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Physician, Heal Thy Disruptive Behavior

Joe Cantlupe, for HealthLeaders Media, July 21, 2011

Physician disruption at his hospital mostly manifested itself in doctor relationships with nurses, Feeney says. It was typically triggered by "a culmination of a series of problems that occurred before" someone lost their temper.

Feeney says he's seen outbursts at the hospital where physicians, in his words, were "acting like four-year-olds," he among them. "There have been times where I've had to deal with these individuals (causing disruptive problems), and sometimes I've had to deal with myself," Feeney says. "That behavior is not tolerated and will not be tolerated in the future. We can't bury our heads in the sand."

Experts say physician disruption issues start in medical school. "Combating this phenomenon is an uphill battle," Barry Silbaugh, MD, MS, FACPE, CEO of American College of Physician Executives wrote in a foreword to the organization's report. "For many of us, this is behavior we learned from abusive instructors in medical school. The constant stress, long hours, and bureaucratic quagmires inherent in health care serve to exacerbate the situation. It's not getting any easier in this era of reform, where the rules seem to shift from day to day and the financial rewards may be shrinking."

Still, too many physicians still don't recognize that "heal thyself" applies to them.

Alan Rosenstein, MD, medical director of Physician Wellness Services, Minneapolis, MN, which advises physicians dealing with stress and burnout issues, says there haven't been enough advances in dealing with physician misbehavior issues.

 "If you look at the results in the current ACP (report), it's exactly the same kind of results we were seeing in other studies in 2000, 2005, 2008 and 2010," Rosenstein says.

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