Hospitals and healthcare organizations throughout the United States are beginning to implement the new Joint Commission (JCAHO) Standards for “disruptive physicians”. Anderson & Anderson is currently one of the major providers of Executive Coaching/Anger Management for Physicians in the nation. Our extensive data base of on-site coaching for physicians has provided us the opportunity to get an inside look at the work environments of participating doctors at many hospitals throughout the nation. As I write this entry, I am sitting in the Air Port in Corpus Christi, Texas, where I have been working on-site for much of the past week providing coaching for a local physician.
The most startling finding to date is the degree to which stress and burnout are factors in decreasing the resiliency of these physicians to appropriately manage anger and use assertive, rather than aggressive, communication with professional staff and patients. Prolonged stress also tends to erode empathic responses to colleagues, ancillary staff and patients. We have learned that it is our comprehensive assessments at the beginning of the intervention that quickly break through resistance and denial of the presenting complaint (disruptive behavior).
Since the presenting complaint is almost always related to “disruptive behavior” rather than symptoms of psychopathology, non-psychiatric assessments designed to determine skill levels in recognizing and managing anger, stress, assertive communication and emotional intelligence are indicated rather than psychological or psychiatric evaluations.
Two of the three Anderson & Anderson assessments are made available on-line to the physician clients prior to the first live meeting. To date we have been told by client physicians that it is the self-reflection that is triggered by the questions posed in the assessment instruments that helps them acknowledge the need for change/help.
The third assessment is completed in the presence of the Coach. This offers the Coach an opportunity to observe a wide range of non-verbal responses to the assessment contents by the participant.
Each of the assessment instruments used in the comprehensive battery provides an action plan for every scale in which the participant scores in the deficit range. This is critical as it offers the participant an immediate answer to the question “how can I change that behavior?”
These action items are incorporated into the coaching plan from the very first hour of intervention. They are, in fact, a natural flow between assessment and intervention. Therefore, it is not a challenge to get the physician client engaged in the change process as the resistance quickly dissipates based on the content of the assessments.
The three major providers of intervention programs that are consistent with the JCAHO standards are: the PACE Program at the University of California School of Medicine (San Diego), the Distressed Physician Program at Vanderbilt University School of Medicine, and Anderson & Anderson, Executive Coaching/Anger Management Program for Physicians.