A new American College of Physician Executives (ACPE) survey finds that two-thirds of physicians witness disruptive behavior in colleagues monthly—and more than 26% of respondents admitted to causing problems.
It has long been acknowledged that disruptive and inappropriate behavior can present a significant problem in a health care setting. In a recent New York Times op-ed, oncology nurse Theresa Brown shed light on toxic relationships between health providers and how to curb bullying.
For the study, ACPE and online physician community QuantiaMD surveyed 840 physicians and physician executives. They found that more than 10% of physicians report seeing disruptive behavior from colleagues every day. More than 50% of respondents said they had witnessed physicians insulting others, yelling, refusing to cooperate with other health providers, and refusing to follow rules. The survey also found that:
- 41% of respondents witnessed profanity;
- 40% witnessed inappropriate jokes;
- 24% witnessed discrimination against colleagues or patients;
- 21% witnessed the spread of malicious rumors;
- 14% witnessed physicians throwing objects;
- 14% witnessed substance abuse;
- 13% witnessed physicians retaliating against perceived slights; and
- 3% witnessed physical violence.
Respondents generally agreed that disruptive behavior has a negative impact in health care settings, the results found. About 60% said their health care organization had received written complaints, while 50% said patients had switched physicians or practices as a result of physician behavior. More than 20% of respondents believed that an adverse clinical event was directly attributable to disruptive physician behavior.
Respondents provided mixed feedback on how well health organizations managed bad behavior. Although two-thirds of respondents reported that their organizations had established policies to prevent disruptive incidents, nearly 25% said they feel uncomfortable confronting physicians engaging in disruptive behavior. According to the findings, women felt more uncomfortable confronting bad behavior than men. Overall, 77% of respondents reported needing training on how to manage bad behavior.
According to ACPE’s CEO, the organization hopes the survey results illuminate "the shadowy, dark corners of our profession." He attributes much of the bad behavior to stress, long hours, and bureaucratic red tape. He notes that health reform likely will complicate many of those factors, because "the rules seem to shift from day to day and the financial rewards may be shrinking."
The researchers acknowledge significant limitations to the study, NPR’s “Shots” reports. The survey was sent to 10,000 physicians and fewer than 10% participated. They note that “it is possible that the respondent group was either more interested in or more likely to have experienced or witnessed disruptive physician behavior" (Knox, "Shots," NPR, 5/25; Physician's Money Digest, 5/25; Hobson, "Health Blog," Wall Street Journal, 5/25).