The cost of disruptive physician behavior to our profession

Dear Medical Staff Leader:

In our recent work with medical staffs, The Greeley Company has found that physician leaders consistently identify disruptive physician behavior as one of their top challenges. The American College of Physician Executives recently dedicated an entire edition of its magazine to this issue. The increased focus on physician behavior appears to be the result of changing expectations--making physician behavior that was tolerated in the past no longer acceptable. Adding to the challenge is the increased frustration felt by physicians negotiating obstacles in providing patient care and running a practice.

Regardless of the causes of disruptive physician behavior, it is taking a greater toll on our profession than many of us recognize. Our profession is demeaned each time a physician acts in a manner that would not be tolerated in a bar. It demeans all of us who have committed our professional lives to serve patients who entrust themselves to our skills, knowledge, and judgment. Patients seek our passion for excellent patient care, not our bullying of fellow workers. When they hear stories of the latter, they lose respect for the former.

Professions, like medicine, are defined by internally developed high standards of performance. Yet the epidemic of disruptive physician behavior speaks volumes about declining professionalism in medicine. In the eyes of physicians I meet across the country, I see a hunger for rediscovering a level of professionalism in medicine of which they can feel proud. Yet, when we fail to establish or enforce high standards, our profession is diminished both in our own eyes and in the eyes of the broader society.

In the face of these challenges, some physician leaders have recently shared with me stories of their success addressing disruptive behavior exhibited by their peers. They've established clear, written expectations of behavior for medical staff members. They've fed back behavior to physicians so they can self-correct their behavior. They've held collegial confrontations with physicians who had acted in a disruptive manner for years. Though often tense, these confrontations, when performed well, have often resulted in dramatic changes in physician behavior nobody thought possible. These physician leaders also tell of rare instances in which they have had to take formal action, either with a short-term suspension or final termination of membership and privileges, for physicians who refused or been unable to follow simple standards of professional conduct. In every case, these physician leaders have saved good physicians from further demeaning themselves and our profession.

These physician leaders are proving that it is possible to eliminate disruptive physician behavior. It has been done by physicians just like you. In fact, if you have a success story about eliminating or reducing disruptive physician behavior, I very much want to hear about it. Please email your success stories to me at rsheff@greeley.com Your confidentiality will be guaranteed, but sharing our successes is a great way to help us reclaim the high level of professionalism our profession has and must to continue to earn.

All the best,

Rick Sheff, MD
http://www.greeley.com/seminars/