Hospital Administrators, Physician Well-Being Committees and Hospital Credential Committees are struggling to find appropriate resources for the assessment and treatment/intervention for physicians whose workplace behavior has been labeled as “disruptive”. The JCAHO Sentinel Alert and Guidelines for “disruptive physicians” did not provide the appropriate guidance for intervention programs to address this issue.
Things to consider in examining programs for “disruptive physicians”:
- Is the program specifically designed to address behaviors defined in the Sentinel Alert as disruptive? Counseling, psychotherapy, substance abuse treatment, sexual abuse treatment or psychiatric impairment treatment are not appropriate interventions for “disruptive behavior”.
- Anger Management with emotional intelligence is the intervention of choice for disruptive behavior. Emotional intelligence is a practice based intervention designed to increase competence in self-awareness, self-control, social-awareness and relationship management. Skill enhancements in these four areas are critical in improving interpersonal relationships in any setting.
- Does the program offer non-psychiatric assessments designed to determine the client’s skill level in recognizing and managing anger, recognizing and managing stress, primary and secondary styles of communication and empathy or emotional intelligence? Physicians suspected of sexual abuse, substance or psychiatric impairment should not be referred to programs for “disruptive physicians”.
- Does the program have curricula specifically designed to teach skills in anger management, communication, listening, empathy/emotional intelligence and stress management? The intervention strategies used in credible programs for “disruptive physicians” must be practice based with ancillary teaching material and exercises to master skill development in the above mentioned areas.
- Just as aftercare is critical to maintain gains made in other mandated programs, so it is for “disruptive physician” programs. A minimum of 6 months is standard for most credible programs. Aftercare services should be provided via weekly or bi-monthly phone contacts and/or small group meetings.
- In recognition of the schedules of many busy physicians, programs need to be flexible enough to offer on-site intervention followed by phone sessions. In addition, these services must be made available on weekends and evenings.
- The two most respected programs in the nation for “disruptive physicians” are the PACE Anger Management Program for Healthcare Professionals at the University of California in San Diego, and the Distressed Physician Program at Vanderbilt University School of Medicine. Both of these program are skill based with after-care components.
For a list of programs which meet most of these standards mentioned above, click here.
George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management