The Ombudsperson's Role
In 2015, Flavio Habal, and I, Lorretta Daniel, were asked to act as ombudspersons for the Department of Medicine (DoM) for University Health Network and Mount Sinai Hospital. The role of ombudsman was created to help deal with issues of incivility and unprofessional/disruptive behaviour within the DoM. We did not have any special training but had the experience of being senior staff who could listen to complaints in a safe and confidential environment. We did not know what issues would come before us but felt we could listen to complaints in a non-judgmental way and offer suggestions as to how to proceed.
When faculty members seek our input, we meet with them, listen to them, and talk about the possible steps that can be taken to resolve the issue. Our experiences thus far indicate that there is substantial variability in the complexity of issues. Some issues brought forward have been successfully resolved with further discussion between parties. In other cases, talking about the issue was sufficient to empower the individual to deal directly with the other party themselves. And still other times, we played an important role in the resolution of the complaint. However, there have been several complaints that have not been resolved due to concerns that moving the process forward would expose the complainant to potential negative consequences related to job security, promotion, funding, clinical and research resources. We have also identified a number of areas requiring clarification. For example, what is the role of the Faculty of Medicine Clinical Faculty Advocate, Carl Cardella? How does it differ from the ‘ombudsman’ role? What can we do to address fear of reprisal sufficiently so that more people will be willing to take their complaints forward?
It is clear that disruptive behaviour has a negative impact on patient care and our work environment. When we see our colleagues act unprofessionally and say nothing, are we teaching our medical students, trainees, fellows and fellow staff that this is acceptable behaviour? We have complex jobs in a complex environment. There are many stresses both personal and professional that can contribute to unprofessional behaviour and we all need to be better at taking care of ourselves and each other. We need to adopt a policy of zero tolerance for unprofessional behaviour and have complete support at the DoM. We also need supports within the hospital to help with both the complainant and the person with unprofessional behaviour to move forward without fear of negative consequences.
The ombudsman role is evolving and for now we will continue to have an open door to listen and discuss any matters of unprofessional behaviour with complete confidentiality. We will be your advocate and help in any way we can.