Addressing the Underperforming Clinician: A Leadership Challenge

Medical groups striving for high performance inevitably encounter the challenge of clinicians who fall persistently below median on key metrics. In this article published in the Physician Leadership Journal, Howard Graman, MD, FACP — Vice President of AMGA Consulting — examines the three most common categories of provider underperformance: low productivity, poor clinical quality outcomes, and low patient experience scores. For each category, Dr. Graman identifies the root causes leaders most frequently overlook and offers concrete, actionable interventions — from shadowing and peer coaching to EMR competency training and communication skills development. The article underscores the importance of assuming positive intent and providing structured support before escalating to more consequential conversations.