Disruptive Behavior by Physicians & Other Health Care Professionals

     "Disruptive physician behavior represents a threat to public health by negatively impacting the safe & effective care of patients. Disruptive behavior also undermines effective staff retention, increases malpractice risk, & jeopardizes patient safety specifically related to the culture of avoidance that ensues. Maladaptive role modeling perpetuates this cycle to the detriment of the empathy, wellness, & overall professionalism of medical students, residents, & allied health professionals.
     Despite a mandate from the Joint Commission to have policies in place to define disruptive physician behavior and intervene when it is identified, many academic institutions, hospitals, practices, & licensing boards are grappling to develop effective means for handling these vexing difficulties. Some are unaware of available resources & feel reluctant to intervene, and some might even believe that disruptive physicians are incapable of change. Sadly, many of these physicians’ behaviors are tolerated until a crisis emerges, such as a patient injury or staff complaint, at which time disciplinary action ensues.

     The American Medical Association defines disruptive physician behavior as 'personal conduct, whether verbal or physical, that negatively affects or that potentially may negatively affect patient care.' This includes but is not limited to conduct that interferes with one’s ability to work with other members of the health care team. However, criticism that is offered in good faith with the aim of improving patient care is not to be construed as disruptive behavior. 
     Disruptive physician behavior may be verbal (foul language, intimidating language, belittling or demeaning words) or nonverbal (facial expressions or other body language, throwing things). The behavior also may be aggressive (see above), passive (chronic lateness, failure to write chart notes), or passive-aggressive (hostile or inappropriate notes, or derogatory comments about colleagues or institutions)."

       Samenow CP, Worley LL, Neufeld R, Fishel T, Swiggart WH. Transformative learning in a professional development course aimed at addressing disruptive physician behavior: a composite case study. Academic medicine : journal of the Association of American Medical Colleges. 2013; 88(1): 117-23.

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