How Big a Problem Is Disruptive Behavior by Physicians, and What Can Be Done?

When a physician engages in disruptive behavior, defined by the AMA as “verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised,” the ripple effect of the behavior can be extreme and the results quite dire, according to studies.1

Nurse retention

HowBigaProblemIsDisruptiveBehavior-1

In a 2005 study, nurses called disruptive behavior the single most important contributing factor to lowered job satisfaction and morale and 31% said they knew at least one nurse who left because of it. Given the cost of replacing a nurse can be from 1.5 to 2 times his or her annual salary, the bottom-line impact of disruption is a serious concern.2

Patient safety

According to a 2003 survey by the Institute for Safe Medication Practices, 49% of clinicians have felt pressured by an intimidating physician to dispense or administer a drug despite their serious objections based on safety concerns. In fact, 40% have kept quiet rather than question the intimidator.3 In a 4,530-participant survey conducted at 102 VA hospitals, 67% of the respondents said they felt disruptive behavior was linked to adverse events, 71% saw a link to medical errors and 27% saw a link between disruption and patient mortality.4

Patient and family dissatisfaction

A 2011 review of complaints to state medical boards from patients and family members showed 36% of them were related to inappropriate behavior by physicians.5

The evidence, then, is clear. Disruptive behavior by physicians is no longer “par for the course,” a regrettable but natural aspect of medicine’s authority structure, but rather a hazard to be understood and worked against for the benefit of everyone involved in medicine.

To adequately address disruption, leadership needs to take three crucial steps, according to the research and recommendations of employment attorney Judith Holmes and healthcare-business consultant Leigh Olson, in an article for the Medical Group Management Association.6 The three leadership steps include:

Confront the problem: Let staff know the administration takes the problem seriously, the incident is not
“business as usual.”

Enlist help: Working with at least one other physician, set a meeting with the disrupter; allow them to explain
their understanding of the incident; tell them a performance improvement plan is being drafted, to which they
will be strictly held.

Develop a prevention plan: A set of policies and protocols on behavior that all must follow.

For details on dealing with disruption, see our article “How to Successfully Manage the Obstacles of a
Disruptive Physician.”

Visit our Physician Intervention page for additional resources and information. Contact VITAL WorkLife today at 877.731.3949 or by visiting us online.

New call-to-action

Tagged with → aging physiciansEmotionalLeadership/ManagementPhysicianPhysician/Providerphysician well beingProfessionalretirementMedical Professionals

  • aging physicians
  • How Big a Problem Is Disruptive Behavior by Physicians, and What Can Be Done?
Author

Sarah Prom, MA, LPC, ODCP

Sarah leads the Service Delivery Team for VITAL WorkLife and serves as a Senior Consultant and Practice Lead for our organizational clients. She has more than 15 years of counseling, coaching and mediation experience. Sarah has trained nationally and internationally and has expertise in the areas of team development and facilitation, workplace stress and conflict management, relational issues and emotional intelligence. Sarah received her Master of Arts in Counseling from the University of North Dakota, is a licensed Professional Counselor, a Certified Transformative Mediator, an Organization Development Certified Professional (ODCP) and serves on the leadership team at VITAL WorkLife.