Dr. Roth is an Orthopedic surgeon with ten years of experience at your hospital. He consistently maintains a high-volume case load, generates significant revenue, and is respected by his fellow surgeons. Over the past year, you have received numerous complaints from patients and support staff regarding his perception of the hospital's culture, and the demographics of patients he cares for. One-on-one counseling has been conducted with Dr. Roth, as well as multiple written warnings to amend his behavior with patients and support staff. Dr. Roth is resistant to change, and continues to spread negativity among his colleagues and patients, to the point of damaging the hospital's image.

• Discuss the challenges you might face related to removing (terminating) Dr. Roth. What factors should you consider?
• Briefly summarize a professional response you could provide to other members of your hospital's leadership team when they ask why you are recommending termination of this physician.