Disruptive doctors can compromise patient care

Every workplace has its share of cranky, rude, or passive aggressive staff members, but when that person is a physician, patient safety is at risk. More than three-quarters (77%) of respondents to a 2008 Joint Commission survey said they had witnessed disruptive behavior by physicians, and 67% agreed that disruptive behavior by doctors leads to adverse events. Furthermore, disruptive behavior can lead to poor communication among care team members and higher staff turnover. When physicians were independent practitioners, hospitals had little authority to prevent disruptive physician behavior or take disciplinary action against physicians who engaged in it. However, with more and more physicians becoming hospital employees, hospitals are now expected to take action. The Joint Commission published standards on preventing and dealing with “behaviors that undermine a culture of safety” which include the following:

• Verbal outbursts
• Physical threats
• Refusing to perform assigned tasks
• Quietly exhibiting uncooperative attitudes during routine activities
• Refusal to answer questions
• Condescending language or voice intonation

To address the problem, many healthcare organizations have created programs for disruptive physicians. Staff members who observe disruptive physicians can refer them to the program for counseling which may include anger management counseling or leadership skills training. Giovanna Zerbi, PsyD, teacher at University of California, San Diego, told MedScape that many physicians lash out in disruptive behavior as a reaction to what they perceive to be a loss of power. Physicians are increasingly being asked to work collaboratively as part of a healthcare team, instead of giving orders to other providers. She also said physicians who practice in high-stress specialties, such as OB/GYN, surgery, and emergency medicine, are more likely to be disruptive. As healthcare models continue to move towards more collaboration, it will be important to make sure physicians understand how to effectively operate in a team environment without yelling or threatening staff members.