New “disruptive physician behavior’ standards create conflict among hospital administration and medical staff.
Hospital administrators and doctors nationwide are experiencing problems in establishing and implementing the new JACHO standards for “disruptive behavior” for physicians. Physicians are appropriately concerned over any damage to their future careers as the results of having been referred by their credential committee, physician well being committee or any other disciplinary unit or hospital administration for “disruptive behavior”. Therefore, they have argued forcefully for all types of written assurances to protect themselves from risk.
One of the consequences of this squabbling is the delay in the implementation of these new standards. Some of the new policies appear to stall actions against any physician accused of disruptive behavior for at least six months by requiring the physician to participate in a survey in which others in his specialty area are asked to respond to a series of questions regarding his or her demeanor in relation to patient care and interpersonal interaction. The goal is to see if the physician is able to make changes in his or her behavior without intervention. If positive changes are seen, the survey is repeated in three months and a decision is made to dismiss the action or to order anger management.
What is clear so far is that psychological/psychiatric intervention is not seen as an acceptable remedy for disruptive behavior by any of the new policies, which are being adopted. All physicians routinely reject any record of intervention, which implies treatment for mental or nervous disorders. This is a reasonable strategy since anger is not a pathological condition and therefore not responsive to psychotherapy or psychotropic medication.
The most reasonable and the most widely acceptable intervention is one which is offered on-site or at a neutral location with an opportunity for the physician to receive an intensive assessment for stress, anger, communication styles, emotional intelligence and motivation to change. The Coaching offered must include skill enhancement in these same areas.
George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management