About Disruptive Doctors & Physician Performance Issues

A 2004 survey of doctors and nurses in the American Journal of Nursing showed that 74% of them had witnessed disruptive behavior by physicians.

A 2004 survey by the American College of Physician Executives (ACPE) showed that 95% of over 1600 physician executives have encountered problems with disruptive behavior, and at least 35% have issues on a daily, weekly, or monthly basis.

Disruptive doctors are easy to recognize, as they’re the ones who:

  • Bully, intimidate and demean nurses and other staff
  • Show disrespect to coworkers and patients
  • Have verbal outbursts that include yelling, insults or other abuse
  • Make physical threats or throw items at others
  • Refuse to complete tasks or carry out orders — either passively or deliberately
  • Engage in sexual misconduct and other inappropriate behavior or language
  • Write inappropriate chart notes
  • Exhibit dishonest or unethical behavior
  • Retaliate against those who make complaints

Causes of Disruptive Behaviors

Research shows that when physicians exhibit disruptive behaviors, or are having performance issues, there may be one or more factors in play that affect doctors to a greater extent than the general population. Those factors include:

  • Depression
  • Alcohol and drug abuse
  • Relationship issues at work and at home
  • Physical illnesses
  • Day-to-day stressors

The rate of divorce among physicians is estimated to be 10 to 20% higher than in the general population.

Physicians as a group share tendencies toward perfectionism and compulsiveness, buttressed by a sense of invincibleness, competitiveness and unquestioned authority. These personality traits are compounded by an overall reluctance to seek help and a fear of losing everything from the respect of their colleagues to their licenses to practice medicine.

JCAHO’s Sentinel Alert

The problem is not only prevalent — there’s an industry move to address it as evidenced by the Sentinel Alert on Disruptive Physicians issued by the Joint Commission for Accreditation of Healthcare Organizations (more often referred to as the Joint Commission or JCAHO). Hospitals are now required to address disruptive and inappropriate behaviors in order to receive and maintain accreditation.

In order to minimize the risk of adverse events and malpractice suits, medical groups must also have the awareness and skill set to intervene effectively when a colleague or employee first begins behaving unprofessionally.