Managing the Disruptive Physician Deal with the problem and address behaviors as they occur BY RENA COURTAY, RN, CASC

I have spent the last 28 years working alongside physicians who are, pri- marily, surgeons. As you can imagine, this experi-

ence has provided me with quite a few anecdotes about physician behavior. These experiences led me to delve into this topic a bit deeper to uncover the full consequences of this behavior and discuss constructive ways to address it in a health care organization. Obviously, the paramount concern

for staff in an ASC is taking care of our patients and making sure this care is safe and does no harm. Disruptive physician behavior is a practice pat- tern of personality traits that interferes with a physician’s effective clinical performance. The disruptive behaviors also negatively impact the people with whom the physician interacts, accord- ing to the article “Dealing with Disrup- tive Physicians” in the Journal of Medi- cal Regulation. Does this sound like it is conducive to great patient care? Let’s review some examples of

disruptive behavior. These can range from degrading comments or insults all the way to causing personal injury by throwing things or actual assault. Things in between, such as discrimi- natory behavior, inappropriate joking, profanity, retaliation and spreading malicious rumors all fall into the bucket of disruptive behavior. There can be a refusal to cooperate with other provid- ers or to follow established protocols. Incompetence and substance abuse also are categorized as disruptive behaviors. What do all these things have in

common? They take focus off the care of the patient and can jeopardize the safety of the patient in numerous ways. These traits also can intimidate staff


around the physician. They become anxious and guarded and are not at their best when caring for patients. The behavior often continues because no one is courageous enough to report and/ or address the behavior.

This problem is so pronounced that almost 60 percent of providers have encountered and are concerned about some of these behaviors, according to the article “Disruptive Physician


Behavior” in QuantiaMD, 2011 (www. Whitepaper_ACPE_15May2011.pdf). The data shows that this behavior does happen most frequently in the operat- ing room (OR) and that surgeons were the most likely physicians to exhibit the behavior. Other health professionals with OR experience suggest that this is in part due to the surgeons’ driven personalities and desire for perfection

The advice and opinions expressed in this column are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion.

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