July 3, 2014

Did you know that up to 70% of physicians report witnessing disruptive behavior at work at least once a month and that 10% witness it daily? 1

In the same survey, 60% of physicians reported that their organizations had received written complaints from patients or their families about disruptive behavior, 50% saw patients change their physician, and 99% of physicians believed that disruptive behavior affected patient care.1, 2 Disruptive behavior in a healthcare setting may contribute to adverse events, medical errors, and compromises in patient safety. Healthcare organizations can suffer ‘internal’ consequences including a deteriorated medical culture, poor morale, disciplinary action against offending physicians, and nurses or other health care staff who choose to resign or transfer in the face of a hostile or dysfunctional workplace.3-8

So what is disruptive physician behavior? The College of Physicians and Surgeons of Ontario defines it as “when the use of inappropriate words, actions or inactions by a physician interferes with his or her ability to function well with others to the extent that the behavior interferes with, or is likely to interfere with, quality health care delivery”.9

Disruptive behavior can take many forms. Behaviors such as yelling, swearing, and throwing objects are easy to identify. Other behaviors, such as intimidating comments, passive-aggressive behaviors (such as sabotage and bad-mouthing colleagues or the healthcare organization), behavior that creates a stressful work environment and interferes with others’ effective functioning, or refusing to co-operate with other physicians, are more insidious and harder to define but are disruptive as well.

If you have encountered this behavior and are unsure how to handle it, you should attend the Disruptive Behavior: A Rational Approach for Physician Leaders course on November 22-23, 2014. It will equip you with the knowledge and skills to deal with disruptive physician behavior effectively. Click here to read more information on the course: http://www.docsmb.org/disruptive-behaviour

You do NOT have to be a University Department Head or hospital bigwig to attend the workshop. It is designed for ALL physicians by other physicians and is open to both CMA members and non-members (you can bring your staff).

At the end of the course, you will be able to:

  • Understand the nature and impact of behavior considered to be disruptive in health care organizations
  • Identify the elements of organizational cultures that influence behavior
  • Review the organization Code of Conduct and analyze its effectiveness in managing disruptive behavior
  • Review policies and procedures for effectively managing behavioral problems in the workplace
  • Employ prevention strategies to encourage respectful behavior in the workplace and reduce the incidence and impact of disruptive behavior
  • Recognize the importance of personal resilience as a physician leader dealing with this complex workplace problem

Doctors Manitoba is committed to helping our members understand and deal effectively with disruptive physician behavior from both an individual and systems perspective. The complex issues that cause and influence this behavior can be difficult to manage; physicians increasingly assume leadership roles with little formal training in how to handle this type of behavior. Doctors Manitoba, the Canadian Medical Association and its leadership development program, Physician Management Institute (PMI), all want to change that.

See you at the Disruptive Behavior: A Rational Approach for Physician Leaders course on November 22-23, 2014!

1. MacDonald O and Silbaugh B (2011) Disruptive Physician Behavior. American College of Physician Executives.

2. “VHA Research Finds Disruptive Behavior Common in Operating Rooms; Behavior Linked to Adverse Events, Medical Errors, and Mortality” (2007), http://www.surgicenteronline.com/ 07/06/2006.

3. Benzer DG and Miller MM (1995) The Disruptive-Abusive Physician: A New Look at an Old Problem. Wisconsin Medical Journal. 94(8):455–460.

4. Pfifferling JH (1997) Managing the Unmanageable: the Disruptive Physician. Family Practice Management. November-December: 87–92.

5. Davies JM (2001) Painful Inquiries: Lessons from Winnipeg. CMAJ. 165(11):1503.

6. Cassirer C et al (2000) Abusive Behaviour is barrier to High-reliability Health Care System, Culture of Patient Safety. QRC Advis. 17(1):1–6.

7. Veltman L (1995) The Disruptive Physician: The Risk Manager’s Role. Journal of Health Risk Management. 15(2):11–16.

8. Cox, HC (1994) Excising Verbal Abuse. Todays OR Nurse. 16(1):38–40.; Rosenstein AH (2002) Original Research: Nurse-Physician Relationships: Impact on Nurse Satisfaction and Retention. American Journal of Nursing. 102(6): 26–34.

9. Guidebook for Managing Disruptive Physician Behaviour. Ontario Medical Association. (2008)

Gigi Osler