Staff less tolerant of rude doctors

Most disruptive behavior stems from conflicts between physicians and staff members, say physician executives.

By Damon Adams, AMNews staff. Sept. 20, 2004.

Code pink means trouble.

A doctor is yelling at a nurse about something, and a call goes through the hospital for other nurses to rally to their colleague's side. Code Pink.

"Any nurse who is not immediately occupied will go up and stand behind the nurse being yelled at. The doctor suddenly stops talking; they see all these silent nurses looking at them and they get the idea that this behavior is embarrassing to everybody," said Timothy Keogh, PhD, associate professor in the Dept. of Health Systems Management at Tulane University Health Sciences Center, New Orleans.

That's what it's like being around a disruptive physician. It's a behavior all too familiar at hospitals, group practices and clinics nationwide, says a new survey of physician executives.

The national survey of more than 1,600 physician executives found that one in three of them sees disruptive behavior by doctors at their facilities on a daily, weekly or monthly basis. Seven in 10 executives said physician behavior problems almost always involved the same doctors over and over again. Disrespect topped the list of offensive behavior.

"Problems usually involve just a few physicians and their interaction with nurses, discharge planners, other team members," one survey respondent said.

But researchers said the survey shows disruptive behavior is an issue that health care leaders must address.

"There could be increasing prevalence of this because of managed care and pressures of liability. As medicine becomes more and more of a business corporate model, it places more pressure on physicians," said William Martin, MPH, PsyD, associate professor in the Dept. of Management, College of Commerce, at Chicago's DePaul University. "The prevalence of disruptive behavior is too high."