Beyond Disruptive Physician Behaviors: Issues and Answers
Have you ever had a problem dealing with disruptive individuals who negatively affect staff and patient relationships, process flow, communication efficiency, and care coordination?
You're not alone. When I originally started this website several years ago the main focus was to recognize and address issues related to disruptive physician behaviors and how they negatively impact staff relationships, process flow, and task completion that can lead to gaps in communication and accountability that may result in preventable medical errors and adverse events.
Disruptive behaviors can take many forms. The more obvious form involves overt intimidating verbal or sexual harassment manifested by inappropriate and non-professional, disrespectful, berating, condescending, and abusive behaviors. A second form of disruptive behavior includes more passive- aggressive type behaviors that sabotage and undermine performance behind the scenes. A third type of disruptive behavior includes non-compliance. This can include delays in returning calls or failures to comply with expected clinical and/ or administrative policies and procedures. All of these behaviors can compromise the care management process and negatively impact the delivery of best practice care.
Over the past several years I have learned that many organizations continue to struggle in developing a consistent effective process to deal with these types of behaviors. These issues need to be addressed. What I am seeing now is a more extensive problem with physician adjustment and engagement perpetuated by the growing pressures and complexities in today's health care environment. On one side is the need to improve physician communication and collaboration in their leadership role as part of an integrated multidisciplinary health care team. On the other side is the growing amount of frustration, anger, stress, and burnout invading our physician population. While still need to council physicians about inappropriate behaviors, equally important is to recognize and respect physicians as being a precious resource and provide the necessary support services to keep them going.
Years of experience as both a practicing physician and Medical Director have given me a better understanding of physician concerns, stresses, barriers, priorities, and motivations that affect physician behaviors. My belief is that no one intentionally starts out the day planning to be disruptive, it's just that a variety of internal and external pressures influence behaviors that may cross the line between professional and unprofessional standards of performance. My focus is to work with physicians in a positive supportive manner to raise their levels of awareness as to the seriousness of the issue, establish accountability, and provide education and support to improve their behavior and communication styles. Physician engagement is only one part of a ten step process that requires a system wide multidisciplinary integrated approach necessary to achieve a successful outcome.