The Intangibles that affect Residency Pam Lupo, CO Residency Director Wright & Filippis

Residency History 5 Years 3-6 Residents per year

Residency Program 2 week orientation for operational issues Primary site 3 days a week Quarterly Rotation 2 days a week under specialties Pediatrics, geriatrics, trauma, diabetic footcare, overall footcare, scoliosis, polio, CMT, adult rehab, central fabrication.

Quarterly evaluations Patient care Technical skills Canon of ethics

Example #1: Resident 1 2 Positive quarterly evaluations Quarterly Evaluation Supervisor/Residency Director Assumed progressing well *research project

Clinical 90 day evaluation nothing negative 6 month nothing negative 4 th quarter Identified lack follow-through with 2 rotations Did not complete research project 10 month point of residency Written notification refusal to sign Final Evaluation of Resident’s Performance.

Personal Sleeping with administrator at hospital Rumor is he is going to marry her. Making matters worse: paraplegic in wheelchair. Renegotiating contract/Impact on business

Resolution NCOPE Intervened Sited favorable evaluations Non-work related issues Mutual agreement sat for ABC Exam under Canadian guidelines

Note: Canon of Ethics Objective 6: Section III Responsibility to the Patient “sexual relations with patients prohibited”

Example #2: Resident 2 O&P Certificate Program Senior President Presented well organized and had good reference from school.

Clinical Exemplary relationship with physicians and staff at the hospital Good patient care

Personal Financial Disaster Asking co-workers for money. Needing time off for bankruptcy court. Eventually no transportation for work.

Resolution Loaned company car for monthly rental. Ongoing problems

Example #3: Resident 3 First 2 Evaluations Positive Rotate to our Medical Center office Fast pace and high stress

Warning Signs Missed 6 out of 8 Mondays. Leaving early on numerous occasions No previous history

Resolution Heart to heart talk Confided spastic bowel and getting physically ill Sunday evenings and Monday mornings. Transferred back to original site.

Tools for Resolution

Employee Assistance Programs TEAM Total Employee Assistance Management Employee Assistance/Counseling Management support and direction

Documentation

Individual Corporate Employee Manual Relationship with co-workers Absenteeism Conflict of interest Guiding Principles

Lessons learned Document Timely Code of Ethics Social taboos Be approachable

NCOPE Site

Issues surrounding residents are NO different than those of all employees. Must be diligent in accountability to NCOPE