Examining Effects Of Physicians' Disruptive, Abusive Behavior
The New York Times on Tuesday examined how some physicians' negative behavior "contributes to medical mistakes, preventable complications and even death," in addition to "low morale, stress and high turnover" among hospital staff.
According to a survey of health care professionals at not-for-profit 102 hospitals from 2004 to 2007 conducted by Alan Rosenstein of VHA, 67% of respondents thought there was a connection between disruptive behavior and medical mistakes, and 18% said they knew of an error that occurred because of an "obnoxious" physician, the Times reports. One-third of the nurses in the study knew of a nurse who had left a hospital because of the behavior of a physician. In addition, a survey by the Institute for Safe Medication Practices found that 40% of hospital workers reported having been so intimidated by a physician that they did not share concerns about prescription orders and, as a result, 7% said they had contributed to a medication mistake.
William Norcross, director of a program at the University of California-San Diego that offers anger management classes for physicians, said that while the majority of physicians are trying to do the best job they can in high-pressure situations, "About 3% to 4% of doctors are disruptive ... and they really gum up the works." Experts say disruptive physicians are most likely to be specialists in high-intensity fields like cardiology, neurology and orthopedics, the Times reports.
The Times reports that "things have begun to change" as there are indications "that such abusive behavior is less likely to be tolerated." According to the Times, "Today, good communication and leadership are two of the six core skills taught in medical schools and residency programs," and hospitals are "trying to improve relations and mutual respect between doctors and nurses." Thomas Russell, executive director of the American College of Surgeons, said many hospitals now are either firing disruptive physicians or sending them to anger management classes.
The Joint Commission has required that hospitals develop a written code of conduct and a means of enforcing it. According to the Times, some physicians are concerned that the codes of conduct will be abused by hospital administrators to eliminate physicians who speak out against hospital policies. According to the Times, "[T]he Joint Commission rulings have spawned a cottage industry of anger management centers and law firms defending hospitals or physicians" (Tarkan, New York Times, 12/2).
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