Sometimes, the situation is hopeless, and a know-it-all, bombastic physician won't try to change his attitude and outbursts. In those cases, the doctor has to be dismissed. But other physicians who act in a disruptive way may recognize trouble with their own behavior, have a desire to improve, and make a commitment to work vigorously for change.
That's why it is important to examine the root causes of disruptive behavior, understand the culture of medicine, and develop programs that could rehabilitate physicians from an organizational and individual perspective, says Hardley Paolini, PhD, LP, a licensed psychologist and director for Physician Support Services at Florida Hospital in Orlando.
Hospitals straddle the line in determining which physicians must be ousted after failing to respond to disciplinary action, and identifying those who can be rehabilitated. Making inroads in this improvement process can be a sensitive balancing act.
Too often, Paolini says, healthcare has not kept up to the challenge of disruptive physicians. "We have not trained our physicians for the resiliency they need, for the teamwork they need right now. When you see 40 to 60% of burned-out physicians, you are going to see some of these behaviors come out not only in depression, but also in aggression," she says.