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Three Ideas to Prevent Physician Disruptive Behavior

December 17, 2015

physician-behaviorA recent USA Today article highlighted the issue of negative physician behaviors and their impact on patients. From the article:

"We believe it’s very under-reported,” says Ronald Wyatt, medical director in the commission's healthcare improvement division at the Joint Commission, "I can’t overstate the importance of it."

Disruptive behavior leads to increased medication errors, more infections and other bad patient outcomes — partly because staff members are often afraid to speak up in the face of bullying by a physician, Wyatt says. That "hidden code of silence" keeps many incidents from being reported or adequately addressed, says physician Alan Rosenstein, an expert in disruptive behavior. Medical school is "such a hazing experience," it's little surprise that the "people who make it through are not the ones with the best personalities," says Rosenstein. After all, "emotional intelligence" isn't what's rewarded, he says.

Dr. Rosentstein will be joining our November 17 webinar with Becker’s Hospital review. He’ll be on a panel discussing, The Role of Emotional Intelligence in Physician and Organizational Success” – A Panel Discussion. He’ll be joined by Dr. Michael J Garren, MD, Clinical Professor of Surgery, Division of General Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, and President of the Wisconsin Surgical Society, and Ted Kinney, Ph.D., Director of Research and Development at Select International.

Experts estimate that as many as 5% of physicians display behaviors that are deemed “disruptive”, but it may be under-reported. A recent survey of nurses and doctors revealed that 77% has witnessed such behaviors and that they raised the risk of patient errors and death. While these extreme negative behaviors are problematic, a wider concern is the overall behavioral skills of physicians in general. Changes to our healthcare system require new levels of collaboration, teamwork, accountability and a striving to constantly improve the quality of care. The type of extreme disruptive behaviors described in USAToday put create immediate patient risks. A failure of physicians to perform to these new expectations means that health systems struggle and patient care is not optimal. At the same time, physician career satisfaction is a problem

How can we improve physician performance and career satisfaction? There are many resources committed to addressing disruptive behavior once it manifests itself, but can we prevent it from occurring in the first place? Here are three potential strategies:

  1. Improve the physician interview. The traditional physician interview does little to convey to the candidate what’s expected or the culture that is valued. Similarly, it does little to evaluate the candidate’s behavioral skills. This can change. For instance, the University of Pittsburgh Medical Center published an article on an interviewing technique that actually predicted disruptive behavior. [AN INTERVIEW TOOL TO PREDICT DISRUPTIVE PHYSICIAN BEHAVIOR Sandy, Edward A, II, MD, MBA; Beigi, Richard H, MD, MSc; Cohel, Clifford, LSW; Nash, Kenneth C, MD, MMM. Physician Leadership Journal 1.2 (Nov/Dec 2014): 36-39.]

  2. Evaluate and develop behavioral skills. Other industries commonly make use of tools that evaluate behavioral skills during the hiring process or as part of a developmental plan. We’ve seen a growing interest in such tools with physicians and other providers. Our initial work with tools designed specifically for physicians has shown great promise.

  3. Alignment of Goals. One of the primary reasons that a physician is dissatisfied with his or her situation is that no one sufficiently vetted or understood the alignment of goals and expectations. The physician often feels he or she was misled about the situation. It’s a partnership. For the physician to perform and achieve his or her goals, there needs to be adequate operational support. The hospital can’t provide that support if it doesn’t really understand the physician’s goals and needs.

Rather than spending millions of dollars to recruit physicians, hope that they succeed and then deal with their inadequate performance, or worse, disruptive behavior, why don’t we take a more deliberate approach?

To learn more, click the button below to download our free whitepaper. Also, keep an eye out for our upcoming webinar: The Role of Emotional Intelligence in Physician and Organizational Success” – A Panel Discussion.

Bryan Warren Bryan Warren was the former Director of Healthcare Solutions at PSI. He was responsible for developing and promoting tools and services designed specifically for the unique challenges faced by healthcare organizations.