unacceptable behavior patterns will arise. For years, counseling, coaching, training, supervising, transfers to less critical disciplines, disciplinary warnings, and offering opportunities to resign have been the typical approaches in dealing with rogues; the outright firing of residents and doctors has been relatively taboo. However, preserving a rogue's professional status as a practicing doctor has become increasingly problematic. In Part II of this two-part series, implementation of a performance management system to remove rogues from the system is discussed. This paper will detail exactly how such a system can work.