by 73 % some , by 20 % often ).
• Reluctance or refusal to answer questions or return calls ( 77 % at least once , 13 % often ).
• Condescending language or demeaning comments or insults ( 68 % at least once , 15 % often ).
• Impatience with questions or hanging up on person ( 69 % at least once , 10 % often ).
• Reluctance to follow safety practices or work collaboratively ( 66 % at least once , 13 % often ).
The least frequent disrespectful behaviors encountered included :
• Shaming , humiliation , or spreading malicious rumors ( 46 %).
• Reporting staff to a manager ( actual or threat ) ( 42 %).
• Insulting or slighting an individual due to race , religion , or appearance ( 24 %).
• Thrown objects ( 18 %).
• Physical abuse ( 7 %).
A comprehensive article on this subject in The Joint Commission ’ s Sentinel Event Alert 2 states that “ Intimidating and disruptive behaviors can foster medical errors , contribute to poor patient satisfaction and to preventable adverse outcomes , increase the cost of care , and cause qualified clinicians , administrators and managers to seek new positions in more professional environments . Safety and quality of patient care is dependent on teamwork , communication and a collaborative work environment . To assure quality and to promote a culture of safety , health care organizations must address the problem of behaviors that threaten the performance of the health care team .”
The Joint Commission ’ s Sentinel Event Alert states that intimidating and disruptive behaviors include those listed above , and also include verbal outbursts , physical threats and refusal to perform assigned tasks or simply cooperate with routine activities as well as safety protocols . Intimidating and disruptive behavior by health care professionals in positions of power are exceedingly harmful to all concerned .
Team-based learning in physician training often does not include training on leader / follower roles . Few leadership training programs exist for trainees ( there are more at advanced levels ). We must start teaching basic people-management skills sooner . Assessment drives learning , and sadly , leadership and management are not assessed early or often : this we must fix , as early intervention is better . compassionate investigation and response .
The Center for Professional Health at the Vanderbilt University Medical Center developed a program for identifying and dealing with inappropriate behavior , including bullying . William H . Swiggart et al ( 3 ) outlined in “ A Plan for Identification , Treatment , and Remediation of Disruptive Behaviors in Physicians ” an infrastructure for addressing unprofessional behaviors :
• Leadership commitment .
• Supportive institutional policies .
• Surveillance tools to capture patient and staff allegations .
• A model to guide graduated interventions .
• A process for reviewing allegations .
• Multi-level professional / leadership training .
• Resources to help disruptive colleagues .
• Resources to help disruptive staff and patients .
Regardless of the amount of stressful pressures that we have on us at any given time , sudden or ongoing , whether they are unfair or self-inflicted , we must not react with inappropriate emotional , psychological or physical behavior towards others or ourselves . We should always respond professionally and appropriately in all situations . We must take mindful care of ourselves , and ask a colleague to comment if they find us subpar in communicating - we can help each other do a better job . If a staff person is courageous enough to make a professional suggestion , we must listen well and thank them truly for their willingness to share an invaluable insight .
We would love for you to get connected to our Physician Wellness Group for valuable support and training with issues like this and many others . Just text Wellness to 833-509-1891 . Note , standard texting rates may apply .
References
1
Grissinger M . Unresolved disrespectful behavior in health care : Practitioners speak up ( again ) -part 1 . P T . 2017 ; 42 ( 1 ): 4-23 .
2
The Joint Commission Sentinel Event Alert Issue 40 July 9 , 2008 Behaviors that undermine a culture of safety Intimidating and disruptive behaviors can foster medical errors ,( 1,2,3 )
3
( Vanderbilt ) William H . Swiggart , et al ., A Plan for Identification , Treatment , and Remediation of Disruptive Behaviors in Physicians , Frontiers of Health Services Management , Vol . 25 , No . 4 ( Summer 2009 ).
Dr . Brian Sosnin is a Primary Care Physician practicing at Baptist Health LaGrange Family Medicine .
Many programs and institutions now have policies in place for bullying . But passive policies without follow-up and an enforcement culture are , in fact , deceptive and hurtful . If an individual believes these policies will help protect them , but the responsible leadership circles the wagons to protect a high-earner / prestigious perpetrator , the individual who reported the abuse gets targeted further . Policies alone are weak . An organization that cares must execute a fair and
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