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Toxic Docs Require Management Finesse

Joe Cantlupe, for HealthLeaders Media, August 8, 2013

Healthcare organizations are working to both discipline and reform physicians who display disruptive behavior. The process requires leaders to strike a tricky balance between "managing disruptive behavior" and "caring for and protecting the victims," says one expert.

A physician shoving a colleague in the operating room? A doctor yelling at a nurse, resulting in patient harm?

Two years ago, reports of those incidents were included in an American College of Physician Executives' study on disruptive physician behavior [PDF], which revealed that more than 2 out of 3 doctors witness other physicians disrupting patient care or collegial relationships at least once a month.

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"Disruptive physician behavior is the issue that just won't go away," Barry Silbaugh, MD, of the ACPE said in a statement after that report was released. Indeed, it doesn't.  

Just this week, the Robert Wood Johnson Foundation released a report linking physician verbal abuse of nurses to nurses' low opinion of their work environments. As one of the co-authors noted, "Physicians' verbal abuse of nurses is a long-standing problem and one we need to do much more to address."

Indeed, disruptive behavior can be wide-ranging in its scope, ranging from verbal abuse to physical or sexual harassment, to confrontations or conflicts that cause significant fallout. When physicians are disruptive, disciplinary action may follow.

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1 comments on "Toxic Docs Require Management Finesse"


Robert Fielder, MA (8/8/2013 at 4:46 PM)
The consequences of a disruptive physician's behavior can be among the most destructive to the effective delivery of medical services! Whatever the environment, behavior of this sort falls under the heading of workplace conflict and as other employers in other industries have repeatedly demonstrated, there's considerable benefit to be gained from implementing the full range of Dispute Resolution Techniques. Taken together, the various strategies and resources that can be deployed, in additional to those cited by Florida Hospital and DePaul University, constitute a Dispute Resolution System (DRS). A DRS can be locally designed and customized (usually by a multidisciplinary committee) at each hospital or practice. They are specifically designed to accommodate progressive discipline and incorporate coaching of and counseling with the offending individual. But [INVALID]ing the behavior is just the first step in the process. Effectively demonstrating to the offended individuals that such a change of heart has been accomplished requires that the offended individuals be involved in the search for effective resolution, as well. The participation of these fellow physicians or nurses, with the aid of peer or professional coaches, facilitators or mediators is the key to rebuilding the fractured relationships and that's the final step in the successful restoration of a functional healthcare team.