Healthcare News & Insights

When good doctors go bad

No one likes to talk about it, but disruptive behavior and interpersonal drama in hospitals and medical practices is putting patients at risk.

That’s the message from a recent survey by the American College of Physician Executives. The organization asked 13,000 physician and nurse executives to report on disruptive, abusive and unprofessional behavior in their hospitals and practices.

The results paint an unsavory picture, and highlight how petty staff bickering that might be shrugged off in a business office can have lethal consequences in a health care setting.

Among the findings: 97% had experienced “unprofessional outbursts” — most said it happened several times a year. Some said it occurred weekly.

The most common kinds of disruptive behavior:

  • Degrading comments and insults — experienced by 85% of respondents
  • Yelling — 73%
  • Cursing — 49%
  • Refusal to work with a colleague — 38%
  • Refusal to speak with a colleague — 34%
  • Throwing objects — 19%
  • Spreading malicious rumors — 17%
  • Sexual harassment — 13%
  • Physical assault — 3%

Doctors took the brunt of the blame: Although 48% said doctors and nurses were equally likely to fly off the handle, another 45% said doctors were the most common offenders. Equally troubling: Most respondents said management didn’t take cases of physician outbursts as seriously, and that nurses were far more likely to be terminated for abusive or unprofessional behavior.

It’s clear from the research: In a medical facility, co-workers’ squabbling can directly impact patients. In one case,  a nurse delayed reporting new complications an intensive care patient was experiencing because the nurse feared the on-call doctor’s temper. Eventually, the patient died. An investigation of the incident indicated the delay in reporting contributed to the death.

Policies and training

It may seem that educated professionals shouldn’t need training and reminders to  just be nicer to each other and act like professionals. But the research shows that some do.

Most health care organizations already have programs and policies in place to prevent such disruptive behavior. But if the rules are applied unevenly, as the survey indicates, that can actually backfire.

It’s also important to make sure employees at all levels and in every department can bring workplace problems to management’s attention without fear of repercussions or of not being taken seriously. Otherwise, staffers clam up, and those issues just grow larger  — until somebody bursts.

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Comments

  1. The findings fit our experieince as well. As a practice administrator I preach “there is nothing so unequal as the equal treatment of unequal people.” The docs are harder and more expensive to replace, therefore, they get unequal (better) treatment than the all others. I might add they also expect and demand better treatment with less consequences. Its just an economic fact of life in any business. Rank has its privledges; and staff abuse sems to be hgh on the list.

  2. Tracey, RN says:

    DrHAwc, you make a thoughtful point but there really is no excuse to abuse a cowork in any job, much less in a service oriented one like healthcare. As a practice administrator, I would think the HR implications would at minimum get some attention from you. I’ve had a physician throw a used a needle/suture at me during an operation. A friend of mine at a different hospital was punched in the stomach by a physician during an operation. She of course took it to court but I was afraid of repercussions and did nothing. To “expect and demand” better treatment is childish and you must know that everyone can be replaced. Sometimes a humbling moment comes when one least expects it. Perhaps the effects of “Obama-Care” will provide that.

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