Arrogant and Disruptive – Doctors Behaving Badly

by Francine Gaillour, MD

in Career Resilience & Fulfillment,Transformational Leadership

Here we go again, bad boy (and girl) doctors causing problems with colleagues AND putting patients at risk.  An article in the December 1, 2008, issue of the New York Times, Arrogant, Abusive and Disruptive–and a Doctor, reminds us once again about an issue that is NOT being addressed well within hospitals and health systems.

The article does a nice job sharing short vignettes about physicians who disrupt and some of the ramifications. However, I disagree with the assertion made by one physician about the possible root cause:

“the brutal training surgeons get, the long hours, being belittled and ‘pimped’ ” — a term for being bombarded with questions to the point of looking stupid. “That whole structure teaches a disruptive behavior.”

I don’t think so. As an Internist, who was also ‘pimped’ during residency, I never saw disruptive behavior emerge as a result.

There is no doubt that the culture of fear and the structure of conflict-avoidance can let disruptive behavior go unchecked for far too many years.  But the environment does NOT cause the problem, it only lets it fester.

The solution, however, is more important to focus on, and a physician offender who is early to mid-career must be given more than a hand slap.

Physicians who are seriously disruptive need one or more of the following: mental health therapy, anger management, and personal development  coaching.  Moreover, their health system much implement a behavior-reward/consequence system at work.

The physician needs to feel an urgency to improve their behavior.  With the risk of privileges being revoked, or compensation withheld, there is no urgency.

I am contacted regularly by health systems who are looking for help with their difficult doctors.  Even though I will coach some of the physicians, I will be the first to admit that some of these docs are NOT coachable until they have had a serious psychiatric evaluation, and possible anger management treatment.  Many of these physicians are “well and whole” — and they do very well with 6 to 12 months of executive coaching.

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