Interview with Dr. Ryan Bayley

In today's episode, John interviews Dr. Ryan Bayley to find out why physicians must wake up about threats to their ability to practice.  They also discuss his new book, “Physician Non Grata: A Survival Guide for Clinicians Around Poor Communication, Boundary Issues, and Disruptive Behavior.

Ryan explains why the system is becoming more dangerous, how to avoid exposing yourself, and what to do if you find yourself accused of disruptive behavior or breaching personal boundaries. 

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What Happens If Physicians Don't Wake Up

Dr. Ryan Bayley was the guest on Episode 64 just over four years ago to discuss his experiences as a business and success coach. Since then, the element of his work that seems to have grown the most is helping to resolve or prevent so-called disruptive or improper behavior.

There is an increasing number of physicians being placed on administrative leave and having their licenses suspended or revoked. So, Dr. Ryan has been studying this subject. Since he was unable to find any book addressing the subject, he decided to write one himself. 

His book serves as a warning and offers potential solutions to this problem. Residency directors and administrators have been providing the book to their trainees. And any physician would do well to implement the advice Dr. Bayley offers.

Damage Control

And state medical boards and human resource departments can unceremoniously sanction physicians with no warning, and little recourse. According to Ryan, if you are notified of an allegation against you, don't expect due process seen in criminal investigations.

Then take these steps:

  1. Acknowledge the notification without becoming defensive.
  2. Gather information and express your concern and willingness to cooperate.
  3. Find a lawyer with experience in this area quickly.

Dr. Ryan Bayley's Advice

…. avail yourself of all resources. And I'd say those three things are the first three things you've got to do the moment you hear your name in the same sentence as “complaint, disruptive behavior, problematic.” Anything negative at all, you need to start thinking this way.


Physicians who provide direct patient care are at risk for complaints against them at all times. Having your license suspended can result in losing your practice, even if it is reinstated. It can be very difficult to successfully contest these charges. All physicians are at risk of losing hospital privileges, being dropped from an insurance provider panel, or losing their license.

Ryan's book is available on Amazon and Barnes & Noble. You can check out his services at

NOTE: Look below for a transcript of today's episode. 

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Transcription PNC Podcast Episode 296

Why You Must Wake Up Before Bad Behavior Ruins Your Career

- Interview with Dr. Ryan Bayley

John: Today's guest first appeared in the podcast over four years ago. As an executive performance coach, he often works with professionals, including physicians whose license is being threatened. In fact, he just released a book addressing this very topic called "Physician Non Grata: A Survival Guide for Clinicians Around Poor Communication, Boundary Issues, and Disruptive Behavior." Sounds really important to me. Welcome Dr. Ryan Bayley.

Dr. Ryan Bayley: Great. And thank you, John. Thank you for having me back. And it has been four years. It's been a bit longer than expected partly due to COVID but it's great to be back and excited to talk about this.

John: I think this is a super important topic. I can't believe it. I've been doing this podcast about five years or so, and every once in a while something comes up that's like "I've not addressed this issue." Anyway, this is definitely one of those. We do want to do a little review before we get into your book and what you're actually up to in terms of coaching and so forth right now. So, go back a little bit. Just tell us a little bit about your story and how did you become an expert in so-called bad physician behavior?

Dr. Ryan Bayley: Well, the one word answer is unintentionally. If you had asked me a few years back was this where my coaching was headed, I would not have said yes. But as you know as we've discussed on the podcast, I became an executive coach because I just saw the need in medicine. Medicine at that time and still today is probably the only educated profession where executive coaching is still very underused.

John: True.

Dr. Ryan Bayley: I had a wonderful experience with an executive coach myself in terms of working on career design and burnout. And so, I looked around and decided that I should become an executive coach. I just saw the need, and especially for physicians trained as executive coaches. And so, that was how I got started many years ago.

My intent was to work mostly on career design and burnout. And I still do a lot of that work. But what started happening is as I immersed myself in the physician burnout world, as I started going to AMA conferences on physician well being, as I started interacting with medical boards and state physician health programs, what started happening is I started getting referrals. But the referrals were never really for burnout. The referrals would always be for a specific behavioral issue. They would never say, "This physician is burned out. Can you work with him or her?" They would say this physician is having a lot of trouble interacting with non-physician colleagues. Or this physician just keeps saying inappropriate things in the OR. It'd be a very specific behavioral request like that.

And what I started realizing as I got into it was that, yes, some of these behaviors are a manifestation of burnout. And there's certainly a lot of burnout with these physicians that I work with. Boundary issues, disruptive behavior, poor communications certainly can be a manifestation of burnout.

But I also started realizing that a fair number of these physicians were not necessarily burned out. They just lacked these skills. And I think it makes sense when you think about it. No one ever sat me down in medical school and said here's how you talk to an upset patient. These are the emotional goals that you need to achieve before you can have a rational conversation with this person. This is the script or the tool for diffusing the situation. I never had any formal skills training. Instead, I just watched my attendings and the fellows I worked with and they sucked at it. And so, I learned to suck at it. And I think most of us as physicians, were actually pretty bad at some of these skills.

I think there's a skills deficit. There's some burnout that plays into it, but regardless of the causes there is an epidemic of physicians who are engaging in poor communication, who are being labeled as disruptive, who are being accused of boundary issues. And these physicians are losing their licenses. They're losing hospital privileges, or they're getting dings on their national provider database report, which if we have time, we can talk about. It's essentially a death sentence professionally speaking.

And physicians have no idea that these levels of behavior are having such huge consequences, particularly in the last few years. And so, that's sort of how I segued into this work. I just started doing it and developed a niche for it. And ultimately that's what led to the book and some of the keynotes that I give.

John: Yeah. In some ways I'm shocked, although when we talked back four years ago or so it seemed like you were doing a fair amount of executive coaching, professional coaching, and this kind of had fallen into your lap as there was a need and you were meeting it.

I'm a little nervous when you're saying it's getting worse, because I can remember back when I was early in my career, some of the things that my colleagues were saying and do in the OR for example, they'd be shocked today. They wouldn't lose their license. They'd be crucified more or less because they were awful. And it seemed maybe things are getting better, but I want to hear more about what your experience has been and why it continues to happen and maybe how to prevent it. But definitely to give our listeners a heads up, that's for sure. Do you feel like this is pretty darn common given the potential consequences?

Dr. Ryan Bayley: Yeah. And you raised this really good point. I think every one of us has stories from our training. There are things that I saw in the OR that physicians did to other physicians, to nurses, on the wards, the way people behave towards each other. And if you were to do that today, it would be criminal almost. Like you said you wouldn't lose your license, you'd just be dragged outside the hospital and shot. And so, it really begs this question, what's going on? Are bad behaviors becoming more common? Is it an actual quantitative increase? Or is it that people are recognizing more subtle behaviors for the problems that they are? So is it like a recognition phenomenon, or is it a reporting phenomenon? Are we finally just willing to do something about it?

I think the answer to all of those is all three. And this is something I talk about. I'm actually giving a keynote in a couple of weeks to the International College of Surgeon's annual meeting in Texas. And one of the things I talk about in that keynote are these reasons.

I think on the recognition front within medicine as physician wellbeing gained traction around 2010 the physician burnout movement got underway. Initially we looked at individual resilience and stress resilience, but over time, that focus on physician burnout has shifted more and more to looking at systems and organizations and culture and are we creating cultures of psychological safety and how are we treating our colleagues? And as part of that, I think there's been a lot more scrutiny of inner physician behavior.

So, it's a recognition issue. We're recognizing more and more that these problems are actual problems. And then of course, that parallels what's happening at the societal level. There's much less tolerance for microaggression, that implicit bias. There's much more scrutiny on seeing subtle forms of racism and misogyny. And so, all of these things coalesce. I think these behaviors are being recognized and called out more, and therefore reported more.

For the reaction piece, I think institutions also now react more strongly because they have to. 10 years ago if you said something bad to a nurse, chances are it would get reported to your clinical supervisor and they would slap you on the wrist and say don't do that. Now it gets reported to HR. Right now with the business of medicine, so to speak, we have the introduction of formal HR and corporate practices into the medical world, and they bring with them paradigms from the corporate world. And in corporate America, these things have not been tolerated for a long time. Medicine is always behind.

And HR professionals look at these behaviors and they don't care about you. They care about what is this going to do to the institution. So they're much more aggressive in reacting and punishing. And also I think they have to.

With social media, it's very hard for organizations to hide things now. If a bunch of nurses keep talking or keep reporting a physician, 10 years ago they would sweep that under the rug if the physician was a high revenue generator. Like someone who was hard to replace, like a neurosurgeon or an interventional radiologist. But now if you do that, those nurses go on TikTok, they go on Instagram, and it can be very powerful because that will then get picked up by mainstream media. And the accountability is thus much higher.

All you have to do is look at what's happening with HCA right now. You look at how HCA is getting eviscerated on TikTok and how mainstream media has started picking that up. And so, organizations have to react because there's just more accountability structures in place. And then the cherry on top of all of that, I think is that the behaviors are increasing. Because I think intolerance has increased in our society. I think most social scientists and political scientists will tell you quantitatively that there's less tolerance in developed countries over the last 10 years.

And when you have less tolerance, it leads to more incidents of incivility and interpersonal friction. And so, I think the behaviors are increasing. They're being recognized more, they're being reacted to more. And all of that is the perfect storm whereby physicians will engage in behavior that again, when you and I trained, we just took for granted. That's just the way medicine was. That attending is a horrible person, but he's a great surgeon, and so it's okay. And that just doesn't work anymore.

And so, physicians are getting called to task on their speech and behavior at much sort of less intense levels than previous. And all of a sudden, they find themselves losing hospital privileges or in front of the medical board, or referred to their state physician health program and they just don't even know these things can happen. They're real threats to their career.

John: Okay. Well, I'm going to have to ask you to give us a couple of examples. I may not have prepped you to do this, but I know you know many examples. Pick a couple that maybe aren't so obviously egregious that you're like, "Well, this is what happened, and they ended up being suspended for a period, or they lost their license." And just a couple of examples that maybe we're not really thinking that these kinds of things would be a trigger.

Dr. Ryan Bayley: Sure. I give a lot of examples in the book, and some of them are pretty egregious, but some of them are definitely more subtle. For example, a physician I worked with not that long ago, who's a surgeon, always had a friction filled relationship with the OR manager who was a nurse by training and ran sort of the OR turnover. And they always were butting heads. The rooms aren't turning over fast enough, you're not doing your cases fast enough.

And so, one day she approaches him in the hall and says we can't start your case because we can't find the consent form. And he knew the consent form had been signed, and he thought she was just dragging her feet and whatever. This kind of escalates. And he has two med students with him, and he says let's not talk here. Let's go talk in your office and puts his hand on the back of her shoulder as they're starting to walk to their office. I don't think he in his heart of hearts in any way meant that to be aggressive. She did not like that.

But long story short his hospital, like almost every institution has an absolute zero tolerance policy for touch. You cannot touch a colleague under any circumstances. If they drop dead in the hallway, you might be allowed to do chest compressions, but that's probably it.

And so, regardless of who escalated that conflict, and what she said to him, he touched her and he was clinically suspended for multiple weeks. He was referred to the state medical board, he subsequently was referred to the state physician health program, and this turned into about a yearlong process where he was under very increased scrutiny and lost revenue because he was clinically suspended and was at high risk of losing privileges permanently.

And to him that moment of touch, to him felt like really nothing. And yet the landscape has changed and you can't hug anyone. You can't touch anyone. You can't even gesticulate wildly in an aggressive manner. That will all be interpreted as hostile. So, that's just very typical of a lot of the examples. I think a lot of people assume that physicians who are referred to me are doing very bad things and they're doing them repeatedly.

But I will tell you 90% of the physicians I work with are doing things more along the lines of what I just said. And most of them have never been called the task on their speech or behavior before. Most of them have perfectly clean records, so to speak. They've never had issues with the medical board or state physician health program. And yet they're finding themselves immersed in these systems being scrutinized.

Another example. An orthopedic surgeon. I'm sorry I'm giving so many surgical examples, but it's not just surgeons. But an orthopedic surgeon was at a hospital he worked at. There was a CRNA who he knew well. They had worked together for many years. They had a very collegial relationship in the OR. They would talk about all types of things during cases, and she went out on personal leave for breast augmentation. And this was well known. This was something that she had talked about openly with the surgeon as well as other staff. Everyone knew why she wasn't at work.

She comes back to work a few weeks later and they're walking down the hallway and he just makes a comment to her, something along the lines of like they did great work. And said it in front of a couple colleagues, all of whom had been privy to the previous conversations that she was getting a breast augmentation and excited about it. He thought the comment would be well received, and he didn't think it was particularly out of keeping with other conversations that they had, but she was clearly flustered and upset. You could tell by her face according to the surgeon.

She reported it to her HR. And we can talk about this a little bit more what happened subsequently, but it ended up resulting in a national provider database line item, which every future employer, every time you apply for privileges, every time you apply for medical licensure or even every time you just try to get billing privileges with an insurance company these types of national provider database dings will haunt you. And it made serious problems for him moving forward.

John: Yeah. He definitely stepped over the line, there's no question. But yikes, you just think for a minute, you lose your concentration, you say something stupid, and there you go.

Dr. Ryan Bayley: And that's what it is. And please understand, I'm not defending him. He clearly made content of a sexual nature. And even though she had brought it up previously, it was clearly a bad call on his part. But I think the degree of reaction, the ramifications is something that as physicians we are not used to or we don't anticipate. I think 10 years ago, again, if that had happened, she would've reported it to her clinical supervisor, which would presume would be the nursing supervisor who would then go to the clinical head of orthopedic surgery, and then that person would have a talk with the physician. And that would probably have been the end of it.

And that is not what's happening now. All it takes is a moment of incivility with a colleague, an inappropriate joke, violating someone's personal space, coming across hostile in an email. Just capitalizing words in a text, that's interpreted as hostile or passive aggressive. That's all it takes for these incidents.

John: That's crazy. How do you read into a text that technically has no emotion in it, but obviously people all the time get an emotional response thinking that it's emotional. You have five minutes to explain to a brand new resident, protect them for the rest of their lives. What are the things you would say in terms of "Be aware of these things?" These are the most common that I see or these are the things that we don't think about. Maybe just give us a quick rundown of a few things to know when you're entering into these environments and being subject to all that scrutiny.

Dr. Ryan Bayley: Yeah. I think the most important thing to know is that you are in fact subject to all that scrutiny. And I think that is a change in the landscape, and arguably for the good. But nonetheless, I think it's something that physicians just don't anticipate or understand. And it's moving pretty quickly, the amount of scrutiny on your behaviors is increasing, if nothing else.

Just the fact that if you're going to lose your ability to practice, it's not going to be or unlikely to be through malpractice or personal disability, or some huge regulatory snafu. These are the dangers you know and these are dangers that we protect ourselves. Again we have personal disability insurance. We practice extremely conservative medicine. That's how we protect ourselves against those known threats.

But it's really these unknown threats that are going to get you. And then I would probably just list the chapters of the book. Each one of those chapters is a key area. But I'd say the big five are incivility. And incivility is a subset of unprofessional behavior that's less intense when it happens. But nonetheless, no less problematic. And actually going through examples of incivility so that they understand that incivility is not just verbal, but it's sematic. It's how you use your body. It's how you opt out of things. Incivility is sometimes the behavior you don't do. Giving them a real good grasp of incivility in where they might be prone to it. That's one major category.

The other category is just not so casual conversations. There are just things you can't talk about. I think where we get in trouble as physicians is when you work 60 hours a week, plus another 10 to 20 hours of unofficial uncompensated time, your work is the bulk of your waking hours. And when your work is life as it is for many physicians, work has to be the place where you vent and flirt and talk about politics and make off-color jokes and you do all these life things. But it can't be any of those things anymore.

And so, you really have to have other social outlets, and you also just have to know what these topics are. Someone has to sit you down and just list them. And some of them are pretty obvious, don't talk about religion, but some of them like I'd say an area where a lot of people screw up is like LGBTQ. Especially with various issues around transgenderism being in the news.

As physicians, there's a lot we can say about the biology of being a sexually reproducing species. And we can sort of approach those conversations empirically. But when we do so, we have a tendency of negating other people's personal lived experience. And so, one of the ways we get in trouble is we talk about a lot of conversations, topics, very cavalierly or from a very sort of scientific perspective, when that's not how they're received by someone who may be actually living that experience. A physician or nursing colleagues. Understanding that there are elements of privilege in these topics that we have a tendency to doctor eyes them and that never works well. Just understanding how these conversations are pitfalls. So, that's number two, is casual conversations.

Number three is really electronic communication. And I use that as an umbrella term. The problem with all of these ways we communicate electronically, which includes social media use, and I think particularly for younger physicians, that's a huge pitfall, is there are just so many ways to get in trouble, not just with HIPAA, but with sort of conduct unbecoming as perceived by your institution.

If you're a physician, you should not have a social media presence. And that's a very hard concept for people who are under the age of about mid-thirties to understand because they grew up as digital natives. But it really is only downside when you post things on TikTok or Facebook or whatever your preferred social media is. That's just quicksand and there's so many ways to go awry. Just as there are so many ways to go awry with the HER, with all this electronic texting that we do now with systems like Halo and Click. We don't call anyone anymore in the hospital. We just text them, right? HIPAA compliance solutions.

And just like you mentioned earlier, we were touching upon, when you text someone, it doesn't have the benefit of your tone of voice or your body language. No one can perceive all those non-verbal aspects of communication. And so, a text can be very well-meaning for you and be interpreted completely differently by the recipient and result in a complaint made against you. And it's going to be very hard to talk your way out of that because in these cases, perception is nine tenths of the law. And in these cases it is not innocent until proven guilty. It's really the opposite. And that's sort of how administrative law works in regards to medical privileges. You're going to have a very hard time convincing people that you meant something else. And so, electronic communications are a pretty big pitfall as well.

Another area I would focus on is what I call disruptive advocacy. I think as physicians, particularly given the challenges of the current medical system, we spend a lot of time trying to advocate. Advocate for patients. We spend a lot of time dealing with administrators trying to convince them why they should or shouldn't do something. And what we see as heartfelt advocacy really comes across as disruptive and almost belligerent.

And unfortunately, organizations have figured out that the best way to shut a physician up is to label them disruptive. And so, this term has almost become weaponized. You really have to have a skillset for dealing with the people above you. Administrators. Over 50% of physicians now are employed physicians, meaning we all have bosses. And a lot of us went into medicine thinking we would never have a boss, but we all have bosses now.

There's a whole skillset called up managing. How do you deal with the powers above you? How do you advocate and have influence and get your points across without generating friction? And so, I would really implore any young physician to develop that skillset. And those are the big areas that are coming to mind.

I mentioned five. The fifth one would just be touch. I think what is considered acceptable in terms of touch has changed dramatically, even with patients. Obviously a patient comes to us and the assumption is they know we're going to examine them. They know we're going to touch them. But even then, you have to be very careful with obtaining verbal consent and making sure you always have a chaperone in the room.

And of course, there's pressures in contemporary medicine to not have a chaperone. If you have to slow down your patient encounter to go find a nurse of a different gender to be in the room with you, that's a pain in the butt and you've got 30 people to see today.

But nonetheless, it's just not worth it. It's just not worth not doing that. And so, I think being very aware of touch, how you communicate with the powers, how you use electronic communication, just your overall content of conversation at work, and also just your tendency to be uncivil. Those stress points that we all have. I'd say those are the big pitfalls, and it's a lot. That's not a five minute answer, but that's what every physician in training needs to have figured out before they're attending or before they're a resident, to be honest.

John: Yeah. Yeah. It can happen at any point while you're interacting. I'm going to ask you to expound a little bit on the issue of why physicians are confused in the sense that we live in a free country and I'm innocent until proven guilty, and that's not really the world we're talking about. So, explain how that works.

Dr. Ryan Bayley: Yeah. For lack of a better word, there is a hidden system. And hidden sounds nefarious, but hidden just that we're not educated about. There's a whole system for dealing with these issues. And I think what happens is, as physicians, we assume that if someone's going to accuse us of something, that there's a certain way that process is going to play out. And we make those assumptions based on what we know about criminal and civil law.

And due process for civil, and particularly for criminal law, is very different than what we're talking about here. These things, hospital privileges, the privilege to practice medicine in a given state. These privileges fall under what's known as administrative law. And administrative law grants very broad powers to the agency or the organization itself. The organization is going to be judge, jury and execution. What they call due process is not going to be what you think is fair due process. They do not have to be transparent. They don't have to involve you as much as you think they would when a complaint is made against you.

And perhaps most importantly of all, you are not innocent until proven guilty. That only applies in a criminal court. In a civil court, they have to prove more likely than not you did something bad. In administrative law, the burden of proof is even lower. It's really whatever the hospital wants it to be. And so, it's very hard to defend yourself in a lot of these situations because these situations come down to perceptive. If someone says you were hostile during a consult or said something that was sexually inappropriate, or moved your body in a way that created a lack of psychological safety for someone, it's going to be very hard to disprove those things. And it doesn't really matter what your intent was.

And so, I think the way people get blindsided straight out of the gate is they assume a due process. They assume that this process is going to play out in a certain way, and it just doesn't because they're ignorant about administrative law. And then there's this whole domino effect. There's a good chance as part of this issue, you're going to be reported to the medical board or the state physician health program, or you're going to go to the medical board and they're going to refer you to the state physician health program and the state physician health program most physicians have no idea that such a thing even exists. But there's one in almost every state.

And they will do very elaborate assessments to try to figure out what's driving this behavior, and then they're going to have recommendations like working with a therapist or a coach, or taking a boundaries course, or some type of educational component that you're going to have to pursue. And if you say, no, that's fine, it's voluntary, but your organization's probably not going to allow you to have privileges unless you play along. And so, it seems voluntary, but it's really not.

And the next thing you know, its 18 months later and you've spent tens of thousands of dollars dealing with this and going to courses and having a physician coach or therapist, and you've been under incredible scrutiny and a zero tolerance performance improvement plan. And most physicians who go through this say this is worse than malpractice. Most of the physicians I've worked with say "I've been sued and I've gone through this process, and I'd rather be sued."

John: Wow. That's something.

Dr. Ryan Bayley: Yeah. And so, it's incredibly time and money intensive. It's incredibly cognitively and emotionally expensive. Again, for behaviors that a lot of physicians just don't think will, for lack of a better word, "be" this big a deal. And so, that's what I try to communicate to physicians. This is how it works. And you need to understand this system. You need to know what to do if you find yourself in it. And more importantly, you probably just need to avoid it, which means really educating yourself on how you are at work. Because it's not the clinical stuff that's going to get you. You're going to do clinical care fine. It's this stuff that's going to screw your career.

John: Man. All right. This is really an important topic. We're going a little long, but I have one more quick question that comes right from that. And again, we can read all about this and should read all about this in your book, which we will really talk about just for a minute and where they can get it. But if I get a whiff that this is happening, if I have someone say, "Hey, we're going to have a meeting because you were reported", or whatever it might be, what would be the first one or two or three things that you should do or not do?

Dr. Ryan Bayley: Yeah. I have a whole chapter on this called damage control. The first thing you need to do is you need to take it as seriously as a heart attack. Again, what happens as physicians is when we're training, it's all about clinical and technical competence. When we're training, it's about learning patient care, and that's all anyone judges us on.

And so, what I think happens is we carry that mentality forward. When someone comes to us with a complaint, the first thing we're going to ask is, "Well, how'd the patient do? Who died?" And of course, these types of situations, they're almost never about a patient and the patient doesn't die as a result. And so, as soon as we realized there's not a patient care component, we're like, "Oh, okay, this is nothing. This is not a big deal."

That's I think where you set yourself up to be blindsided. As soon as someone calls you to task on your behavior or says there's a complaint against you, you need to seem like you care. You need to be responsive. Someone asks you to set up a meeting, you make that meeting, and you make it happen.

Someone sends you a request for a response, you create that response promptly and non-defensively. You play the game and you act like a concerned participant. I think about half the physicians out there shoot themselves in the foot because they're lackadaisical from the get go. I'd say that the first thing is to take this extremely seriously.

The second thing is don't assume due process. Don't assume for the reasons we just discussed. If you assume those things, you're probably going to get blindsided. The third thing is lawyer up or find some resource. A lawyer is a great resource one who specializes in employment law, one who hopefully has interacted with medical boards and hospital executive committees.

But even if you don't find a lawyer, a mentor, someone who's been in the organization a long time, someone who may be held an administrative role and kind of knows how these things play out culturally within your institution. Just some type of advocate and resource. My book is a good resource, but I wouldn't stop there. I would avail yourself of all resources possible because it is that serious.

And if you get a lawyer, for example, they can't jump up and object and argue the way they would in a court of law, but in these types of proceedings, you're almost always allowed to have an advocate with you.

And your lawyer can sit there and interpret and help you craft responses and help you understand your contract and make sure that everything remains above board so they can be a huge asset.

I've seen a lot of physicians just again, be very passive. They don't want to escalate things, they don't want to make things adversarial. So, they go it alone with no knowledge about how this system works with no one on their side. And your entire livelihood is at stake. If you have to pay $5,000 for a lawyer, that's probably the best money you've ever spent regarding your medical education. Yeah, avail yourself of all resources. And I'd say those three things are the first three things you got to do the moment you hear your name in the same sentence as complaint, disruptive behavior, problematic. Anything negative at all, you need to start thinking this way.

John: A lot to think about but good advice. All right. Tell us where we can get the book.

Dr. Ryan Bayley: Yeah. The book right now is available on Amazon as both paperback and Kindle format. My last name is Bayley. I think sometimes the hardest part of finding the book is spelling my name correctly, but as you said, it's called Physician Non Grata. I of course have a copy right here for anyone who can see the video, but you can get that on Amazon right now. It'll be available on Barnes & Noble probably in about two to three weeks as both a paperback and Epub book.

I would recommend don't wait until something bad happens. I think half the value of this book is as a cautionary tale. I have a lot of interests from residency directors and administrators who really like the book to try to get it out there before bad things happen. Because once you're immersed in the system, once you have a complaint against you, you're really fighting an uphill battle. And so, as cheesy as it sounds, prevention is the best medicine. I think that's a lot of the value of the book. So, yeah, I of course think every med student in the country should be reading this book, but I might be a little biased there.

John: You might be, but I think the earlier you are in your career, probably the more important it's to get this book. Because if you've made it 30 or 35 years through and never had a problem, then maybe you're going to be okay but I suppose.

Dr. Ryan Bayley: You hope, but I will say the age range of physicians who are referred to me, there is no consistency in that pattern. Two years out, 20 years out, you would be surprised. Yeah, you would assume that if you've made a couple decades in medicine that you're going to make it maybe another decade without an issue. And yet even very seasoned physicians find themselves in these situations. And nine times out of 10, they probably could have been avoided with a little more social emotional awareness, a little more sense of what the healthcare landscape is really like in terms of working as a healthcare provider. Understanding how current trends in society are impacting that. I think the book it's of value to anyone of any age, any point in their career.

John: All right. And what if somebody wants success or professional or business coaching? Obviously, you have a website we can go to and find out about that.

Dr. Ryan Bayley: I do. My website is It's all one word, And that's really my composite website, which talks about my individual coaching as well as my institutional work. And if you go on the contact page, it actually provides links where you can just access my calendar directly and we can set up a session and talk.

Sometimes all it takes is one session to help people figure some things out and move things in the right direction or sometimes it takes more than one session. I'm available always, whether it's dealing with career design and nonclinical transition, or about 50% of my work now is these types of issues that we just talked about. If you find yourself immersed in one of these processes, don't hesitate to reach out. As I said, avail yourself of all resources because it's that important.

John: An institution that might want to have you come and talk to their staff or something can obviously do that as well, I'm assuming, particularly about this issue.

Dr. Ryan Bayley: Yeah. And that's already happening with this book. Even the pre-public copies have resulted in speaking gigs. And I have a keynote that I give as well as workshops, not just on the content overall, but each chapter really lends itself to an individualized workshop. And so, I've done all of that. And as we mentioned, I'm talking at the international College of Surgeons annual conference coming up. I'm hopefully distributing some of these books at the Federation State Medical Board and Federation of State Physician Health Program conferences that are coming up. And so, yeah, there's lots of opportunities like that. But if you're an administrator or in some type of institution or practice group and you want a little preventative medicine for your group, I'm more than happy to facilitate that for you.

John: That's excellent. We'll put that link in the show notes. We'll put a link to the book Physician Non Grata in the show notes as well. And maybe we'll have to swing back sometime in a year or so and see if things have quieted down in terms of this issue. I hope they do.

All right, well, that is all the time we have. I really want to thank you for coming, Ryan. This has been really interesting and important. To me, I really feel like this is one of the most important conversations I've had in this year and last really about this topic. So, I'm glad you contacted me, let me know about the book.

Dr. Ryan Bayley: Thank you for having me. It's always a pleasure to be on the podcast and to see you again. We mentioned before, we're not crossing paths quite as much as we used to with conferences being canceled from COVID but hopefully that's all coming to an end now and we'll see each other in person soon.

John: That'd be great. There's more live events, that's for sure. Okay, Ryan, thanks a lot and I hope to see you then. Bye-bye.

Dr. Ryan Bayley: Thank you.


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