Taming the Disruptive Physician

  1. Anyone who has worked in a hospital for any length of time probably knows one - and wishes he didn't. I'm talking about the disruptive physician. You know the type, he (and with increasing frequency, she) throws temper tantrums, yells at colleagues, threatens lawsuits if his conduct or medical practice is reviewed, complains to patients about the nursing staff and generally adheres to the belief that the hospital's rules apply to everyone but him.

    The disruptive physician's impact on patient care and hospital operations can be severe. Nurses and support staff may be so intimidated by the disruptive physician's conduct that they hesitate contacting him about patient issues for fear of incurring his wrath. Medical staff members may find him so abusive that they choose to move their practice elsewhere. Hospital administrators may find themselves constantly addressing employee complaints and threats of hostile work environment litigation.

    So how do you break the cycle and tame the seemingly untamable?
    Full story:
    http://www.healthleaders.com/news/feature41638.html
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  2. 11 Comments

  3. by   Stargazer
    Very intersting article, thanks, Karen. Have forwarded to my boss and some nurse colleagues. Might be some ideas in there we can adapt.
  4. by   emily_mom
    Thanks Karen! You seem to always find the best stuff...very pertinent to a situation at work right now. Too many "gods", not enough congregation...

    Kristy
  5. by   Sleepyeyes
    Thanks Karen!

    This article needs to be displayed on every board in every break room in the country--and a copy should be given to each UM.
  6. by   -jt
    Thanks for posting the article. I printed it out & hung it up on one of our RN union bulletin boards. I chose to put it on the one outside the nursing & CEO offices in the hospitals executive wing so the head honchos would be sure to see it. It was very timely because we have been having a problem with some disruptive physicians. Grievances & an unfair labor practice charge are pending on this issue and the article was a subtle way of reminding them of that. Just wanted you to know that 2 days after I put it up, we were contacted by the VP of Medicine, admitting that he recognizes there is a problem, is researching ways to eliminate it and he asked for a copy of the article - which we gladly gave him.

    I expect that when the grievance & ULP against our hospital for allowing MD abusive behavior are heard, some of what this article suggested will be stated in their corrective action plan. Thanks again.

    And thank you Brian for creating a forum that is more than just a place to vent but is actually a place where we can share info and ammunition to really help each other make improvements at work.
    Last edit by -jt on Mar 6, '03
  7. by   RN2B2005
    Thanks, Karen, for posting the link.

    I think that the point about some disruptive physicians wanting to change but not knowing how is particularly salient. One of my close friends (and former boss) is a physician who was disciplined for disruptive behaviour, including screaming fits, throwing objects, etc.

    He was (and is) an extremely bright guy who had gone straight from college into medical school, and from there into his residency and later his fellowship. Part of his problem was a frustration at explaining things that were eminently obvious to him but not so obvious to those around him.

    Although he knew that his behaviours intimidated staff, he didn't know how to change or stop it. Eventually, the other physicians in the practise transferred him away from our practise and sharply limited his non-medical duties. Perhaps if someone had talked to him earlier in his career, and given him some direction, he wouldn't have ended up losing his medical directorship and the respect of employees and colleagues.
  8. by   pickledpepperRN
    Excellent post and responses!
    At one hospiat the nun who was DON would not allow verbal or other abuse. It did not happen. What a surprise when I worked registry at a nearby hospital and heard an MD yelling and cursing! He was always polite where it was expected.

    The nursing staff on one unit have stopped even the worst by doing what was taught by Laurs Gasparis Vonfrolio:
    www.greatnurses.com
    They call a "Code Pink" when the abuse begins. All including clerks and aides come and "record" exactly what is done and said. Names of witnesses are included. Seems there was once a surgeon who berated nurses in front of patients then denied it later. Now he is appropriate.

    Another surgeon and nice man did make very inappropriate comments in the name of humor. I once told him, "That is embarassing to me." in the room with a very sick patient and a new RN I was orienting.
    He since has made a point of telling me a clean joke every time he is on the unit at night.

    Management and other medical staff can mandate it like in the article. Staff nurses DO have some options if they are not supported.
  9. by   NRSKarenRN
    from _JT
    ...I chose to put it on the one outside the nursing & CEO offices in the hospitals executive wing so the head honchos would be sure to see it. It was very timely because we have been having a problem with some disruptive physicians. Grievances & an unfair labor practice charge are pending on this issue and the article was a subtle way of reminding them of that. Just wanted you to know that 2 days after I put it up, we were contacted by the VP of Medicine, admitting that he recognizes there is a problem, is researching ways to eliminate it and he asked for a copy of the article - which we gladly gave him.

    Right Timing and Location---so often can make the difference.
    Glad I found the article and that it will help others.

    Being written by an MD didn't hurt either and that the source was a website many administrators visit.

    KNOWLEDGE=POWER ... trying to do my part here to enpower nurses.
  10. by   lyn27604
    What about the nurse that is rude and disruptive to her collegues.
  11. by   LasVegasRN
    Originally posted by NRSKarenRN
    ..KNOWLEDGE=POWER ... trying to do my part here to enpower nurses.
    Yes you do Karen, and you rock!

    Our facility has adopted this practice and it is working WELL.
    Last edit by LasVegasRN on Mar 25, '03
  12. by   sjoe
    "What about the nurse that is rude and disruptive to her collegues."

    Unfortunately, I have seen much more of this than I have of disruptive doctors. Head nurses throwing screaming tantrums, "getting in people's faces," and so forth (NOT mine, I might add). Abusive and publicly insulting nursing supervisors, etc. But I guess we need a different link for that.
  13. by   Used and abused
    I recall this "code pink" being done. What we did as a group is surrounded the nurse that was being berated and believe me, there is strength in numbers. When he or she is losing it and several nurses stand with arms crossed WITH the victim, the steam is lost by the offender.
    What my experience is, how do you deal with a MANAGER who does this? I lost my job because MANAGEMENT STICKS TOGETHER. She is a bully and it just did not work, I am the third to leave in 6 months, 3 cut to part time. MY career was halted and stopped and I was there a long time.
    A bully gets rid of the weakest and strongest.

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