Survey Results: Doctors' Disruptive Behavior Worries Physician Leaders

TAMPA, Fla. -- Some doctors yell and scream.  Some throw surgical instruments.  They berate nurses, other healthcare workers and even patients with snide remarks and insults.

In many cases, the doctors who exhibit these types of disruptive behaviors are seldom punished, according to results of a new national survey that examines physician behavior problems.

When doctors are punished, they are routinely treated more leniently than other staff members because of their professional stature, the survey found.

Conducted by the American College of Physician Executives (ACPE), the survey drew more than 1,600 responses from physician executives working in hospitals, group practices, health systems and clinics across the country. Physician executives are doctors who hold management positions and oversee other doctors.  With 10,000 members, ACPE is the nation's largest health care

association for physician leaders.

"We have a horrible track record in our own profession of even recognizing

physicians with difficult personalities, much less dealing effectively with

them," wrote one of more than 300 physician executives who submitted comments

with their completed surveys.

Survey respondents emphasized that most doctors get along well with

patients, nurses and other healthcare workers.  However, the few bad apples

that can be found in almost any health care organization can cause ongoing

problems.

Fully 70 percent of survey respondents reported that physician behavior

problems nearly always involve the same doctors over and over again.  One in

three survey respondents said they observe problems with physician behavior

either weekly (14 percent) or monthly (18 percent).

"This has been a chronic problem that is acutely getting much worse,"

wrote another survey respondent.  "The stress of our jobs (I am a surgeon) is

increasing due to the decrease in reimbursement for professional activities,

increasing regulatory requirements and severe financial constraints placed

upon the hospitals."

Results of the survey are included in a special series of articles in the

September/October issue of The Physician Executive, ACPE's journal of medical

management.

Survey co-authors Timothy Keogh, PhD, of Tulane University and William

Martin, MPH, PsyD, of DePaul University teach ACPE-sponsored courses on how to

tackle behavior problems.  They say coaching physicians on appropriate

behavior, mediating disputes between doctors, nurses and other staff,

referring problem physicians to counseling and taking firm disciplinary

measures against the offenders are keys to reducing behavior problems.

"The focus is never directed toward the person, only toward the behavior.

It is far easier to change behavior than it is to change personality," Keogh

and Martin write.

Source: American College of Physician Executives (ACPE)