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One Bad Partner Can Ruin a Practice


Got someone nasty in your practice? Your best option is not to feed the troll.

I’ll avoid naming Dr. X and the facility in which we worked. Names must be changed to protect the innocent, and all that…Suffice it to say that this was some years ago.

Dr. X had a penchant for stirring up trouble. While entirely capable of being confrontational, of looking someone in the eye and saying borderline-obnoxious things in the name of being (brutally) honest and bluntly (like a 2x4) to-the-point, X was also very good at operating indirectly and behind the scenes.

A team of 10, with Dr. X on board, could quickly and easily become two rival groups of 5, separated by any number of issues-who’s being more productive, how productivity should be calculated in the first place, who sits on the important committees, who gets which office, who’s taking long lunches, who worked fewer holidays last year, etc.

Near as we could tell, Dr. X had no grand scheme, no master plan which was being furthered by turning harmony into discord. X didn’t even seem to be using these machinations to retaliate for old grudges. Perhaps X wasn’t consciously working at creating strife, and was just passive-aggressive. Whatever the reason, Dr. X was a troll (on the web this refers to someone who disrupts the community).

Working with a troll is unlikely to be a relaxing affair. Certainly, there may be good days (or weeks, if you’re lucky), where nothing is brewing. There may even be times when the troll considers you a necessary ally for whatever feud is at hand. It may be downright pleasant to you under such circumstances…but you lower your guard at your peril, since trolls have few lasting loyalties. Eventually, others on the team may get sick of this and look for saner places to work. With fewer docs left on board, the factions that once comprised your team can get smaller and smaller; eventually, it could wind up being just you and the troll, assuming you don’t bail out beforehand.

Online, there is an oft-repeated piece of advice for dealing with such individuals: “Don’t feed the trolls.” That is, when you participate in their intrigues, you give them what they’re seeking, and their maladaptive behaviors are reinforced.

A community (such as a team of radiologists), if it has a strong infrastructure of communication and goodwill, can remain unified in the face of such antagonism from within. It’s not easy-trolls are good at identifying hot-button issues and using them to rile us up. If the group recognizes the troll for what it is, however, the beast can be starved, rather than fed by playing its games. Then, the troll can either roam elsewhere to find new victims (of its own volition, or because the group ejects the troublemaker), or it might just learn to play nicely for a change.

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