Addressing the Underperforming Clinician: A Leadership Challenge

Howard B. Graman, MD, FACP


Mar 6, 2026


Physician Leadership Journal


Volume 13, Issue 2, Pages 62-64


https://doi.org/10.55834/plj.9307937603


Abstract

Medical groups striving for high performance often encounter the challenge of underperforming clinicians. This article examines common areas of low performance — productivity, clinical quality, and patient experience — and provides strategies for leadership to address and improve these issues. Productivity concerns are often linked to inefficiencies in interview skills, support personnel utilization, or electronic medical record (EMR) competency. Clinical quality issues may arise from inadequate patient monitoring, reluctance to adjust medication, or hesitation to escalate treatment plans. Low patient experience scores frequently stem from ineffective communication or a lack of empathy during patient interactions. Interventions such as shadowing, coaching, additional training, or peer mentoring can help struggling providers enhance their performance. Leaders must assume positive intent and provide support, while remaining prepared to address a lack of improvement through crucial conversations. By implementing targeted strategies, organizations can foster growth and minimize the need for more drastic measures.




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